Medical Services in New Zealand and The Pacific
VI: Medical Supplies and Equipment
VI: Medical Supplies and Equipment
At the outbreak of war some of the medical equipment belonging to the 1914–18 period was still in stock and a small proportion in use. The greater part of it was not only obsolete but practically page 263 unusable. As a result of recommendations made early in 1939 by the DGMS, some new medical equipment was beginning to arrive from England in September 1939. During 1939 a number of big camps were held and the stocks of medical supplies were almost exhausted. As the medical units proceeding overseas to the Middle East were equipped on arrival at their destinations, a major difficulty was avoided. The army in New Zealand would have been embarrassed by lack of medical supplies if it had been called upon to equip any medical units on the outbreak of hostilities in Europe.
Medical equipment and stores for troop transports were drawn from the Army Medical Store or else secured from commercial firms in New Zealand and placed on board each transport. A standard list of drugs was carefully prepared but it was not always possible, especially at the outset, to supply everything which might be required. Senior medical officers were always given verbal and written instructions regarding these supplies and were expected to improvise wherever necessary. Difficulties were sometimes occasioned where senior medical officers expected an unlimited supply of drugs as in civilian practice.
A similar position applied in the case of surgical instruments. Surgical and medical panniers were placed on board each transport, but it was impossible to equip a ship on the same scale as a general hospital. As it was, in view of the limited amount of medical equipment available, the DGMS had to make arrangements for medical equipment to be off-loaded from the transports when the troops had reached their destination. This equipment was then packed and returned to New Zealand for the equipping of the succession of transports.
During the war medical stores were obtained from local drug houses, the United Kingdom, Canada, and under Lease-Lend from the United States of America. The Joint Council of the Order of St. John and the New Zealand Red Cross Society War Purposes Committee provided large quantities of surgical dressings and an impressive quantity of textile garments and other articles made with material supplied, as a general rule, from ordnance stocks.
The US Navy medical authorities (in New Zealand from 1942) were most co-operative in supply matters, and constant liaison was maintained with exceptionally cordial relations.
The DGMS, during a visit to Australia, was successful in procuring field tranfusion equipment and established contacts which facilitated the obtaining of further medical supplies later.
Navy and Air Force medical supplies were provided from Army medical stocks, a twelve months' reserve being held in the respective page 264 service stores. Frequent discussions with Navy and Air Force administrative officers enabled requirements to be regulated and technical difficulties mastered.
The need for economy in medical supplies was frequently emphasised by the DGMS, not only by means of memoranda and instructions through the QMG's routine orders, but especially at personal inspections and conferences. Certain supplies were placed on special lists, with reasons required for all indents. Evidence indicated that these measures, coupled with the routine inspections, frequent check and careful custody, went a considerable way to conserve medical supplies without impairing efficiency.
Frequent inspections during the routine visits of the DGMS and his staff ensured technical efficiency, and the auditing of accounts by inspecting quartermasters and audit inspectors regulated routine transactions and ensured reasonable care in the custody of the valuable and often irreplaceable medical stores.
Scales of medical equipment and supplies for camps and troopships were prepared under the direction of the DGMS in 1939 and were amended as occasion demanded, and additional tables were authorised for all units mobilised.
The year 1942 was a difficult one for the supply of medical stores and equipment as the expanded forces in New Zealand had to be catered for and all the medical units of 3 NZ Division equipped.
Field medical equipment was required also to meet extraordinary demands due to general mobilisation in 1942, including that of the Home Guard. Old equipment was brought up to standard, new equipment was designed, tabulated, procured from wide and often very unusual sources, and assembled ready for the new army, of which certain units, such as anti-malaria and blood transfusion units, were new to this Dominion.
Fortunately supplies began to come in from the United States under Lease-Lend in 1942. The first consignment containing a small quantity of drugs was received at the end of June, and in November there arrived 600 cases of supplies, 1329 cases of drugs and 250 packages of dressings from the United States, and 1030 cases of medical supplies from India. Small quantities of supplies and equipment came to hand from Australia, and some supplies were obtained from the estates of deceased practitioners and from warehouses. Over £100,000 worth of supplies and equipment was received from the United States and Canada in the year ended 31 March 1943, and an estimated £30,000 worth from India, nearly £10,000 worth from Australia and some £1500 worth from the United Kingdom, while over £100,000 worth was obtained within New Zealand.
Medical equipment was assembled to provide regimental panniers, medical companions, surgical haversacks, shell dressing haversacks, page 265 first-aid boxes and haversacks, malaria panniers, fracture panniers, transfusion packs, field ambulance boxes, medical inspection chests, and company and section medical chests.
Army Medical Stores
At the outbreak of war, and for a year thereafter, the Medical Store was part of the Ordnance Depot, Trentham Military Camp, but stocks, requisitions and indents were controlled by the Director-General of Medical Services. In 1940 the Army Medical Store was established in Victoria Street, Wellington, and was brought under the full control of the DGMS. Dispensary, packing facilities, assembly room, bins and shelving were suitably arranged. Stock mixtures were manufactured for all requirements.
Ordnance items which were used only in medical units were issued from Army Medical Stores during 1942 and 1943 in order to assist the overloaded ordnance depots.
Expansion of the forces, the policy of dispersal of stocks, and requirements of the Navy and Air Force, which were included with those of the Army, eventually called for considerable further reorganisation. A main medical store was therefore established at the Horticultural Hall, Lower Hutt, with a bulk store at Wellington. A reserve store was situated at Palmerston North, and Advance Depots of Medical Supplies were established at Auckland, Christchurch and with 3 NZ Division. Reserve stocks were accommodated at certain military camp hospitals, notably at the strategic centre, Waiouru. Temporary accommodation for assembly or disposal of equipment was required, chiefly at Wellington and Mangere. Railway ambulance carriage depots were established at Wellington and Auckland under district control. Dispersal to Whangarei and other towns was arranged, but the military necessity did not arise and the proposal was cancelled.
The staff increased from 1 NCO, NZMC, in 1939, to some 6 officers and 51 other ranks when the full expansion and dispersal was operating.
Rapid expansion at the critical period imposed a strain upon an expanding but often untrained staff, while a wide diversification of units and technical requirements extended the demands on the medical stores organisation.
A new establishment for the Medical Stores and Equipment Section was approved in March 1943 providing for 6 officers, 45 NCOs and 16 privates to staff the various stores.
When Army Medical Stores were organised on a satisfactory basis, the DGMS authorised routine medical equipment conferences. These were of the greatest value, being held twice monthly when page 266 exigencies permitted. Specialists were co-opted to give advice on technical matters, such as blood transfusion, X-ray, and optical requirements.
Medical quartermasters from field units, medical stores and district depots staffs met half-yearly to discuss problems peculiar to those units.
Conferences were responsible for much of the co-ordination and implementing of policy. The DGMS gave details regarding organisation, expansion and policy at conferences held in his office. The QMG called conferences of stores and quartermaster officers to discuss accounting for stores and transport vehicles. Conferences were also held with the Controller of Medical Supplies (Health Department) regarding lease-lend stocks; with the Standards Institute regarding army equipment; with the War Purposes Committee of the Joint Council of the Order of St. John and the Red Cross Society regarding scales of equipment and relative matters; and with the Patriotic Board regarding gift supplies.
In 1943 new demands made on the Medical Stores and Equipment Section were the equipping of Linton Camp Hospital, the PW Camp Hospital and the Plastic Surgical Unit, and the provision of chemical warfare and X-ray equipment and anti-malaria panniers. In 1945 the depots at Burnham and Auckland were closed and the staff reduced to twenty-four. At the end of the war surplus stores were disposed of to institutions and 100 tons to the Netherlands East Indies Government.
Motor Ambulance Vehicles
At the outbreak of the war no military motor ambulance cars were available. Conversion of private motor vans into motor ambulances was considered impracticable as the majority of commercial motor vehicles were of the light van type, with little height and length and narrow rear doors. In some instances hospital boards' ambulances were used, and where they were not available Army Service Corps trucks were adapted by placing mattresses or stretchers on the floor. In October 1939 the Salvation Army donated two motor ambulances, and about the same time five Morris chassis were obtained and bodies were built on them at the Post and Telegraph workshops, Wellington. Other donations of ambulances were made by various organisations and individuals, but further ambulances were needed. One of the difficulties was a shortage of suitable chassis and all types had to be used. This did not lend itself to any standardisation in design or carrying capacity.
It was reported that the Australian Army had adopted the Indian Army type of motor ambulance with Chevrolet chassis and canvas sides, back and top, and it was decided to follow on similar lines page 267 in the construction of bodies for New Zealand Army ambulances in order to obtain quick production and economy in cost. The use of canvas was far from satisfactory, quite apart from the inferior materials and poor workmanship which went into the construction. The provision of sides and backs of wood in place of canvas was a big improvement. Some standardisation in design was obtained when bodies were built on twelve Bedford chassis in November 1940, but unfortunately the springing of the Bedford chassis was totally unsuitable for motor ambulances.
About this time approximately a hundred ambulance vehicles were required to complete authorised establishments, and as suitable chassis were not available the feasibility of carrying stretchers on special movable brackets (Flint stretcher equipment, as described in RAMC Journal, November 1936) fitted to army service trucks and wagons was investigated; but, as during the investigation some 100 Ford chassis came to hand, ministerial approval for only seven sets of brackets was sought and obtained. The 100 Ford chassis were fitted with bodies by private contractors during 1941, and with subsequent minor alterations were considered to be reasonably satisfactory but not in comparison with civilian ambulances.