New Zealand Medical Services in Middle East and Italy
CHAPTER 15 — Administration in Italy, November 1943–December 1944
Administration in Italy, November 1943–December 1944
THE administrative units of 2 NZEF were primarily concerned with the organisation for the efficient functioning of 2 NZ Division. When the Division moved to Italy and it became apparent that it was committed to a long campaign, the separating expanse of the Mediterranean Sea made administration from Egypt difficult. Not the least important difficulty was the delay in reaching decisions, in spite of the use of the air service for mails and for liaison visits by senior officers. On 22 November, at a conference in Maadi Camp, the decision was made for HQ 2 NZEF and additional units to move to Italy about the middle of January 1944.
The medical units concerned were DMS Office, the Consultants, Principal Matron, 2 General Hospital, Detachment 1 Convalescent Depot, Medical Stores Depot, and detachments of Base Hygiene Section and 23 Field Ambulance (1 Camp Hospital). The last was to form a camp hospital at Advanced Base. At this time both 3 General Hospital and the main body of 1 Convalescent Depot had gone to Italy.
After the transfer of all these units to Italy only 1 General Hospital, 23 Field Ambulance, Base Hygiene Section, and 1, 2 and 3 Rest Homes remained in Egypt. It was not long before 1 General Hospital was subdivided into two, with the larger section proceeding to Italy and the smaller section remaining at Helwan as 5 General Hospital. The general base medical administration in Egypt then became the charge of the Senior Medical Officer, Maadi Camp, Lieutenant-Colonel Kronfeld, who was also OC 23 Field Ambulance and was responsible to DMS 2 NZEF.
Of the units involved in the transfer from Egypt to Italy at the end of 1943 and the beginning of 1944, the first to cross the Mediterranean was 2 General Hospital, the main body of whose staff sailed from Port Said on 3 January 1944. There were difficulties about shipping arrangements and the staff had to be split into two parties, while the equipment was loaded on yet another ship. It was planned page 568 by DMS 2 NZEF to locate the unit in the seminary buildings at Molfetta, a seaside town about 16 miles north along the Adriatic coast from Bari, to relieve the strain on 3 General Hospital. The switch of the New Zealand Division to the Fifth Army front at Cassino, and the inability to obtain possession of Molfetta, led to a sudden change of plans and, as was stated in the previous chapter, the hospital was established at Caserta, near Naples.
To establish a camp hospital at Advanced Base at San Basilio, between Taranto and Bari, fifty beds and other equipment were sent to Italy from 23 Field Ambulance at Maadi. The staff for the new unit, mostly posted from the staff of the parent unit, went to Italy early in January. The staff remaining at Maadi was able to cope with the fewer patients admitted.
The other units arrived at Taranto on 25 January 1944 and went to Advanced Base at San Basilio, except Detachment 1 Convalescent Depot, which rejoined its parent unit at Casamassima after a separation of ten months, and the Principal Matron, who stayed temporarily at 3 General Hospital. On 2 February HQ 2 NZEF, including DMS Office, the Consultants, and Principal Matron's Office, moved from Advanced Base to San Spirito on the Adriatic coast, some 6 miles north of Bari, and all were quartered in buildings. They remained in this location until September when they moved 300 miles up the coast to Senigallia, north of Ancona, at the time when the Division was switched back to the Adriatic coast after the capture of Florence. Arrangements were also finalised for the transfer of 1 Convalescent Depot from Casamassima to San Spirito. This latter move, however, did not take effect until 25 March.
Meanwhile, on 25 February Allied Force Headquarters made the request to DMS 2 NZEF that 1 General Hospital be brought to Italy in view of the coming malaria and dysentery season, when it was anticipated that every hospital bed that could be made available in Italy would be required. After discussion it was agreed that a 600-bed hospital should be despatched, but that a section sufficient to run a 300-bed hospital be left at Helwan to service troops still in Maadi Base Camp. The retention of a base general hospital was essential, especially as reinforcements were still being landed in Egypt from New Zealand. Preliminary orders for the move of 1 General Hospital were given on 28 February, but the move did not take place until the beginning of April, when the unit (with 101 VDTC attached) was transferred from Alexandria to Taranto by hospital ship. The unit then moved into the seminary buildings at Molfetta, which had finally been made available by the Vatican after a good deal of negotiation at the highest levels. (Shortly afterwards 101 VDTC was attached to 3 General Hospital.) When page 569 established the hospital provided a measure of relief for 3 General Hospital which had been holding over 1000 patients.
Hospital Ship Policy
After the first divisional operations in Italy in November 1943, battle casualties were evacuated back to 3 General Hospital, Bari, as the base hospital in Italy. From here long-term cases, especially those likely to require invaliding to New Zealand, were transferred to Alexandria by hospital ship and thence by ambulance train to 1 General Hospital, Helwan. Special arrangements had to be made for a hospital ship service between Bari or Taranto and Alexandria, as the majority of British invalids went from Italy to Sicily, Algiers, and thence to England. After February 1944 all invalids, including battle casualties from the Cassino operations, were retained in Italy for embarkation direct to New Zealand on hospital ship at Taranto.
On 21 March 1944 HS Maunganui called at Taranto and filled about half her berths with invalids for New Zealand, and then called at Port Tewfik where she completed her load with invalids waiting in Egypt to return home. This was the practice adopted from then on. This policy avoided transhipment of seriously wounded from Italy, facilitated changes in the staffs of hospital ships, and enabled medical reinforcements and Red Cross comforts to be shipped to Italy without delay.
A measure of detailed liaison was necessary between DMS 2 NZEF and SMO Maadi Camp to ensure the best loading of hospital ships between the two sections of 2 NZEF. Evacuation of invalids by hospital ship was controlled by DMS 2 NZEF, and to provide for adequate liaison and the training of the staff of SMO Maadi Camp in the important details of evacuation an NCO was temporarily detached from DMS office to the SMO's office when the staff of DMS 2 NZEF first went to Italy. Liaison was most necessary to ensure that the right total of special classes of patients, e.g., women, mental cases, tuberculosis cases, lying patients and walking patients, were embarked from the two ports. Selection was necessary in both Italy and Egypt as the number of invalids awaiting evacuation almost invariably exceeded the capacity of one hospital ship. Sometimes two small hospital ships could have been filled when only one was available. A result of this was that many invalids had recovered sufficiently to be able to be returned by ordinary transport during the sometimes considerable wait of several months for hospital ship accommodation. A ‘build-up’ of invalids awaiting return to New Zealand had occurred following the breaking of a tailshaft by HS Maunganui when she called at Tripoli on 17 October 1943. This accident necessitated her travelling to England for repairs and she page 570 was not again available until March 1944. Thereafter, except for her period of attachment to the British Pacific Fleet in 1945, the Maunganui made regular trips between Italy and New Zealand, and occasional trips were also made by NMHS Oranje and HS Wanganella.
The accommodation of the three hospital ships serving 2 NZEF during late 1943 and 1944 was: Maunganui, 368 beds, Wanganella, 548 beds, and Oranje, 750 beds, later increased to 869. The Wanganella was lent by the Australian Government to fill the gap created by the breakdown of the Maunganui and she made three trips at this period. Numbers of the patients embarked at the end of 1943 were Australians, who along with many New Zealanders had been recently repatriated from Germany in an exchange of prisoners of war. The Oranje, staffed mainly by New Zealand personnel at this stage, made a trip to New Zealand at the end of 1943, but the next one was not made until July 1945. As part of the Allied shipping pool she was mainly engaged in the transport of British invalids from Italy and the Middle East to South Africa or the United Kingdom. The Maunganui was back on her normal run by March 1944. All three ships had first-class accommodation and equipment, which ensured the greatest comfort for our casualties.
With the transfer of three base hospitals and the Convalescent Depot to Italy in addition to the field medical units and casualty clearing station, the medical layout of 2 NZEF was similar to that adopted in Egypt and North Africa. The New Zealand units formed a complete chain, thus enabling most of the sick and wounded New Zealand soldiers to receive continuous treatment within their own units. As a matter of fact the percentage of New Zealand patients admitted to other than New Zealand hospitals during the campaign in Italy was much less than had been the case in some of the Western Desert operations. When lines of evacuation were long, as from the operations south of Florence and from the Trieste area, use was made of air transport from the Casualty Clearing Station to the nearest New Zealand base hospital. There were, however, small numbers of New Zealanders in British hospitals at Rome from time to time when their journey from northern to southern Italy was broken at that city. Many New Zealand patients were also admitted to British medical units during transit from the Division to the base hospitals, especially during the battle for Florence, and to a lesser extent at the Sangro. Moreover, the New Zealand medical services were glad to avail themselves of the special facilities offered in British and American hospitals for the treatment of head and faciomaxillary cases, a few chest cases, and a few mental patients.page 571
The only medical units in Egypt not transferred to Italy were the rest homes, which had very small staffs and served a useful purpose in Egypt, particularly 2 Rest Home for other ranks at Alexandria. In Italy an arrangement was made for certain convalescent officers discharged from 3 General Hospital to stay at the New Zealand Forces Club, Bari, without payment of fees during their convalescence. Later, use was made of the British Red Cross rest home for sisters, nurses, and officers established in February 1944 at Fasano, near Brindisi. Similar arrangements to utilise British Red Cross homes at Sorrento and Loreto were made by 2 General Hospital and 1 General Hospital at their locations of Caserta and Senigallia respectively.
Leave camps were organised in several areas and were freely utilised. Some were organised by divisional units, some by hospitals, and some by the YMCA. No. 3 General Hospital established one at Putignano, on the coast south of Bari; 2 General Hospital established one on the island of Ischia in the Bay of Naples and also rented some houses on the Sorrento peninsula at Positano. These camps did much to improve the health and preserve the morale of the troops.
Throughout the period in Italy 3 General Hospital remained the main base hospital, having the best accommodation and being capable of expansion up to 1200 beds. It was from this hospital that all evacuations of invalids from Italy to New Zealand were made.
Tour by Director-General of Medical Services
The transfers of medical units between Egypt and Italy had (except for the move of 1 General Hospital and 101 VDTC) been completed by the time of the tour in March of the Director-General of Medical Services (Army and Air) from New Zealand, and Major-General Bowerbank was able to see for himself the complete layout on each side of the Mediterranean and gauge the efficiency of individual units and the functioning of the system as a whole.
One of the purposes of the Director-General's visit to 2 NZEF was to examine the medical arrangements on the spot and, if possible, propose methods whereby there could be a reduction in the number of medical units and, more especially, of medical officers. It had apparently been the intention to recommend a reduction of medical units in Egypt, but the DGMS found that the medical units remaining in Egypt (allowing for the projected move of 1 General Hospital to Italy) was the minimum number required for the servicing of New Zealanders as long as the reinforcement and training camp was retained in Maadi. He also found that the training base was unlikely to be transferred to Italy, firstly, because the restricted areas in Italy page 572 were unsatisfactory for advanced training; secondly, because it would be an advantage to have a base in Egypt when hostilities ceased; and thirdly, because of the expected high incidence of malaria and dysentery in Italy during the summer months.
The DGMS discussed with the DMS GHQ MEF, Major-General Hartgill, a New Zealander, the question of the transfer of 1 General Hospital to Italy. The latter agreed that the transfer was inevitable but insisted on the retention of a 300-bed hospital (5 General Hospital) for the treatment of sick New Zealand soldiers in Egypt. The DGMS was in full agreement with the arrangements made but, from the point of view of conservation of medical officers, regretted their necessity. (In point of fact, the splitting of 1 General Hospital into two hospitals did not involve extra medical officers.)
In Italy the DGMS inspected all New Zealand medical units and also spoke to all medical officers on the provisional rehabilitation plans for medical officers. In the forward area at Cassino he recognised that the principles underlying the medical arrangements of the New Zealand Division were mobility of the units combined with efficiency and the rapid transfer of patients from the forward areas to a unit where they could receive treatment for shock and, later, full surgical investigation. The siting of the MDS and CCS as far forward as possible had, he agreed, undoubtedly resulted in a marked fall in the death rate of battle casualties and a great reduction in pain and suffering.
After visiting the non-divisional medical units in Italy the DGMS was able to form his opinion of the necessity for three general hospitals, totalling 2400 beds, which had been questioned by the National Medical Committee. In his report to the Adjutant-General in New Zealand the DGMS stated:
It must be remembered that although 2 NZEF is, as far as possible, self-contained, medical arrangements and especially bed accommodation must be based on the requirements of an army of which 2 NZ Div. is only a part. It must also be remembered that medical officers are required for transport purposes, prisoner of war camps, hospital trains, etc., and 2 NZEF is not called on to supply any for these purposes. Although it is the policy to use NZ medical units for New Zealanders, evacuation during actual fighting must pass through certain channels, and it is by no means infrequent for New Zealanders to be admitted to British or American medical units. The same thing happens when men are on leave and are taken ill.
There are also special units attached to certain of the hospitals to which New Zealanders may be sent for special investigation. For instance, the special neuro-surgical unit at 16 US Evacuation Hospital to which New Zealanders are frequently transferred who are suffering from brain and spinal lesions.
During the recent fighting, in which Indian, New Zealand and British Divisions were engaged, all casualties were evacuated by the best and quickest route, irrespective of the medical unit.page 573
The total strength of 2 NZEF in Italy is roughly 35,000 and hospital bed accommodation of 2100 (900, 600, 600) gives a percentage rate of 6 per cent. It is agreed that each of these hospitals may be expanded in an emergency to 1200 or 900 beds respectively, but only as a temporary measure. In a comparison of the total staffs of military hospitals and civilian hospitals in New Zealand of approximately the same size, it has been found that the civilian hospitals had a staff of medical officers, sisters, etc., nearly one-third more than that of the military hospitals.
Another argument against the reduction in the hospital bed accommodation is that an emergency is likely to arise in the near future when the malarial and dysentery season commences in a few weeks.
It has been recognised that the original estimate of 10 per cent for the sick and casualty rate was too high but any reduction in the accommodation under the present 6 per cent rate would be dangerous and affect very considerably the efficiency of the medical services, and this, in turn would seriously react on the care of the sick and wounded New Zealand soldier. Under the circumstances, therefore, I cannot advise any reduction in the number of hospitals or medical officers.
As it was, in order to maintain an efficient medical service, it had been found impossible to allow medical officers to return to New Zealand on furlough as soon as combatant officers of similar length of service. Medical officers could not be released until replacements were available. As the DGMS found, this created a certain feeling of unrest, and he found it desirable to explain the reasons from the New Zealand viewpoint and to assure the medical officers concerned that every effort was being made to provide replacements so that they could proceed on furlough or obtain their release from the Army, and so help to maintain the civilian medical service in New Zealand.
The visit overseas of the DGMS was of great value to 2 NZEF medical services. There had been some conflict ever since the beginning of the war regarding the relative needs of the Army overseas and the civilian medical services, for which social security legislation had increased the demand. The Minister of Health and the National Medical Committee were inclined to the opinion that the Army was relatively overstaffed and its hospital provision excessive. The DMS 2 NZEF had to press with the DGMS the needs of his force, especially for medical officers and for more senior men and specialists. Some experienced medical officers had been returned to New Zealand for service with the Pacific force, and some had been lost as prisoners of war, and their places had never been adequately filled. On his tour of inspection the DGMS realised that the requests of 2 NZEF were not unreasonable and the hospital provision not excessive. It was a pity that a period of four years had elapsed without a visit by the DGMS to the Middle East to see for himself the requirements of the force. He, on his part, would have had the opportunity of urging the appointment of non-professional medical officers in the medical units for routine administration, and also the page 574 earlier use of an optician unit overseas. The occasional differences with regard to the staffing of hospital ships would also have been more readily adjusted.
Closing of 1 NZ Rest Home
After having been open for two and a half years, 1 Rest Home for NZANS and NZWAAC was closed at the end of May 1944. Requests had been received from General Headquarters, Middle East, for the use of 1 and 3 Rest Homes as offices, the area in which the rest homes were situated having been declared a ‘Military area reserved for HQ offices only’. The DMS 2 NZEF felt that it was reasonable that 1 Rest Home should be closed if 3 Rest Home remained open to serve sisters and nurses as well as officers.
Visit of Prime Minister of New Zealand
The Prime Minister of New Zealand, the Rt. Hon. Peter Fraser, accompanied by Lieutenant-General E. Puttick and others, arrived in Italy on 26 May 1944, and between then and 4 June visited New Zealand divisional troops in the forward areas and also the base units in the Bari district. He displayed particular interest in the medical units and spoke individually to nearly all the patients. Colonel King, ADMS 2 NZ Division, accompanied him on the tour of the field ambulances, while Brigadier Kenrick, DMS 2 NZEF, conducted him round 1 Mobile CCS, 1, 2 and 3 General Hospitals and 1 Convalescent Depot. At the conclusion of his tour and prior to leaving by air for Egypt to make further inspections there, the Prime Minister expressed himself as being very pleased with the adequate arrangements made for the care of New Zealand sick and wounded.
In a special Order of the Day General Freyberg quoted a fine tribute paid to the Medical Services in 2 NZEF by the Prime Minister, and added, ‘The praise of our medical arrangements is, as we all know in the Division, well merited.’
More Prisoners of War Repatriated
Arrival of Second Section, 11th Reinforcements
The second section of the 11th Reinforcements arrived in Egypt on 3 May and included 5 medical officers, 12 NZANS, and 118 other ranks NZMC. After completing a syllabus of three weeks page 575 intensive training, these medical reinforcements were either posted to medical units in Egypt or despatched to Advanced Base in Italy. From Advanced Base Camp Hospital they were posted to divisional and other units as required. At the end of May the Medical Corps was in the happy position of having 155 reinforcements available above establishment requirements, but the surplus was soon converted into a shortage when further furlough drafts departed. (The 4th Reinforcements began to move homewards in July.)
14 Optician Unit
This unit arrived in Italy on 1 June, having been sent on to Italy as soon as possible after its arrival from New Zealand with the second section of the 11th Reinforcements. It was attached to 1 Mobile CCS and was also for periods at Advanced Base, where it performed most useful work.
New Medical Units Formed
A unit known as 1 Field Surgical Unit was officially formed on 10 June 1944. In September 1942 a surgical team was first formed as a detachment from 1 General Hospital. It accompanied 2 NZ Division through the desert campaign until the fall of Tunisia in May 1943, when it returned to Base and was temporarily disbanded. On 8 October 1943 the team—called 1 General Hospital Surgical Team—was reformed and accompanied the Division to Italy. It was this 1 General Hospital surgical team which was now formed into an official unit of 2 NZEF as 1 NZ FSU. In effect, the unit consisted of a surgeon (Major A. W. Douglas), an operating theatre corporal, three theatre orderlies, and two truck drivers, with provision for an anaesthetist, who was generally ‘borrowed’ from another unit when required. The name of the unit was changed to 3 NZ FSU in October 1944.
On 25 July a new establishment became effective for 4 Field Hygiene Section, whereby the unit was combined with 2 and 3 Anti-Malaria Control Units to become 4 Field Hygiene Company, and extra transport was also provided. The change simplified and improved administration and proved very advantageous. In the following winter one malaria-control section was disbanded and the other became a typhus-control section.
At the same time a new war establishment was issued for 102 Mobile VDTC, enabling it to have extra vehicles and to raise the number and rank of its NCOs.page 576
Plans for Move Forward of Base Units
After the fall of Rome the enemy retreated to a line 150 miles to the north of that city, which meant that when 2 NZ Division was again operationally employed it would be about 400 miles from the base at Bari. Accordingly, on 19 June a decision was made to move HQ 2 NZEF and Advanced Base to Ancona, 100 miles up the Adriatic coast, when that town should fall into the hands of the Allied forces. The DMS 2 NZEF arranged for 1 General Hospital to participate in the move north. Admissions to 1 General Hospital were reduced accordingly, most cases being diverted to 3 General Hospital. The move north was delayed considerably, until August and September, because of firm enemy resistance, and the move of the Advanced Base was cancelled, this camp remaining in southern Italy.
Shortage of Medical Officers
The shortage of medical officers in 2 NZEF now became so acute that difficulty was experienced in maintaining a satisfactory service. The position was discussed by Brigadier Kenrick with General Freyberg on 5 July 1944 and the latter asked for a written report on the situation. The GOC then took up the matter with the Minister of Defence, stating that it was becoming increasingly difficult to maintain the high standard of treatment usual in 2 NZEF. Up till that time 2 NZEF had endeavoured to meet New Zealand requirements and had sent back experienced doctors to meet urgent demands in the Pacific and at home. Knowing the difficulties, 2 NZEF had carried on without replacements as best it could, but it was felt that numbers were now below the safety line.
Allowing for the arrival of four medical officers with the 12th Reinforcements, there was a deficiency of eighteen medical officers on the establishments of medical units. In addition, it was desirable to have a surplus of at least five to make provision for leave, sickness, and special detachments. Since 2 NZEF had been overseas seventy-eight medical officers had been returned to New Zealand or the United Kingdom, and the number then being returned was exceeding the number of replacements arriving.
In the operations near Florence in July and August the shortage of medical officers was such that the field ambulance in reserve had always to ‘lend’ all its medical officers but two to the two field ambulances admitting battle casualties and sick respectively.
(With the return of 3 NZ Division to New Zealand from the Pacific in the latter half of 1944 more medical officers were made available for service in 2 NZEF in Egypt and Italy, some being flown to the Middle East in August, others arriving in HS Maunganui page 577 in September, and eighteen arriving with the 13th Reinforcements on 5 November. These, however, could not make good the heavy loss of experienced surgeons and senior administrative officers with long experience in the force.)
At this period there arose a marked deficiency in the numbers of medical specialists in 2 NZEF. This was partly due to the wastage of medical officers through sickness and invaliding to New Zealand, and partly to the employment of specialists in administrative posts in the divisional medical units. In January 1944 no orthopaedic surgeons were available. Of the original three attached to the base hospitals, two had been invalided to New Zealand, and the other, after he had gone home on furlough, had been retained in New Zealand to look after the amputees. It can be realised how serious a deficiency this was when so many serious fracture cases were being treated in the hospitals. In May there was an acute shortage of ophthalmologists, ear, nose and throat surgeons, and radiologists, and urgent representations were made to New Zealand to send replacements to the Middle East. There were at that time two ophthalmologists (one of them having been obtained from the RAMC from England), two ENT specialists, and no relieving radiologist for four hospitals. In Italy it became necessary to concentrate the specialist cases in the hospital where the particular medical specialist was available.
Promotion of Specialists in the NZMC
Throughout the war there had been difficulty with regard to the promotion of senior medical practitioners who were retained in hospitals because of their value as clinicians. The hospitals had rigid establishments with a minimal number of senior ranking officers, and only the commanding officer and officers in charge of the surgical and medical divisions had ranks above that of major. In the RAMC every medical officer graded as a specialist automatically was granted the rank of major, but this was not so in our Corps. In the early period of the war we had experienced senior surgeons ranking as captains. Later, it was impossible for any specialist to be promoted above the rank of major unless he became an officer in charge of a division in a hospital, for which position he might not be qualified, or unless he became CO of a field ambulance or of a hospital unit, when he was no longer available for his specialist work. Some recognition of the position was given by Headquarters 2 NZEF in September 1944 by the promotion of Majors Coverdale and Russell to the rank of lieutenant-colonel as consultants in ophthalmology and psychiatry respectively. The promotions were both long overdue. page 578 In the future better provision should be made in the New Zealand Army for recognition of senior professional status.
Recruitment of New Zealand Doctors in the United Kingdom
Because of demands on the Emergency Medical Service in England during the war many New Zealand doctors could not be released from British civil hospitals to serve in any force. The question of service by New Zealand doctors generally was discussed by Major-General Bowerbank with the DGAMS, Lieutenant-General Hood, in London just before D Day in 1944. Realising the great shortage of medical officers and medical men in Great Britain, General Bowerbank directed the New Zealand Liaison Officer in London to cancel all applications for transfer and to refuse all applications for enlistment in the NZMC. In Italy in 1944 two specialist physicians and an ophthalmic surgeon were seconded from the RAMC to 2 NZEF to make up deficiencies and they gave valuable assistance in our hospitals.
Making references to the subject in letters to General Bowerbank in 1945 General Hood said:
As you know, there is a very great shortage of medical men in the United Kingdom, and the fighting services are in keen competition with the civilian medical authorities, including the EMS, for any doctors who are of recruitable age. If New Zealand medical men employed with the EMS are permitted to join the NZMC, their places would have to be filled by English or Scottish graduates who might otherwise have been available for the Army.… Fortunately for us and through your good offices, all transfers and applications for enlistment in the NZMC are resisted by your Government. From my point of view this decision has been of the greatest assistance.…
New Zealand medical men, both in a service and civilian capacity, have played a valuable part in augmenting the all too few doctors at our disposal.… indeed I do not know what we should have done if the Dominions had pressed for the return of their officers who have given us such great help in the last few difficult years.
Many of the New Zealand doctors concerned were specially suited by age and qualifications for service in 2 NZEF, but they rendered valuable service in Britain in the treatment of the severe casualties arising from the bombing of the civilian population.
In Italy appointments of NCOs to non-professional commissions as quartermasters, hospital registrars, hospital company officers, and dispensers were continued, thus saving many professional medical officers, and those appointed proved satisfactory in every way.page 579
Average Strength of 2 NZEF
The average strength of 2 NZEF in July 1944, from which time the resumption of replacement schemes involving the 4th, and later, Reinforcements began to take effect and result in a continuous ebb and flow, was:
Furlough for Medical Officers
As has been said earlier, it had been found impossible to grant medical officers furlough to New Zealand in the same way as other officers of the force. This was due to the fact that there were no replacements available and the medical officers could not be spared without lowering the efficiency of the service. Medical officers of the First Echelon with four and a half years' service overseas had still not been granted furlough. Some had had to be invalided back to New Zealand—not surprising when it was considered that many of the medical officers in the first medical units sent overseas were older married men.
When medical officers did go on furlough very few returned to serve in 2 NZEF. Officers were lost to 2 NZEF for a number of reasons. Among them were: (a) Those medically boarded as unfit for further overseas service; (b) Those asked for by Army Headquarters, Wellington, for service in the Pacific or for special service in New Zealand; (c) Those granted compassionate leave; (d) Direct exchanges with similarly qualified men in New Zealand; (e) Exchanges of young medical officers with long service for senior house surgeons. (Less than 50 per cent of those returning wished to take up house-surgeon appointments.)
In November 1944 it was notified that all sisters with four years' service were to be given the opportunity of returning to New Zealand as replacements and shipping arrangements allowed. The health of the sisters had been very satisfactory, and only a few had been invalided. Promotion had been slow as a result, and a small increase in establishment was made at this time.page 580
NZWAAC (Medical Division)
On a similar basis the voluntary aids were able to return to New Zealand after three years' service.
The status of the voluntary aids had recently been revised. The nursing sisters had always had the status of officers and wore badges of rank as such. Except for their few officers, the WAACs were rated as NCOs and privates. This debarred them from first-class rail travel in the Middle East and also from certain hotels and clubs. This handicap, especially undesirable in Egypt and Italy, was fully recognised by our administration. To improve the position all badges of rank were abolished and all members of the NZWAAC (Medical Division), except the officers, were designated as nurse and their identity cards amended to state that the bearer was allowed the privileges of an officer as regards travel, accommodation, and club facilities. This was a satisfactory solution to a difficult problem.
Red Cross Organisation
The Red Cross Commissioner, Major Tweedy, at this period urged the adoption of an establishment of Red Cross personnel to carry out work in the hospitals and at the store. It had been possible in Egypt to enlist the help of civilian women as hospital visitors and in the occupational therapy department at the Helwan hospital, but such arrangements were not possible in Italy. Here the work was continued by Mrs Chapman, attached to the YMCA, and Mrs Blackford, attached to the Red Cross organisation. Where New Zealand clubs were established NZWAAC (Welfare Division)—the Tuis—distributed Red Cross comforts to hospitals in their area. Occupational therapy had become a responsibility of the NZWAAC (Medical Division) on the hospital staffs. The few men assisting the Red Cross Commissioner were supplied by the Army.
Major Tweedy suggested a Red Cross establishment of one woman in command and ten others to be attached to the different hospital units. They would take charge of the libraries, distribute Red Cross comforts, give help in correspondence and in the purchase of gifts for patients, and assist in occupational therapy. The personnel could have been provided by attaching women from the WAAC or by the despatch of a separate unit from New Zealand. These recommendations were not approved.
Hospital Staff for Repatriation Units in United Kingdom
On 5 August 1944 a group of two medical officers, six sisters, and twenty other ranks was selected as a camp hospital staff for duty in the United Kingdom with the New Zealand prisoner-of-war page 581 repatriation organisation then being formed. The group went to England on 2 September. The successful Allied advance across France from Normandy presaged that in due course the release of large numbers of Allied prisoners of war could be expected. New Zealanders would be included among them and special units were necessary to care for them as they reached England from the Continent. By 1945 the organisation had grown considerably, and when the rush of repatriation occurred towards the close of hostilities the augmented medical units were kept very busy.