The New Zealand Dental Services
For security reasons the forward area had been referred to as MAINYARD and was now revealed as Guadalcanal, an island of the Solomons Group. The dental units were split up among American ships of the convoy and sailed from Nouméa on 24 August 1943. They immediately encountered a heavy swell which accounted for the loss of nineteen artificial dentures from seasickness. It was perhaps at this moment that the full significance of the GOC's prophecy about transport was appreciated. If boats were to be the future transport rather than trucks, there was plenty of work ahead. There was every reason to expect loss and damage to artificial dentures after the Division came out of action. Reports from the Middle East substantiated this. The expectation of casualties before the Division went into action was something new. To have relied on a rigid attachment of dental sections to medical units, such as Field Ambulances and the Casualty Clearing Station, would have been totally inadequate to meet the prosthetic problem. The Mobile Dental Section was free to mingle with the whole force and either send self-contained sections where they were needed or bring the prosthetic work in to a central laboratory. Should the type of warfare merit the attachment of dental sections to medical units, the organisation was there to meet it. The whole dental organisation was built on the principle that changing circumstances could be met without any interference with the basic administration.
The first port of call was Vila on the island of Efate in the New Hebrides. Disembarkation drill was practised and landings were made on Meli Beach, the night being spent ashore in bivouac in heavy rain.page 322
Leaving Vila harbour on 1 September, the convoy arrived at Guadalcanal the following day. The Mobile Dental Section set up headquarters at Point Cruz and the Maxillo-Facial Injuries Section at the Casualty Clearing Station nearby. This was one of the best sites on the island. Some of the jungle was cleared away, the ground was levelled by bulldozers and the tents were set up. Some of the larger trees were left for shade and, being on the neck of a small isthmus, it was close to the sea and a good bathing beach. To begin with the surgeries were tents with coral floors, but later a building with a wooden floor was built, a great advantage in a land where high rainfall and violent thunderstorms were of almost nightly occurrence and the lower-lying areas constantly flooded. The rivers, unlike those in New Caledonia, were dirty and muddy, and until supplies from springs were organised, there was a shortage of water for washing and drinking. Everybody managed, however, and shower baths of all descriptions were improvised, even old gas masks being used for the purpose.
Guadalcanal had been freed from the Japanese in February 1943 and, at that time, was the principal forward American base for actions in other islands of the group. It was still close enough to Japanese bomber bases to receive regular attention and consequently camps had to be dispersed and camouflaged. They spread for over 60 miles along the coast and up steep ridges into the hinterland. The heat was oppressive, the island being latitude 9 degrees south, and the slightest exertion produced trickles of sweat. The digging of foxholes in the hard coral, an essential chore for every man as a protection from enemy action and our own falling shrapnel, was a labour not easily forgotten. During the day the men could work stripped to the waist but after dusk shirts had to be worn as a protection from the mosquitoes, whose bite brought malaria. This precaution, plus insect repellent lotion plus atebrin, paid dividends, for proportionately the New Zealand Division had a much smaller number of casualties from malaria than the Americans, who placed more faith in atebrin alone.
Sub-sections were attached to units but the days of leisurely training were over and the Division was feverishly busy. ‘On active service’ really meant what it said and few were inclined to waste precious time on dental parades. Casualty treatment was all that could reasonably be done and the routine of examination and treatment, as carried out at the Base, could not be attempted. This was anticipated and was the chief reason for the intense drive for dental fitness at the Base, but the need for constant vigilance was not forgotten. As the ADDS reported on 14 January 1944:page 323
There is a noticeable similarity in the amount of dental treatment completed in the Base Area (Necal) and in the forward area (Mainyard). In other words, the amount of treatment required to make fit and maintain 5,000 men in Necal is about the same as the casualty treatment carried out for 13,000 men in the forward area. The natural conclusion is that there is a considerable amount of treatment outstanding in the forward area.
It is when the fighting forces come out of action and concentrate in static form that the Dental Corps can catch up with arrears. This never happened with the whole 3 Division. It was under the general command of the Americans and never went into action as a complete force. Apart from the fact that it was never a complete division of three brigades, the two brigades, the 8th and the 14th, never fought on the same island and did not join up again until the return to New Caledonia in 1944. Even on Guadalcanal they were not together for long as, when 8 Brigade landed on 14 September, the 14th was actually preparing to leave for the assault on Vella Lavella. No. 10 Mobile Dental Section therefore never had the opportunity of working other than as detached sub-sections.
The Mobile Dental Section was supplied with panniers containing enough for ninety days. In addition, three ‘units’ of dental stores from the United States Maintenance Schedule were shipped forward with the Advance Base Medical Stores. As in New Caledonia, however, this shipment contained few of the essentials and could not be relied on except as a stopgap. The only sure source of supply was from the ADDS, but if everything had to go through his store at Bourail, it meant unnecessary movement, delay and expense. On the other hand, the ADDS was in charge of all dental stores in the force, whether at the Base or hundreds of miles away in the forward areas. Setting up a new store at the Forward Maintenance Centre, as the forward base at Guadalcanal was called, would deprive him of full control and lead to duplication and confusion. A section of the existing Advanced Base Dental Store was therefore established with an NCO in charge, responsible to the OC Mobile Dental Section as deputy for the ADDS. This branch was stocked and maintained by the ADDS, but time and expense were saved by dividing the requisitions on Wellington into New Caledonia and Guadalcanal requirements so that they could be shipped direct but were still under the control of the ADDS. Controlled and Maintenance United States stores could also go through the branch store. The system worked smoothly and was one worry less for the ADDS, who was always uneasy about the uncertainty of American supplies, especially of prosthetic materials. Indeed, after visiting the DDS in November, he decided to draw practically everything from Wellington and to use the American source only for minor non-essentials or materials known to be stocked in reasonable amounts.page 324
Before going any further it is opportune to glance at the character of the war in the Pacific so that the dental problem may be more easily appreciated. This was no open warfare with fast transport, easy communications, broad vision and movement on a large scale, but was fought in dense jungle by small patrols when distances were counted in yards rather than miles. To quote from a survey written for the New Zealand Army Board by an officer who served in the campaign:
Conditions were harsh and difficult. Rain fell, drenching the men and soaking their equipment and stores and turning the jungle into a bog. Progress was slow, amounting to only 300 to 600 yards a day during contact with the enemy, and a company front was rarely more than 100 yards wide. The men moved along narrow tracks in single file, hindered by tree roots and clutching vines and always on the alert against ambush or enemy traps. The construction of roads was impossible and would have taken months of work with bulldozers. Every noise was suspect, for the Jap, hidden among the roots of the trees or up the trees themselves, held his fire until patrols came within five or ten yards…. Every yard of ground had to be searched thoroughly, and when it was declared clear by the patrols, other troops followed round the coast in landing craft, establishing bases at sites dictated by openings in the reef for the next probe forward.
Quite obviously there was no place for the Dental Corps in warfare of this type. Its contribution was to see that all men going out on these patrols were in such a good state of dental health that dental casualties, unassociated with general casualties, could be ignored as being too few to affect the efficiency of the campaign. There was therefore no need, and indeed no justification, for placing a dental section further forward than the Casualty Clearing Station. It was the medical policy to evacuate all casualties as soon as possible, so anything serious affecting the Dental Corps, such as maxillo-facial injuries, would be sent back immediately.
As an example, in the Vella Lavella operation 22 Field Ambulance had an Advanced Dressing Station with each of two battalions converging on the Japanese in the north-west of the island. They evacuated the sick and wounded as soon as possible by barge to a field hospital established among the palms of Gill's Plantation on the other side of the island. Emergency operations could be carried out here but usually the casualties were sent on, sometimes even by plane, to the Casualty Clearing Station on Guadalcanal. With the exception of preliminary treatment of maxillo-facial injuries, there was nowhere on this chain forward of the Casualty Clearing Station where a dental section would have been of use. When, however, the Japanese had been driven out of an island, there came a time when the brigade paused while acting as a garrison to protect air-fields and naval bases and to plan the next move. Then the Mobile page 325 Dental Section could send forward sub-sections to attend casualties and carry on the drive for dental fitness.