The following medical units returned to New Zealand from Fiji in July 1942: Base Hospital (from Tamavua); Base Hospital (from Namaka); 7 Field Ambulance; 22 Field Ambulance; Hygiene Section (from Samambula); Hygiene Section (from Namaka); ADMS with Medical Stores Section. After a period of leave the members of these units reassembled at Papakura and the reorganisation of the Division began.

The two hospitals were amalgamated to form 4 NZ General Hospital. Equipment and personnel for a general hospital were made up from the constituent units and Army Headquarters supplied deficiencies. This was the first time a general hospital had been equipped in New Zealand, and many items had to be improvised or manufactured locally; some were not available when the unit went to New Caledonia. The two field ambulances (7 and 22) were light field ambulances. These were built up to full field ambulance war establishment in both equipment and personnel.

The two hygiene sections were formed into 6 Field Hygiene Section. The Medical Stores Section was formed into an Advanced Depot of Medical Stores and brought up to war establishment in both equipment and personnel.

New units formed were two Field Surgical Units, which were complete in equipment and personnel, and whose personnel were drawn mainly from the experienced orderlies of 4 NZ General Hospital; a Malaria Control Unit – again complete in personnel and equipment, its officers being a medical officer, an entomologist and an engineer officer; a Field Transfusion Unit complete with equipment and refrigerator van; an Optician Unit and a Motor Ambulance Convoy. (Additional units formed and equipped in New Zealand during 1943 and sent forward to join the Division were 2 NZ CCS, 2 NZ Convalescent Depot, and 24 NZ Field Ambulance.)

Towards the end of July 1943 the ADMS 3 Division, Colonel Speight, accompanied the GOC's reconnaissance party to Guadalcanal, where an examination of the staging area allotted to 3 Division was carried out. The sites of the brigades were decided upon and satisfactory positions for medical units were selected. Generally speaking the areas were in good order, were clean, and had not been occupied for some weeks. Drainage was good and few mosquitoes were seen. All drinking and washing water had to be carted to the camp sites, but this state of affairs was alleviated somewhat by the fact that nowhere was any camp likely to be farther than two miles from the beach and one brigade would actually be camped beside the beach.

Early in August 3 Division was engaged in preparations for its move to the Solomon Islands. The move itself was carried out in three flights, 14 Brigade Group embarking on 15 August, Divisional Headquarters Group embarking on 22 August, and lastly, 8 Brigade Group embarking on 2 September. For the purpose of the move and until further notice, 2 CCS (Lieutenant-Colonel Wilson

Lt-Col S. L. Wilson, DSO; Dunedin; born Dannevirke, 17 Apr 1905; surgeon; surgeon 2 Gen Hosp Aug 1940–Jun 1941; Mob Surgical Unit Jun 1941–Feb 1942; 1 Mob CCS Feb 1942–Mar 1943; CO 2 CCS (Pacific) Aug 1943–Jan 1944.

The groups exercised en route in amphibious operations at Efate in the New Hebrides and then concentrated in Guadalcanal.

When the units of the Division landed on Guadalcanal in three successive flights on 27 August, 3 September and 14 September 1943, that island was the principal forward base for actions in progress 200 miles away to the north-west in the New Georgia Group of the Solomon Islands. New Caledonia was 1000 miles away to the south and New Zealand a further 1000 miles farther back.

By the time the Division arrived to play its part in the Solomons campaign the strategy of bypassing enemy-occupied islands was in operation. In order to achieve success this strategy required the use of large numbers of aircraft to provide air cover, patrols and to pulverise enemy bases and aerodromes; motor torpedo-boats to work at night attacking enemy barges transporting personnel and supplies to their various island garrisons; landing craft of all sizes to ferry our own troops and equipment for each engagement, and naval vessels to protect convoys of smaller craft and, if necessary, to bombard enemy positions at the point of attack. These were all available for Admiral W. F. Halsey's forces, of which 3 Division was a valuable striking unit.

Briefly, the strategy of bypassing was to get behind the enemy, isolate his bases, and force him to evacuate or surrender by cutting his supply lines and smashing his airfields and defences. This was achieved by capturing some island ahead of an enemy base and establishing there with the greatest possible speed airfields, naval bases and supply dumps. Thus established, air power from the new base supported the next move forward and enabled a continuous assault to be maintained on the enemy.

The capture of Vella Lavella was a typical example of this bypassing strategy. It forced the Japanese to evacuate Kolombangara and several smaller islands north of New Georgia and paved the way for the next forward thrusts to the Treasuries, Empress Augusta Bay, and ultimately to the Green Islands.

After the arrival of 3 Division on Guadalcanal action was not long delayed, but the Division seemed fated to be dispersed. Never once during the Solomons campaign did the two brigades work together in one concerted action. By the time 8 Brigade was disembarking on Guadalcanal 14 Brigade was embarking for its move forward. From then on the two brigades fought on separate islands, one a long hop ahead of the other, so that their only direct links were by wireless and aircraft. There can be no connected story of their activities, for the brigades did not join up again until they returned to New Caledonia in 1944.

The Division's first task, that of clearing Vella Lavella, fell to 14 Brigade. When the units disembarked on Guadalcanal two American divisions were engaged in eradicating the last of the Japanese from Arundel Island and the north coast of New Georgia. Munda airfield was operating and fighter planes based there supplemented those from Guadalcanal which daily pounded the enemy strongholds in the north. Units from one of the American divisions based on New Georgia had been in action on Vella Lavella for some time and had succeeded in driving the Japanese garrison into the north of the island, where they were holding an area in Paraso Bay on the north-east coast, and at Mundi Mundi on the west coast.

Between 500 and 700 Japanese were cornered by American troops, supported by Fijian scouts, along the northern area of the island where the coast was deeply indented and mangrove swamps added to transport and communication difficulties. The task of 14 Brigade was to relieve the Americans and clear the island as quickly as possible. Vella Lavella was clothed in dense jungle from the water's edge to the mountain crests of the interior. In this jungle the enemy had to be found and attacked.

The plan of operation entailed the use of 35 Battalion and 37 Battalion as combat teams, with 30 Battalion in reserve. Each combat team had its engineers from 20 Field Company, medical sections from 22 Field Ambulance, and supply personnel from 16 MT Company, with artillery working in support. The method of attack was to make a pincer movement, bringing each battalion in from a flank and ultimately trapping the Japanese garrison when the two battalions affected a meeting.

By 21 September beach-heads had been established by 37 Battalion at Paraso Bay on the north coast and by 35 Battalion at Mundi Mundi River on the north-west coast. American units withdrew as the New Zealanders took over, and with them went the Fijian scouts. Then from the beach-heads units moved in bounds round the coast in small landing craft. Patrols crept through the jungle and swamps along the coast, paving the way for the advance of each battalion as the enemy was driven back on his main base at Timbala Bay.

Conditions were harsh and difficult. Rain fell, drenching the men and soaking their equipment and stores and turning the jungle into a bog. Progress was slow, amounting to only 300 to 600 yards a day during contact with the enemy, and a company front was rarely more than 100 yards wide. The men moved along narrow tracks in single file, hindered by tree roots and clutching vines and always on the alert against ambush or enemy traps. Every noise was suspect for the Japanese soldier, hidden among the roots of trees or up the trees themselves, held his fire until patrols came within five or ten yards. At night perimeters were formed and not a man moved beyond the spot where he lay and secured himself as darkness fell. Every yard of ground had to be searched thoroughly, and when it was declared clear by the patrols, other troops followed round the coast in landing craft, establishing bases at sites dictated by openings in the reef for the next probe forward.

By 5 October the enemy garrison had been forced back into an area between Warambari and Marquana Bays. The following night, while the two battalions were preparing for a final assault, the encircled Japanese, numbering about 400–500, were evacuated by barge to destroyers which were waiting off the north end of the island. But the enemy did not escape unscathed. Three American destroyers attacked the Japanese convoy and sank many of the barges which were evacuating their men from Vella Lavella. By 9 October, when patrols from the two battalions met, all Japanese resistance was considered at an end.

Enemy casualties were estimated at 200–300 killed and wounded.

Fourteenth Brigade Group casualties were 3 officers and 28 other ranks killed, 1 officer died of wounds, and 1 officer and 31 other ranks wounded.

The task had taken nineteen days and on its completion 14 Brigade Group was made responsible for the prevention of Japanese re-entry into the island, and also for the prevention of any isolated Japanese escaping from the island.

Attending the sick and wounded in the jungle was full of difficulties and threw considerable strain on unit medical officers. With each of the two combat teams there was an advanced dressing station of 22 Field Ambulance. Sick and wounded were evacuated by barge to a main dressing station established by 22 Field Ambulance under Lieutenant-Colonel Shirer

Lt-Col W. F. Shirer, ED, m.i.d.; Wellington; born Wellington, 16 May 1898; medical practitioner; CO 22 Fd Amb Aug 1942–Nov 1943.

The average time of evacuation from front line to RAP varied from two to six hours, being prolonged at times by infantry losing their direction. Two cases lay where they fell for two hours before they were removed by an officer under machine-gun fire in a Japanese fire lane. The troops had no blankets and stretchers were improvised from jungle coats; the wounded were carried along a bewildering maze of tracks, no compasses being available.

When battalion headquarters moved forward the RAP staff packed its equipment into haversacks and moved forward too. At the new site a tarpaulin was erected for protection against torrential rains, and under it medical equipment such as splints, dressings, instruments, drugs and blood plasma was set out in preparation for casualties. When a man was wounded, first aid was given on the spot by the company medical orderlies, and the man was taken to the aid post as quickly as possible. It usually took eight men to get one stretcher case back to the RAP, and the stretcher-bearers found their work difficult in the extreme. At the RAP additional treatment was given and the casualty sent on to the ADS.

The ADS was one mile behind the RAP, along a mud track. Evacuation took from one to two hours according to the condition of the patient. At the ADS wounds were dressed with sulphonila-mide powder, haemorrhage arrested, fractures splinted and morphia and ATS administered. There was a hold-up in evacuation between the ADSs and MDS. Both ADSs were five to six hours away by Higgins boat, and evacuation depended entirely on when these boats were available. In most cases this meant an all-night wait at the ADS for the patients, who left on barges in the morning after twelve to fourteen hours' delay. After a six-hour journey the barges landed patients at the MDS landing at Gill's Plantation, Joroveto. Thus patients did not reach the MDS until up to twenty-eight hours after wounding. Requests were made for casualties to be evacuated by boat at night to reduce the evacuation time by about half. Boats, however, were in short supply and this constituted a bottleneck for military movement, the forwarding of supplies and the evacuation of casualties. This also limited the number of medical personnel who could be sent to the forward area.

The first group of battle casualties to arrive at 2 CCS on Guadalcanal were five men from 35 Battalion, who reached the CCS on 1 October. Battle casualties continued to arrive until 15 October.

Most of the surgery was performed by 1 Field Surgical Unit. This unit, besides operating on New Zealand wounded from the forward areas, attended to numerous bomb casualties from the enemy strafing of American troops and barges on nearby beaches. A well-equipped resuscitation ward proved invaluable. Between 25 September and 10 October seventy operations were performed under general anaesthesia in the theatre. Many blood transfusions were given, and about 150 infusions of plasma and many infusions of glucose and saline. Abbott's apparatus was used and proved very satisfactory.

The set-up of the surgical unit at this stage consisted of one IPP tent for the theatre, one IP 180 lb. tent at the rear end for stores, and another IP 180 lb. tent leading off from the side which provided space for scrubbing, sterilisation, linen and other supplies.

The operating theatre was an IPP tent with a coral floor and with sides attached so that it could be blacked out during a bombing raid. An operating table fitted between the tent poles, and round the sides were various shelves made of rustic saplings or undressed timber. Batteries in a corner provided the lights which were suspended over the table. Dressings and guards were sterilised in two small autoclaves which were heated over primus burners. Slightly forward of the theatre tent another IPP tent was erected for resuscitation and connected with the sterilisation tent. All tent floors were covered with white coral sand and well drained. There were some splinter-proof wards sunk to a depth of three feet in the coral. The tents were camouflaged and blacked out. This set-up proved eminently satisfactory.

One difficulty was sweating. Sweat literally poured from all the occupants of the theatre and it was difficult for a surgeon to bend over a wound without contaminating it.

The anaesthetic was usually ether (Squibb's) following an induction by either ethyl chloride or a mixture. The difficulty in hot climates of preventing the too rapid evaporation of ether did not prevail here on account of the excessive humidity. Very frequently pentothal sodium was given, up to 40 cc., and was invariably satisfactory.

Surgical treatment again was as simple as the nature of the case would allow. Débridement and sulphanilamide powder were the essentials. Wounds were not closed. Foreign bodies were removed only if easily accessible. Fractures were usually put up in plaster or Kramer wire. There was of course no X-ray.

Of the battle casualties that arrived at the MDS (where the field hospital was situated) only one New Zealander died. No case of tetanus was seen. Anti-tetanic serum was in very short supply and when not available tetanus toxoid (1 cc.) was given instead. Gas gangrene occurred in some neglected wounds and was treated by wide excision and heavy doses of sulphadiazine. One man died with gas gangrene, and in this instance the infection was secondary to multiple wounds from bomb splinters.

At Vella Lavella 22 Field Ambulance actually received more casualties from air attack than from ground fighting, but these casualties were mainly Americans. On 25 September enemy aircraft bombed an LST that was unloading and wounded some troops, and a week later inflicted more serious casualties among a small concentration of troops on a supply ship. Fifty-five cases were admitted on the second occasion, most of the wounded being gravely injured — buttocks blown away, traumatic amputations of arm or leg, pneumo-thorax, perforation of abdomen and diaphragm, fracture dislocation of spine, etc. Most had some form of compound fracture and all had ugly flesh wounds, often multiple, yet forty-eight cases survived and were later evacuated by air, nearly all within a week. Some had to be evacuated prematurely so as to obtain special nursing attention. Treatment of the New Zealand battle casualties was a welcome contrast – their wounds were mainly from bullets, and only those who survived surgical shock during evacuation from the jungle were received at the MDS. The bomb casualties were brought in promptly over a short distance by truck, ambulance car and jeep. The mounting superiority of the Allied air force soon minimised bombing dangers and only an occasional bomb casualty was received later.

In regard to the Japanese attitude to the Geneva Convention, the ADMS 3 Division made exhaustive inquiries from American officers and officers of the South Pacific Scouts who had had extensive experience of jungle fighting. It was found that the treatment accorded to the Allies in Japanese hands depended largely on the attitude of the particular Japanese commander in the area concerned. At the same time it was known that Japanese troops in the Solomons area included large numbers of fanatics whose one aim was to kill as many men as possible, wounded or otherwise, before they themselves were killed.

The field of vision in jungle fighting was so extremely limited, and parties of both sides came upon each other so suddenly, that shooting commenced before any question of the recognition of medical units arose.

The policy laid down by the ADMS in forward areas was that the Red Cross emblem was not to be shown and red crosses on ambulances were to be painted over. Stretcher parties going into the jungle were convoyed by ASC personnel attached to field ambulances, armed with tommy guns. These precautions had been found necessary by American medical units.

(Note: Experiences during the Treasury Islands operations, when Japanese on patrol were found infiltrating into the lines of medical units, and publications indicating the active hostility of Japanese medical personnel and the general attitude of the Japanese to this subject, led to authority being granted for the issue of suitable arms to members of the New Zealand Medical Corps, if they so desired, for the protection of their patients and of themselves. All NZMC personnel, whether in base or forward areas, were early in 1944 given instruction and practice on a voluntary basis in the use of pistol, rifle, bayonet, hand grenade and Thompson sub-machine gun.

Stretcher-bearers effecting long carries in the jungle would have been considerably hampered by having to carry arms, and to obviate this the practice was often followed of sending an armed escort with stretcher-bearer parties in the jungle.)

Active operations of 14 Brigade Group on Vella Lavella showed a remarkable lack of appreciation by the individual soldier, in spite of training, of matters of field hygiene, and in particular the disposal of faeces and the treatment of water for drinking. This resulted in many cases of dysentery during the operations. Sanitary policing of any newly occupied areas or beach-heads came to be regarded as of the utmost importance as gross fouling could occur in the first hour, and the resultant damage to health could be out of all proportion to the short time of occupation. Where possible the Field Hygiene Section endeavoured to include some sanitary personnel from the unit with the initial body of troops making a fresh beach landing or moving a camp site. The primary object of these men was to establish latrines on the beach-heads for immediate use and to arrange a rubbish dumping area. Two types of field latrines were advocated – either a simple hole to be filled in after use, or a hole with a covering of a simple hinged lid over a foot-square piece of board with a latrine hole in the centre. Units, especially combat units, required individual chlorination tablets and platoon water filters of German or Italian pattern.

Supervised rubbish dumps on the Bradford tip system were liberally provided by 6 Field Hygiene Section on Vella Lavella. With a bulldozer a hole was cut out of the coral, 50 yards long and 10–12 feet deep. Trucks could be run into it and the rubbish placed at one end. The rubbish was burned and later covered with coral by the bulldozer. Owing to difficulty in keeping this constantly covered, it was necessary to insist on all tins being crushed to prevent insect breeding in retained water. As the troops were on American rations there were large numbers of tins to be disposed of, and they were potential fly and mosquito breeding places. At first on Vella Lavella flies were troublesome, but the problem was gradually controlled. Breeding occurred in decaying coconuts and other vegetable matter, and partly in unsatisfactory food dumps and latrines. Fly traps and safes at first were too few in number, but units remedied this as supplies of material came to hand. Unfortunately most of this type of equipment was left behind by units as ‘unessential’ for the forward move.

In the first month on Vella Lavella skin diseases were very prominent, and in some units 40–50 per cent of the troops were on sick parade daily with these complaints. It was impossible to state the aetiology, but it was thought that all the following factors were involved: poor conditions of living during combat, combined with lowered resistance from exhaustion and exposure and poor food during this period; insufficient personal cleanliness, including washing of clothes; rapidity-of bacterial growth in the tropics. The climate was hot and humid but not unbearable.

A large number of cases of dysentery occurred in the early stages of the fighting but later only sporadic cases were seen. The dysentery was of a mild bacillary type and the epidemic affected 37 Battalion while in combat. It was controlled by the use of sulpha-guanidine. In such circumstances Lieutenant-Colonel Sayers, the Consultant Physician, thought it would be well worth while giving sulphaguanidine or sulphathiazole prophylactically.

There were twenty-eight new cases of malaria in the Division in October, a number occurring in 35 Battalion which was in combat on Vella Lavella. This to some extent was inevitable as it was impossible to carry or use nets during actual operations. October was stated by Colonel Sayers to be always a good month as regards malaria. There were few anopheline mosquitoes although a certain amount of larval breeding was going on, mainly in streams. Excellent work was done by 1 NZ Malaria Control Unit. Very soon after arrival the unit had roughly surveyed the whole area, marked the breeding places, and started oiling and other control measures. It contacted the American control unit and divided up the territory to be covered by each organisation. Blood films of samples of troops were taken to estimate the true malaria rate. Malaria discipline at first was deficient. Atebrin was taken regularly under supervision, but there was some laxity in enforcing dress regulations. Officers did not set a good example to their men and punishment was not inflicted on offenders. Repellent was not used and washing and bathing after 5.30 p.m. was widespread. Discipline, however, was tightened up and malaria was not a real problem, even with the advent of the wet season later.

The general health of the troops, however, deteriorated and they became listless due to the climatic conditions and unsatisfactory food. There seems little doubt that insufficient attention was paid to hygiene by combatant officers.

From the time of its arrival in Guadalcanal in mid-September 8 Brigade embarked on a series of battle exercises. On 16 October 1943 the Brigade Commander received orders from 1 US Marine Amphibious Corps to seize and hold the Treasury Islands, capture or destroy the enemy forces in the area, establish a long-range radar station in the north of Mono Island, and establish an advanced naval base with facilities for motor torpedo-boats and a staging refuge for landing craft. The first flight of the brigade was to land in the Treasury Group on 27 October.

At this time the brigade was camped on the north coast of Guadalcanal, 350 miles from the prospective scene of operations. Approximately 2000 American troops, who were to come under the command of 8 Brigade Group for the operation, were also assembled at Guadalcanal. A total force of 6574 was prepared for embarkation in five flights at five-day intervals. The medical units included were 7 Field Ambulance (244) and 2 Field Surgical Unit (11). Of the above force 3700 were to sail with the first flight.

This flight arrived at Blanche harbour, Mono Island, in the early hours of 27 October. The destroyers Pringle and Philip opened fire on the Falamai area at 5.45 a.m. and the first wave of infantry landed on the beach between the Saveke River and Falamai at 6.26 a.m. The landing craft came under enemy machine-gun fire from Mono Island and also from Cummings Point on Stirling Island. Eight men were wounded at this stage. A beach-head was quickly established by 29 and 36 Battalions, though it was not secure until later in the day.

The medical plan was limited by several factors. First, there was restricted accommodation for personnel – 128 for 7 Field Ambulance and 10 for 2 Field Surgical Unit was the allocation in the first echelon. This allowed for little more than half the personnel to be taken forward in the first lift. Second, there was a limitation on the tonnage of equipment which could be carried on the LCTs and also on the number of vehicles.

Briefly, the medical plan called for the establishment of an MDS or (more properly) a field hospital on Stirling Island at a spot in reasonable proximity to the landing beach, a bearer company to establish an ADS and beach evacuation station on Mono Island within the two-battalion perimeter, and a small detachment of one medical officer and four other ranks to accompany the Soanotalu force, where little opposition was expected. It was visualised that all casualties would be held until the LSTs of later echelons could evacuate them to Vella Lavella, where there would be an American hospital. Evacuation from the Beach Dressing Station to the MDS was to be by small surface craft across Blanche harbour.

It was mutually arranged by CO 7 Field Ambulance, Lieutenant-Colonel Hunter,

Lt-Col S. Hunter, OBE; Christchurch; born Ashburton, 10 Dec 1902; medical practitioner; CO 7 Fd Amb Jun 1942–Dec 1944.

It was envisaged that after the initial unloading of the LCIs a Beach Dressing Station would be set up at the centre of the perimeter in close proximity to the beach. This was to be run by one medical officer and approximately eight other ranks, with a minimum of first-aid and ordnance equipment. The remainder of the company were to establish a more elaborate dressing station about 150 yards from the beach towards the left flank. The beach station was formed in a small creek bed, much as planned. Owing to the fact that the majority of casualties were occurring on the beach among ship-unloading parties and that the area chosen for the ADS was still under heavy fire, no endeavour was made to establish a fully functioning ADS before late afternoon. Runners readily made contact with the adjacent RMOs, but stretcher parties were not sent out until called for because they were needed more on the beach itself. At this stage there were no trucks and all carriage of wounded was by hand. Distances were short and four-men stretcher parties were sufficient. During the day only RAP treatment, including plasma, could be given on account of the exposed position of the Beach Dressing Station. Most casualties were evacuated direct to the LSTs until 4 p.m., but some casualties from early afternoon onwards were diverted to the MDS, largely to avoid over-burdening the LST. The number of men available (46) was only just sufficient to do the requisite stretcher-carrying from RAPs and on to the LSTs. By 4.30 p.m. all casualties had been evacuated and the beach station was moved to the site originally chosen for a dressing station. Foxhole digging for personnel had priority and was all that could be accomplished before dark. Heavy mortar and bombing attacks were experienced during the night. At daybreak an attempt was immediately made to set up a proper ADS consisting of tarpaulins and tents, one tent being dug three feet under the ground with a coconut log pallisade. Casualties that had occurred during the night commenced to come in about 8 a.m. and filtered through all day. All movement of casualties from forward positions ceased at dusk. During the night of 28–29 October extensive infiltration of Japanese took place into the ADS lines and there was a lot of desultory firing and grenade throwing throughout the night. Fortunately there were no casualties among the personnel, most of whom were armed. As a result of consultation with the Brigade Commander, the ADS personnel were withdrawn to the MDS site at dusk on the second night and a small Beach Dressing Station was set up on Mono at an early hour the following morning, the personnel returning thereafter to the MDS every night. This worked efficiently.

Along with the Field Surgical Unit, Headquarters Company personnel and equipment belonging to each unit were disembarked on Stirling Island about thirty minutes after the first assault wave of troops had landed (approximately 6.45 a.m.). No opposition had been encountered there, which was fortunate as the infantry had not landed in the same place and no perimeter had been established. A track was hacked through some 150 yards of heavy jungle and equipment carried up from the beaching area. All the area had to be cleared by our own working parties, but by midday a skeleton dressing station was working and ready to receive the first casualties, which arrived about 1 p.m. Both Field Ambulance and Field Surgical operating theatres were in commission and were fully occupied until 10 p.m. or later. During the late afternoon further tentage was erected. On the following days a steady stream of casualties and sick came in for treatment. Five days after the initial landing when the second echelon arrived, fifty-one patients were evacuated with the outgoing LSTs. A new site had been selected for a hospital area and partially cleared, and with the evacuation of another thirty-seven patients on the third echelon LSTs a move was made with the remaining patients and all tentage and equipment were taken to the new area. This area was much more suitable, clearer, better drained and not encroached upon to the same extent by numerous other camps. In the initial stages tentage was in short supply. Owing to weight difficulties only a minimum was brought on LCIs in the expectation that within twenty-four to forty-eight hours the heavier tents and equipment would be transhipped across to Stirling Island. This movement did not occur and it was many days before all equipment was reassembled. Difficulties in unloading under fire were greater than was anticipated. There was marked confusion of unit equipment and some was destroyed by bombing and fire. When a fire broke out salvage parties pulled equipment to the outskirts and a great deal lay undiscovered in the surrounding bush for several days. By dint of a good deal of overcrowding all patients were under shelter, but one lesson learnt was that tentage accompanying personnel should not be reduced so much in future. One unfortunate result of overcrowding in the area was that sanitary arrangements temporarily broke down. Dysentery cases were admitted at an early stage from one of the units and unfortunately many of our nursing personnel contracted it, largely due to the general rush and proximity of the dysentery latrines to the general camp and cookhouse area.

From November 1943 to February 1944 was a time of consolidation for 3 Division while the ground was prepared for another northward move. On the right flank of the central Pacific battlefield United States forces landed on Tarawa and other islands of the northern Gilberts in November, and a further thrust carried them to Kwajalein, in the Marshalls, and into the inner ring of the Japanese defences. On the left flank successful landings had continued along the northern coast of New Guinea and on New Britain in the plan to immobilise the big enemy bases of Rabaul and Kavieng. New Zealand troops were concerned with the central thrust up through the Solomons which was to end with the capture of the Green (Nissan) Islands.

These islands, only four degrees from the Equator, lie north-west of Bougainville and only 135 miles from Rabaul. Their capture was to assist in completing the Allied ring around New Britain and New Ireland and it disrupted all traffic between Rabaul and Kavieng and Bougainville and Buka. A vital reason for the seizure of the group was the need there for airfields from which pressure could be maintained on enemy bases.

Detailed medical arrangements were made by the Americans aboard the LST flotilla to deal with heavy casualties from the initial landing, but as the landing was unopposed the surgical teams on board were not required to function prior to the departure of the convoy on its return journey on the afternoon of 15 February. During the morning 24 Field Ambulance and 1 Field Surgical Unit were fully occupied in establishing an MDS, delay being occasioned by an LST landing the heavy medical equipment at the wrong beach. Consequently, equipment weighing about 20 tons had to be manhandled some 400 yards north to the site originally selected. The MDS, however, was ready to receive casualties at 2 p.m.

The site of the MDS was in a swampy and necessarily restricted area in Pokonian plantation in 30 Battalion zone. It was originally understood that this confined area was to be occupied for security reasons for the first night only. This was a gross underestimate, and when the move to a permanent site was eventually possible five days later, this initial area had become a morass. The new site was in a drier area about one mile south of Pokonian plantation on the lagoon shore. Work with a bulldozer and much blasting of coral, which was very near the surface, was necessary to prepare the site for the MDS. On 20 February 1 Field Surgical Unit moved to the site and set up its theatre, resuscitation tent and hospital tents. By 22 February the whole of the MDS and patients had been transferred to the new site.

Three beach dressing stations from 24 Field Ambulance, one for each battalion, were functioning soon after the landing on 15 February, but later that day two of these moved forward with the advancing infantry battalions. During the following week the sporadic encounters with the enemy produced few casualties, which were handled without difficulty. Twenty-eight battle casualties, mostly with gunshot and grenade wounds, were admitted to the MDS up to 25 February, 26 operations being performed.

On 20 February an evacuation of twenty-two patients, including sick, was made by LST to Guadalcanal, and a further evacuation of thirty-three patients was made on 25 February, the patients having first to be transported across the lagoon for embarkation at Tanga-lan plantation. Evacuation by air began on 13 March, 24 Field Ambulance establishing a holding hospital at the airstrip itself to enable patients to be loaded promptly.

In the meantime 22 Field Ambulance (Lieutenant-Colonel Barrowclough

Lt-Col F. G. Barrowclough; Palmerston North; born Riverton, 27 Nov 1898; medical practitioner; medical officer 7 Fd Amb Jan 1941–Nov 1943; CO 22 Fd Amb Nov 1943–Dec 1944.

The medical situation now resolved itself into caring for the growing garrison force, no further active operations being undertaken by the Division.

Water supplies proved the greatest problem on Nissan Island, as no water suitable for drinking or cooking occurs naturally there. For the first few days after landing there was an acute shortage and troops drank copious quantities of coconut milk. Water had to be provided by distillation plants which produced approximately two gallons per man per day. In a few places wells were bored and the water, though brackish and very hard, was used for washing. Tents were used for rainwater catchment, and thus the most satisfactory water for washing was obtained, although the number of containers was inadequate for some time. Extensive facilities for sea bathing were available to almost every unit on Nissan.

During the first three weeks units disposed of their rubbish and garbage within their own lines, but as roads permitted, dumps were established at suitable points along cliffs on the sea coast, with shutes leading straight into deep water. Inadequate disposal of empty coconuts and food refuse led to a large fly population. However, with clearing of camp sites and improvement of sanitation generally, the number of flies was reduced. Native pigs abounded on the island and proved a nuisance by rooting up refuse that had been buried.

Medical stores during active operations were supplied through the New Zealand Medical Stores Depot, which had its forward headquarters at Guadalcanal and a base store in New Caledonia. A section was on Vella Lavella for a time. Almost all supplies were drawn from American medical depots, under lease-lend agreement, although such items as field equipment and Red Cross hospital supplies came direct from New Zealand. Certain ordnance supplies were handled more satisfactorily by the Advanced Depot of Medical Stores. Some of the items issued in six months from Guadalcanal were: Petrolatum 718 lb.; Fuschin Basic 360 gms.; Zinc oxide 250 lb.; Calamine 240 lb.; Multivitamin capsules 330,000; Cresol Sap. Soln. 280 gals.; Mercury bichloride 28,000 tabs.; alcohol 640 gals.; Acid acetysal 350,000 tabs.; bandages, 3–in. 1000 doz.; 2-in. 800 doz., 4-in. 500 doz.; Cotton abs. 1200 lb.; Cotton abs., 1 oz., 5800 pkts.; gauze, 1 yd., 1300 pkts.; gauze, 100 yds., 128 rolls; plaster, 1-in. 2500 spls., 3-in. 2800 spls.; sponges surgical 2 × 2, bags of 200, 600; sponges surgical, bags of 500, 280.

It was estimated that during the period of greatest activity the unit was supplying nearly 40,000 troops, including some Americans, RNZAF and RNZN units in the islands.

While the unit was on Guadalcanal from 14 September 1943 to 19 May 1944 2 NZ CCS admitted 2210 patients with only two deaths occurring. Twelve hundred and fifty-four patients requiring prolonged treatment or convalescence were evacuated to New Caledonia to 4 General Hospital and 2 Convalescent Depot. The policy was laid down that patients with a convalescent expectancy of less than thirty days (reduced in January 1944 to twenty days) were to remain at the CCS until discharged fit to their units, others being transferred to New Caledonia; air evacuation was used throughout the whole of the period on Guadalcanal, thanks to the co-operation of American air headquarters on the island. The first casualties from the Treasury action were back at 4 General Hospital within forty-eight hours of being wounded. The number of battle casualties from actions by 3 NZ Division was not large, but they were augmented by Fijian wounded admitted from actions on Bougainville. Fijians were cared for in New Zealand medical units where possible and a suitable line of evacuation from New Caledonia to Fiji was in operation. Sickness, notably skin diseases, neurosis and malaria, contributed largely to keep the average bed state of the CCS at 130, with ten to fifteen admissions each day. There was very little sickness in the Division and no epidemics.

The CCS site was originally cleared with a bulldozer by engineers, who also built kitchens, mess huts and recreation huts. Later, in January 1944, the tented wards were replaced by prefabricated wooden buildings. The unit put in much work under the leadership of Lieutenant-Colonel S. L. Wilson, making its camp site a model area. Later COs were Lieutenant-Colonel Comrie (in January 1944) and Major Riley

Maj C. G. Riley; London; born Dunedin, 16 May 1912; medical practitioner; medical officer 2 Gen Hosp Nov 1940–Oct 1941; 1 Gen Hosp Oct 1941–Dec 1942; 4 Gen Hosp Feb–Sep 1943; 2 CCS Oct 1943–Jun 1944.

The CCS was well staffed and equipped to carry out both medical and surgical treatment. Full knowledge of war wounds as seen in the Middle East was possessed by Lieutenant-Colonel Wilson. Tulle gras dressings were supplied from New Caledonia. X-ray facilities at the adjoining United States hospital were used until an apparatus was available at the CCS. (The X-ray plant was not installed until December 1943 after the Vella Lavella and Treasury actions. The delay was occasioned by scarcity of plant in New Zealand, and then by slow shipment. It was realised that a radiologist and equipment should have been available for the CCS when it was established.) Although the majority of cases had already been operated on by the FSUs or field ambulances, there were batches of wounded admitted for primary treatment.

From 16 October to 31 January 139 wounded were admitted, 80 of them being sent on later to New Caledonia. There was only one death in these cases in the CCS.

The possible role of 3 Division in future operations planned for the seizure of Kavieng and the final neutralisation of Rabaul did not eventuate owing to the early and successful occupation by the Americans of the Admiralty Islands and Emirau Island. The campaign in the south-west Pacific was then virtually ended. From New Zealand instructions were received in March for the withdrawal of troops of 3 Division for work in essential industries in New Zealand. A regrouping of forces at the end of May saw the Division taken out of the combat area and brought back to its old base in New Caledonia, where arrangements were made for its disbandment and return to New Zealand.

Because of its size and composition, 3 Division was not used in the larger operations of the Solomons campaign – Munda and Empress Augusta Bay – but it found its niche and did its work well in the smaller, very valuable, if less spectacular sallies into Vella Lavella, the Treasuries and Green Islands.

EQUIPMENT CARRIED AS FIRST PRIORITY BY 7 NZ FIELD AMBULANCE AT LANDING ON TREASURY ISLANDS Headquarters Company Description Weight lb. Cubic Ft. Contents Case 100 3 Table, operating FA, 1. Case 85 4½ Steriliser, HP portable, 1. Steriliser drums, 3. Procaine soln, cartons, 4. Pentothal sodium amps., 20. Case 60 4½ Towels, hand, 72. Gowns, operating, 15. Gowns, nursing orderlies, 12. Masks, anaesthetic, 4. Masks, theatre, 1. Case 60 4½ FA Box No. 6, 1. Case 100 3 FA Box No. 7, 1. Case 55 4½ Tulle gras, tins, 4; dressings, sterile, tins, 3; vaseline gauze, tins, 19; bandages M/tailed, 6; elastoplast 3-in., tins, 22; sulphanilamide, tins, 12; stretchers ambulance, cushions, 2. Case 60 4 FA Box No. 5, 1. Pannier 60 4 FAP No. 1, 1. Pannier 60 4 FAP No. 2, 1. Pannier 55 4 Transfusion pannier, 1. Case 50 4 Head mirror, 1. Blood plasma, sets, 17. Sodi cit, amps., 15. Pannier 50 4 RMP, 1. Pannier 80 4 RFMP, 1. Pannier 50 4 Fracture pannier, 1. Case 25 2 FA Box Nos. 1 and 3, 1. Case 50 4 FA Box No. 4, 1. Case 60 4 FA Box No. 8, Dettol, 1; bleaching powder, tins, 4; companions, medical, 1; instruments, operating, case, 1; clippers, hair, 1. Case 25 1½ Reserve dressing box, 1. Case 50 4½ Dressings, shell, 7. Dressings, sterile, tins, 22. Crate 80 5 Splints, Thomas, 14. Crate 60 4 Bars, suspension, 14. Stirrups and clips, 14. Pillows, stretcher, 12. Cases (10) 48 4½ Blankets, 10 in each case. Case 80 4½ Pyjamas, prs., 40. Case 80 4½ Pyjamas, prs., 36. Bottles, HW, 16. Bottles, HW covers, 14. Case 100 4½ Sheets, ground, 34. Case 100 4½ Sheets, ground, 33. Case 100 4½ Sheets, ground, 34. Case 35 4½ Basins, IE, 13; scissors, stretcher bearers, 24; brushes, shaving, 4; brushes, tooth, 6; sponges, bath, 2; funnel IE, 4-in., 1; brushes, feeder, 11; towels, bath, 24. Case 35 4½ Nets, mosquito, 15. Case 35 4½ Nets, mosquito, 15. Case 30 4½ Nets, mosquito, 20. Case 30 4½ Bedpans, IE, 6; feeders, 12; measures, IE, 4; bottles, water, FP, 8; buckets, canvas, 4. Pannier 40 4 Medical comforts pannier, 1. Case 35 4½ Lamps, hurricane, 12; funnel IE, 4-in, 1; torches, electric, 10. Case 30 4½ Lamps, hurricane, 9. Case 35 4½ Spare globes, 2; mantles, spare, 7; lamps, paraffin, pressure, 6; torches, button, 6; burner washers, 53; meth. filler can, 1. Case 120 4½ Plates, ST, 50; bowls, soup, 50; pannikins, 50; knives CS, 50; forks NS, 50; spoons, dessert, 50; forks, meat, 2; knife, bread, 1. Case 60 4½ Stoves, oil wickless No. 5, 7. Case 50 4½ Brush, scrub, 3; brush, nail, 2; jugs, 2; kettles, camp, oval, 5; ladles, cooks, 2; openers, tin, mechanical, 1; buckets, canvas, 2. Case 50 4½ Stationery bundles, 1; Case WT, sterilising, 1; sprays, hand, pump, 6; slings, stretcher, 48; twine, rolls, 1; stools, camp, 2. Crates (15) 110 3 Containers, water 2-gal., 5 each. (ea.) (ea.) Case 100 4½ Axes, 3; hooks, bill, 2; hooks, reaping, 3; knives, cane, 8; shovels, GS, 4; spades, 2; twine, balls, 1; taps, 2; pulleys, 1; ttrel, 1; adze, 3; pick, 2; slashers, 6. Bundles (5) 180 13 Tents IP 180, 1 each. (ea.) (ea.) Bundles (4) 300 11 Tarpaulins, WP, 6. (total) (total) Case 30 3 Ether, tins 1 lb., 28. Case 100 5 Plasma sets, 30. Bundles (12) 24 4 Stretchers, ambulance, 2 each. (ea.) (ea.) Package 28 3 Hydro-burner, 1. Crate 24 3 Stands and plates, 4 each. Case 100 3 Batteries, 6-volt, 3. Case 100 4½ Surgical sponges; abdominal swabs; face masks; vaseline gauze, sterile, tins, 12; water, sterile, amps., 4; sulphanilamide powder, 5-gr. sterile packets, 48; sheet, WP, 1; tube, drainage; tube, suction; tetanus, toxoid, 300; procaine, spinal; quinine, intrav., amps., 24; atebrin, intrav., amps., 10; procaine 2 per cent, bottles, 5; sod. sulphathiazole, intrav., bottles, 6; sod. cit., amps., 12; soln. copper sulph., 2 per cent oz., 4; cannister dressing, 1; battery, lamp, 1; brushes, nail, 2; suture, dermal boxes, 3; washer, autoclave, spare, 1; applicators, wood, boxes, 1; tabs pot. permang., 200; procaine and adrenalin, amps., 25; tincture benzoin co., oz., 4; liq. iodi. mit., oz., 4; soln. acriflavine, oz., 4; phenol liq., oz., 4; collodion flex, oz., 2; blades, razor, pkts., 3; safety pins, tin, 1; note book and pencil, 1; tab azochloramide, 100; soluble M. and B. amps., 5; matches, pkt., 1.

A Company Description Weight Ib. Cubic Ft. Contents Case 60 3 Laboratory equipment. Case 40 4½ Orderly room equipment. Case 40 4½ Pentothal, sodium; ether; chloroform ethyl chloride; syringes and needles; face masks; adhesive plaster. Case 50 4½ Ether; dressings. Case 60 4½ Sterile dressings; gauze swabs, tulle gras; guards; gowns, operating; plaster. Case 60 4½ Thermette; steriliser; instrument trays; bowls IE; dixie. Case 70 4½ Primus; Coleman double burner; instrument table; steriliser; SVM. Case 120 6 Pharmaceutical supplies. Pannier 80 5 FAP No. 1. Pannier 60 5 FAP No. 2. Case 100 5 Plasma sets, 30. Pannier 50 5 Fracture pannier, 1. Pannier 80 5 Medical comforts pannier, 1. Crate 80 3 Tables, folding, 3. Crate 28 3 Hydro-burner, 1. Bundle 20 2 Thomas splints, 5; Kramer wire, pieces, 16. Bundles (12) 20 3 Stretchers, 2; cushions, 2; slings, 4 each. (ea.) (ea.) Crates (12) 85 2½ Water cans, full, 2-gal, 4 each. (ea.) (ea.) Crates (2) 85 2½ Petrol tins, 2-gal., full, 5 each; kerosene tins, (ea.) (ea.) 2-gal., full, 3. Bundles (2) 180 13 Tents, IP 180, 1 each. (ea.) (ea.) Case 60 4½ Cooking equipment. Pannier 70 4½ RMP, 1. Pannier 70 4½ Medical comforts pannier, 1. Cases (2) 100 4½ Tools: Rake, 1; slashers, 8; shovels GS, 6; shovels LH, 5; picks, 4; axes, 5; handsaw, 1; spades, 2. (ea.) Crate 40 3 Cooking stands, 4. Bundles (3) 180 11 Tarpaulins, including Red Cross, total, 4. (total) (total) Bundles (3) 30 3 Tent poles, operating theatre. Pannier 70 4½ RMP, 1.

Syrettes are greatly preferable to morphia in solution. All medical officers are in agreement with this, one reason being that morphia in solution seems to deteriorate, and that syrettes are much easier to give under adverse conditions. In our opinion they should replace morphia tablets and solution in all panniers and packings.

Plasma was of course of great value. We felt the need at times of whole blood, and in two cases whole blood was given. The difficulty is to procure donors who can reasonably spare the blood under active-service conditions.

I have discussed the question of a blood bank at some length with the medical officers concerned in the evacuation of our initial casualties and they feel also that something should be done in regard to blood in the forward zone. In an initial assault landing the blood should be available in large quantities. To obtain it, it was suggested that a blood bank be established at Guadalcanal from whence it could be carried by LSTs. In later trips maintenance levels only to be carried. It would entail priority 1 for the Fd. Amb. refrigerator but this should not be an impossible task and at least 10–12 pints of blood could be stored in the refrigerator within 4 to 6 hours of landing. It would be taken off the LST just prior to the latter's departure.

Vehicles: Under Brigade instructions a minimum of vehicles was allowed, in our case the first echelon brought one 30 cwt. and 4 Jeeps. These vehicles were really sufficient though we would have welcomed an additional 30-cwt. and a water cart earlier in the picture, especially so in view of the fact that the 30-cwt. was called on frequently for a Brigade Transport pool. The water cart must be an early priority vehicle. It is of value as soon as roads of any sort exist.

Water Cans: These are required in large numbers, either 2 gallons or US 5 gallon pattern. Water may have to be carried by hand some distance through the jungle. Ours were crated in 5 tins (2 gal.) crates with rope handle. This was a mistake, they would have been better carried singly.

Medical comfort panniers are invaluable. Large quantities of sugar and tea should be carried. There is a big demand for these and they are not available from ASC sources for some days.

Hot water bottles were taken in early priority. They are unnecessary in tropical warfare except possibly one or two.

Primus stoves are of great value, but hydra burners are still of more value. The extra weight is more than compensated for by the amount of heating that can be done with them.

Tentage cannot be reduced below present NZEFIP establishment, viz.: 7 IPPs and 45 IP 180 1b. These may not all be required in early stages but tents suffer in transport more than most articles and are more likely to be burned or damaged. Tarpaulins are of more value than tents for small dressing stations.

Tools: Cane knives are useless – they are far too light. Machetes are the tools required. Similarly G.S. shovels are no good in this soil – spades and hand picks are of much more value. Crowbars would be useful. All tools must be available immediately on landing as they are the first requirement.

Sheets were never used. We had hoped to put the more seriously ill cases in sheets in view of the climate, but this proved to be quite impossible because of the washing difficulty and water shortage. Sheets can never be used in an early stage until water is in free supply and washing facilities organised. The washing machine is worth its weight in gold and should be priority 1 even if it is a bulky article.

The refrigerator was a later arrival and was badly damaged in transit. It would have been very useful, and would be so now if it were functioning but it is not imperative. If a blood bank is to be instituted, the refrigerator must be priority 1.

Fuel (white spirit, kerosene), toilet paper and soap must be taken in large quantities early. Though the ASC carried supplies, there is little possibility of ever getting an issue from ASC sources for some days. They must be carried on the LCIs.

Tin mugs are very poor articles. They taint every drink, get extremely hot immediately hot drinks are put in them, while their sole virtue is that they are unbreakable.

EQUIPMENT OF LOGAN FORCE Description Weight Ib. Cubic Ft. Contents Case 30 4½ Ether; WSP; Carlisle dressings; jungle kits; liq. iodine; towels; torch batteries; POP bandages; cotton wool; pentothal and sterile water; ung. salicyl; torch; masks. Case 50 4½ Mugs; vaseline gauze; pulv, sulphaguanidine; towels; shell dressings; hurricane lamp; mess gear; basin, IG; hammer; calamine; tabs quin. bisulph; Horrocks box; jungle kits; surg. haversack; primus; ground sheets; pup tents. Case 30 4½ Blankets; biscuits; stirrups; tea; medical companion; Millbank clips; pup tent. Crates 2 80 3 Water tins, full, each 4. (ea.) (ea.) Case 30 4½ Medical comforts, splints and tools. Tin 20 Kerosene, 2-gal. tin, full. Bundles 2 20 3 Stretchers, 2 each, (ea.) (ea.) Case 30 4½ Plasma sets. Bundle 180 13 Tent, IP 180. Pannier 50 4 RMP.