War Surgery and Medicine
This hospital, opened on 13 October 1941, was planned to serve the needs of over 30,000 men and was undoubtedly the best designed and equipped hospital for British prisoners of war in Germany. It occupied six acres of flat land in a forest, and its eleven concrete buildings were fitted with double windows and wooden shutters. In every room was a large, efficient tiled stove. Six buildings were self-contained parallel blocks of wards, each holding from 70 to 100 patients. The five service buildings were the staff, administrative, and treatment blocks, kitchen and morgue. In the area was a large brick Red Cross as a sign for aircraft.
The ward blocks were divided into large and small wards with service rooms and with the necessary sanitary conveniences as in a modern hospital. The operating theatres were well equipped with efficient sterilising and full X-ray and laboratory facilities. Although the overall control was in the hands of a German medical officer, full control of the clinical work was given to the British, Australian, and New Zealand medical officers working under a senior British officer. The nursing staff, all medical personnel among the prisoners of war, lived at the hospital, while a daily party of general duty men was drawn from Stalag VIIIB, a mile away. There was a German chief dispenser in control of the stores, but otherwise the staff of the service departments was British. Besides physicians and surgeons there were anaesthetic, ophthalmic, radiological, neurosurgical, psychiatric, and ENT specialists available, either on the regular staff or visiting the hospital from time to time.
A Mixed Medical Commission of one German and two Swiss doctors visited the hospital twice a year to inspect it and also to determine which patients should be repatriated. At first the Germans insisted on all the preliminary investigation being carried out by German staff, thus necessitating the temporary transfer of the patient to a German hospital. Later the clinical reports of the British staff were generally accepted. Full case records were kept, with copies available for the Germans and the original for the United Kingdom, German forms being used. Admissions from the camp were arranged from a waiting list drawn up by the senior physician and surgeon at consultation clinics in the camp, and urgent cases were admitted at any time. Special accommodation was provided for the infectious and mental cases. page 468 The rations supplied by the Germans were meagre, but the Red Cross parcels enabled a satisfactory diet to be maintained, and four meals a day were served in the wards from a communal kitchen.
Entertainment and sport were permitted freely. In general, the Germans appear to have provided an excellent hospital with all supplies satisfactory except the rations, and allowed the British medical personnel to carry out their work with a minimum of control.
Surgical Work: Captain Slater, NZMC, was chief surgeon at Lamsdorf from October 1941 to March 1943 and developed the surgical service. A record of eleven months' work (March 1944 to February 1945) kept by Captain J. Borrie shows that 373 patients were admitted to one of the two surgical blocks. The patients were thoroughly investigated and records carefully kept. The majority were cases of appendicitis, hernia, rectal and genito-urinary diseases, orthopaedic problems, and nerve injuries. Simple fractures and late effects of septic gunshot wounds were common.
Peripheral nerve injuries were operated on by a visiting British neurosurgeon. Herniorraphy was performed under local anaesthesia, and the Germans finally agreed that none should work for three months after such operations. Deep X-ray therapy was administered for malignant cases at the University clinic in Breslau. In 1944 an inter-medullary nail was used with good primary results at the Breslau hospital in a case of mal-union of the femur. For the fracture cases excellent walking calipers and other splints were made by RAMC men from material obtained from Red Cross or German sources. Altogether opportunity was available for the performance of efficient surgical work.
The 432 complaints treated in the 373 patients were: appendicitis, 63; hernia, 50; fractures, 61; genito-urinary, 62; alimentary, 23; rectal, 6; peripheral nerve injury, 29; orthopaedic, 25; spinal disease, 13; joints, 26; osteomyelitis, 25; muscle and tendon, 3; tumours, 13; ENT, 7; minor surgery, 25.
Medical Supplies: There was in Germany the equivalent of most standard British medical preparations in the way of lotions, powders, solutions, ointments, anaesthetics, and sedatives. These were indented for by British medical officers and were apportioned out from central stocks by German dispensers. Some of the earlier sulphonamide drugs (sulphapyridine and sulphathiazole) were supplied to British medical officers by the Germans, but a German sulphaguanidine preparation was not available. Penicillin, of course, was not available.
Throughout the war the German supply to hospitals of cotton bandages, cotton wool, and dressings was inadequate, the standard page 469 issue being paper bandages and paper wadding which were also used for German casualties in base hospitals. The paper dressings were useful as they were absorbent, but the paper bandages were unsatisfactory. Fortunately the British Red Cross sent liberal supplies of bandages, cotton wool, and lint in their medical parcels for prisoners of war.
Medical Equipment: The original hospital instruments consisted of German field hospital panniers, which were not unlike British surgical panniers. In some hospitals, as at Lamsdorf, the Germans issued a sigmoidoscope, a cystoscope, and instruments for laparo-tomy, thoracotomy, spinal anaesthesia, wiring fractures, and plaster work. For intravenous work the Germans had a very useful 2 c.cm. syringe with a side inlet on the barrel. Suture needles were usually of the French or split eye variety. Record syringes and needles were available in all sizes. Silk, cotton, or catgut were used for suturing, and Michel clips were obtainable for skin. Blood transfusion sets had to be improvised. In general the equipment supplied was adequate for most surgical operations done, including even excision of semi-lunar cartilages from the knee joint, and partial gastrectomy.