Mobile Chest X-Ray Unit

In the mid-20th century, tuberculosis (TB) was a significant public health concern in South Australia. To tackle this, the government introduced Mobile Chest X-Ray Units, revolutionising the detection and management of the disease across the state. Consequently, the mobile units brought critical diagnostic tools to remote communities far and wide and made healthcare accessible across South Australia.

Mobile Tuberculosis Care

For nearly thirty years, the South Australian Government focused on combating tuberculosis via compulsory mass chest x-rays. In 1943, a specially appointed State Government committee recommended voluntary mass x-ray surveys to identify and manage TB cases. In 1945, the Australian Parliament passed the Tuberculosis Act, launching the country’s first large-scale public health campaign to combat TB. Known as the Australian Tuberculosis Campaign (1948–1976), it provided free chest x-rays, medical care, and allowances for patients.

The South Australian Government commissioned in 1948, the first mobile x-ray unit, followed by a second in 1949. These early units, however, relied on local halls or public buildings for setup and electricity. Initially, staff used these units to screen voluntary patients. Then in 1952, the South Australian government introduced compulsory tuberculosis screening for everyone between 14 and 65.

Soon after, in 1954 that South Australia introduced a self-contained mobile x-ray unit. Designed by the Public Health Department in collaboration with the Architect-in-Chief’s department and the Government motor garage, this innovative unit could operate independently with its built-in generator. The new unit included a trailer equipped with an x-ray plant, a lead-lined darkroom, dressing cubicles, and a power supply, enabling it to function in remote areas without access to electricity.

Design and layout of unit

The 1954 self-contained unit, which cost £18,000, was a technological marvel. These units featured a large X-ray vehicle resembling an oversized bus, accompanied by a smaller trailer carrying a generator for power. The generator, originally built in England for the RAF during World War II, ensured the unit could operate independently in locations without electricity. Together, the two vehicles stretched 60 feet in length and supported a team of four: a radiographer, a driver-mechanic, a trained nurse, and a clerk-receptionist.

The interior of the eight-foot-wide x-ray vehicle was designed for both efficiency and privacy. The space was divided into sections, including undressing and dressing cubicles, a lead-lined darkroom, and an area for the X-ray equipment. A reception desk was positioned near the entrance, with heavy blue curtains strategically placed to maintain patient privacy. Wire baskets were available for patients to keep their clothing, and the dressing cubicles included small leather-covered seats and fold-out tables. After their X-ray, patients exited through a separate door at the rear of the vehicle.

The unit included a lead-glass window for the radiographer to monitor operations, a microphone to communicate with patients, and a forced ventilation system to keep the air fresh. A 60-gallon water tank was installed beneath the vehicle. Also included were cupboards for gowns, a washbasin, a wardrobe, and even an electric urn for making tea.

As a result, this self-contained design allowed the mobile x-ray unit to operate in areas without standard electricity or to connect to local power supplies in towns. Capable of managing up to 150 patients a day, the unit was a technological marvel for its time.

A Day in the Life of a Mobile X-Ray Unit

The following was taken from notes from a conversation with Jan Heinicke (2014). In 1963, Jan Heinicke joined the Chest Clinic as a switchboard operator, and by 1964, she had transitioned to working on the mobile x-ray units as an x-ray assistant. The primary mission of these mobile units was to conduct chest x-rays to detect signs of tuberculosis (TB), which was a significant public health issue at the time. Jan was one of 12 x-ray assistants at the clinic, all of whom received specialised training from a radiographer to operate the equipment and handle film changes

Chest x-rays were mandatory in 1964. As patients arrived, staff checked their name against the local council electoral roll. Three x-ray assistants staffed each mobile unit, rotating roles every 50 patients. Typically, one person handled reception duties, taking patient details and managing paperwork, another operated the x-ray machine, and the third positioned the patient and gave instructions through a microphone.

Patients entered through the front door, handed in a pre-filled card with their details. Staff escorted them to the back of the unit for the x-ray. Technicians positioned each patient, and after receiving instructions to take a deep breath, the image was taken. Afterward, the patient exited through the back door, keeping the flow smooth and private. In rural areas, especially on rainy days, the workload could be intense, with as many as 400 patients x-rayed in a single day.

Daily Operations

Given that the workforce was primarily female, to help accommodate home responsibilities, in Adelaide the team worked split shifts on Mondays and Wednesdays, from 1 pm to 5 pm, then again from 7 pm to 9 pm. The caravan, towed by a dedicated driver, was equipped with everything needed for the day, and one unit even had a generator to operate in areas without electricity. While on the road, teams often stayed in communities for up to three weeks, including weekends. Jan fondly recalled her first trip to Mt Gambier, where she and her colleagues travelled by train to meet the mobile unit.

When not on the road, x-ray assistants worked at a static clinic behind Scotts Church on Pulteney Street until the operation moved to North Terrace in 1974. Compulsory screening ceased in 1976. Eventually, all but one of the mobile units were retired from service.

Up until 1987, high risk groups were being monitored and treated using the remaining mobile chest x-ray unit. However, they eventually retired the last unit due to its deteriorating condition.

A New Mobile X-Ray Unit

In 1991, the Royal Adelaide Hospital’s Department of Thoracic Medicine unveiled a new $300,000 mobile x-ray unit to support tuberculosis (TB) screening across South Australia. Designed to address the rising rates of TB in high-risk groups, such as homeless individuals, migrants and refugees, Aboriginal communities, elderly people in institutions, and those with weakened immune systems, the unit brought essential health services to populations often unable to access centralised care. Socioeconomic challenges and geographic isolation were significant barriers for many in need of screening, making this outreach initiative vital.

The mobile unit was purpose-built, inspired by the Red Cross Blood Transfusion Service’s mobile vans, and featured a lead-shielded x-ray area, a darkroom for film processing, two changing cubicles, a reception and waiting area, and even a refreshment area for staff. Equipped with a generator to power air conditioning, lighting, and office equipment, the unit was fully self-contained and included a detachable ramp to facilitate equipment handling.

On-site, the mobile unit screened individuals at high risk of TB or those who had been in recent contact with active infectious cases. Tuberculin skin testing and chest x-rays were performed, with the x-rays developed immediately during the patient’s visit. Each trip was meticulously planned in collaboration with radiology staff, who operated the x-ray and darkroom equipment.

Life on the Road

The bus travelled extensively, reaching communities in the far northwest of South Australia, including the Pitjantjatjara lands of Ernabella, Amata, and Fregon, as well as the Yalata community on the Nullarbor Plain. It also made its way to the southeast, Port Augusta, the Riverland, and local prisons. Its longest journey was to Docker River, a remote Aboriginal community in the Northern Territory, just 10 kilometres from the Western Australian border.

During off-duty hours, particularly in the evenings, staff relaxed with Scrabble or other indoor activities like indoor carpet bowls. They often shared accommodation with local teachers, building camaraderie and enduring friendships.

For many staff members, working on the mobile units was both a professional and personal experience. Teams often spent two to three weeks in regional areas, staying over weekends and forging strong bonds with one another and the communities they served.

Inventory of Equipment Survey Bus 1999

Radiology Equipment:

• 1 AMX 4 mobile xray unit
• 1 Scopix 60 Bench top xray processor
• 1 safelight and filter
• 1 bench top film safe
• 1 wall cassette holder
• 1 Kodak identification printer
• 1 2bank viewing box
• 1 protective screen
• 6 35×43 cassettes
• 2 30×40 cassettes
• 2 24×30 cassettes

General Equipment:

• 1 5kW Honda Generator
• 1 1.5 KW Honda Generator
• 1 microwave oven
• 1 Kambrook urn
• 1 bar fridge
• 3 20W portable fluor0 lights
• 1 Codan Radiotelephone
• 1 NEC mobile phone
• 4 restraining straps
• 2 small restraining straps
• 1 7ft ladder
• 1 6ft ladder
• 1 pick
• 1 shovel
• 2 jerricans
• 3 20l water containers
• 2 9kg gas bottles
• 1 BBQ and fittings
• 1 gas stove and stand
• 1 portable toilet
• 2 toilet/shower tents
• 1 shower bucket
• 1 complete annexe
• 1 12×12 marquee tent
• 4 folding beds
• 2 tarpaulins
• 1 tool box
• 3ft spirit level
• 1 adjustable wrench
• 1 hammer
• 1 set screwdrivers
• 1 teac televideo
• 1 computer
• 1 label printer
• 2 extension screens
• 1 bar fridge
• 2 6×3 folding tables
• 10 stacking chairs
• 2 fire extinguishers – electrical and dry powder
• 1 heavy duty tow rope

Written by Margot Way, CALHN Health Museum

(Information sourced from online and the CALHN Health Museum collection.  Copies of all newspaper articles and other relevant documents are available on request).