As we move into 2015, we have a unique opportunity to look back to the origins of Australian Defence Force health services 100 years ago, the changes in Defence healthcare in the intervening years and where we might expect to go into the future. The fundamentals of conflicts and wars themselves have changed – from the set piece battles and trench warfare of the Great War to the highly mobile conflicts of the 21st century. The establishment of the No. 1 Australian General Hospital (No. 1 AGH) is a case in point. First sanctioned by the Commonwealth Defence Department in August 1914, the unit left Australia as a General Hospital of 520 beds on board the S.S. Kyarra on 21 November 1914. Arriving in Egypt on 14 January 1915, the No.1 AGH was set up in the Heliopolis Palace Hotel. By June 1915, this 520 bed hospital and surrounding buildings held nearly 2500 patients, cared for by only 150 nurses. Needless to say, hospital equipment and supplies were totally inadequate. (1) The sheer scale is daunting and, arguably, way beyond the worst nightmares of today’s Defence health planners. The resilience of the medical, nursing and health support staff, the innovation in difficult situations and the dedication to support the broader military forces continues on. Ian McPhedran’s description of the life-saving health care provided by RAAF and other ADF health staff after the Bali Bombing, in his recent book “Air Force”, (2) highlights both this continued dedication and the appreciation of these efforts by other non- health ADF personnel. How we apply these lessons in years to come will be of great interest.
Some of the more perceptive of our readers may have noticed that we did not publish a 4th issue in 2014. This was to allow us to realign our publication dates and to get the first issue out early in 2015. Our first issue has a tropical medicine theme, with excellent articles on rabies and the more recent history of the Army Malaria Institute. We also continue looking at cancer cases in serving members and veterans with a review of bladder cancer deaths among veterans. This issue also looks at the nurse practitioners’ role in facilitating treatment in post-traumatic stress disorder. Finally, this issue includes all the abstracts from our recent AMMA Conference in Sydney in October 2014.
We continue to get a good range of articles, but other military and veterans’ health articles are always very welcome and we would encourage all our readers to consider writing on their areas of military or veterans’ health interest.
Dr Andy Robertson, CSC Editor-in-Chief