WOUNDED IN BATTLE
WAR HISTORY BRANCH
DEPARTMENT OF INTERNAL AFFAIRS WELLINGTON, NEW ZEALAND 1950
IT IS THE INTENTION of this series to present aspects of New Zealand’s part in the Second World War which will not receive detailed treatment in the campaign volumes and which are considered either worthy of special notice or typical of many phases of our war experience. The series is illustrated with material which would otherwise seldom see publication.
new zealand war histories
printed by whitcombe and tombs limited christchurchnew zealand
Diary of a Corporal in 26 NZ Battalion:
ON the night of 19 December 1944 at 9 o’clock, 6 NZ Infantry Brigade and 43 Gurkha Infantry Brigade launched an attack under a heavy barrage and threw the enemy back to the line of the Senio River, Northern Italy. Much ground was taken after heavy fighting and over 200 prisoners were captured at a cost to 2 NZ Division of about 20 killed and 80 wounded.
War Diary of Director of Medical Services, 2nd NZEF, 20 December 1944
‘My section’s job on the night of 19–20 December was to cover a party of sappers who were minesweeping a road which ran along the axis of 6 Infantry Brigade’s advance. Just after midnight, I went ahead with the officer in charge of the sweepers to inspect the road and we found two demolitions which completely blocked it.
‘It was while the two of us were between the demolitions that the enemy began to cover the road with mortar and gun fire. The officer and I dived into a deep ditch and lay there waiting for the shelling to finish. I was thinking about getting up to move on when I experienced a sensation in my legs not unlike being hit on both heels with sledgehammers.
‘I had an idea I had been hit, but was not sure until I felt down with my hand and found my battle-dress trousers very warm and sticky from the blood that was oozing out. I called to the officer to let him know that I had been hit and tried to get out of my equipment to make it easier to get at the first field dressing in my pocket.
‘My officer had reached me by then. He had a very hard job getting at the wound for a start, not having a pocket-knife and being forced to lie on his stomach to avoid being hit also. At last he managed to rip the leg of my trousers and bandaged my first field dressing over the wound. My leg was just like a log of wood by then and I had no control over it at all. The officer then left me to go back and get someone to carry me out for medical attention. Instead of feeling scared, as I and most others used to feel when making an attack, I then felt quite happy and lay flat out in the wet ditch and went to sleep. The two soldiers who came for me did not have a stretcher and started to carry me sitting on their clasped hands. I fainted almost straight away and do not know how I reached the floor of the house where I awoke. The thing that I remember most vividly was the intense cold. My leg was aching painfully and I was very thirsty. A regimental stretcher-bearer from 25 NZ Battalion came into the house and he gave me an injection of morphia. The dose was not powerful enough to send me to sleep and did not seem to lessen the pain in my leg a great deal.
‘Communication had somehow been made with the Battalion RAP* and a Bren-gun carrier was promised as soon as it could get through to take me back to a medical officer. A hold-up had been caused by a road demolition which a bulldozer had to fill in before any motor traffic could get through. All the fields on either side of the roads were heavily sown with anti-personnel mines, thus making it very risky for stretcher-bearers to travel across country.page 4
‘The carrier came at last and I was put on board. All I remember of that journey was the bumping, the cold, and the moaning of a fellow-patient. I awoke once more when the carrier stopped and found we were outside our Battalion RAP. Here I waited my turn to be treated.’
* Regimental Aid Post
Throughout the war the regimental stretcher-bearers, by the promptness with which they brought the wounded back to medical aid, were able to save many lives. Officially called battalion medical orderlies, they were infantrymen trained in battle first aid, who went into the attack carrying only a stretcher and a bag of surgical dressings. They were not members of the Medical Corps, but they wore Red Cross brassards and were entitled to protection under the Geneva Convention. The subsequent success of the treatment of wounded in medical units largely depended on their efficiency. They had heavy casualties, for their duties were performed under fire. On one occasion, for instance, a stretcher-bearer waded the ice-cold Rapido River at Cassino and carried back across it a wounded man—all this under sniper as well as mortar and artillery fire.
Bren-gun carriers and jeeps, adapted for stretcher-carrying, were used where possible in the later stages of the war to bring patients back to the Regimental Aid Post. The jeeps were much preferred by the regimental medical officers. These vehicles, if possible, went as far forward as infantry company headquarters, to which point the patients were brought by stretcher-bearers. This innovation, by shortening the distance a patient had to be carried by hand, was an important advance. In the forward areas the driver of the jeep had to face shelling and mortaring of roads and crossroads; often fire might be called down by the dust raised by his jeep.page 5
‘The RAP had been established in a deserted house and I was very pleased to see the fire burning in the grate. The medical officer examined me and my wounds were dressed. It was found that my left thigh was perforated, involving the femoral artery, and also a wound below the knee was discovered. My thirst was terrific and I was overjoyed when the medical officer gave me a hot drink of cocoa. I was marked down as seriously ill, given a dose of morphia and placed on a jeep, which had been converted to carry stretchers, and sent on the next stage of my journey.’
Regimental Aid Post
In a fixed position, as was common in Italy, the Regimental Aid Post was often in a partly demolished house. During a battle the medical work at the aid post was carried on under the din of gunfire and exploding shells; the earth shook under the continued shock of explosions.
The chain of medical services really began at the Regimental Aid Post where the medical officer was the advanced representative of the Medical Corps. He was responsible for giving the essentials of first aid treatment to the wounded so that they could be sent on as quickly and as comfortably as possible. To the soldier there was some comfort and reassurance in having a qualified doctor in attendance in the line itself, and this knowledge had its effect on a man’s morale before and during an action.
Resuscitation measures were limited to wrapping the patient in blankets, warming him with hot water bottles and hot drinks. Transfusions of whole blood were available only in exceptional circumstances, but blood plasma and serum, which could be kept without refrigeration, were often made up and used for transfusions even at the Regimental Aid Post.* Rapid transfer to the Advanced Dressing Station was always the aim.
* * *
‘The jeep moved along rough roads on its journey from the RAP to the Advanced Dressing Station and every bump was agony. We safely reached 6 NZ ADS, in a house on the outskirts of Faenza, at half past nine in the morning. I was examined again, given five sulphanilamide tablets, and evacuated to 4 NZ MDS, which had opened in Faenza following the capture of that town on 16 December. The conveyance for that stage of the journey was a motor ambulance car, which was much more comfortable than the Bren carrier and the jeep.’
* Blood is a mixture of a fluid called plasma and millions of tiny red blood cells. When a man is wounded he loses whole blood from the injured vessels and also plasma seeps into the damaged tissues. The body compensates for this by contracting the blood vessels and accelerating the rate of flow by more rapid heart action, and bleeding is stopped by clotting. The loss of blood both produces and accentuates shock.
Blood transfusion is the mainstay of resuscitation. Whole blood is the most useful as it supplies all wants. A transfusion of plasma, which can be preserved in sealed bottles, is sufficient when bleeding is less marked. Saline and glucose solutions are of great use in replacing fluid in patients suffering from loss of fluid alone. Refrigeration is required for the preservation of whole blood but not for plasma, and as plasma can also be dried it is very easily transported.
Many hundreds of our wounded owe their lives to the thousands of bottles of blood, plasma, and glucose-saline that were sent to the forward medical units. A wounded man can lose as much as six or seven pints of blood and still be saved providing his injuries are not overwhelming.
Advanced Dressing Station
The wounded, attended in transit by a medical orderly, were delivered at the Advanced Dressing Station by New Zealand Army Service Corps drivers. Ambulance cars were the usual means of transport. They gave a patient a smoother journey and a greater feeling of security than an open jeep. Valuable assistance to the Field Ambulances’ own cars was often provided by drivers and vehicles of the American Field Service. This volunteer unit was serving in the Middle East before the United States entered the war, and it was associated with the New Zealand Division from the fateful days in the desert in 1942, the drivers cheerfully accepting the risks of the forward areas and giving tireless and outstanding service.
The Advanced Dressing Station, at which there were normally three medical officers and sixty men from the Field Ambulance, was usually not far from the line. The duties of the staff were to receive battle casualties from the Regimental Aid Posts, adjust wound dressings, immobilise fractures with splinting, relieve pain and shock and give blood transfusions to the more seriously wounded. Even the worst cases responded magnificently to the blood transfusions. Thus resuscitated, the wounded were made comfortable for the journey to the Main Dressing Station. No operative treatment was done at the Advanced Dressing Station except for the control of serious bleeding and the removal of an almost severed limb. As at the Regimental Aid Post, there was a constant urge to get the casualty to the operating centre with the utmost speed consistent with safety.
The company forming the Advanced Dressing Station had the mobility of the nomads of the desert. Its duties were to keep up with the brigade as it advanced, to be ready to set up a miniature emergency hospital to admit wounded at any time, and to undertake urgent treatment, being careful always to limit the surgical nature of its work so as to preserve the unit’s mobility. If called upon to move again, it was able to pack up and be on the move in half an hour. If it still held patients it might be necessary to leave a detachment to care for them until they were cleared to the Main Dressing Station. Mobility was an essential feature of the desert campaigns, especially when the Division engaged in its famous ‘left hooks’, and was a highlight of the final advance in Italy from the Senio River to Trieste.
The company adapted itself to the topography of the country as well as to the needs of the battle in setting up its dressing station. In Greece it had first used dugouts burrowed into the hillside and concealed under canvas and cut scrub. Vehicles were parked under natural cover some distance away. Red Crosses were not usually displayed by the medical units at this stage. When it was established that the enemy respected the Geneva Convention, prominent Red Crosses were painted on tents and vehicles. An Advanced Dressing Station was set up on Mount Olympus, and in the withdrawal the wounded were treated under the leafy camouflage of olive trees. Again, in Crete, the olive trees gave protection from the unchallenged and ever-active Luftwaffe.
In the Western Desert, tarpaulins fixed over and around three-ton trucks formed the reception and evacuation wards of the Advanced Dressing Station. The Italian terrain in the winter presented difficulties and caused privations. At the Sangro one Advanced Dressing Station was set up among thickets of bamboo, the men digging themselves and their bivouac tents into the muddy page 7 banks of a tributary of the river, trying to shelter from the frequent heavy rainstorms which made the days dismal and the nights cold. In the slow-moving war in Italy a night barrage would throw the tarpaulin shelters and vehicles of the Advanced Dressing Station into a flickering silhouette, and overhead the air would throb with the roar of outgoing shells. Inside the shelters (or in one of the war-battered buildings which became almost indispensable in the winter of 1944 in Northern Italy) the sterile instruments were laid out ready and the orderlies on duty waited the first casualties from the impending attack. As the Regimental Aid Posts sent in the wounded a rush might develop; at times the wounded would be cold and exhausted, urgently needing warmth and blood transfusions to prepare them for the next stage of their journey—on to the Main Dressing Station.
THE RESUSCITATION DEPARTMENT AT 4 MDS, FAENZA
‘The distance to the MDS was short and we reached it at ten o’clock. It was in a commercial bank building in Faenza. Here I was examined once more. My pulse registered 140 and I was placed in the resuscitation department, where I was given a blood plasma transfusion with morphia included in the drip feed. The transfusion brought my pulse down to 110 and I was considered fit for further evacuation, this time to the Casualty Clearing Station. The plasma bottle was fitted on the side of the stretcher and the transfusion continued while I was travelling.’page 8 page 9
TAKING MEDICAL SUPPLIES ACROSS THE LAMONE RIVER, FAENZA
RAP Carrier, near the Senio
RAP Jeep, from the Sangro
5 NZ Field Regiment Aid Post, Orsogna
Labelling wounded men’s packs, Rimini
Advanced Dressing Stations
BRITISH AND ENEMY WOUNDED
OFF THE RAILWAY ROUTE NEAR MOUNT PORCHIA, Cassino
At Four Main Dressing Stations
4 NZ FIELD AMBULANCE AT KATERINE, Greece
The reception tent is to the right of the ambulance
MDS IN A WADI, near Sidi Rezegh
This station was captured and remained in enemy hands for eight days
A FIELD SURGERY—two vans backed together, Alamein
A FIELD OPERATING THEATRE
—a surgical team applies a Thomas splint, Cassino
6 NZ FIELD AMBULANCE, Greece
Result of enemy aircraft action
FIELD OPERATING THEATRE, Alamein
NEW ZEALAND NURSING SISTERS AT A CCS, Cyrenaica
UNLOADING AN AMBULANCE CAR AT 3 NZ GENERAL HOSPITAL, Bari
Casualty Clearing Stations
AN AERIAL VIEW OF 1 NZ MOBILE CCS on a bypass of the main road, near Cassino. The theatres and administration tents are on the left by the road, and the wards on the right
VOLUNTARY AIDS, 3 NZ GENERAL HOSPITAL, Bari
A SISTER, 2 NZ GENERAL HOSPITAL, Caserta
A MASSEUSE, Bari
A MEDICAL OFFICER ON HIS ROUNDS, Bari
Main Dressing Station
In Italy the Main Dressing Station for battle casualties (battle MDS) was invariably situated near a road seething with traffic. The air of bustle on the road pervaded the dressing station too, with its staff of at least six medical officers and up to 200 men, including the Army Service Corps drivers and the medical orderlies. Down this road, fighting against the almost ceaseless stream of traffic pressing towards the forward areas, came the ambulance cars.
Routes to the Main Dressing Station were, in some cases, raw, newly-formed roads hurriedly constructed by the Engineers, or else winding Italian roads that seemed more concerned with strangling their hills, rata-like, than providing a way for traffic. It was not unusual for ambulance cars to arrive at the Main Dressing Station in winter with their bodywork streaked and plastered with clay from scraping along the inner bank, either in squeezing past other vehicles on the narrow stretches or through skidding down into the ditch at the side of the road. Over the long, dependable summer months, the Main Dressing Station could be placed on any type of road, its location being governed only by the evacuation routes.
The road alongside the Main Dressing Station reverberated with the noise of traffic; sometimes it was the clattering of whirling chains on road or mudguard, sometimes the hammering roar of passing squadrons of tanks and the rumble of tank-transporters. In addition, the unit’s lighting plant whirled for long hours with its slack, rattling roar.
At any hour of the day or night ambulances halted outside the reception centre. From them came the walking wounded and the stretcher cases. If it was dark, the stretcher-bearers moved with a studied shuffling between Ambulance and Reception, Reception and Resuscitation and Theatre, Theatre and Evacuation—searching out the ground with their feet.
Every so often there was lifted from an ambulance car a patient with one arm lightly bound to a rigid arm-rest, a part-empty transfusion bottle in the frame clamped to the stretcher, with the red rubber giving-set running down to the needle taped in place in the bend of his elbow. Exposed bandages on walking patients showed patches of dried or damp blood; bandaged hands or arms were dirty and streaked with flakes of blood dried hard. Faces were grimy, with a heavy stubble of beard. A man moving among them, unbandaged and seemingly unhurt, would perhaps be an exhaustion case.
The wounded entered the reception centre with the air of understanding, patient waiting that wounded men always seemed to bring with them. In contrast, the staff of the reception centre worked with all speed to examine their new patients and classify them for treatment. All the more serious or badly shocked cases went to the unit’s resuscitation centre with its heated room or tent. Later, some would be moved into the operating theatre.
It was always difficult for medical officers to decide which cases should be operated on at the Main Dressing Station and which should wait until the Casualty Clearing Station was reached. Major surgery was best dealt with at the Casualty Clearing Station as it had better surroundings and equipment for that purpose, and the stability that allowed serious cases, such as abdominals, to be held till they were fit to travel to the General Hospitals. Special conditions arose, however, such as existed at the battle of Tebaga Gap, which made it impossible to evacuate the wounded in time for surgical attention in rear units. Under such conditions major surgery was done at the Main Dressing Station, and extra surgical teams were provided so that all the work could be carried out efficiently.page 26
At other times the work was shared by the two units, both working together to allow the maximum amount to be done in the shortest time. Priorities of operation for different types of wounds were laid down as experience dictated. At the time of the battles to break through to the plains of Northern Italy, first priority was given to cases of serious bleeding, mangled limbs, large muscle and open chest wounds. During these battles wounded were operated on at the Main Dressing Station, at the Casualty Clearing Station, at the special British head, eye, and maxillofacial hospital, and at our General Hospital at Senigallia, while some were flown to Bari to have their first operations performed at our hospital there. The Main Dressing Station provided resuscitation for the serious cases, giving blood transfusions if necessary, before evacuating them to the Casualty Clearing Station.
The evacuation centre cared for a spaced and steady procession of wounded. Some were drowsy with morphia, others relaxed with the heartening knowledge that they were within sheltering walls after a trying ordeal and the discomfort of travelling. Some came startled and alarmed out of the deep fogginess of anaesthesia, others answered questions obediently and from mere habit, as though they had found something more interesting to hold their attention and had replied out of politeness. This population was transitory, patients being sent on to the Casualty Clearing Station as soon as they were fit to travel.
After a period as battle MDS the unit would be tired—sleep was disturbed by the internal noises of the dressing station at work or by the external noises of war; and there was, too, the steady drain of energy from long and intense concentration and the persistent call for quick and precise work.
But the unit preferred to be battle MDS rather than sick MDS or in reserve. The life was more exacting and more urgent. Constant thought and ceaseless energy saved life and limb for the wounded: the work left a sense of satisfaction and a keen appreciation that it was a task in which any man might take pride.page 27
‘I was admitted to 1 NZ Mobile Casualty Clearing Station at Forli. When I was carefully examined at seven o’clock in the evening it was found that the femoral artery had been severed. The sack of the calf of my leg was opened widely but was bleeding only a little. I was operated on and put to bed with my leg in an iron frame, and 15,000 units of penicillin were injected every three hours from nine o’clock on the night of 20 December to nine o’clock in the morning of 26 December. Also, injections for protection against gas-gangrene poisoning were given six-hourly from midnight on 20 December to six o’clock on 23 December.
‘In spite of all this attention my leg began to get discoloured by 23 December and I had lost all feeling below the knee. The medical officer told me my leg would have to be amputated or else it would most likely endanger my life. At eight o’clock that evening I went into the operating theatre and was put under an anaesthetic. Then my leg was amputated through the lower third of my left thigh. On Christmas Eve I had another transfusion of two pints of blood. For several days I could feel the heat and cold in my missing leg just as plainly as if it were still there, and that sensation wore off only after two or three weeks.’
Casualty Clearing Station
In Forli the Casualty Clearing Station was established in a former school building where conditions allowed more than the usual comfort. Here elaborate surgical treatment was carried out as near to the forward areas as was practicable for tactical reasons (usually within 12 to 15 miles), and here, too, was provided the necessary post-operative nursing until the patient was fit to be sent farther along the route of evacuation to a General Hospital. The aim was always to reduce the time-lag between the wounding of a soldier and his first surgical operation. On occasions wounded were sent on to a General Hospital from the Casualty Clearing Station by air.page 28
The Casualty Clearing Station was usually a tented hospital, specially equipped and staffed as a mobile unit. Mobility was of prime importance as the unit had to be ready to move to a fresh site at short notice, or it might have to set up in an open field. It was equipped to hold 300 patients, of whom about one-third could be nursed on beds and the remainder on stretchers. During a battle a Casualty Clearing Station might handle from 200 to 500 patients in 24 hours, with a high proportion of urgent major surgical operations. In active periods the staff was usually supplemented by Field Surgical units, a Field Transfusion unit with its blood bank, and sometimes by a British Mobile Laboratory as well.
As in the Main Dressing Station, the standard practice was to set up the tented wards along a semi-circular road running from the entrance to the exit of the field. First came the reception tent, then the pre-operation ward, with an X-ray tent attached, followed by two to four tented operating theatres and finally some seven or eight tented wards. Each of these wards held 25 patients on beds, or 35 on stretchers. Conveniently arranged about this group were the special departments, medical stores and dispensary, ordnance stores, cookhouses, and mobile lighting sets for the theatres and wards. It was possible to establish the Casualty Clearing Station, pitch tents, and equip wards and theatres ready to function, within six hours from the time of arrival on the site.
During an action the ambulances would arrive from the Main Dressing Station in a steady stream, one moving in to take the place of another as it pulled out, sometimes two unloading at once. Stretcher-bearers brought the patients into the reception tent. One, perhaps, had his eyes and head bandaged. Another might be very still, with the envelope tied to his battle dress clearly marked ‘Abdominal’; he would be passed on immediately to the resuscitation and pre-operation ward. Here his stretcher was placed on trestles.* He was stripped of his clothing, bloodstained and mud-soiled as it was, washed and put into pyjamas. The extent of his injury was carefully estimated, and he was listed in order of priority for operation. In the meantime, the transfusion officer injected warmed blood so that the patient would be in the best condition to stand the operation.
When a patient was taken into one of the operating theatres the anaesthetist gave him an injection of pentothal in the inner vein of the elbow, followed if necessary by an inhalation anaesthetic. The surgeon would call for instruments and begin the operation. His assistant tried to anticipate his wishes, while orderlies held limbs, attended to the steriliser, obtained swabs or anything else demanded by the surgeon. When the excision of the wound was completed it was treated with penicillin and one of the sulphonamide drugs. Damaged limbs were usually encased in plaster and, the operation completed, the patient was carried to one of the tented wards. Here he came under the care of a nursing sister and six orderlies.
The Casualty Clearing Station had on its staff eight nursing sisters of the New Zealand Army Nursing Service who lived and moved with the unit. They provided the high standard of nursing necessary in serious post-operative cases, especially with abdominal wounds. Their presence alone so soon after a soldier had been wounded had a seemingly magical influence on his recovery.
As a surgical centre in the form of a well-found hospital unit within a short distance of the fighting line, the Casualty Clearing Station was a vital link in the chain of medical services. The page 29 work of the surgeons was greatly helped by blood transfusion and by two great life-saving discoveries, the sulphonamide drugs and penicillin, which gave the wounded soldier of the Second World War a much better chance of survival than in the First World War. Speed in evacuation, care in handling, constant supervision and correct treatment during the first few fateful hours from the time a soldier was wounded until he was operated on at the Casualty Clearing Station meant, in many cases, the difference between life and death, or between complete recovery and chronic invalidism.
* * *
‘On Boxing Day I was on the road again—this time in an ambulance of the NZ Motor Ambulance Convoy section—to 1 NZ General Hospital on the sea-coast at Senigallia, seventy miles away. The atmosphere in the General Hospital was a great help to morale and I felt 100 per cent better as soon as I was between the sheets. However, I had no sooner settled down than a medical officer came and after examination prescribed another two bottles of blood for me. I did not like having the blood transfusion but I always felt much better and stronger afterwards.
‘December the 28th saw me back in the operating theatre again, and this time my leg was stitched up and two rubber tubes were inserted in my stump. I then started another course of penicillin injections, which were no doubt the direct cause of my stump healing so quickly, but I was not sorry when the sister said that the course was finished.
‘Here I must put in a good word for the nursing sisters I found in the New Zealand hospitals. They were an excellent group and I always had a feeling of safety and security when they were around. The treatment and attention I received at 1 NZ General Hospital was thorough and good all the time, and no praise is high enough for the nursing staffs—both sisters and voluntary aids.’
* Formerly a kerosene heater was placed under the stretchers and blankets were draped round the trestles, but the application of heat as a means of resuscitation was later discarded, the room being heated sufficiently to prevent undue chilling but no direct heat being applied to the patient.
At Senigallia 1 NZ General Hospital was established in what had been an Italian children’s health camp; up till a few months previously it had been used as a German military hospital. The buildings, though insufficient for a hospital, enabled many of the amenities of a large civilian hospital to be supplied. Water and electricity were laid on, amenities which had not always been available in the hospitals in Egypt.
The central building had lent itself to conversion to the needs of the administrative, laboratory, X-ray and other departments. It also provided some of the wards. A walk beneath a vine-covered pergola ended at a two-storeyed building used as the surgical block. This block showed more window than wall on all sides and was admirably suited for a hospital building. All other accommodation was provided by tents. New Zealand engineers had worked to provide access roads and other conveniences, while Italian labour had been employed on inside alterations.
The main highway passed the entrance to the hospital, and there was the continual noise of transport moving up to the front line and the droning of aircraft overhead. During the last few weeks of summer and in the early autumn, the staff had enjoyed living in tents by the sea, but when the sea breezes turned to boisterous gales, and heavy rain saturated the ground underfoot, and snow page 30 a week before Christmas left its aftermath of slush, it was another story. Nissen huts were being erected all over the hospital area to replace tents as wards and living quarters.
From the date it opened on this site, early in September 1944, the hospital had been busy with an inrush of patients. The staff always had its unremitting round of duties. To be a good orderly a man needed to be a jack-of-all-trades. For ten hours a day he dealt with recalcitrant primus stoves and kerosene heaters; he acted as a transport mule in the hospital area, carried large bundles of soiled clothing to the linen store, collected the lotions from the dispensary or medical store, brought rations of soap, kerosene, and methylated spirits from the ordnance store, went to the main kitchen for morning and afternoon tea for the patients, carried stretcher patients to operating theatre or X-ray department, and was always at the beck and call of sisters and patients. In between times he managed to obtain on the side many needful extras for the wards.
Voluntary aids now attended to many duties which had fallen to the orderly in pre-1942 days. The nurses made beds, took temperatures, washed patients, worked in the operating theatre and special-diet kitchens, delivered meals, swept and cleaned wards, and helped in the ward kitchens.
Sisters were in charge of the wards of 80 to 100 beds, carrying out professional nursing duties as in civilian life. They co-operated with the medical officers in the treatment of patients, keeping a watchful eye on each man’s progress, maintaining discipline, but always trying to keep their charges contented and comfortable.
When the First Echelon went overseas in January 1940, eighteen sisters of the New Zealand Army Nursing Service sailed with it—a small band of women in a trim uniform of grey and scarlet. On the staffs of the New Zealand military General Hospitals in the Middle East and the Pacific were many more sisters. They, with their reinforcements, brought the total who served overseas to 602, all of them volunteers. By May 1940 more than 1200 nurses from New Zealand hospitals had offered themselves for overseas service.
A sister’s service was seldom dramatic or spectacular. Hers was the life of the hospital unit in which she served, sharing its difficulties and problems, its joys and honours. The standard of treatment and service given to each patient was equal to that of any modern hospital in New Zealand, but the difficulties overcome could be known only by those who had worked long hours to establish and maintain that standard.
No sister in a civilian ward, filled with all modern appliances for the patients’ well-being, ever viewed her surroundings with more pride than did a sister of the New Zealand Army Nursing Service who, with the help of her ward staff and walking patients, fashioned furniture from wooden boxes, discarded tins, and other waste material. Many times a sister’s thoughts, as she stoked a copper fire or tinkered with a temperamental primus that at a critical moment refused to do anything but gush a sooty smoke-screen, must have turned to the hospital she had left, where the gleaming faucets at a touch would pour forth gallons of boiling water and where the behaviour of the steam sterilisers never gave a moment’s worry. Nor, as she endeavoured to work in a duty room that also served as the doctor’s office, dispensary, linen room, and perhaps sterilising room as well, could she be blamed if at times she thought with longing of the hospital at home, where there was a room and a place for everything. No, in a military hospital it was no press-button life, but for the sisters who watched their units become efficient hospitals, it was a life that had its rewards.page 31
The medical officers were qualified doctors; many were recognised experts in specialised branches of medicine and surgery. Upon them rested the responsibility for the conduct of the hospital, and their science and skill paved the way for the recovery of so many men to full health and strength. The General Hospitals admitted an annual total of sick and wounded equal to the numerical strength of the 2nd NZEF. The greater proportion were sick, but during the war there were over 16,000 wounded and an almost equal number accidentally injured—all making demands on the surgeons. Throughout the war there was a steady advance in the technique of surgical treatment and the use of drugs, and a surgeon had always to keep abreast of the latest curative developments and apply them as occasion arose.
* * *
‘On 7 January 1945 some of us moved out of 1 NZ General Hospital on our way to 3 NZ General Hospital, 300 miles farther down the Adriatic coast at Bari. We travelled by a British hospital ship, staffed by English men and women of the RAMC.* We were treated very well by the Tommies during our short trip with them.
‘Bari was reached next morning, and we travelled the short distance to 3 NZ General Hospital by ambulance. We got into bed just in time for lunch. By this time my appetite was returning. This hospital was one of a group situated in what had been planned as an Italian Polyclinic. The medical treatment was first-class as expected. Facilities were as good as those in any civilian hospital. Just a few days before my arrival the hospital had admitted its 40,000th patient. I was one of 900 patients there.’
The British, Indian, South African, and New Zealand hospitals were accommodated in a very extensive group of buildings at Bari, designed as a medical school and hospital centre for the whole of Southern Italy. In November 1943, 3 NZ General Hospital took over part of one block from a British Casualty Clearing Station. This was ready for use, but the main block allotted to the New Zealanders was only a framework with unfinished floors and walls, and with very few glazed windows. Many of the casements were bricked up and there were no fittings for water and sanitation. Demobilised and undisciplined Italian troops were in possession and the building was in a filthy state. A transformation into a well-equipped hospital provided with all the essentials of modern cleanliness and sanitation was effected.
Third NZ General Hospital had come from Tripoli, where it had been a tented hospital clustered round an old fort. There, fittings from a sunken hospital ship in the harbour had provided extra equipment: the capacity of New Zealanders to improvise and adapt had produced first-class hospitals in all situations.
* * *
‘On 15 January I tried to use crutches but my good leg was too weak to hold me. I was graded and placed on the list of invalids for return to New Zealand.
‘We embarked at Taranto on 20 January 1945 on the NZ Hospital Ship Maunganui and from then onwards all was a pleasure. The treatment, food, and general atmosphere of the Maunganui were excellent and I will always have pleasant memories of the contacts I have experienced with members of the New Zealand Medical Services.’
* Royal Army Medical Corps
Amongst the thousands of ships which entered New Zealand ports during the Second World War, there were a few that did not have the dull grey camouflage of war. Their bright white paintwork was relieved by a broad green band girdling the hull; on their sides were two or three large red crosses and the flag of the International Red Cross—a red cross on a white background— flew at the masthead. These were the hospital ships. They were completely fitted with all the equipment necessary today for the treatment of sick and wounded. Cabin walls and fittings were torn out to make large airy wards in which rows of neat white beds were screwed to the decks or suspended to counter the roll of the ship. Other sections of the ship, which might have been music rooms, smoke rooms, or lounges, were also converted to the needs of the sick and wounded.
A central feature was the operating theatre. On its walls were glass cupboards containing shelves of surgical instruments. In other cabins were an X-ray department, a laboratory, a dispensary, a dentist’s surgery, and a massage department. None of these lacked anything, either in supplies or fittings. A hospital ship must be self-sufficient.
The Maunganui, a troopship of the First World War and a passenger liner between the wars, was converted to a hospital ship at the beginning of 1941. She was a fully-equipped General Hospital afloat, with accommodation for 365 patients. The operating block was the object of special pride: it had been so well designed and equipped in Wellington that it was the envy of many British hospital ships.
There was no mistaking the pleasure of the patients returning to New Zealand when they first caught sight of the gleaming white side of the hospital ship at the port of embarkation. There were still pleasant surprises in store for them. In the wards the beds were as good as they looked and the walls were a restful green and cream.
The first meal on board was a revelation to the home-coming men. After an interval of one, two, three and even more years they tasted excellently cooked New Zealand food—the best the Dominion could produce. It had been kept in perfect condition in the ship’s freezing chambers and included plenty of green vegetables and fruit and many delicacies—lamb, chicken, even oysters and whitebait. No wonder that convalescence was rapid on the homeward voyage.
* * *
‘There was great excitement when we sighted the New Zealand coast in the vicinity of Cape Farewell on the afternoon of 27 February 1945 and still greater excitement when we sailed up the Wellington harbour next morning and berthed at Aotea Quay. Patients lined the ship’s rails, and those whose homes were near Wellington picked out members of their families in the crowd pressing against the barriers on the wharf and waved and shouted. Soon we disembarked—many who had come on board as stretcher patients were able to walk down the gangway. What a thrill it was to set foot on New Zealand soil again (even if it was only one foot in my case) and know that we would all soon be checked through the Casualty Clearing Hospital on the wharf, and then be taken home by train in special hospital carriages. The chain of medical services had brought some of us right from the front line in Northern Italy to our own homes.’
THE DIARY used in this account is that of Cpl A. A. Swanston, of 26 NZ Battalion. For the description of medical units the author relied on miscellaneous material in the records of the Medical History Section, War History Branch. The map and diagram are by L. D. McCormick, and the photographs come from many collections, which are stated where they are known:
K. G. Killoh Cover
L. V. Stewart Inside Cover
Dr. G. H. Levienpage 13 (bottom)
R. H. Blanchardpage 16 (top left)
J. B. Hardcastlepage 16 (top right)
Dr. S. L. Wilsonpage 16 (bottom left)
Dr. D. T. Stewartpage 18 (top)
G. Morrispage 19 (bottom)
A. R. Andersonpage 20 (top)
Department of Internal Affairs, John Pascoepage 22 (top)
New Zealand Army Official, M. D. Eliaspage 23 (top)
THE AUTHOR, J. B. McKinney, who graduated at Victoria University College as MA in History in 1939, served in the New Zealand Medical Corps in the Middle East and Italy from 1941 to 1945, and is at present on the staff of the Medical History Section of the War History Branch.
the type used throughout the series is Aldine Bembo which was revived for monotype from a rare book printed by aldus in 1495 *the text is set in 12 point on a body of 14 point