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New Zealand Medical Services in Middle East and Italy

2 NZ General Hospital

2 NZ General Hospital

During the summer of 1941 the greater part of the work of 2 NZ General Hospital at Helwan consisted in the normal care of base troops, including those of other forces in the surrounding area and Italian prisoners of war from a camp nearby. Battle casualties were not admitted in large numbers.

Infectious diseases endemic in Egypt accounted for the majority of the medical cases, and bacillary dysentery generally supplied the largest quota of cases every month, being more prevalent in the early and late summer. The majority of the cases were Flexner in type, but some seriously ill cases with some deaths followed Shiga infection. Other cases were due to infection by Sonne, Schmitz, Para Shiga, and Boyd I bacilli. It was not till May 1941 that sulphaguanidine began to be used in small quantities, but by August it was realised how successful it was in the treatment of the more severe type of case, and thereafter sulphaguanidine became the routine treatment in all cases of bacillary dysentery, and was even used by RMOs in camps for the lighter cases. There were only a very few cases of amoebic dysentery admitted, including one with abscess of the liver.

Slightly fewer than three hundred malaria cases were admitted during the summer months from both the base camps of Maadi and Helwan. In May and June 15 cases were admitted following infection in Crete. All the cases except two were of the benign tertian type and responded well to treatment.

Infective hepatitis had been common in mild form in November 1940, but there were few further cases till June 1941 and a minor peak of 77 cases in July. Convalescence was noted to be slow, the average case requiring five to six weeks before return to his unit. It was noteworthy that no cases occurred in Greece and Crete and that most cases arose in 4 Brigade, which had suffered from the disease in the previous September.

Skin conditions accounted for a high proportion of minor sickness in unit lines and also for many admissions to hospitals, where their chronicity kept many beds occupied. Seborrhoeic conditions were especially troublesome and fungus infection was common at page 228 times. Desert sores were noted to be common in September, when bacteriological examination showed the common presence of haemolytic streptococci as well as staphylococcus aureus and diphtheroids. In hospital these cases cleared well with local sulphonamide, rest, and vitamins.

Dyspepsia was a common complaint, the majority of the cases being functional in origin, though there was a small proportion of ulcer cases, most of them with a pre-war history. Unfortunately, the careful investigation of these cases in hospital tended to fix the neurosis and few of the hospital cases were subsequently of any use in the Army.

Psychoneurosis became a major problem and appeared in many forms. The large majority of the cases arose at the base in men either with a previous history of nervous disorder or with an unstable personality which could not stand the strain of disruption from their civilian surroundings. Anxiety states were common but hysterical states were not often seen. Exaggeration of minor disabilities such as flat feet was noted. Colonel Spencer drew attention to the danger of implanting ideas of disability in the soldier.

In May attention was drawn to the prevalence of functional disorders of the eye, with signs of diminution of visual acuity, contraction of visual fields, blepharospasm, photophobia, and weakness of accommodation. In May 28 cases were seen at Helwan hospital. Half of them were severe, all with hysterical amblyopia, only four of whom had been in Greece. Of the other half six had some degree of hysterical amblyopia, and one had been in Greece and two Australians at Tobruk. Major Coverdale1 considered that these men were hysteria prone and that severe cases were seldom really cured, and their disposal was made difficult by the wide diversity of views on this matter held by the senior medical officers. He considered these men should not be exposed to combatant service since, at the best, they would be useless and a source of weakness in their units.