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Medical Units of 2 NZEF in Middle East and Italy

The Casualty Clearing Station

The Casualty Clearing Station

All CCS men will have clear memories of Gharbanyat, where they moved early in October after providing a staging post in the Delta on their return from Syria in June. Not that there was anything special about the area—it was much the same as the surrounding desert—but it will be remembered for the busy dramatic days that were spent there. Situated west of Burg el Arab and a few miles inland from the sea, the area was bisected by an extremely rough road deeply covered with a fine, creamy-coloured dust. From the camp site the barren desert sloped gently down to the main desert railway about a mile away, rising again to merge into a series of ridges and wadis stretching as far as the eye could page 222 see. On a clear day the dust of Army convoys moving up to the Alamein Line could be seen in the distance. In the broad monotonous panorama the only relieving feature was the tall chimney of a factory and a cluster of dusty palms down by the railway.

The weather in early October had become much cooler, and the first light rains of the approaching winter were experienced. Occasionally, thunderstorms typical of the Mediterranean coast provided vivid electrical displays at night. Strong winds were frequent and on at least two occasions caused severe sandstorms. During these storms the problem of keeping operating theatres and surgical wards clean and sterile can be imagined. Sand filtered everywhere. Visibility was restricted to a few yards, while in the dim light of closed, wind-torn tents it was impossible to read or write. All one could do off duty was to go to bed with a damp towel over one's head. One feature of the late autumn days spent preparing for the Battle of Alamein was the beauty of the rising and setting sun.

The general layout of the unit at Gharbanyat remained practically the same throughout the following months in the desert. The tented wards and all sections of the hospital were widely dispersed, for although it was expected that the enemy would respect the Red Cross no chances were taken, even though the dispersal caused some inconvenience and loss of time. In open desert the number of tents that constitutes a CCS, and the vehicles that are forever around it, present a fair target from the air. Despite the Red Crosses, enemy bombers could easily make a mistake, especially at night. Thus, at Gharbanyat, 100 to 200 yards separated most departments.

In the reception tent, where ambulances first arrived at the CCS, all admissions and evacuations were registered and controlled, while the pack store nearby was responsible for the storage and handling of patients' gear and valuables. The medical officer on duty at Reception decided whether patients required operation, whether they were to be admitted direct to a ward, or whether they were fit to travel on a stage further to some other unit. In the rush periods this medical officer was perhaps the busiest person in the unit, since he had also to visit the wards and arrange the evacuations. When ambulances arrived during his absence from the reception tent, he was summoned by two blasts of a whistle—or three page 223 for emergency. Many times the Reception whistle shrilled out over the calm midnight air.

Patients for operation went direct to the pre-operative ward where blood transfusions and other resuscitation aids were provided. From here they were taken by ambulance or carried on stretchers to the operating theatre. This consisted of two EPIP tents laced together, a part of one being partitioned off for X-ray. In later locations the X-ray department was part of the pre-operative ward. An ambulance was stationed at the theatre to transfer patients to wards immediately after operation. The ‘major surgical’ wards consisted of EPIP tents joined together, but most of the other wards were of the large, square, tarpaulin type. Beds were available in only one of the surgical wards; other patients lay on stretchers. In the early days of the desert campaign these were laid on the ground, making tiring work for sisters and orderlies dressing wounds. Later, petrol tins were salvaged and filled with sand and the stretchers placed on them. At Gharbanyat South African engineers graded a road from the reception tent, linking up the theatre with the wards. The staff slept either in their own departments or in small bivouacs close by. The MI Room, dispensary, and laboratory each had its own tents close to Reception, while the two cookhouses were conveniently sited.

Across the road and separated from the rest of the unit were the various QM tents—ordnance, ration, medical, linen, and Red Cross stores. Each morning they had to replenish stocks for the theatres and wards as well as replace breakages. Fresh linen was always in demand. A chapter could be written about activities in the linen store alone. The methods employed to meet the daily demand for sheets, guards, towels, and gowns were many and various. Oil drums were cut down to serve as wash-tubs. Washing had to be done daily. Shortage of water, insufficient fuel, high winds and sandstorms, and collapsing clothes-lines were some of the difficulties to be overcome. And ever the wards called for clean linen; at times it had to be rationed among them.

The unit had other small departments, too: the orderly room, the post office, the dental tent, and the workshop. Situated in a small stone hut, the workshop was a hive of industry, or at least it sounded like one when two of the unit's handymen, Len Lambourn and Vic Thompson, got to work on tins and oil drums. Both page 224 were kept busy answering SOS calls from wards and theatres. All manner of tasks were tackled; ingenious plumbing and clever carpentering produced many useful articles from benzine tins and old packing cases. The hygiene, transport, and general duties sections were other indispensable parts of the unit.

Although the unit officially admitted patients only every second day, it was usually necessary to open in the latter part of the closed day to take the overflow from 10 British CCS. For the first three weeks of October the daily average of admissions was approximately 120. Of these the majority were sick patients. It was essential to clear the hospital daily to make room for next day's admissions. 1 NZ MAC ambulance cars took patients to an ambulance train which left Gharbanyat station on most mornings at ten o'clock.

Because of a shortage of staff these heavy admissions kept the unit very busy, but all the while it also made preparations to deal with the even greater demands that the forthcoming battle would bring. Extra tentage was drawn, medical stores were built up, extra rations and Red Cross comforts obtained, while ordnance stocks such as stretchers and blankets were increased. As far as possible plans were made for emergencies and difficulties that might arise. At this time the unit resembled a military transit camp—there were so many new faces around. For a while a number of American Field Service volunteers were attached, as well as RASC and MAC drivers. Maj D. T. Stewart10 and the energetic team of the newly-formed 2 NZ Field Transfusion Unit were also with the CCS for some considerable time. In subsequent battles it was usual for the Transfusion Unit to work with the MDS which was admitting casualties.

The eight nursing sisters who had been with the CCS in Syria rejoined the unit during October. Glad to be back with the unit, they were extremely eager to share in the work, dangers, and discomforts that conditions in the desert would bring. Tents pitched in the open desert do not afford much privacy for women, and scrim was erected around a small area to form a compound. However, no special compound was ever provided again at the CCS.

10 Maj D. T. Stewart; born Wanganui, 3 Aug 1911; Pathologist, Christchurch Hospital; Pathologist 1 Gen Hosp Mar 1940-Jun 1944, except while OC 2 Field Transfusion Unit, Oct 1942-Feb 1943.