Volume 17 Number 1 October 2008 Journal of Military and Veterans’ Health ■ Deploying a microbiology laboratory ■ Plastic surgery and the Kiwis ■ Organisational analysis and ADF structural changes ■ Submarine escape and rescue The Journal of the Australian Military Medicine Association Table of Contents Editorial Inside this edition ............................................................................................................................................................. 3 President’s message .......................................................................................................................................................... 4 Letters to the Editor ......................................................................................................................................................... 5 Original Articles Logistic aspects of a deployable molecular microbiology laboratory ........................................................................ 6 Plastic Kiwis – New Zealanders and the development of a specialty ........................................................................ 11 Applying the RAAAKERS™ framework in an analysis of the command and control arrangements of the ADF Garrison Health Support ............................................................................. 19 Reprinted Article Submarine escape and rescue: a brief history ............................................................................................................ 27 Book Review John Murtagh’s General Practice Companion Handbook........................................................................................... 30 Java Rabble ........................................................................................................................................................................ 32 CDC Health Information for International Travel 2008 ............................................................................................. 33 Obituary Surgeon Lieutenant Bruce James Cheffins .................................................................................................................. 34 Surgeon Captain ‘Sandy’ Ferguson ................................................................................................................................ 39 Instructions to authors ........................................................................................................................................ 40 Copyright policy ................................................................................................................................................... 48 Volume 17 Number 1; October 2008 Page 1 Journal of Military and Veterans’ Health EDITORIAL BOARD Editor in Chief Russell Schedlich Managing Editor Scott Kitchener Graeme Cannell Keith Horsley Peter Leggat Malcolm Sim Bob Stacy Darryl Tong Australian Military Medicine Association PATRON Rear Admiral Graeme Shirtley RANR Surgeon General Defence Health Reserves Australian Defence Force COUNCIL President Russell Schedlich Vice President Nader Abou-Seif Treasurer Neil Westphalen Secretary Janet Scott Council Members Kerry Clifford Greg Mahoney Andrew Robertson Geoff Robinson Public Officer Paula Leishman STATEMENT OF OBJECTIVES The Australian Military Association is an independent, professional scientific organisation of health professions with the objectives of: • Promoting the study of military medicine • Bringing together those with an interest in military medicine • Disseminating knowledge of military medicine • Publishing and distributing a journal in military medicine • Promoting research in military medicine Membership of the Association is open to doctors, dentists, nurses, pharmacists, paramedics and anyone with a professional interest in any of the disciplines of military medicine. The Association is totally independent of the Australian Defence Force. ISSN No. 1835-1271 Page 2 Journal of Military and Veterans’ Health Editorial Inside this edition This Edition of the Journal of Military and Veterans’ Submarine escape and rescue is a highly specialised Health has an array of papers considering operational area of Defence capability with specific medical and strategic issues confronting military health implications. JMVH has been fortunate to have received services in this region. approval from The Seapower Centre (Australia) to republish a brief history of this field that appeared for Infectious disease has always been a significant cause readers of Semaphore. of non-battle casualties throughout the history of warfare and the more recent history of peacekeeping Professor Peter Leggat has provided a review of the and humanitarian missions. Being able to deploy a popular handbook by John Murtagh of General microbiology laborator y to assist in the diagnostic and Practice. There are few texts in this field. Professor management process of tropical disease is a dream Leggat has conducted his characteristic detailed for many who have faced the challenges of decision review to inform those considering purchase. Professor making in an information poor environment. More Leggat has also reviewed another new edition of what recently the capability has assumed greater need has been a required desk text for military health with emerging risks of biological threat assessment practitioners, the 2008 CDC Health Information for and management. While principles of health support International Travel. and logistic management apply, the kit is diverse and The history of the first HMASPerth in the Battle of the sensitive requiring specific knowledge and solutions Sunda Straits is a great Naval story. Fred Skeels was to ensure capability in the field. Inglis et al apply there in 1942 returning for the remembrance in 1992 logist ic ex per t ise in t he establishment of t he capabilit y on the second HMAS Perth. He is a great character for deployment of field medical microbiology in and author of Java Rabble, recalling this battle and Sri Lanka. the journey of the survivors. Java Rabble is reviewed The unfortunate association of the development by Dr. Andrew Robertson. of reconstructive surgery during times of war has The Journal is very appreciative of Neil Westphalen produced a silver lining of improved management for providing an Obituary for Bruce Cheffins of disfiguring injuries and deformities among and. Mike Dowsett for recalling Sandy Ferguson. civilian communities in addition to improvements These recollections are of the typically colourful in veteran outcomes. Daryl Tong and colleagues and adventurous life in military health, no doubt provide a valuable and readable background on the resonating with many of the readers of JMVH while development of a specialty that is becoming core to celebrating the lives and service to Australia of these military medicine and dentistry. It is difficult not to two great contributors to naval medicine in peace be impressed by the recollections of the pioneers of and war. maxillo-facial surgery. It is equally difficult to believe that the authors have no conflict of interest in the Finally, JMVH’s Instructions to Authors are included. unabashed New Zealand connections. These appear daunting, however, the Journal is committed to assisting new authors to publish and So what is RAAAKERS™? It is a model of organisational the Editorial team is available to provide guidance analysis that has been used to inform a seachange and support if required. Contact can be made through in the structure of Defence Health Services. [email protected]. RAAAKERS™ was developed by Durant-Law, and his paper with Burnett from DSTO outlines the findings used to inform the recommendations for change in the Defence Health Services Directorate that were contained in the Alexander Review. The acceptance of these recommendations has led to the recent creation of the Joint Health Command. Volume 17 Number 1; October 2008 Page 3 Editorial President’s message I am writing this message several days after the To that end, Council will take on board the feedback completion of another highly successful AMMA that was provided at the AGM, specifically in relation conference. Held in Hobart over the weekend 17-19 to a tiered structure of membership that endeavours October, some 300 delegates attended, supported by to recognize individual affordability. In the process over 30 trade exhibitors. As always, the quality of the of developing this proposal the membership will be pap er s t h at wer e r e ad w a s e xcept ion a l l y h i g h, a nd t h i s i s approached for its views. a tribute to the expertise and dedication of those people In relation to its conferences, Council will continue to who are involved in military and veterans’ health. work to ensure that value for money is provided. Direct A full conference report will be provided in the next sponsorship of these events contribute significantly edition of JMVH, but two of the highlights were the to reducing fees and Council will continue to work on attendance of Vice Chief of the Defence Force (VCDF), its relationship with those companies that support Lieutenant-General David Hurley, and the address us. We will also look to other opportunities to join provided by the Surgeon General Australian Defence with organisations that have similar interests as our Force (SGADF), Major-General Paul Alexander. With the experiences in the past show that these events provide health services now within the VCDF group, General significant opportunities for the