New Zealand Medical Services in Middle East and Italy
Work at Base Hospitals
Work at Base Hospitals
The heavy actions fought by 2 NZ Division from 27 June onwards resulted in a large number of battle casualties, and the trying conditions also produced a relatively high sick rate. The only New Zealand hospital able to admit patients from the forward areas was 1 General Hospital as 3 General Hospital was in Syria; and 2 General Hospital's setting up at El Ballah was postponed by GHQ MEF until near the end of July, when it was fairly certain that the enemy was being held at El Alamein.
The first casualties arrived at 1 General Hospital on 30 June, and during July 444 battle casualties were admitted, some coming by ambulance train from Alexandria and some by ambulance planes direct from the main dressing stations. Ambulance planes at first arrived at Heliopolis aerodrome, some 40 miles from Helwan, but it was later arranged for New Zealand patients to be landed for a time at Helwan aerodrome, only a mile from the hospital.
Many New Zealanders were admitted to British hospitals in Alexandria and in the Canal Zone, especially prior to the opening of 2 General Hospital on 29 July. On 20 July there were 752 New Zealand patients in British hospitals in the Canal Zone, but many of these were transferred to 2 General Hospital in the same locality early in August. This hospital, when established, also received casualties direct from the battle area.
At 1 General Hospital it was found that the condition of battle casualties on arrival was excellent in most cases, owing to the efficient treatment received in forward areas. Air evacuation was a noteworthy improvement. Most wounds were clean on arrival at Helwan, although five cases of virulent anaerobic infection, including three cases of gas gangrene, were encountered. In the treatment of uninfected wounds the closed plaster method was used as little as possible. Local sulphonamide insufflation, tulle gras, and frequent saline dressings were used. This involved more work for the nursing staff, but the results were good and early skin grafting and secondary suture were possible. During August there were opportunities of effecting wound coverage by the use of Thiersch grafts, thereby accelerating healing, reducing fibrosis, and reducing the period of hospital treatment by many months in some cases. The saline bath unit was found to have a very wide sphere of usefulness in the page 352 treatment of battle casualties. The amputations were all done in the forward areas, and good results followed the cutting of unsutured flaps and the application of skin traction. Most wounds were due to bombs and shells, and there were relatively few bullet wounds. For this reason wounds with gross tissue loss were frequent and multiple wounds often occurred. Blast effects were common, including ruptured tympanic membrane, haemothorax, and cerebral concussion. The burns were mostly petrol burns due to trucks being set on fire by enemy action.
After arriving at El Ballah at the end of July, 2 General Hospital rapidly got into its stride and the surgical arrangements were very satisfactory. The wounded seen by the Consultant Surgeon at the hospital in August seemed to have developed more infection than those admitted to 1 General Hospital, possibly owing to the more frequent transfers from one hospital to another. Cross infection and infection during dressings was a factor in all cases with large surface wounds. Steps were taken to counteract the possible spread of infection by the provision of extra surgical equipment such as dressing forceps, and the adoption by sisters and orderlies of an improved aseptic technique.
At Beirut in Syria 3 General Hospital received only a few battle casualties from the Western Desert by ship, although the hospital, functioning practically as a British hospital, was kept very busy with local admissions, which were mainly medical. Admissions for the three months, July to September, came to the large total of 5234. Of these only 592 were 2 NZEF troops.