The New Zealand Dental Services
CHAPTER 16 — A Roving Commission
A Roving Commission
APART from the Division and the troops at the Base, there were other New Zealanders in the Middle East such as Army Troops, Mechanical Equipment Companies and Survey Batteries. On many occasions these were separated from the New Zealand command and were used by the British Army. From a dental point of view, however, they were still the responsibility of the NZDC, and as they were scattered over a wide area, became a problem to service. A complete sub-section was therefore recalled from the Mobile Dental Section to Maadi Camp, where it was more fully equipped and given instructions to go to Transjordan and Palestine, find these men and treat them. The sub-section was under the administrative control of the ADDS but could be given only broad instructions and had to rely on personal initiative to complete the task. It was instructed to go via Jerusalem and Amman to Aqaba, where it was expected to find 21 NZ Mechanical Equipment Company.
The section, under the command of Captain H. G. Lynch,1 left Maadi on 1 December 1941 and the story of the next eight weeks reads like a tale of the North-West Mounted Police ‘getting their man’. It is best told in the words of the Officer Commanding the section:
On 2 December 41 we reached the Egyptian-Palestine frontier and camped. Both that night and the following day exceptionally heavy rain fell and we suffered a delay of several hours at Beersheba where the bridge was washed away. Travelling with a convoy via Gaza and El Ramele we reached Jerusalem on 3 December. Next day I went to the Hotel David only to discover that Force Headquarters had moved and the remaining staff knew nothing of the whereabouts of NZ troops in Trans Jordania or Palestine. I got a map of Trans Jordania and on 5 December set out for Akaba via Amman where we stayed the night at the R.A.F. station.
On receiving assurances that the main Amman-Maan road was in good order we left for Maan but again the weather upset our plans. Some 30 miles south of Amman terrific rains forced me to turn the truck west and out of the Wadi which was fast becoming a river. That night, after some difficulties, we reached Kerak in the hills and stayed at the barracks of the Arab Legion. Despite the language difficulty, these people did everything possible to make us comfortable. Rain persisted all that night and the page 209 following day so that we could move neither backwards nor forwards. Next day, 8 Dec., I made contact with two RASC trucks which had been marooned at Quatran and we decided to try and get to Maan via Tifilia—the main road being completely impassable.
After a difficult day, pushing each truck in turn, we reached Mazer, a distance of only 30 miles. Again we stayed at a fort of the Arab Legion of whose kindness and hospitality I cannot speak too highly. The following day, conditions being greatly improved, we arrived at Maan staying the night with the Trans-Jordan frontier force. Even that part of the journey was not without trouble as the heavy going raised our petrol consumption and although I managed to buy 4 gallons from a native store we had to pool all our petrol to get the three trucks as far as Shoback, 30 miles from Maan. All the remaining petrol was then put into one truck which went on to Maan and returned with supplies for the others. At Maan I found that part of the 21 ME Coy was at Naqb Ashtar, about half way between Maan and Akaba, and I reached this camp on 10 December setting up my tent there…. Severe storms prevented work next day—the camp is at a height of 4,000 feet—but since then conditions gradually improved and I hoped to go on to Akaba about 16 December.
At Naqb Ashtar I completed, amid rain and snow, as many of the [men] as were available and, still in the rain, slipped down the steep face of the Naqb to the Great Red Plain of Guweira, now a vast sea of mud. After some 15 miles of this the truck foundered in a hole….
Our puny efforts to push it out were unsuccessful so we sat down to await the arrival of a large truck that I knew to be following. To this we tied the little Bedford truck and, like a child dragging a toy in the gutter, it towed us across the plain to the hard stony ground at the head of the Wadi Ithm, whence a very rough track lead to Akaba….
It was at Akaba that I met an English Officer in charge of Royal Engineers stores who needed dental treatment urgently. In return for my treatment he provided us with piping and canvas from which we made a canopy for the truck. This … was the only way I could get some cover which was essential if we were to continue to travel through these stormy lands….
All work here was completed and, as the road was again passable, we left Akaba on 29 December getting back to Naqb Ashtar without assistance. Here they had collected the untreated men of the repair section and when these had been made dentally fit we left for Amman on 31 December.
As the weather had been fine for some days and after consultations with a very odd Arab-living Englishman, Abu George, I decided on the route via the Wadi Hasa. This would cut out the mountains of the Kerak route but, in case the rain caught us in this lonely desert, I arranged with the OC Trans-Jordan Frontier Force at Maan to have us checked through his forts on the way. If anything went wrong they were to come out and look for us. We were fortunate and after travelling over the worst road I have ever seen, reached Maan that night. Next day, 1 January 42, I left Maan in heavy rain in search of the 36 NZ Survey Battery known to be somewhere in the Jordan Valley and was lucky enough to cross the bridge at Es Salt a few hours before it was washed away. As we neared Jericho we saw a group of New Zealanders across a flooded stream which we forded without trouble and were directed to the Survey Battery's camp higher up the Jordan Valley.
The weather was execrable—Jerusalem was under snow—but I completed the work on the Battery by 9 January and set out in search of No. 1 Section of 21 ME Coy, who were on the Haifa-Bagdad road in Iraq. Rain made it page 210 useless to try to cross the desert to Marfrak so I spent the night in Jerusalem. After refuelling at the Allenby Barracks we set off for Nablus on the minute and implicit directions of a Military Policeman. When the sun came out and the shadows were seen to be lying exactly the wrong way we found we were nearly at Hebron so returned to Jerusalem and tried another M.P. Again the careful instructions with the result that we started on the road to El Ramele and Egypt. Finally broken English and the greater accuracy of the local police got us to Nablus in the pouring rain and we spent a night and day in a small Australian Camp waiting for the weather to improve.
Leaving next morning on the long run to Marfrak we were lucky to meet a NZ truck on the shores of Lake Tiberius and receive our exact location otherwise we might not have got to Marfrak that night. The next day our route was across the dreadful black desert of Iraq to the Iraq Petroleum Company's pumping station H.3. Here the NZ troops were so scattered that I used the truck as a taxi to bring them in for treatment. Bitter winds and terrific frosts made working conditions unpleasant but the Petroleum Company's officials kindly lent me a room in one of their huts.
From H.3. we moved down along the pipe line to G.1. and completed treatment for the 21 ME Coy, leaving for Haifa on 17 January to find the Headquarters Section of that Company. Severe dust storms and later heavy rain delayed us and night found us at Tiberius…. Here for the first time the truck gave serious trouble. Two spark plugs gave out and there being no 14 mm plugs to be got we had to crawl over the hills to Haifa which we reached in the afternoon…. After much difficulty I got authority from Ordnance at Haifa to get plugs from a Depot on the road to Tel Aviv. Here they only had 18 mm plugs so I accepted them in the hope of trading them in Tel Aviv which we reached on 20 January. We had no success in Tel Aviv but left the following day for another Depot at Sarafand. We caught them before breakfast and bemused for they swapped the plugs with not a form to sign. At our best four-cylinder speed we hurried away lest they awake and begin the usual delaying action, stopping a mile or so down the road to fix the truck.
Our work in Trans-Jordan, Iraq and Palestine was completed and we set course for Beersheba and across the Sinai Desert to the canal. We reached it in darkness but the Australians when they recognised us threw their bridge across allowing us to reach the road staging post that night. Next morning we left for Maadi reaching there at 1400 hours on 23 January 42.
This was an example of how the whole service was built up as a combination of small self-contained units. It showed how a dental section could perform all the functions of a Camp Dental Hospital or a Mobile Dental Section on a smaller scale. It was the smallest unit in the Corps that could function in other than emergency work, and it is interesting to note that while this sub-section of the Mobile Dental Section was on its roving commission, the word ‘sub-section’ as applied to the Dental Corps in the Middle East went out of existence. The Mobile Dental Section became 1 NZ Mobile Dental Unit, consisting of a Headquarters Group and a number of sections.
Another Administrative Battle
In early February 1942 the control and command of the Mobile Dental Unit again became a bone of contention between the ADMS and the ADDS. The ADMS was adamant that he should be in full command of the unit and the ADDS was just as determined that the unit should be, firstly, part of the main dental organisation, and secondly, subject to the control of the ADMS when attached to the Division. The argument was bitter and it would seem unnecessary. A ruling had already been given by Headquarters 2 NZEF (see p. 162). This headquarters, while recognising that a degree of co-operation would have solved the problem, had to seek a solution which would restore harmony whilst still carrying out the intention of its policy. The obvious link between the antagonists was the DDMS, to whom both were ultimately responsible. The ADDS was his adviser on dental matters and the ADMS his deputy within the Division. Certain additions were therefore made to the ruling which emphasised the ultimate responsibility of the DDMS and channelled the decisions of the ADDS and the ADMS through him:
The Mobile Dental Unit is intended to serve the NZEF as a whole and will therefore from time to time be moved where it can most usefully carry out its duties.
The decision whether the Mobile Dental Unit or part thereof is to be attached to NZ Division or to be withdrawn from NZ Division rests with the DDMS and it is for him to say at what stage attachments are to commence or cease. The ADDS is the adviser of the DDMS in this as in other matters.
When NZ Division is under orders to move from one location to another it will be the responsibility of the ADMS to raise with the DDMS the question whether or not the Mobile Dental Unit or such part of it as is attached to NZ Division is to move with the Division.
This gave the ADDS a stronger position and more control over the maintenance of dental health in the force.
No. 2 Mobile Dental Unit is Formed
The number of troops in Maadi Camp was getting less and it was found that one of the three dental hospitals could not be kept fully occupied. On the other hand, within the 2 NZEF there was too much work for the number of dental officers, the greater part of it being for units in the field. No. 1 NZ Mobile Dental Unit could be kept fully occupied with the Division but more was needed to attend to NZEF units elsewhere, such as railway units, Army Service Corps units, Army Troops and Mechanical Equipment companies and other small non-divisional units.page 212
It was recommended, therefore, by the ADDS that 2 NZ Camp Dental Hospital should be disbanded and 2 NZ Mobile Dental Unit formed in its place. Should large numbers of reinforcements arrive in the future the Mobile Unit could always re-form as a camp hospital, or, as dental personnel arrived, a new hospital could be formed.
Authority was granted on 12 March 1942 for the unit to be formed and Headquarters 2 NZEF guaranteed to produce the necessary transport, a matter which had been causing some concern. Major B. H. K. Young,1 who had previously been in command of the Base Depot Dental Hospital, was given command. At the same time 2 NZ Camp Dental Hospital went out of existence and its commander, Major B. Dallas, took over the Base Depot Dental Hospital from Major Young.
By the end of April 1942 the unit was equipped and staffed and by the end of May was ready for operation although, at this time, it was only built up to about 60 per cent of its full strength. By the time it was ready for work the tactical situation was such that it was kept on a tight rein and allowed no farther into the Western Desert than Mersa Matruh.
Dental Condition of the Force
It is convenient at this stage, after the withdrawal of the Division from the Libyan campaign and before following it farther, to take stock of the results of the work of the Corps. In his report of 1 February 1942 the ADDS states:
With the exception of 5 Brigade Group, which is at present under treatment, the entire Force is virtually dentally fit.
A most striking feature is the almost complete absence of Acute Ulcerative Gingivitis and Stomatitis (Trench Mouth) a condition which is prevalent in all Forces in the Middle East other than the 2 NZEF.
The 2 NZEF is probably in better condition dentally than other Forces in the Middle East and, in general, all men with carious teeth have had them filled. Furthermore, mouths are inspected regularly and maintained in healthy condition. Since all Forces in the Middle East are living under similar conditions it would seem as if the predisposing cause of the disease is mainly the presence of either salivary calculus or carious teeth which, by lowering the resistance of the gum tissue locally, provides a home for the pathogenic organisms to flourish and multiply.
Regarding trench mouth, it is interesting to note the precautions, other than those mentioned in the above report, taken by the NZDC to prevent an outbreak and to compare them with those taken by the Army Dental Corps attached to the Royal Air Force.page 213
In the NZDC every case was treated by the Dental Officer but was also reported to the Medical Officer, with a recommendation that it be strictly isolated. In addition to this it was recorded on a dental history sheet which was sent to Headquarters for attachment to the soldier's personal file. Any suspected outbreak was reported immediately to the ADDS, with reasons for the suspicion and details of the steps being taken to prevent further spread of infection.
The Dental History of the Royal Air Force published by the Air Ministry in September 1947 states:
The importance of being prepared for outbreaks of this disease when personnel were living under war time conditions was realised. The difficulty of deciding what constituted an outbreak was overcome by making all dental officers report if seven or more persons in any one week developed the disease. Vigorous measures were planned to control outbreaks and a special team consisting of a dental officer experienced in the treatment of diseases of the gums and two dental hygienists was formed to be sent to any station on which an outbreak had been reported. Extra dental hygienists were available if required. However, as this team was only formed in 1943, treatment before this date was undertaken by unit dental officers with such extra assistance as could be provided. Fortunately outbreaks were so seldom encountered that only on four occasions was the team required.
Constant vigilance was common to both Corps and the elimination of salivary calculus was recognised as one fundamental in the prevention of the disease. The British service recognised this by the employment of dental hygienists and the NZDC by repeated emphasis in instructions to dental officers. Seven cases in one week in one unit would have created a state of extreme urgency in the NZDC. Apart from this, the elimination of caries was a large contributing factor in the prevention of the disease. The NZDC had to work at high pressure to achieve this result and it was working on the ratio of one dental officer to 1000 men, while the ADC with the RAF was working in June 1940 at 1 to 1250 and from January 1943 onwards at 1 to 1375. On some stations, of course, where there were possibly only 1000 men, the ratio would be exceeded by the ADC, but over-all, and taking into consideration the larger proportion of natural dentitions in the RAF compared with the New Zealand Forces, it would appear that there could not be such a complete elimination of caries.
The work done by the NZDC to achieve this happy result during the twelve months 1 February 1941 to 31 January 1942 is as follows, the corresponding figures for the previous twelve months being given in parentheses:page 214
|Number of men examined||66,739 (14,347)|
|Number requiring treatment||36,083 (10,170)|
|Number rendered dentally fit||28,785|
|Number of fillings||33,468 (6,657)|
|Number of extractions||5,401 (Not available)|
|Number of dentures, new or remodelled||5,694 (1,297)|
|Number of denture repairs||5,222 (1,308)|
|Total denture cases||10,916 (2,605)|
|Maxillo-facial cases: Number treated and discharged||36 (12)|
In view of the fact that 67,000 men were examined during the year it can be assumed that most men in the force were examined at least twice.