New Zealand Medical Services in Middle East and Italy
Auxiliary Departments of Hospitals
Auxiliary Departments of Hospitals
At Helwan 2 General Hospital had an X-ray department and full investigations could be carried out, though difficulty arose with fluctuations in the local power supply. The bacteriological laboratory was kept busy and steadily increased the scope of the work undertaken. It proved to be a very essential service to assist with the treatment of tropical disease, especially of dysentery. From April 1941 biochemical estimations were also carried out. It is interesting to note that only one positive diphtheria case was found during the year. A specialist anaesthetist was on the staff at Helwan and full use was made of intravenous and spinal anaesthetics, which proved very suitable in the hot climate. Pentothal was very much used. Physiotherapy was available with trained staff and full use was made of the massage department for orthopaedic and other cases. An ultratherm was presented to Helwan at that time by Watson Victor, Ltd. A dietitian was appointed to the hospital staff in April 1941 and proved of great value in the preparation of special diets for such cases as diabetes and dysentery. There was at first some difficulty in arranging smooth working with the army cooks, but this was soon overcome.
A dental department which was started in December 1940 was very fully employed. Extractions were frequently referred to the hospital from the camps, and conservative dentistry was carried out to render dentally fit as many of the patients as possible before discharge. A great deal of extra work was entailed in the replacement of artificial dentures lost in Greece and Crete. Fractured jaws were dealt with by inter-maxillary wiring for two weeks, followed by the application of a modification of the Hammond splint. The results drew high praise from Colonel W. A. Hailes, Consultant Surgeon to the AIF.
A splint-maker was posted to the staff in April 1941, and gradually a small department was set up and proved very useful in page 234 the making and adjustment of splints, adjustments to boots, and in metal and leatherwork generally. Such a department is indispensable in a hospital with an overseas force. Provision for one was made by 1 General Hospital when the unit left New Zealand, but the lack of any provision in the army establishment prevented its development, though the very experienced mechanic was able to gain further experience in England in a special orthopaedic hospital under Brigadier Bristow, RAMC.
The out-patient service was very extensively developed at Helwan and covered all branches – surgery, medicine, orthopaedics, eye, ear, nose, throat, massage, and dental. The service was open to the RMOs at the NZEF camps as well as to other forces in the area. It was thought at first that too much use was made of the department by RMOs and that some patients relished the day's visit to the hospital, but undoubtedly it was of great value that cases of doubtful diagnosis or those needing specialist treatment should have had the opportunity of seeing specialists under conditions allowing of first-class treatment. RMOs were later encouraged to attend the clinics and undoubtedly benefited thereby.
The institution of an occupational therapy service was started in December 1940 by Colonel Spencer, who was very enthusiastic in its development for psychoneurotic as well as physically disabled patients. He advocated occupational therapy for the treatment of psychological disorders such as anxiety neurosis, as a distraction for patients with mental disorders, for orthopaedic surgery to train individual muscle groups, and for patients confined to bed over long periods for the preservation of morale and provision of escape from tedium. Fortunately, an enthusiastic group of women resident around Cairo, under the leadership of Mrs Washbourn, undertook the work, which was at first confined to the anxiety neurosis cases and proved very successful. Colonel Spencer considered that wholetime officers for this work were necessary both in the general hospitals and at the Convalescent Depot. The work developed considerably at Helwan, and later was instituted at the other hospitals and the Convalescent Depot as recommended by Colonel Spencer.
At Helmieh, where it had taken over the site of 1 General Hospital at the end of March, 3 General Hospital spent some months developing the hospital site and setting up its special departments. The laboratory and physiotherapy departments were opened in April, the operating block in May, the X-ray department in June, and the dental department in October. The hospital was disorganised by a widespread sandfly fever epidemic amongst the staff in June, the effects persisting into August and necessitating restriction of admissions. Some 400 battle casualties from Crete, mostly lighter cases, were admitted in May.