Medical Services in New Zealand and The Pacific
V: Sickness in New Zealand
V: Sickness in New Zealand
In accordance with a War Cabinet decision at the outbreak of war all cases requiring hospitalisation for more than a short period were admitted to civil hospitals. All major stations had a sick quarters which contained casualty room, inspection rooms and from ten to twenty beds. Other stations (Mangaroa, Swanson, Te Awamutu, Te Rapa, Weedons) had less elaborate facilities and relied on nearby service or civil hospitals for the admission of their bed patients. A small hospital was built to service Whenuapai and Hobsonville in October 1943 but was closed in May 1944.
Ashford hospital was established at Delta during the existence of that station from October 1943 to November 1944. It had accommodation for fifty patients and a complete ear, nose and throat surgical unit. During its existence it admitted 1300 patients.page 218
Royal New Zealand Air Force patients requiring convalescent treatment were admitted to the hospital at Hanmer Springs and to Raventhorpe Convalescent Depot, which was opened early in 1943.
In March 1944 a convalescent hospital was opened at Rotorua. It was felt that for aircrew personnel returning from exacting operational duties in the Pacific area the routine restrictions and general 'institutional' atmosphere of the existing convalescent depots were unsuitable. In addition, it was claimed that Air Force medical officers trained in the special problems pertaining to flying could best handle the many cases of sickness which had a psychological basis.
The Convalescent Depot at Rotorua had accommodation for 130 walking and 30 bed patients. It was staffed by three medical officers, three sisters (one nursing and two masseuse), physical education and recreational training instructors, occupational therapeutists, etc. Two part-time consultants in neuro-psychiatry and orthopaedic surgery attended the hospital monthly. The most modern methods of convalescent training were used in the hospital, emphasis being placed on the rehabilitation of as many personnel as possible for further useful duties in the service. A small number of selected cases from the Army and Navy were admitted to the hospital.
Between 12 March 1944 and 31 August 1945 the depot treated 1235 patients (368 aircrew and 867 ground staff). Of these 931, or 75.38 per cent, were made fit again for service duties.
Air Force stations situated in the Marlborough-Nelson area were relatively isolated and a considerable distance from the Army convalescent camps at Christchurch and Auckland. It was therefore considered desirable to set up a small convalescent depot to serve this area at the naval camp at Curious Cove in the Marlborough Sounds, where buildings of excellent quality and design and all conveniences, such as lighting and water supply, were available. The camp was taken over from the Navy and new buildings in the form of a recreation hut and additional sleeping accommodation were added.
The depot opened on 6 March 1944 and was closed down in March 1945, having by then treated over 500 cases.
Administration of Sick and Wounded Organisation
The RNZAF Sick and Wounded Section was formed in July 1943 under the general control of the Director of Medical Services. Its object was to facilitate the administration of personnel who page 219 became temporarily or permanently unfit for service through medical reasons, and to control sick leave and convalescence.
The earlier system of dealing with the sick and wounded was recognised as inadequate and the section had special functions to see that all medical cases requiring recuperative treatment were admitted to convalescent depots, that they got paid during treatment, or while on sick leave, and that no sick and wounded members of the force were officially lost sight of.
For administrative purposes the sick and wounded organisation was divided into three areas. Personnel who were likely to be non-effective through medical reasons for a period of fourteen days or more were posted to the nearest Sick and Wounded Section and became the complete responsibility of the section until they were fit to return to full duty or were transferred to the RNZAF reserve.
The general policy of treatment was to reduce the amount of sick leave at home to a minimum; and unless there was good reason, medical or domestic, in favour of a member returning to his home during convalescence or treatment, all personnel requiring convalescent treatment or 'hardening-up' on discharge from hospitals were posted to various institutions under RNZAF supervision.
From its inception to May 1945, Sick and Wounded was responsible for 7604 personnel, of whom 5310 were posted back fit for duty. Discharges and postings to the Reserve accounted for 1443, leaving 851 on Sick and Wounded strength as at 1 June 1945. Over 2500 personnel were given treatment at convalescent depots.
The guiding principle in the administration of Sick and Wounded personnel was at all times one of personal contact with the individual and attention to his welfare. This policy ensured continuity of medical supervision of all cases and resulted in the return of personnel to duty with a minimum of delay. In cases where a man became permanently unfit for further service, it was possible to facilitate his release from the service as soon as he became fit for a civilian occupation. Such cases were given full advice on their future medical welfare, the claiming of pensions, and rehabilitation procedures.
In its Sick and Wounded organisation the RNZAF created a better and more complete control than did the Army. The common difficulty was that of limiting the time spent at home by the recruits after their discharge from hospital. The Army difficulties were manifold and control was weakened by the divorce of Army Sick and Wounded Branch from Medical Headquarters. Although the Air Force Medical Branch controlled the Air Force personnel on discharge from hospital, it seems that the fullest use was not made of convalescent depots, and persistent check was still necessary to reduce manpower wastage in convalescence at home.page 220
Health of Force
Non-effective Rate: The average rate of medical non-effectiveness for each year is set out below, expressed as a percentage of the average total strength in New Zealand:
|Period to 31 March 1941||2.73|
|Year ended 31 March 1942||3.04|
|Year ended 31 March 1943||3.17|
|Year ended 31 March 1944||3.55|
|Year ended 31 March 1945||4.84|
|Year ended 31 March 1946||5.89|
The non-effective rate increased each year.
In the earlier years of the war, personnel who remained off duty for medical reasons for longer than three months were posted to the Reserve and consequently were no longer included in the non-effective rate. Following the War Cabinet's decision of 27 August 1943 that unfit personnel were to be retained on the strength of the RNZAF till fit for a civilian occupation, personnel who remained off duty for over three months, instead of being posted to the Reserve, were kept on the strength of Sick and Wounded Section. This naturally caused the non-effective rate to increase.
In the later months of 1944 a large number of personnel who were fit for duty were demobilised, and this naturally had the effect of increasing the proportion of total strength who were medically unfit.
Incidence of Diseases: The principal groups of diseases which caused personnel to become non-effective in New Zealand are tabulated below:
|Disabilities||Approx. Rate per 1000 per Annum (Average)||Percentage of Total Disabilities (Average)|
|Diseases caused by infection or infestation||143||25|
|Diseases of the nervous system and mental diseases||28||5|
|Diseases of the ear and nose||23||4|
|Diseases of the respiratory system||26||4.5|
|Diseases of the digestive system||123||21|
|Diseases of the bones, joints, muscles, fasciae, and bursae||37||6|
|Diseases of the skin and areolar tissue||47||8|
The largest single group of diseases comprised those caused by infection or infestation. They accounted for one-quarter of new cases, and out of every thousand men approximately 143 became non-effective by reason of one of these diseases during the course of a year. By far the largest proportion of these diseases were of course relatively mild, the highest individual incidences being in such disabilities as common cold, mild influenza and various infections of the respiratory tract.
Injuries accounted for 11½ per cent of the cases, the incidence rate being approximately 67 per thousand per annum. It is of interest to note that injuries sustained in aircraft accidents formed an extremely small proportion of this figure, the actual incidence rate for the year ended 31 March 1945 being 1.4 per thousand. The incidence of deaths and reported missing as the result of aircraft accidents during the same period was 1.9 per thousand.
Venereal Disease: In the RNZAF in New Zealand from the beginning of the war to 31 March 1945 the number of cases of gonorrhoea was 527 and of syphilis 45.
The incidence of gonorrhoea dropped sharply after March 1942. The rate of venereal disease compared favourably with that of any other service.
Sick Parades: From the beginning of the war to 31 March 1945 there were approximately 824,000 attendances on sick parade in New Zealand. The average during each year varied between 8 and 11 attendances on sick parade for each man in the service in New Zealand.
There was no incidence of disease other than that normally met with in civilian life in the same age group, and there was no serious epidemic of any infectious disease. The medical administration was not faced with any serious problem.