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New Zealand Medical Services in Middle East and Italy

Treatment of Casualties

Treatment of Casualties

The RMOs of the various infantry battalions had a trying time during the battle at Takrouna as their RAPs were constantly under heavy shellfire and, in some cases, evacuation could be done only at night. However, the RMOs carried out their duties with skill and determination and their men were given all possible medical aid. A report by the RMO 25 Battalion, Captain Pearse,1 indicated the nature of the difficulties that had to be surmounted:

There was a major difficulty in evacuation in the Takrouna area, where advance from the RAP to the battalion position was on foot and motor evacuation by ambulance car or jeep was possible only at night, and even then was slow and uncertain. Here stretcher-bearing teams were formed from the anti-aircraft section of the battalion and held as mobile teams at the RAP, whence they could, if necessary, be sent to any part of the battalion area.

As usual, the wounded man was first seen by his platoon medical orderly and evacuated to the RAP either by a party from the company or by the team held at the RAP. In this position the most that could possibly be done in the platoon or company area was the application of soft dressings, any attempt at splinting being impossible owing to very heavy enemy activity. Fortunately the battalion was concentrated in a small area and the timelag

1 Lt-Col V. T. Pearse, MC, m.i.d.; Dunedin; born Auckland, 12 Nov 1913; medical practitioner; medical officer HMAS Somer setshire, Dec 1941–Mar 1942; 6 Fd Amb Mar–Oct 1942; RMO 25 Bn Feb 1943–Oct 1944; DADMS 2 NZ Div Nov 1944–Oct 1945; SMO 2 NZ Div Oct–Dec 1945.

page 439 from company to the RAP was very short. In some cases it was found better for the medical officer to go to the wounded man over exposed ground and dress his wounds there, leaving the man in the area until conditions of evacuation were somewhat improved.

The RAP was situated in a shallow winding wadi, in slit trenches and subjected to the heavy shelling, mortaring and small arms fire that covered the whole battalion area. The difficulties of work were extreme in cramped conditions with numerous casualties and inadequate cover. With a collection of many cases it was necessary to hold some above ground until they could be evacuated, thus adding to the mental distress of the wounded men.

The line of evacuation from the RAP was by hand carry to the RAP of the battalion on the right flank, to which ambulance cars could be taken in daylight. The approach was along the wadi in which the RAP was established, with moderate cover for a distance and then across open ground and a small minefield covered by shellfire to the shelter of the neighbouring RAP—in all, a distance of about one and a quarter miles. Five men generally made up the stretcher-bearer team, prisoners being employed when possible.

In spite of the difficulties of the position and the exhausting work of the carrying, it was found possible to maintain a steady stream of cases to the ambulance cars throughout daylight. Many cases were serious, there being at least three cases of fractured femur, two with penetrating brain injuries, two abdominal cases and many compound fractures of arms. For some of these it was necessary to replace blood loss with plasma in order to enable them to stand the long and uncomfortable carry, and the use of a Thomas splint and plaster proved of great benefit during evacuation to the MDS for forward surgery.

The work of the forward battalion medical orderlies in this area under heavy and continuous enemy fire was beyond praise. No wounded man was left unattended for more than a matter of minutes, and evacuation to the RAP was equally swift, the inevitable discomfort of the man with a fracture being brought to the RAP with soft dressings only being more than offset by the fact that no man suffered a further wound. The splendid work of the carrying parties from the RAP to the ambulances was such that when the RAP received a direct hit with a very heavy shell, the last casualties had been evacuated a short time before.

Casualties from the assault on Takrouna began to reach 6 ADS at 1.30 a.m. and 5 ADS at 2 a.m. on 20 April, and continued to arrive in a steady stream. With lighter casualties from its brigade, 6 ADS had its brigade clear by 8.30 a.m. and its ADS clear by 11 a.m., when 88 cases had been handled, but 5 ADS under Major MacCormac1 was not so well placed. At 4 a.m. it received advice that the RAPs were flooded with casualties and sent forward all available transport—three ambulance cars and six 3-ton trucks. Six additional ambulance cars were sent forward from the MDS to the ADS at 6 a.m., enabling evacuation to proceed smoothly. By 8.30 a.m. 130 cases had been received by 5 ADS, and the steady flow of patients continued until 2.30 a.m. on 21 April, after which admissions were

1 Maj T. J. MacCormac, m.i.d.; Wellington; born Makotuku, Hawke's Bay, 7 Jan 1915; medical practitioner; Mob Surg Unit May 1941–Mar 1942; 1 NZ CCS Mar–Nov 1942; 5 Fd Amb Nov 1942–Jun 1944; PW Repat Hosp (UK) Jun 1944–Sep 1945.

page 440 only occasional. The total number of admissions to 5 ADS on 20 April was 276.

As these casualties were all transferred to 4 MDS that unit was kept very busy, and on 20 April 334 battle casualties, mostly New Zealanders, were admitted and treated. Both surgical teams worked long hours but there was no hold-up or undue delay in attending to cases. Evacuations were made to 1 NZ CCS, 8 miles north of El Djem, in ample ambulance cars (21 AFS cars being attached to the unit and 10 cars lent by 5 British Light Field Ambulance) along a good bitumen road, and so at no time was there undue congestion at the MDS. The unit had another busy day on 29 April when 151 battle casualties were treated, almost all being from 56 British Division.

At El Djem 1 NZ CCS was the most forward casualty clearing station and acted more as a staging post. Special cases, such as ophthalmic and neurosurgical, were admitted without prior surgical treatment and dealt with by the attached 1 British Mobile Ophthalmic and 4 British Neurosurgical Units respectively. Also attached were a field surgical and a field transfusion unit, both British. Evacuations were by road to Sfax, thence to 3 NZ General Hospital at Tripoli, but later upwards of fifty patients daily were loaded in returning transport planes from a landing ground north of El Djem and sent to Tripoli. Arriving at Suani Ben Adem, 15 miles south of Tripoli, at the end of March, 3 NZ General Hospital under Colonel Gower admitted its first patients on 10 April and by 30 April had 520 beds occupied, chiefly by New Zealand battle casualties.

The month of April 1943 was an interesting one from the medical administrative point of view, as it started with an extremely rapid advance of nearly 200 miles in a week, with all the problems of distance to contend with, and ended with a set-piece battle of the 1914–18 type. The divisional medical units showed that they could cope with both types of warfare equally well, and at no time was there difficulty in dealing with casualties.