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Medical Services in New Zealand and The Pacific

CHAPTER 4 — Italy

page 121


I: Prisoners from Second Libyan Campaign

APART from the end of the campaigns in Greece and Crete, the two other occasions when large numbers of New Zealanders became prisoners of war were at Sidi Rezegh in November 1941 and forward of the Alamein line in June and July 1942. Some 2000 were taken on the first occasion and 1800 on the second, and most of them were later taken to Italy. From Libya in 1941, 15 officers and 182 other ranks of the New Zealand Medical Corps were taken to Italy, but in June and July 1942 the only members of the corps captured were 1 RMO and 15 other ranks of 5 Field Ambulance, the latter group in the break-out from Minqar Qaim.

In December 1941 the medical personnel from the captured medical centre near Sidi Rezegh were shipped to Italy, some staying at Crete on the way. Those disembarked at Taranto or Bari went to a transit camp on the outskirts of Bari, and those disembarked at Naples to a transit camp at Capua. In subsequent months they were dispersed to other camps. They arrived in Italy in the middle of winter into camps ill prepared to receive them and when the food supply of the Italians themselves generally was limited. Their discomforts were many – underfeeding, poor and overcrowded accommodation, insufficient clothing and extreme cold.

Most of the prisoners were housed in huts, though in the early stages some men were forced to occupy tents made of Italian ground-sheets buttoned together, and when snow lay on the ground conditions were miserable. Many of the huts were flimsy constructions letting in the wind and rain and without any heating. Straw mattresses and blankets, but sometimes only two, were provided, and men's clothing was limited to the little in which they were captured. Overcrowding was general throughout the camps, air space sometimes being as little as a third of that regarded as a normal standard, and sanitation arrangements were often primitive. Personal hygiene was difficult, with showers limited to about one a month and no change of clothes available. Camps were infested with lice. Sickness such as dysentery and pneumonia became common. Medical attention by the Italians was very poor and very few drugs or medicines of any sort were available.

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The diet supplied to prisoners of war in Italy was almost completely lacking in essential vitamins and poor in first-class proteins and fats. The daily food allowance (in grammes) was: bread, 200; meat, 34; macaroni and rice, 66; peas and beans, 30; sugar, 15; olive oil or lard, 13; cheese, 40; tomato essence, 15. The value in calories worked out at 1081, less than half the normal requirement. Had it not been for the distribution of Red Cross food parcels the general health and physical condition of all would have suffered severely. These parcels contained an excellent variety of concentrated foodstuffs with a calorific value of 12,000–15,000 calories. In some of the camps in 1942, however, Red Cross parcels were rarely received; one medical group received only one and a half food parcels per man in four months in Italy, whereas normally from the middle of February onwards the issue was one parcel to every four prisoners about every eight days. Without Red Cross foods all prisoners lost weight rapidly, felt the cold intensely, and had little energy for exercise. Cigarettes were issued only at infrequent intervals.

Medical facilities were inadequate according to New Zealand standards. At Bari camp, for instance, an Italian medical officer was in charge of the medical arrangements, and in spite of repeated requests, British medical personnel were not permitted to care for their fellow countrymen. Medical men were employed on labouring jobs when employed at all. Any cases of sickness of more than a minor nature were sent off to the local Italian hospital, at which British medical personnel were not allowed to work. Dental facilities were likewise inadequate. A New Zealand dental officer, Captain Skegg,1 with a few instruments which he had in his kit, did all the necessary temporary work and extractions under difficult conditions. Medical supplies, drugs and bandages were very scarce in medical inspection rooms, and efficient and adequate treatment often impossible. Red Cross medical comforts parcels were received occasionally and these helped to overcome the shortage to some extent.

Treatment of Wounded

Most of the wounded who were captured by the enemy in Libya in November 1941 were later released by our own forces, but among the prisoners taken to Italy there were some 200 New Zealanders who were wounded. Most of them were taken across the Mediterranean by hospital ship, some going into a hospital at Caserta and some to a hospital at Bari. At Caserta conditions seem to have been reasonably good as regards accommodation, and the Italian staff page 123 did their best. From December onwards three British medical officers and some orderlies were allowed to work in the hospital and were able to bring about improvements in treatment, although there were shortages of instruments and drugs. Red Cross comforts parcels were of great assistance as they supplied all the soap and supplemented shortages of toothbrushes and paste and toilet paper. During the period when the hospital was entirely staffed by Italians no attempt was made to wash any of the bed patients, and bed-sores were quite common. Sanitary conditions generally were inadequate, a state of affairs which the prisoners found to be common throughout Italy. Food in hospital was better than in the prison camps but was still far from adequate, but Red Cross food parcels provided supplements. Tea, sugar, margarine, chocolate, and condensed or powdered milk were the most appreciated items.

Other hospitals were no better, and in Bari hospital there were indications of neglect of prisoners and a definite shortage of food.

1 Capt W. P. Skegg; Auckland; born Wellington, 20 Dec 1913; dental surgeon; p.w. Nov 1941.

II: Prisoners from the Pre-Alamein Period

As a result of the battles in the Western Desert in June and July 1942 at Minqar Qaim, Ruweisat and El Mreir there were 1800 more New Zealanders captured by the enemy, among them some 231 wounded. The wounded left on the ground at Minqar Qaim were promptly treated by German surgeons, but at Ruweisat many wounded were left by Germans unattended at RAPs for some hours – in fact some of the walking wounded were able to escape to British lines under cover of darkness. It seems, however, that the Germans had a large number of their own casualties to treat and were handicapped by limited medical supplies, and that in later battles the seriously wounded were attended to promptly.1 At rear medical units the wounded were treated adequately and were admitted to hospitals at Matruh, Tobruk and Benghazi. Thence they were taken by hospital ships to Italy and went to hospitals at Caserta and Bari, which, with the sick from the prisoner-of-war camps in Italy, became overcrowded. Although wards were sometimes set aside in Italian military hospitals for British prisoners, the Italians found it necessary to set up special hospitals at Bergamo and Lucca in July 1942, and later at Bologna, Altamura and Nocera. At the same time most of the British medical officers and chaplains were transferred from officers' camps to the hospitals. Thus all the eleven medical officers at Camp 35, near Salerno, were sent to Lucca on 11 July to be employed in minor capacities. Orderlies were also sent to the hospital, which soon held 530 prisoner patients, with 13 medical officers and 104 orderlies to look after them.

1 British prisoners taken in North Africa were handed over to the Italians for custody.

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At Bergamo the hospital was housed in a large modern building with excellent equipment and a number of separate wards. British medical officers and orderlies treated the patients, but were still under Italian control. By the end of the year there were over 300 patients, mostly from Bari and Caserta. At Bologna a large school building was used; it also was well equipped and by the beginning of 1943 held 450 patients.

The overcrowding at Caserta hospital in the latter half of 1942 caused a considerable falling off in food supplies and medical attention. Although theoretically on a reasonable ration, the patients received only a fraction of it and, like all other prisoners, depended greatly on the food from Red Cross parcels. In November 1942, in spite of the transfer of over 400 patients, there still remained some 1300. At Bari hospital the food shortage was felt more acutely as no Red Cross parcels were delivered before May 1942.

The hospital building (Ospedale) at Lucca, where Captain Webster, NZMC,1 worked, was very old and had virtually no modern facilities. The wards were overcrowded, each ward holding about double the number of patients that we would consider desirable. Hot weather, bad drainage, infected wounds and innumerable flies made the smell almost unbearable. The Italian medical officers and orderlies did their honest best for the patients, but their best was not very good. Their knowledge of medicine, with a few exceptions, was 20 or 30 years behind ours. Their refusal to give British medical officers any position of authority was not only very galling but also greatly handicapped their efforts to help the patients. Slowly and gradually over the ensuing months, as a result of Italian inefficiency and slackness, the British medical officers were able to do more and more, until in the latter months they were doing almost all of the work, and most of the surgery was done by Captain Webster. This undoubtedly helped the patients, not only physically but also in their morale. With few exceptions the behaviour, discipline and morale of the patients were always worthy of the highest praise.

General equipment and supplies of drugs and dressings were satisfactory. The Italians always did their best to procure the special drugs required, but these naturally were not always available. Splints such as Thomas splints did not exist, but fortunately plaster of paris bandages were nearly always available. There was no special operating table, but in this and many other things the medical officers soon learnt to improvise with satisfactory results. The Italian treatment of fractures was poor; there was never any attempt at reduction of

1 Maj F. E. Webster; Auckland; born NZ 20 Jan 1903; medical practitioner; p.w. 28 Nov 1941; repatriated Sep 1944.

page 125 the fracture, the Italians simply allowing the bone to unite in any position of shortening, angulation or rotation. The later cases were treated by British medical officers with good results.

Food for patients was adequate but not too appetising – largely carbohydrates, but some meat every day. It was deficient in fats. For medical officers and orderlies the food was considerably less, again mostly carbohydrates and a small ration of meat twice a week.

It was literally astounding to the medical officers to see how rapidly large wounds healed after the arrival and distribution of the Red Cross food parcels. These gave the patients a welcome change of first-class and varied foods. They were likewise essential not only to the health but also to the lives of the orderlies. The rations for prisoners of war in Italy were inadequate to maintain life, and without these Red Cross food parcels very many prisoners would have slowly died of starvation. The ration issued was theoretically the same as that for base troops and Italian civilians, but whereas they had access to the ‘black market’ the British prisoners, with few exceptions, did not have this access, and in addition the full amount of their ration seldom reached them.

III: Repatriation of Prisoners

At intervals during their stay the medical officers captured in Libya made applications for repatriation of protected personnel. Towards the end of 1941 an agreement had been reached between the United Kingdom and Italy that either power could detain any protected personnel whose services were required to care for their fellow countrymen who were prisoners. Although very few British protected personnel were employed in looking after British prisoners, the Italian authorities were not willing to arrange any large-scale repatriation. In March 1942 they selected the four senior medical officers (Lieutenant-Colonels Twhigg, Tennent and Speight, and Major T. G. de Clive Lowe1) and twenty-seven orderlies and three amputees to be the New Zealand component of a party of 60 British sick and wounded and 69 protected personnel who were exchanged for 919 Italians in Smyrna harbour on 7 April. The medical officers informed the representative of the International Red Cross on the Italian hospital ship of the unsatisfactory conditions in the Bari camp, and in Egypt recommended that steps be taken to improve the knowledge of our forces in regard to the laws and usages of war on land in general, and to the Geneva Convention in particular, in order to reduce ill-treatment of prisoners and wounded of combatants on both sides. It was stated that in Libya there had been page 126 considerable illegal confiscation of personal equipment and effects belonging to prisoners, and medical work was hampered through misappropriation of transport and equipment of field medical units.

The crowded state of the hospitals led to amputees and other disabled men being discharged to a camp soon after their wounds were healed. Most of these men and other serious cases had their names sent forward by our medical officers for submission to the Mixed Medical Commission. After the first small repatriation of April 1942 the Commission continued with the examination of cases brought to its notice. Unfortunately some local camp commandants prevented a number of prisoners suitable for repatriation from seeing the Commission.

After protracted negotiation, on 19 April 1943 at Smyrna 150 sick and wounded, including 44 New Zealanders, were exchanged for 1211 Italians, while at Lisbon at the same time there were 15 New Zealanders in a party of 430 British repatriated to the United Kingdom. At Smyrna further exchanges were made. On 9 May 150 sick and wounded (12 of them New Zealanders) and 350 protected personnel (96 of them New Zealanders) were exchanged for 2400 Italians, and on 2 June 140 sick and wounded (4 of them New Zealanders) and 290 protected personnel (6 of them New Zealanders) were exchanged for 2676 Italians.

There still remained in Italy a number of amputees and eye and tuberculosis cases, but a further exchange arranged for the autumn was prevented by events at the time of the armistice. On 8 September 1943 an Italian train with over 100 prisoners for repatriation left for Lisbon for exchange with 550 Italians, but the train fell into German hands and was not allowed to proceed; some of those on board were sent back to their camps and others to a hospital at Treviglio. In spite of British Government requests the German authorities refused to allow the sick and wounded to go on to Lisbon, and in addition refused to recognise the findings of the Italian Mixed Medical Commission, stating that the men would have to be medically boarded again in Germany.

In 1943 prisoners in the south of Italy were steadily moved north and in mid-1943 the hospital patients at Nocera and Altamura were transferred to Milan. Though moved out of the danger zone of Allied landings, they were then more exposed to Allied air operations. A hospital was set up in a school building opposite a factory in central Milan, and on 13 August during a bombing raid the building was wrecked by blast, a number of prisoners losing their lives, including three New Zealand medical orderlies. Along with all other prisoners, patients were taken from Italy to Germany after the Allied invasion of Italy, most going to Lamsdorf or Spittal, at least some of the seriously disabled being taken by hospital train.

1 Maj T. G. de Clive Lowe; Auckland; born Auckland, 17 Sep 1900; surgeon; medical officer 5 Fd Amb Dec 1939–Dec 1940, Aug-Nov 1941; p.w. 28 Nov 1941; repatriated Apr 1942.