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The New Zealand Dental Services

War Diary ADDS, 8 March 1941:

War Diary ADDS, 8 March 1941:

Discussed with AA & QMG, 2 NZEF Base the question of command of NZDC Officers and the procedure to be adopted in instances where breaches of discipline occur. He assumes that the ADDS commands NZDC personnel in the 2 NZEF and accordingly in all instances where breaches of discipline are reported as regards officers the papers will be sent to the ADDS who will either discipline the officer himself or decide that the case requires investigation by higher authority. (In the case of 1 Camp Dental Hospital, Base Depot Dental Hospital and Mobile Dental Section when at Base the ADDS in the latter instance would direct the officer commanding the unit to frame a charge, prepare a summary of evidence and make application through him for a Court Martial.)

The powers of Officers in command of 1 Camp Dental Hospital and Base Depot Dental Hospital have never been sufficiently defined and at present these officers appear only to have the powers of Company Commanders. NZDC personnel who have committed offences which cannot be dealt with by a Company Commander are tried before Officer Commanding Headquarters Company in the case of the Camp Dental Hospital and Officer Commanding Reception Depot in the case of Base Depot Dental Hospital. The dental units are formed as Units of the 2 NZEF and now it is felt that NZDC personnel where possible should be disciplined by NZDC Officers. Accordingly application will be made to Headquarters 2 NZEF Base for these Officers to be granted the powers of Officers Commanding Detachments in accordance with Para 577 K.R. (1935)1 while acting as Officers Commanding their units.

This was a distinct advance as the powers of a company commander are strictly limited in comparison with those of an Officer Commanding a detachment. Discipline within the units was more easily maintained and the Corps spirit was enhanced.

Meanwhile, Maadi Camp was expanding, and although it depended on the fortunes or misfortunes of the Division whether the extra area would always be occupied, it became necessary to consider building a second Camp Dental Hospital. In early April 1941 it was decided to establish No. 2 Camp Dental Hospital of the same size as the existing one, to be ready for occupation by the time of arrival of the 5th Reinforcements.

At the same time, further consideration was given to the provision of dental reinforcements. The scheme whereby dental staff attached to transports could be retained was not entirely satisfactory. There was apparently a mental attitude of dissatisfaction in personnel unexpectedly retained for service in the 2 NZEF. With so many of the Corps in New Zealand clamouring for the opportunity to serve page 174 overseas, this attitude is inexplicable and it is probable that, if there had not been other factors influencing the position, little notice would have been taken of it. Later it was not evident. The ADDS estimated that through sickness, one officer was off duty each week, and that, with extended leave every six months, one officer was absent on leave each week. He suggested that reinforcements be provided on the basis of a six-monthly wastage rate of 17½ per cent.

The establishment of the general organisation having been described in some detail, it is now convenient to study how that organisation fitted into the 2 NZEF plan. It has already been seen that it was flexible and capable of immediate modification and expansion to meet special circumstances, but notwithstanding this, there was a well defined blueprint to which the service had to be built.

For the purposes of dental treatment, the Expeditionary Force was divided into three groups, each with its own dental problems:

1.

Reinforcements entering training units in Base Camps. Also, office and administrative personnel in these camps.

2.

Troops in the field, i.e., Advanced Base, Lines of Communication units, non-divisional units and the New Zealand Division.

3.

Sick and wounded passing through General Hospitals, Convalescent Depot and Discharge Depot.

To understand the dental problems connected with these groups it is first necessary to study the flow of troops between the groups. The following diagram will help the reader to visualise this:

plan for dental operations

page 175

On arrival in Egypt all reinforcements entered a training depot in a Base Camp before being posted to units in the field. Although they had all been made ‘dentally fit’ before leaving New Zealand, they were immediately examined again and treated if necessary. This was in accordance with Dental Corps policy, which was not to allow anyone who was not dentally fit to proceed to the field. The two Camp Dental Hospitals carried out this work in addition to attending to the regular six-monthly examination and treatment of the base administrative staff. They were dealing with fit men of a static force undergoing training and were working under much the same conditions as existed in the mobilisation camps in New Zealand. One small difference between the camp dental hospitals in Egypt and New Zealand was in the keeping of records. In New Zealand records were of the utmost importance as an indication of the state of the mouth on entry into the force for comparison with the condition on discharge. As Colonel Fuller wrote in the New Zealand Dental Journal of July 1942:

Records are not retained in this group when the treatment of the soldier has been completed. The objects are to examine men, to complete all treatment and to see that no man proceeds to the Field unless completely dentally fit. Since this object is attained in every case there is no point in forwarding records to the Field with the soldier. Should he return eventually to the Base Camp it will be through a General Hospital and/or Base Reception Depot, where he will be examined and treated, and from which he will enter the Base Camp dentally fit.

A simplified method of charting is used which records, not so much the condition of the mouth, but rather the work actually requiring' attention. Throughout the entire service, in point of fact, the emphasis is on the practical, and any procedures found to be merely of academic use are discarded immediately. Our responsibility is the creation of an efficient Army Dental Service of war-time use and duration only.

With the exception of a few men who through sickness were sent to hospital, the troops left the training camp for service in the field, entering this second group dentally fit. Dental treatment then became governed and limited by general conditions and military circumstances. The moment for which the soldier had been trained had arrived and the Dental Corps had played its part in producing him as a physically fit member of a fighting force. Everything had been done to reduce to an absolute minimum the occurrence of dental pain and to prevent his loss from his unit because of dental lesions. The responsibility of the Corps, however, did not end at this point, nor did the soldier have to await his return to Base or hospital for future dental attention. Within the Division each of the three brigades had a field ambulance, to which was attached a dental section consisting of dental officer, clerk-orderly and, later, a page 176 mechanic. The dental health of the troops in the Division was primarily the responsibility of these dental officers, each of whom was responsible to the brigade to which his ambulance was attached. In addition to this there was the Mobile Dental Section with its 8 officers and 39 other ranks, self-contained with its own transport and capable of dividing into sub-sections for attachment to any unit requiring its services. This Mobile Dental Section was non-divisional but could be used within the Division, co-operating with the field ambulance sections. When, however, the Division was in action, the Mobile Dental Section would on most occasions reassemble and either wait for more suitable conditions to rejoin the Division or join other New Zealand units. The ADDS, in his ‘Notes and Instructions’, writes:

No organised attempt will be made on every occasion (in the Field) to render every man dentally fit. This is neither necessary nor desirable if troops have been sent forward dentally fit, for, if attempted under all circumstances, it would be out of proportion to other needs.

Therefore it is the duty of dental units in the Field to ensure primarily that the standard of dental fitness attained in base areas does not deteriorate unduly. Their duties are thus concerned mostly with maintenance and with attention to work of an urgent nature. For example, in the open, highly mobile warfare of the Western Desert (North Africa) in 1941 and 1942, it was the duty of dental units in the field to ensure primarily that the standard of dental fitness attained in base areas did not deteriorate unduly during those phases when the Force was actively engaged and in consequence mostly on the move.

The position is entirely different however when field units are resting or reforming and training or performing duties outside active areas of operations or occupying static (or virtually static) forward defended localities, etc. Under these circumstances the treatment carried out is the same as that undertaken in Base Camps and is organised with a view to rendering each unit dentally fit once every six months.

In this group, which can be conveniently called the ‘Action circuit’, it can be seen that the aim was to promote practical rather than actual dental fitness and that the Corps, in attempting the former, in many cases achieved the latter. Before leaving this group it is timely to quote the words of the ADDS:

The size of the Service must be in balanced proportion to the other needs of a force whose purpose is primarily to fight. The Service must never be organised and expanded to such an extent that some of its operations, when measured in relation to the purpose of the force, are unnecessary; nor should they ever hinder essential military activities of units of the force but, on the other hand, their effect should be continually to contribute towards and act as a stimulus to general fitness and efficiency.

The third group was the ‘Hospital circuit’. Soldiers in the field, either divisional or non-divisional, who became casualties through sickness or enemy action, were evacuated to a General Hospital page 177 and from that moment were struck off the strength of their unit. Once in the hospital circuit they had to follow a definite course and their future destination was decided on medical grounds. From the hospital they went to a Convalescent Depot to recuperate. The next step was to a Reception Depot, where they were medically examined and, if fit, sent on to the Training Depot, whence they returned to the field when reinforcements were needed. If found unfit for further service they were medically boarded for return to New Zealand and were posted to the Discharge Depot to await a return passage. Similarly, those men evacuated to hospital from the training camp could only leave the hospital circuit through the same channels.

This compulsory immobilisation of men afforded a good opportunity for the Dental Corps to establish complete dental fitness and the group was organised to ensure that no man left the circuit until this was accomplished. Dental sections were attached to the general hospitals and to the Convalescent Depot, and a Camp Dental Hospital, termed the New Zealand Base Depot Dental Hospital, was responsible for the Reception and Discharge Depots, which were close to each other. Dental charts were used in this circuit to provide a check that no man should leave the circuit unless dentally fit. Each man's chart followed him in his progress through the circuit.

The ADDS at his headquarters kept in touch with every dental unit and could interchange or augment personnel to achieve the objective of each group. Especially was this of value with dental units in the field, for, knowing the dental condition of every unit of the force, he could notify dental officers of those units which became due for organised treatment.

Just as there was a regular progression of men in the 2 NZEF, there was a system of training and reinforcement of dental personnel within the framework of the Corps organisation. The No. 1 Camp Dental Hospital was considered the training unit of the Corps and reinforcements and personnel surplus to establishments were posted to the strength of that unit. All dental personnel, irrespective of any allocation to a specific unit in New Zealand, were, without exception, posted to No. 1 Camp Dental Hospital in Maadi Camp. As an example, Lieutenant A. B., who left New Zealand as dental officer attached to X Field Ambulance, arrives in Egypt. No. 1 Camp Dental Hospital renders a casualty return placing him on the strength of the dental hospital, quoting a letter from the ADDS initiating the posting as authority. Although posted to the Camp Dental Hospital he is still nominally attached to the Field Ambulance, but this does not mean that in the event of the ambulance requiring dental reinforcements in the field, Lieutenant page 178 A. B. will automatically be chosen for this duty. The demand for reinforcements is made on the Camp Dental Hospital, whose Officer Commanding selects, under the supervision of the ADDS, a suitable officer for attachment to the Field Ambulance. Similarly, should the Division suffer a large number of casualties and the Base Depot Dental Hospital find difficulty in establishing dental fitness in the hospital circuit, extra personnel could be sent from the Camp Dental Hospital. As this would bring the Base Depot Dental Hospital above its establishment, the surplus personnel would be shown on the strength of the Camp Dental Hospital and as being temporarily detached to the Base Depot Dental Hospital for duty.

Dental Corps casualties, that is those who were evacuated beyond a Regimental Aid Post, would enter the hospital circuit in the same way as any other casualties, but on reaching the Base Reception Depot and being graded fit for duty, would join the strength of No. 1 Camp Dental Hospital. They would then be either posted to a unit at Base or in the field, or remain as unposted reinforcements until demands were received for further personnel.

1 King's Regulations.