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Naval Health Services Memorial

Over recent timeswhat was the Naval Health Services has undergone a significant transformation, becoming part of a unified Defence Health Services organisation. To many past members of the wider naval community this has gone largely unnoticed. It is therefore fitting that a tribute to the valiant deeds performed by these dedicated men and women is recalled in a memorial located in the Mosman War Memorial Remembrance Gardens, situated near the site of our former largest naval hospital, at HMAS Penguin.

The Mosman War Memorial was originally dedicated to servicemen and women of the First World War but has since included those who served in the Second World War and subsequent conflicts. The poignant smaller memorial in commemoration of the men and women of the Royal Australian Naval Health Services was jointly unveiled on 30 August 2015 by the then Director General Health Capability and Director General Navy Health Services, Commodore Elizabeth Rushbrook, RAN and the President of the NSW Branch of the Naval Health Services Association and great stalwart of the Association, ex-POSBA Ron Rosenberg.

The ceremony was well attended by past and present members of the naval medical fraternity and their families. The guest speaker was Dr. Ken Hay. For this task he was well qualified as a former Sick Berth Attendant, becoming a POSBA (L), who left the service in 1967 to pursue a medical degree in Perth, WA. Ken later served as a Surgeon Lieutenant RANR but because of other commitments has since retired. Dr. Hay’s fine speech is worthy of a wider audience.

Royal Australian Naval Health Services Memorial at Mosman War Memorial Remembrance Gardens     Family Archive

Distinguished guests, ladies and gentlemen.

It is an honour and privilege to be asked to speak at this ceremony and to witness the culmination of the project to establish this memorial.

The project was conceived in 2013 over a lunch in Secret Harbour, WA, attended by John and Barbara Rae, Ian and Jan Lorimer and my wife Maureen and me. John, Ian and I had served together at Cerberusand Penguinin the early 1960s. At the lunch we discussed the closure of the naval hospitals at Penguin, Cerberusand Tarangauon Manus Island, where I served through 1965. We came to the conclusion that there should be a memorial to those hospitals and to those who served in them.

John committed to doing something about it and set about the recruitment or, more precisely, the shanghai-ing of Ron Rosenberg, President of the New South Wales Branch of the Naval Health Services Association, Jim Chapman, Jock and Tina Heath and others, all with the able assistance of Barbara. And here we are today.

I must say that without the optimism, dogged persistence and determination of John and Barbara the whole thing would most likely have been just another bright idea, the flame of which flared, fluttered and died.

Now, back to the navy hospitals and, by way of example I will focus on Balmoral Naval Hospital but most of what I say applies also to the Cerberushospital. I am acutely aware of, and ask you to bear in mind, that the time frame for my comments began 55 years ago. Also, the inevitable and continuous processes of change have rendered my navy experience incompatible with today’s navy.

Balmoral Naval Hospital was more than just a place where ill and injured sailors, of allranks, were sent for medical or surgical treatment. In my view, the presence of that hospital, and the others, projected a powerful image of a navy that cared for and looked after its people in sickness as well as in health.

It also enabled the ill and injured sailors to be treated without leaving the comfort zone and the camaraderie of the mess decks. While in hospital they were in the company of, and were treated by, their peers.

These hospitals were the prime training venues for Sick Bay Staff. There was a Medical Training School at both Cerberusand Penguin hospitals. We junior Sick Berth Attendants learned the basics and the refinements of good nursing care under the supervision of some wonderful, old school nursing sisters likeMatron Maud Jones and Sisters Patti Vines, Barbara Lawry, Carmel Scarfe and others. We learned to understand and to dispense compassion. We learned the tolerance and patience required to nurse the ill and injured.

We were instructed in the ways of the navy by senior Sick Berth Attendants like Chief Petty Officers George Powell, Ron Josey, Doug Hay (not related), Reg Black, Les Hart and Bill Pope. Most of these senior sailors were World War Two or Korean War veterans.

There were senior doctors like Surgeon Captain Brian (BTT) Treloar, Surgeon Captain Armstrong and Surgeon Commanders John Cotterell and John Mitchell. Then there were a number of very junior, inexperienced Surgeon Lieutenants mostly serving out four year, post graduate, navy scholarship commitments. They were not much older than us and some envied our lifestyle. They contributed to our medical education. Many of them, after completing their naval service, went on to become highly respected specialists in various fields.

We worked in the hospital wards on general nursing duties and did the occasional one week of night duty. We were rotated through outpatients, laboratory, x-ray, specialist clinics, medical stores and ambulance escort and attended lectures in the Medical Training School.

After we had proven our worth most of us, by now Able Bodied Sick Berth Attendants, were seconded off to places like Royal Prince AlfredHospitaltobetrainedasLaboratory, Operating Theatre and X-ray Technicians. There was no formal or structured learning process, we just went off and learned what we could. It was probably not the best way for us to learn those skills but we did it and brought the skills back to the navy – and sewed on our right arm rates.

Penguinwas certainly not a bed of roses but, in the best traditions of the services everywhere, we made the most of it and it helped build our characters. As junior sailors we lived in an open mess deck housing about thirty people devoid of privacy, with just a single wooden locker and a bunk to call home. Relationships were sometimes strained but I never did witness a mess deck fight. We learned all about tolerance. We worked in two watches which meant we could only go ashore on alternate nights and alternate weekends. Our average age was about 21 and, while we were working, our long haired, red blooded, sun tanned, civilian peers flopped about on Bondi Beach and raised Cain in Kings Cross etc. We resented that and tried our hardest to offer them a little competition. The wet canteen was only one flight of stairs away and the entertainment highlight of each week was watching The Flintstones on a black and white TV set up in the mess hall. We were lucky to see the screen through the pall of smoke.

There was the occasional drama: at about 1030 on 11 October 1960 HMAS Woomera, while dumping obsolete ammunition, suffered an accidental explosion and sank with the loss of two lives about 20 miles off Sydney Heads. We were still undergoing training but most of us, still wearing our hospital whites, were despatched to the wharf at Penguin and put aboard a workboat. Surgeon Commander Mitchell was also there, as well as a few seamen. The boat got under way and we progressed through the heads and out into the Pacific Ocean. Some time later we saw a naval ship approaching. We had no radio so a seaman rating climbed onto the roof of the workboat with a couple of us holding his legs and proceeded to semaphore the ship using two sailor’s caps. It turned out the ship was HMAS Quickmatchand with all the survivors aboard was proceeding post haste into Sydney. So we turned about and wallowed back to Penguin.

And, of course, Balmoral Naval Hospital played a significant role after the terribleVoyagerdisaster. I had been posted to Leeuwin only a few weeks before. Don Nash, one of my contemporaries, was still there and wrote an excellent account of his involvement that was published in LCDR Jeppesen’s book, Constant Care.

We endured Penguin for about three and a half years during which time sailors who had enlisted with us in other branches had been posted to ships at sea, many for the second or third time. Then eventually our postings started to come through and we went our separate ways but sharing friendships that have lasted lifetimes and countless memories both good and bad. Not by design, but I never did go to sea.

The hospital at Tarangau was different. There we cared for navy personnel, their wives and children and the civil administration population at Lorengau. Then there was the estimated 14,000 indigenous population of Manus Island. They rarely required our services but when they did it was usually serious stuff.

Our one doctor worked hard at general practice medicine, surgery and obstetrics. The nursing sister administered anaesthetics. There was one Operating Theatre Technician, a Chief Petty Officer Pharmacist Rate and one Laboratory Technician – me. When we had serious surgical problems my job was to arrange blood transfusions by taking blood from donors, doing the blood groups and crossmatch then scrubbing up to assist the doctor. We did have the support of civilian, indigenous and some PNG navy people trained in these various fields. Another of my roles was to supervise the native hospital where we admitted those with non-life-threatening illness but requiring admission. Seriously ill native patients were admitted to the main hospital. The native hospital had a maternity ward run by a very competent native male midwife.

The nearest medical help was at Rabaul but only rarely did we need it, usually for worrisome obstetric patients.

My experiences there, with the support and encouragement of an enlightened and extremely competent doctor, Surg. Lt Brian McDonald, cemented my ambition to become a doctor.

The early 1960s were relatively quiet in terms of hostilities and natural disasters. The Vietnam War was still ramping up but it wasn’t long before some of my peers were on active service there with the helicopter squadrons serving ashore or in the destroyers on the gun line. The period since has seen medical staff who were trained in the navy hospitals serving in all sorts of hot spots involving hostilities and natural disasters. Some made the supreme sacrifice. This memorial honours all those who made the supreme sacrifice before, during and since the 1960s. It is also a memorial to the navy hospitals and acknowledges the service of all health professionals who have served in the Royal Australian Navy.

The Naval Hospitals – as we knew them – no longer exist. But they live on in the memories of those of us who lived and worked there; those who simply worked there; and those who were treated there. And they played a major role in the formative years of many impressionable young men and women.

It is not my place to comment on today’s Navy Health Services – I know little of them and there is nothing to be gained in comparisons of the ways of the past with the ways of today. And fifty years hence the navy will not be comparable with today’s navy. Change is inevitable and continuous.

To close, it is my hope and wish that this memorial will become a perpetual reminder that an old fashioned navy hospital once existed near this place. Perhaps, from time to time, an occasional school teacher will bring students here, show them this shrine, and the others, and ask them to research their history.

 

The RAN and the 1918-19 Influenza Pandemic

Editor’s Note: This article first appeared in Issue 6 of Semaphore, the publication produced by The Sea Power Centre Australia in March 2006. We are indebted to them for their permission to reproduce the article.

Between April 1918 and May 1919, influenza, or its secondary complications, caused up to 50 million deaths, far more than had been killed in four years of war. Many died within the first few days of infection, and nearly half of these were young, healthy adults. The speed with which it spread has been described as ‘…perhaps the most extraordinary feature of this extraordinary pandemic…‘, for the easy transfer, from shore to ship and ship to shore, meant that even communities isolated by sea were vulnerable. A rigorous maritime quarantine policy reduced the immediate impact in Australia, but by the end of 1919 the nation had still suffered more than 11,500 deaths.

The ships of the Royal Australian Navy (RAN), dispersed as they were around the world, were certainly not spared. The pandemic occurred in waves and the cruisers operating with the British Grand Fleet suffered several outbreaks in 1918, with up to 157 cases in a single ship. Outbreaks in the Mediterranean were even more severe with the cruiser HMAS Brisbane recording 183 cases between November and December 1918, of whom two died of pneumonia. In all, the RAN lost some 26 men to the disease. When the cramped mess decks and poorly ventilated living spaces of early 20th century warships are recalled, it is perhaps remarkable that the toll was not greater. The saving factor was largely the ready availability of professional medical treatment.

Pacific Islands

Some of the most virulent outbreaks occurred in the islands of the South Pacific, where few among the indigenous populations escaped infection. The disease arrived on the regular cargo vessel SS Talune, which had sailed from Auckland on 30 October 1918, knowingly carrying sick passengers. Successively calling at ports in Fiji, Samoa, Tonga and Nauru, the steamer’s visits were marked by the first cases of influenza appearing ashore a few days after her departure. With local authorities generally unprepared, the infection spread uncontrollably, a situation aggravated both by the shortage of suitable drugs and the fact that local health workers were among the first to fall.

Hardest hit was the former German territory of Samoa, where inept New Zealand administration resulted in no attempts at patient isolation and the rejection of medical assistance offered from nearby American Samoa. With the forced closure of government institutions and stores, few people being in a fit state to assist with the distribution of food and medicines, and a growing number of uninterred dead, the Samoan situation rapidly became critical. On 19 November the military governor in the capital of Apia telegraphed Wellington for help, but had his request turned down on the grounds that all doctors were needed in New Zealand. Australia offered the only alternative source of aid.

The Commonwealth Naval Board was already aware of the developing regional crisis. The sloop HMAS Fantome, stationed at Suva in Fiji for police duties, had reported her first cases of influenza on 11 November, and soon had more than half her ship’s company incapacitated. More importantly in terms of an effective Australian response, of all government departments only the RAN had suitable assets at immediate readiness. On 20 November, the Board began gathering a joint relief expedition from among the available naval and military medical personnel, placing it under the command of Surgeon Temple Grey, RAN. The commanding officer of HMAS Encounter, Captain Hugh Thring, RAN, was then ordered to embark the expedition at Sydney and proceed at the earliest possible date to Samoa.

Even today the speed of Encounter’s response must be admired. Her sailing orders were telegraphed from Melbourne on Friday, 22 November, and throughout the next day and night the ship’s company worked tirelessly to get in relief stores. Without any information from Samoa as to specific requirements, Thring loaded almost 150 tons of cargo ranging from blankets and tents through to drugs and dry provisions, expecting that these would meet any emergency. The weekend created further difficulties as shops were shut and some items not in stock had to be purchased. Nevertheless, on Sunday forenoon the medical teams embarked, the last of the stores were in by 1550, and ten minutes later Encounter sailed from Sydney.

The Health of the Navy

Its Influence on Battle Outcomes In Nelson’s Day

We tend to believe that the long distance voyages in the days of sail were riddled with death and disease, notably scurvy, because the sailing time was extended and because the sailors missed the benefits of land-based recreation and balanced diets. This was true to some extent, especially before people like James Cook showed that careful planning, navigation and attention to some basic essentials such as diet, sanitation and hygiene could not only keep sailors healthy but would save lives.

There is a lot of relevant history leading up to the period of exploration which gradually unraveled some of the medical mysteries of deficiency diseases and it might be possible to return to that later. Meanwhile there were certainly expeditions during Nelson’s time which came to grief because ships’ crews were decimated by disease; or they were so severely weakened that they required assistance to limp into port. Such an embarrassing experience occurred in 1802 when the French ship Geographe under Nicolas Baudin reached Port Jackson.

Geographe

Baudin barely made it into Port Jackson and spent the next five months recuperating and replenishing supplies – a situation at the time that begged the questions as to what did the French knew about scurvy and what preventive measures did they practice to avoid the disease. The crews of the Geographe and the Naturaliste were also severely attacked by dysentery when they landed in Timor. The sad consequence for many of the French captains was that they too suffered and a significant number did not return home after months or years at sea.

Though Baudin’s medical officers were much less aware of the causes, prevention and treatment of scurvy than their British counterparts, they nevertheless showed impressive clinical skills and keen interest in medical research. On their return to France two of them published doctoral theses on scurvy and a third published a thesis on dysentery. Francois Peron, a naturalist and a medical graduate from Paris, who belatedly published the journal from this voyage, also wrote on medical aspects of the expedition.

Thirty or forty years later when passengers paid to emigrate to Australia from England the death rates on hundreds of successful voyages were considerably lower than for the shorter trans-Atlantic crossings to America. And the logical reason for this is shown by the reports extant from surgeon superintendents on each ship who kept meticulous records. Their recommendations regarding diet, exercise, hygiene and sanitation were adhered to because the surgeon’s word on these matters was accepted as law. There are many types of illness that can affect the efficiency of a crew just to sail a ship let alone go into battle against an aggressive, determined enemy. Well before Nelson’s time sea voyages had become a matter of endurance, long drawn-out expeditions of uncertain or unpredictable outcome. The early explorers had no idea what to expect and generally were unprepared for the uncertainties of resupply of essentials like water and fresh fruit.

Trade and Colonisation

Not until regular trade routes were established to India or the West Indies did they find reliable sources of food and water at regular ports of call. As ships and navigation improved, the sea-going nations encouraged their sailors to go further into the unknown, to explore and to investigate potential trade routes, but for centuries the distance and time at sea were always their enemies.

It seems that trade and colonisation were the two factors that created intense competition between the various sea-faring nations, the one following the other as a necessary protection for their valuable business investments. As one thing led to another one might expect the protection of such national enterprises which included trade in spices, sugar, gold, ivory and slaves to lead to fierce competition and even conflict between nations. On some occasions it led to war.

Some of these nations were already at war across Europe, including Russia and even North America, so that at various times during the eighteenth and nineteenth centuries it is understandable that their navies were constantly recognizing new allies and confronting new adversaries.

At the time of both the American war of independence against Britain (1776) and the French Revolution (1789) the resources of all countries involved were stretched, even before the extra burden imposed by the Imperialist campaigns of Napoleon. In the ten year period from 1774 the Royal Navy increased in size from 103 ships with 17,000 men to 430 warships with more than 107,000 men.

Green and Gold Malaria

The day would soon arrive when I could not ignore the rash. I was obviously ill and so I called on Doctor Nash. This standard consultation would adjudicate my fate. I walked into his surgery and gave it to him straight:

‘Doc, I wonder if you might explain this allergy of mine, I get these pins and needles running up and down my spine. From there, across my body, I will suddenly extend – My neck will feel a shiver and the hairs will stand on end.

And then there is the symptom that only a man can fear – A choking in the throat, and the crying of a tear.’ Well, the Doctor scratched his melon with a rather worried look. His furrowed brow suggested that the news to come was crook.

‘What is it Doc?’ I motioned. ‘Have I got a rare disease? I’m man enough to cop it sweet, so give it to me, please.’ ‘I’m not too sure,’ he answered, in a puzzled kind of way. ‘You’ve got some kind of fever, but it’s hard for me to say.

When is it that you feel this most peculiar condition?’ I thought for just a moment, then I gave him my position: ‘I get it when I’m standing in an Anzac Day parade, And I get it when the anthem of our native land is played,

And I get it when Meninga makes a Kiwi-crunching run, And when Border grits his teeth to score a really gutsy ton. I got it back in ’91 when Farr-Jones held the Cup, And I got it when Japan was stormed by Better Loosen Up.

I get it when the Banjo takes me down the Snowy River, And Matilda sends me waltzing with a billy-boiling shiver. It hit me hard when Sydney was awarded the Games, And I get it when I see our farmers fighting for their names.

It flattened me when Bertrand raised the boxing kangaroo, And when Perkins smashed the record, well, the rashes were true blue. So tell me, Doc,’ I questioned, ‘am I really gonna die?’ He broke into a smile before he looked me in the eye.

As he fumbled with his stethoscope and pushed it out of reach, He wiped away a tear and then he gave me this stirring speech: ‘From the beaches here in Queensland to the sweeping shores of Broome, On the Harbour banks of Sydney where the waratah’s in bloom.

From Uluru at sunset to the Mighty Tasman Sea, In the Adelaide cathedrals, at the roaring MCG. From the Great Australian Bight up to the Gulf of Carpentaria, The medical profession call it ‘green and gold malaria’.

But forget about the text books, son, the truth I shouldn’t hide.
The rash that you’ve contracted here is ‘good old Aussie pride’.
I’m afraid that you were born with it and one thing is for sure
You’ll die with it young man, because there isn’t any cure.’

HMS Byron and the Captain’s Appendix

HMS Byron was one of the 78 American-built Destroyer Escorts (DEs) acquired by the Royal Navy as welcome additional convoy escort vessels under Lend-Lease arrangements, and immediately employed in the Battle of the Atlantic. The following account recalls an unusual incident, unrelated to enemy action, during a return convoy from North Russia.

The US-built Destroyer Escorts in Royal Navy service during WW2 were never really considered robust enough to be considered ‘Destroyer Anything’ and were reclassified by the Royal Navy as frigates. On their arrival in the UK, they were stripped of many of their original American refinements (out went the coffee percolators and drinking water coolers) to be replaced by more mundane regular-issue items (in came depth charges and Hedgehog mortars) to bring the new renamed Captain Class ((32 USN DEs of the Evarts Class were lent to the RN, of which five were lost, and the remainder returned to the USA for scrapping after the war.  The Captain Class frigates of WW2 were all named after distinguished Captains RN.))1  up to Western Approaches standards. However, for our current purposes, the salient facts were the state-of-the-art Sick Bay and the 27 foot Montagu whaler seaboat on the port side.

The Sick Bay

The lavishness of the Sick Bay and its equipment was not matched by the expertise of the sole member of the medical staff. Leading Sick Berth Attendant Stockwell was an admirable fellow in many ways, much admired for his open-handedness with the family planning requisites and the elegant way he read us the more lurid passages from the chapter on anti-social diseases in his Seafarer’s Medical Companion. He would be the first to admit, however, that Doctor Crippen ((Dr. Crippen was a notorious serial murderer, caught and sentenced to gaol in the late 19th Century.)) was better qualified medically.

It was against this surgical background that our Captain developed appendicitis. Now the Captain, Lieutenant Commander Ken Southcombe, Royal Navy, was a gentleman to his fingertips and one would have expected him either to have his appendix brew up in the privacy of his own home, or at the very least, within comfortable hailing distance of the Royal Naval Hospital, Haslar. ((RN Hospital Haslar, Gosport (near Portsmouth) was a formidable establishment, built during the Napoleonic Wars, to restore wounded sailors to further service, and later in living memory, feared for its reputation of retaining naval patients for at least a fortnight  (for observation) before their release back to their ships, no matter what their suffering, diagnosis, or treatment!)) Not so. The spot he chose was off North Cape, in a violent snowstorm, on our way back from Murmansk. We reviewed our surgical capabilities: things were not encouraging.

The Seafarer’s Companion and Medical Expertise

The Seafarer’s Companion had some fascinating diagrams, in full colour, of the human internal pipework, but they looked tricky to follow, and the First Lieutenant, and honorary ship’s Medical Officer, David Repard, admitted that his recollections of his Dartmouth First Aid Course did not bring to mind any mention of ‘hands-in’ surgery. Our only hope – we put it that way, rather than ‘the Captain’s only hope’ – was to be talked through the procedure by the Escort Group’s Doctor, who was way out on the beam of the convoy in HMS Redmill (a sister ship). According to Damon Runyon, the chances of anything happening are seven to four against, but the doctor did not rate ours as high as this, so he decided to come across to our ship.

Far from being a solution, this decision compounded the problem. It was nearly dark, snow showers had reduced visibility to about a cable, we were rolling gunwales under, there was heavy cloud, with nothing much visible anywhere, even supposing there had been anything to see. As an added complication, we were towing Foxers, ((Unifoxers – a mechanical pipe noisemaker towed astern of  convoy escorts to decoy acoustic torpedoes – a very cheap and highly effective device for its purpose.)) and therefore had a lot of wire out over the stern. Nevertheless, undaunted, we launched the whaler.

The Seaboat

The seaboat’s crew was not the carefully selected group of experts one might expect under the circumstances, but as was common practice aboard Byron, all alarms and excursions were dealt with by the cruising Watch on Deck – in this case, B gun’s crew. The only exception on this occasion was that the expedition was put in the charge of Mr. Midshipman Peter Topping RNVR, an appointment which he maintains to this day was a tribute to his seamanship skills, rather than, as was suspected at the time, that Mr. Topping had just sufficient seniority to divert criticism from everybody else if disaster should strike.

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