New Zealand Medical Services in Middle East and Italy
Surgery During the Campaign
Surgery During the Campaign
The pre-Alamein period of the desert campaign is notable for the developments in the surgical treatment of the wounded in the forward areas. Very important innovations were made to enable efficient surgery and post-operative nursing to be carried out at the main dressing stations of the field ambulances. The difficulty of evacuating serious cases over the rough, trackless desert made it impossible to defer operation till the casualty could be brought back to the CCS. The fluid and uncertain military situation made it impossible for the forward (British) CCS to be stabilised and undertake operative work. In fact, the CCS was completely withdrawn a few days after its hurried withdrawal to the Alamein line. The full responsibility for forward surgery for 2 NZ Division was thus undertaken by our active MDS. Fortunately, all our MDSs possessed extra equipment for this purpose and, particularly, each field ambulance had surgeons capable of performing major surgery. Surgical teams had been made available previously during the desert campaigns by the RAMC, and more had recently been supplied. Some of these British teams were attached to our active New Zealand MDS from 10 July till 8 August. During that period there were normally two extra teams attached. One was the Greek unit under Captain Taylor, RAMC, with its specially equipped operating van; the other, from 15 CCS, was supplied after that unit's withdrawal from the battle area. These teams were constituted of capable, well-trained surgeons experienced in forward surgery, all of whom combined well with our units and did most excellent work, dealing with the abdominal and other serious cases, while our own surgeons usually dealt with the less serious cases. The disadvantages of the lone surgical team were not present as there were always at least three teams available in the MDS and, if required, further help was available from the resting MDS.
At the end of July a surgical team under Major S. L. Wilson was sent forward from our New Zealand CCS. This team at first worked in conjunction with the British teams, but later, when operations quietened down, it enabled the British teams to be released. The adequate provision for surgery by means of these teams, concentrated page 361 as they were in one forward operating unit, was an eminently satisfactory development at this period. There was a well-sustained evacuation of cases from the MDS, mainly by ambulance over the rough and uneven desert, but partly by air from airstrips alongside the operating unit. Unfortunately, experience showed that air evacuation of abdominal cases shortly after operation, and of serious chest cases, was very dangerous, and this led to arrangements being made to retain the abdominal cases up to ten days at the MDS. For this purpose a section of 1 NZ CCS was attached to the active MDS. This section consisted of nursing orderlies, beds, and bedding, as well as the surgical van with lighting and sterilising units, and these facilities were thereafter always available when required in the field ambulances.
The surgical teams at that time were all conscious of difficulty in lighting, sterilisation, and the nursing of serious cases after operation. Arrangements were made so that, in the event of the MDS having to move quickly, a section of a field ambulance under an officer would immediately take over the patients and nurse them until they were fit to move to the CCS.