ENDURANCE, COURAGE AND CARE: THE KOKODA TRACK CAMPAIGN

OF CAPTAIN ALAN WATSON,

DENTAL SURGEONAUSTRALIAN MILITARY MEDICAL ASSOCATION

JOINT HEALTH COMMAND SYMPOSIUM Oct 2010

BARRY REEDRoyal Australian Army Dental Corps

Australian Army ReserveOral & Maxillofacial Surgeon:

~ 1st Health Support Battalion Senior Specialist Oral & Maxillofacial

Surgeon~ John Hunter Hospital, Newcastle

Lecturer (part-time)School of Medicine

University of Newcastle, Australia

This lecture reflects my personal professional opinion

1st HSBC.O: LTCOL L Sinclair

This historical research has been supported by an

Australian Army History Unit Research Grant Award

• Australian War Memorial, Canberra. ~ Photographic Image collection: p2424 and p2423.

• Kokoda War Diary 1942-43. The Recollections and Photographs of Dr Alan Watson A.M. ~ Video. 1991.

• Mitchell Library collection, Sydney. Reference MSS 1825:~ Extracts from the War Diary of Captain Alan O. Watson~ Image collection~ Biographical notes

• Little by Little. A centenary History of the Royal Australian Army Medical Corps by Michael Tyquin. Australian Military History Publications. 2003

• Australia in the War of 1939–1945. Series 5 – Medical -Volume Volume 3 – The Island Campaigns.1st edition, 1957.

References & photo acknowledgments

The Australian military health care tradition:The Australian military health care tradition:endurance, courage and care for wounded endurance, courage and care for wounded

soldiers whatever the circumstances soldiers whatever the circumstances

Simpson Kirkpatrick, RAMC stretcher bearer & “Duffy”Gallipoli 1915

World War One:

Gallipolli 1915: dental treatment

Western Front 1918: dental treatment

2/4th Field Ambulance: Lead Medical unit for the Advance phase

October to December 1942

Deployed medical units • Were the 14th and 2/6th

Field Ambulances for the initial advance to Kokoda, the fighting withdrawal phase and then mostly as rear units for the later advance phase

• 2/4th Field Ambulance took over as lead unit for the later advance phase of the Kokodacampaign from October 1942 and the Gonacampaign in Dec 19422/6 Field Ambulance. Myola 2. October

Roles of Capt Alan Watson, Dental Officer

• Emergency & urgent dental care

• General anaesthesia• Aeromedical evacuation

Officer

photography• Capt. Alan Watson appointed by his

Commanding Officer LTCOL Arthur Hobson as unofficial photographer for the unit

• Two German Leica cameras

Experienced• Graduated with

Honours 1938• Rural private dental

practice 1939• Joined Army 1939• Syrian campaign 1941• 25 years old• received a short

concentrated course in the administration of general anaesthesia at the start of his Kokodacampaign

Roles of the 2/4th Field Ambulance

• “The Field Ambulance must be capable of instant movement and change. In the New Guinea campaign there was no question of leaving the field ambulance behind. It had to and did keep up with the battle troops”.

by WO2 LC Thompson in an article published in SALT March 1943

• Triage and Resuscitation• Ward nursing care with patient

holding• Initial wound surgery and further

surgery• Primary health care• Preparation for evacuation• Dental care• Environmental health support

Example of instant change: Efogi 15th October. Emergency arm amputation

“the field Ambulance must be capable of instant movement and change.. ….. It had to and did keep up with the battle troops”. (WO2 LC Thompson, SALT March 1943)

• Of crucial importance, it had a surgical team attached for the campaign

Proximity for surgical care with the Field Ambulance

th Field Ambulance had a comparable sualty care role to today’s role two nhanced) deployable Army hospital

Some problems of the Campaignoblems In neral:

rrainWeather

ansport opical diseases

ommunication nemy action

• Specific casualty care problems:

• Medical evacuation• Resupply difficulties

(medicines & food) • Hospital staff levels:

surgical workload and ward workload

• Lack of equipment• Lack of adequate shelter• Staff health

maintenance ~ diseases & t bl ill

errain: jungle and mountains mita Ridge (northern view)

mita Ridge (southern view towards Port Moresby)

“Golden Stairs”. Imita Ridge

Terrain obstacles: streams

Terrain obstacles: Rivers (Wairopi)

Weather: torrential rain (mud), cold and heat

Mode of Transport: walking

Distinctive feature of the Kokodampaign were the walking wounded

who self evacuated along the track

ansport of supplies & equipment: rimary method of the campaign

~ native carriers

Native carriers for resupply

tive carriers for severely wounded

CAPT Geoffrey Vernon

ransport: First stage of campaign ~ mules

Last stage of campaign:

motor transport

nsport of supplies/replenishment: aerial drops

0% losses with

Supply by air: strips ~ weather & terrain difficulties

air strips ~ terrain difficulties

Proximity for the Field Ambulancehe revolutionary conditions imposed on us gave e to a new leap frog movement. The unit was ead out along the track in a series of posts”.

O2 LC Thompson in an article published in LT March 1943)

Kokoda Track

ersonnel 2/4th Field Ambulance in the Kokoda Campaign

officersother ranks

______________________________ginal War establishment:officers

5 other ranks

Main Dressing Station. 2/4 Field Ambulance. Myola 1.

Treatment of the Sick 0% of hospital admissions or more)

e.g. 8th November: 52 battle casualties, 205 sickMalariaDysenterySkin diseasesFatigue, exhaustion malnutritionTyphus

Hospital ward: Nauro jungle

Hospital ward: Dry lakes at Myola

1 W d d ldi i f th t t th t h it l d t th

ospital ward: native construction at Kokoda

uta M.D.S. (operating theatre & kitchen)

Preparedness

ress shows evidence of the unit's lack of preparedness for the campaign ahead the Kokoda Track, with Captain Day wearing puttees as used in the deserts of

eparedness & improvisation/adaptability

Operating theatre equipment

puta 2. The operating theatre. The operating table is a makeshift piece of bush handicraft made from trees.

surgical equipment was most primitive: a Primus stove

Dental clinic

Preparedness

No dental replenishment for five monthsCapt Watson prepared his o n kit and his

Modern day emergency dental kit

Dentistry by Capt. Alan Watson• 3rd October to 18th December

(11 weeks):• 208 patients ~133 made fit

(64%)• 2 fractured mandibles • ~ closed reductions• 238 extractions• 74 fillings and dressings• 19 Acute Necrotising

Ulcerative Gingivitis (“trench mouth”)

• (30 gingivitis/periodontal disease, 12 denture

difi ti 6 U S A

Surgical team

Types of woundsLimb~ common ~ “a really serious problem was lack of control of the femoral artery by tourniquet”Chest ~ sucking chest woundsAbdominal ~ transfusion often~ “wounds of the buttock

were misleading”HeadGas gangrene ~ 4.5% of battle casualties~ “value of surgical excision”

Surgical teamOperated day and night. Myola 1. Dawn

Surgical Team Workload: n major cases in twelve hoursth perhaps additional five less serious casesckled all branches of surgery

ay and night shiftsp to 36 hours continuously in operating theatre

General anaesthesia

General anaesthesiaEther, chloroform (from 1918 supplies) and Pentothal later

neral anaesthesia by Capt. Alan Watson

16th October to 18th December (9 weeks):

Surgical team

Efogi North. Members of the surgical team of the 2/4th Field Ambulance perform an operation in the tent that serves as the operating theatre at the unit's Main Dressing Station. Left to right: Captain Douglas Leslie, the surgeon; Lieutenant Colonel Arthur Hobson, the unit CO, who is assisting; Capt Alan Watson, the unit Dental Officer, who is

Operations performed

ain Douglas Leslie applies plaster to a soldier's broken left leg Assisting Captain

Operations performed

0 battle casualties admitted In 24 hours,

Resuscitation evere degrees of shock not uncommon”od transfusions: Serum, whole bloodwalking blood bank”: unit members, soldiersx-rays

Historical record: First operation, 2/4th Field Ambulance

Historical record: First operation, 2/4th Field Ambulance

Transport of the wounded &medical evacuation

The stretcher is slung below a single carrying bar supported at each end by one rriers; the carriers work in teams of eight under the supervision of a native 'boss

Evacuation by air

da, November. USAAF Stinson Vigilant ambulance aircraft prepares to take rom the airstrip. The aircraft is evacuating two sick or wounded Australian s to Port Moresby from the 2/4th Field Ambulance The Stinson was capable

pt. Alan Watson s aeromedicalevacuation

oading Officerokoda airstrip, 5 Nov to 16 Nov: rganised evacuation of 350 patients est two days: 111 and 99 casualties

opondetta airstrip, one day only, 27th Nov:rganised evacuation of 400 battle casualties & ck

Bartering with Japanese rifles & helmets for aeromedical evacuation:

Four hundred evacuated on the day of air raid

good scale of payment. A Japanese helmet equaled sick or wounded. A Japanese rifle equaled ten-

r raid Soputa M.D.S: 27th November

n a few minutes a busy ospital was transformed to a miniature battlefield.”

Air raid: wards hit

Air raid: 22 killed, over 50 wounded

Completing both the Kokoda Campaign and Kokoda track.

Gona beach. 16th December 1942

casualties Papuan Campaign: 942 to January 1943 Australian troops served:

killed

Some problems of the Campaignoblems In neral:

rrainWeather

ansport opical diseases

ommunication nemy action

• Specific casualty care problems:

• Medical evacuation• Resupply difficulties

(medicines & food) • Hospital staff levels:

surgical workload and ward workload

• Lack of equipment• Lack of adequate shelter• Staff health

maintenance ~ diseases & t bl ill

Morale: Lack of timely replenishment of

hospital suppliesBandages and dressings, essential drugs, anaesthetic agents, tents, stretchers, food, sutures, sterile water…..

provisations, Ingenuity and Solutions Fuzzy Wuzzy AngelsLocal suppliesEquipment improvisationleapfrog” unit movement

First use of aeromedical evacuationHolding non-walking casualties long term in wardsWalking wounded self evacuationAerial supply dropsField Training and Multitasking personnel for staff shortages e.g. general anaesthesiaMedical liaison officers with HQRole of kitchens and food in morale maintenanceCombat health support: Mobility, proximity, flexibility,

Historical record

ng hard, PO Archer exclaimed excitedly, 'Sir, sir, I think I've shot down a Zero!' s the Control Officer replied, 'Don't be silly, Archer, Wirraways can't shoot down ' 'Well, sir,' continued Archer, 'I went in to look at the wreck off Gona and I saw

wards South West Pacific between October 1st 1942 and March 31st 1943:

BE (Military Division): Lt. Col. A.G. Hobson NX454tation”: Lt Col. Hobson was personally responsible r good service rendered by his Field Ambulance Unit.

his unit served continuously two brigades during the vance from Nauro to Gona.

entioned in Dispatches (Posthumous):aj. I. F. Vickery NX473aj. H.F.G. McDonald VX 14704

entioned in Dispatches:apt. D.R. Leslie VX39117apt. A. O. Watson NX 34655

Alan O. Watson, A.M. 1917 - 1993 entioned in despatches”, for “having rendered gallant and tinguished services” in the Kokoda Track campaign

omotion to Majorlaria for three years; dysentery

scharged 1944vate practice with his father, Macquarie St, Sydneyovations in the dental care for Cerebral Palsy patients for

rty years; established dental operating theatre at the Spastic ntre Mosmanrt time lecturer, University of Sydney from 1962norary life membership Spastic Centre of NSW 1979ctor of Dental Science 1955mber of the Order of Australia 1983tor Histor of Dentistr in NSW 1788 1945

his qualities live on:edication, adaptability, excellence,

Questions?

panese prisoners awaiting aeromedicalevacuation

Morale: central role of an integral unit kitchen as

the unit social venue & the provision of adequate food proved invaluable in maintenance of morale