Richard Rycroft, MO – Medical History of War

MEDICAL HISTORY OF WAR

No. 21. Base Defence Sector

 

(1). Operational purpose of Unit.  Defence against night bombing of base during invasion of continent.  Threat from Luftwaffe has been considerably less than was expected.  Threat diminishes with the passing of each day and with the withdrawal of the German forces from France.

Unit is subdivided into:

(1). Sector Headquarters. 42. Officers.  260.  O.R.

(2). Five G.C.I. units, averaging 5 Officers. 80. O.R.

(3). Many small signal units.  Ranging from 4 to 20 personnel on each unit.

(4). I.M.R.U. 2. Officers. 30. O.R.

(5). I.M.S.S.U.  4. Officers. 35. O.R.

(6). 1. Company of Air Formation Signals attached to Sector H.Q. 9. Officers. 249. O.R.

The composition of the Sector is constantly changing and small units move with great frequency and are therefore difficult to keep under medical supervision.  When first posted to this Sector the arrangements of units is almost too difficult to visualise.  Quite unlike any other branch of the R.A.F.

 

(2). Sector was formed at Church Fenton Yorkshire in January 1944.

Many of the constituent units had been formed since the previous year and were experienced in camp life under canvas.  There was only one move in England before the overseas move.  This was to Sopley near Christchurch in 1944.  The movement to France was done in three main bodies.

(i).  One G.C.I. and attached bodies (Total. 190 Officers and O.R’s) landed on D-Day.  This unit wounded and killed.  (Killed. 11. Wounded. 33.)  The loss in technical vehicles was even heavier and as a result this unit was unable to carry out the job it had been landed for.

(ii). Further units landed on D+12 and had an uneventful landing except for a wetting due to inefficient landing craft command.

(iii). Sector Headquarters landed on about D+20.

Conditions in France.  Sector H.Q. living in Chateau (officers) and tents (men).  These were left by Germans who had headquarters in chateau.  Other units under canvas.  Widely dispersed from Sector H.Q. (2 to 100 miles).  Tendency for units to get further away from Sector H.Q.

Very hard to keep contact.

 

(3). Medical problems caused by preceding paragraphs

A Medical Officer was considered necessary for this unwieldy unit at the eleventh hour.  (Previously the sick had been taken daily to the nearest R.A.F. Station.)  After two years as a Squadron Medical Officer, a job that does not give one a command of paper work and organisation, it was my lot to be chosen for this task.  I arrived at the unit, then at Sopley, near Christchurch on May 23rd 1944.  It is hard to be dispassionate about the conditions one found, especially since one was told a move into “concentration” was expected daily.  Briefly the facts were as follows:

Equipment.  Medical panniers were still in Equipment Section together with rest of Z.I. equipment.

Ambulance. Arrived on May 24th.  Unserviceable for 24 hours because of sign painting and removal of grease from body work.

Tentage. Hospital was being used by Headquarters as office tent.  This was only discovered after four days, and then by chance.  It was not considered worth while using this tent because of daily expectation of moving.  Small tents had not arrived.

One was borrowed for immediate use.

Having had no experience of tent conditions and life in the field, conditions were very hard for making decisions.  The time given seemed to be so very short.  The main problem was vaccination and inoculation of the many scattered units.  The state of inoculation was very much below average, and Typhus vaccination was needed by every man in the Sector.  I had very considerable difficulty in collecting enough material for this, since R.A.F. Hurn had no supplies and the Mobile Field Hospital had short supplies.  All the material that was collected was injected, and after a week of incessant inoculations the state of the unit was satisfactory.  I was not able to complete all the inoculations because on June 2nd I was suddenly removed and put in the advance party which embarked that evening.

Another problem that had to be met was the non-existence of medicines, forms and paraphernalia necessary for the running of the smallest Sick Quarters.  This had to be collected by the “scrounging” method from the nearest R.A.F. unit.

Since my time was fully occupied by other more vital matters, I did not manage to collect many mixtures and minor requisites.  I am convinced that a more efficient method of obtaining the minimum supplies necessary for a Sick Quarters could be evolved.  A small cabinet containing the basic mixtures, forms and stationery would meet the case and is the method used by the U.S. Army in the field.  The day of the Boy Scout camping atmosphere has surely passed.  The contrast between the U.S. Field Dispensary and the R.A.F. Sick Quarters in the field is, to say the least, illuminating.

I have been informed that it is “uneconomical” to supply each unit with these mixtures, but since they have to be collected in the long run I cannot see the validity of this argument.  It would be a saving in transport, medical officers’ time, and a good deal of anxiety.  I have discussed this at some length because in an already difficult position it was a great source of annoyance and time-wasting.

 

(4). Sick Quarters Layout.

No experience of tented sick quarters in this unit.  Unit had taken over chateau at Torqueville by the time medical equipment arrived at end of June 1944.

German Sick Quarters taken over.  In a very confused state when first seen, Sick Quarters consists of:-

(1). M.I. Room. Well lit.  Concrete floor.  Roomy.  Only disadvantage is lack of drainage and water.  Water collected in 5 gallon drums from bowser.  Soakage pit outside Sick Quarters for water disposal.  Laborious but satisfactory.

(2). Ward. Similar to M.I. Room.  Well lit.  Ample room for four beds and can hold six beds.  Corner behind screen used for Sergeant’s office.  Provision for heating in winter by stove.

(3). M.O’s Office. Lies between M.I. Room and Ward.  Very satisfactory.

All rooms have electric light.  Radiant heat cradles left by  Germans are used daily.  Glass cabinets for instruments and medicines also procured from German sources.  The Sick Quarters as a whole compare favourably with those in Britain.  Ideal for this unit.  There is a bucket latrine in a small shed behind the main buildings.

 

(5). Medical arrangements.

The units within five miles of Sector Headquarters bring their sick in daily for 8.30 sick parade.  (Average number on parade all told is ten).  The outlying units have arrangements with American units for sick parades.  This works well and there have been no complications.

Dental treatment in all cases is obtained from American Dental Officers.  The nearest unit to Sector Headquarters is seven miles away.  Service has always been exceptionally good.

Hospital arrangements

298th General Hospital in Cherbourg (17 miles away) provides an adequate service.  Any cases that are likely to be in for more than 10 days are evacuated to U.K.  This is a complication that cannot be avoided.  So far we haven’t had more than half a dozen cases evacuated in this manner.

Transport to hospital is provided, if possible and if the case is suitable, by jeep.  The Fordson ambulance rides very badly on the uneven roads and is a very real ordeal for even a fit man.  It is absolutely unsuited for service in this part of the world, and is only used when conditions forbid the use of the Jeep.  The only advantage it has over the Jeep is that it is weather-proof.

 

(6).  Equipment.

The equipment provided for a mobile sick quarters would have seemed adequate in World War No. 1, but in this war it leaves a great deal to be desired.  Having seen at the same time the American equipment, and having had to work with both, one has the impression that the American stores have been carefully thought out to meet certain definite conditions, whilst the British have been collected piecemeal with no definite plan.  The Z.1. equipment, when analysed, contains bandages, cotton wool and gauze for innumerable wounds and fractures and beyond that it has only a few bottles of tablets.  The conditions that one meets in this part of the world call for medical stores rather than surgical.  (The provision of a dental case for instance is a sheer waste of metal.  The average Medical Officer has never used a dental instrument.)

Improvement could be made by supplying in the pannier now filled with bandages and splints:

(1). Quart bottles of necessary mixtures e.g. Mist Expect in concentrated form. Mist Magnesium Trisil. Mist Kaolin Sed. Linctus Codeine

(2). Ointments. Zinc Oxide. Benzyl Benzoate. – (No provision for scabies treatment in a field  unit). Sulphadiazine. Whitfields. Hydrarg Oxy.Flav.

(3). Agyrol 20% in drip bottle. Chromic acid 5% (Gingivitis very common and easily spread under field conditions) Hydrogen Peroxide Methyl Salicylate linament. Vaseline gauze for burns – common injury with petrol stoves and dry cleaning. Tubonic ampoules. Small number of sterile tubes for pathological fluids.

(4). Sulphadiazine tablets. Insufflator for sulphonamide powder.

These items would not take up a great deal of room and yet would give the Medical Officer a chance of treating most of the common diseases met in the field.

Some provision should be made for office equipment.  Forms necessary in the field should be available.  A typewriter is indispensable.  At the moment Sick Quarters depend entirely on the goodwill of the Orderly Room for envelopes and stationery.  Group policy letters were not held by unit and so one was very much in the dark about higher policy.

 

(7). Incidence of illness of particular interest.  –  Epidemic. Gastro-Enteritis.

(1). In common with all units in this theatre of war this unit has had a large number of cases.  Most cases conform to the 24 hour pattern with acute diarrhoea during that period.  Blood in stools has been seen in a minority of cases.  It is unusual for the diarrhoea to last more than 72 hours.  The number of people reporting sick is not an index of the numbers affected.  There can be few personnel who have avoided this trial.  Culture of a few cases has failed to produce an organism.  There is little doubt however, that this is a mild form of dysentery carried by the many flies in this area.  Anti-fly precautions are taken in the form of keeping all food not in use under cover.

(2). Injuries from anti-personnel mines and other enemy material.

The danger from mines still persists and there have been a number of accidents.  Fatal accidents have been rare fortunately.  The injuries are usually a matter of many small particles being driven into the skin.

(3). Burns

There have been a number of petrol burns of the arms and chest owing to  personnel using insufficient care with petrol burners for cooking and heating water.  Treatment has varied according to the drugs available.  The most satisfactory method I consider to be the combination of sulphanilamide powder and Vaseline gauze.  Gentian Violet was unavoidably used on one occasion and was very unsatisfactory.  Sepsis occurred under the coagulium.

(4). Epidemic.  Skin Diseases

Contrary to expectation the incidence of pediculosis and scabies has been very low.  Only half a dozen cases have been discovered in the whole sector.  Benzyl Benzoate is used for the scabies.  The U.S. Army insecticide powder proves efficient in the pediculosis cases.

There have been a large number of insect bites caused by an unknown insect.  Mosquitoes have been suspected, but are definitely not the main source.  Practically all personnel have had bites on the legs and abdomen.  The insecticide powder mentioned above appears to give some protection.

 

(8). Messing and Rations.

The U.S. Army food supplied to this unit is excellent and is very much more popular than the English counterpart.  The abundance of fruit juices and canned fruit is a very strong point.  There are practically no complaints about the cooking.  The only difficulty has been in washing the eating utensils after meals.  There is no provision of adequate water containers for the necessary hot water.  One unit has managed to obtain the American type of hub with immersion heater and has benefited accordingly.  Utensils are then able to be kept clean easily since the water can be kept boiling, and there is a good volume of water.

 

(9). Entertainments and Comforts.

The Sector Headquarters have had a small theatre since coming to Tocqueville left behind by the Germans.  Outlying units send parties in each day for a cinema.  The show is changed thrice weekly.  Films are obtained from the British Sector and are about up to average standard of service films.  (A great opportunity is missed in the services here – good films could become part of the life of the average man in the street instead of the “Boy meets Girl in glorious Technicolor” type.)

Stage shows have been provided by the men themselves.  During our stay in France we have seen one U.S. show here – a swing band.

It would have been thought that discussion groups and talks would have had an appeal for people cut off from the usual pursuits, but the usual apathy of the Serviceman has not changed and there has been little of this nature over here.  Again an opportunity is being missed – an Education officer is vitally necessary on a unit of this nature.

Up to the present cigarettes have been supplied free (140/week from the American “P.X” together with chocolate and toilet requisites.  The N.A.A.F.I. ration has seemed a little meagre compared with this.  Beer has been provided by the N.A.A.F.I. at a price that does not make it popular with the troops.

Mail on the whole has come through very well and complaints have been the exception.  For the party that landed on “D-Day” the first mail came on June 24th – an entirely unnecessary delay due to muddling by the Sector Headquarters in England.  This long delay was resented by this party and was the cause of much worry about relations in the Flying Bomb early days.  The non-arrival of mail is a very likely cause for lowered morale and should be avoided whenever possible.

 

(10). Morale.

The first thing that struck me when I arrived at this unit on May 23rd 1944 was the extraordinary feeling of frustration and confusion throughout the unit.  It didn’t seem possible that such an unprepared body of men could be going into the greatest expedition in this war within a matter of days.  Every seemed to have been left to the last moment – tents, transport, clothing etc.  The unit reached France and has gradually settled down, but still there remains that unusual, atmosphere, which is usually expressed by “This is 21 Sector, what can you expect?”

The diagnosis of this malady is not very difficult to arrive at, but the treatment, being of a radical nature, is beyond the scope of this communication.

 

(11). Hygiene and Sanitation.

The most usual form of sanitation is by the bucket latrine, the contents of which are buried each day.  Otway pits are in use in a number of units.

The main problem here is the disposal of waste water, since the subsoil is clay and is therefore non-permeable.  The solution has been to dig numerous soakage pits.  Water has not been a problem.  There is usually an American water point within easy distance of each dispersed unit.  The Sector Headquarters water comes from an Artesian well and is chlorinated locally.  There is apparently no water shortage in this part of France.

The flies have constituted a problem and have been combatted by keeping foodstuffs in safes and fly-proof boxes.  Mosquitoes were numerous in July, but have decreased in numbers recently.  There have been no cases of Malaria in this unit.

The sanitary arrangements in this field depend very much on the parpenting skill of the airmen in the unit.  There is a large variation in the ingenuity shown.  A professional carpenter in each G.C.I. unit would be a very useful addition to the personnel and would ensure that adequate accommodation was made at each site.

 

(12). Liaison with Americans.

The Americans authorities have been most helpful in the way of giving us stores and medical aid.  It was regrettable that my first contact with the U.S. forces we were to work with came after the landing on D-Day.  Liaison beforehand would have been very valuable.  Being single handed and unconnected with any other Medical Officer in the landing I did not know what to expect on the beach in the way of aid posts and casualty clearing stations.  (As it happened it didn’t matter since on that particular beach there were not any in action,)  It has been a very interesting and instructive experience to work with the American forces for two and a half months, and has made up for the late and unsatisfactory start as Medical Officer to this unit.

Signed:-  R. Rycroft. F/Lt.

2.9.44

 

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