The Reflections of a Battalion Medical Officer
I served as the Regimental Medical Officer (RMO) of the 5th Battalion on the second tour in 1969/70. Forty years on details have faded but the following is a general account of my experiences.
Just as RMO's have done in previous wars, the RMO in South Viet Nam was responsible for the health of the 800 men in the battalion. As they were there because they were fit, we did not have to manage chronic diseases ( such as heart problems or diabetes) which would be treated in a normal medical practice in Australia.
The medical team comprised a Sergeant who ran the medical centre in Nui Dat and Medical Assistants. Some "medics" worked in the medical centre while others were allocated to each platoon of 30 men to provide first aid assistance in the field and treat other minor problems. The base hygiene was overseen by a Hygiene Sergeant.
A medical record was kept for each soldier at the medical centre .... all illnesses and injuries were recorded in this record as well as the vaccination status; booster injections were administered as required. The medical record accompanied the soldier when he changed units and on his discharge it was filed away at Army Records. In later years, if the soldier believes his health has suffered as a result of his service, he can apply for assistance with medical treatment or a pension. His medical record is an important part of the application process.
Skin problems were common with Tinea being particularly prevalent. This was the result of working in a tropical climate without regular washing and changing of clothes. Clean uniforms were flown in with the resupply to the men on patrol every third day. It was usually not possible to remove boots or clothes at night while sleeping as the enemy could attack at any time.
Working in muddy paddy fields or lying or sitting on the ground could result in an infestation with Hookworm or other parasites. Collecting water while on operations had to be done carefully as there was a good chance of contamination with amoeba and /or the bacteria which cause dysentery. All of which could be very disabling for the soldiers so in some areas water was resupplied by helicopter.
Diseases with high fever were common ... while the men could contract the common flu, high temperatures from infections caused by other microbes were common and often proved difficult to diagnose without a blood test. Malaria was prevalent so it was essential that all personnel avoided mosquito bites by covering up with long trousers and shirts after dark and sleeping under a mosquito net. Each day we were required to take tablets as prophylaxis against malaria.
Towards the end of the tour I became increasingly concerned about the condition of many of the soldiers ... they were underweight and appeared malnourished. Their condition was no doubt partly due to exhaustion after a demanding tour but their diet while on patrol left much to be desired. The tinned ration pack which was supplied every three days provided a balanced diet but after much of it was discarded because it was heavy or swapped for favourite tins, it was anything but balanced. On one occasion I supplied vitamin supplements to the troops on patrol in an effort to improve their nutrition ... unfortunately the tablets made the men so hungry they ate their rations on the first day and refused to continue with the supplements !!!!!
On occasions when the battalion was back in base, in the interest of WHAM ... winning hearts and minds ... the medical team would do some MEDCAPS ... medical civil aid projects. We would take a small team into a village which was selected by the Australian officer who was liasing with the Vietnamese local government. Working through an interpreter with a limited understanding of things medical, I attempted to make a medical assessment on each of the numerous people who queued. We had a good supply of a palatable cough mixture which was very popular ... almost everyone I saw was complaining of "cough"!!! In the absence of good communication with the patient and basic investigations, it was not possible to make a firm diagnosis. As an aside, I used to wonder how many Viet Cong were in the queue and how much of what we dispensed was passed on to them!!!
Air superiority and the great mobility provided by the ubiquitous helicopter made a big difference. When the battalion was on operations, a Fire Support Base was established in the middle of the area to be patrolled . The Commanding Officer and supporting staff including the RMO moved to the Fire Support Base along with the artillery battery and mortar platoon. Despite the RMO being at the Fire Support Base, it was usual for the wounded to be picked up from the battlefield and taken directly to the hospital without the RMO seeing them. Unlike the wounded soldiers on the Kokoda track who might have had to be carried for days to reach a basic hospital, our wounded were often in the hospital within half an hour of their injury.
Such prompt evacuation meant that soldiers with serious wounds reaching a well equipped hospital so soon after their injury had a much better chance of survival than in previous conflicts. As some required very large blood transfusions, there were problems with the blood clotting, necessitating a lot of research which advanced the understanding of the processes involved..
The Australian Field Hospital at Vung Tau on the coast provided very good treatment for our sick and wounded. The wards were staffed by nurses from the Royal Australian Army Nursing Corps and medical assistants. Some of the doctors were serving members while many were specialists from Australia who spent three months at a time at the hospital. Pathology services and a blood bank were also at the hospital. The occasional complex case was transferred to one of the vast American Hospitals at Saigon or Long Binh.
The management of wounds was usually staged to reduce the chance of leaving damaged or contaminated tissue behind. High velocity bullets dissipate so much energy when they enter tissue, that the tissue damage is much more extensive than just the small entry wound especially if a bone is struck. All the damaged tissue must be removed, the wound is packed with gauze and wrapped up usually in a plaster cast. A couple of days later, under another anaesthetic, the wound is again inspected and if only healthy tissue is seen, the wound can be sutured closed, if there is still damaged tissue present, the process can be repeated as many times as needed until only healthy tissue can be seen and there is no evidence of infection.
Wounded soldiers were sent back to Australia if it was thought they would not recover sufficiently to return to their unit within 30 days. If they needed transport on a stretcher, they were transported in a specially equipped C130 Hercules transport aircraft and travelled by way of Butterworth Air Base in Malaysia where they were rested and reassessed at the RAAF Hospital before the long flight back to Sydney.
© Hugh Roberton
RMO 2nd Tour