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Annual Report the Surgeon General United States Army Fiscal Year 1960


Lessons Learned in Lebanon

The Army Medical Servicemade concerted efforts in fiscal year 1960 to evaluate all aspects of the medical support provided during the Lebanon Operation (July-October 1958) and to recommend measures for improving and strengthening such support in any similar operation in the future. The Lebanon incident furnished much valuable experience on which to base corrective action.

A study conducted in the OTSG at the request of the Assistant Secretary of Defense (Health and Medical) found that several published accounts which were critical of the medical support in the initial phase of the operation were nevertheless reasonably accurate and constructive in nature. Regardless of the critical comments pertaining to medical support of the Lebanon Operation, subsequent detailed analysis established that Army Medical Service personnel performed their basic mission in a creditable manner. Early deficiencies were resolved, and the effectiveness of the Medical Service increased as the operation progressed.

On the basis of the OTSG study and similar studies conducted in the offices of the Surgeons General of the Navy and the Air Force, The Secretary of Defense, on 14 March 1960, requested the Chairman of the Joint Chiefs of Staff to take appropriate steps to assure that there be a permanent medical staff authority in each of the established Unified and Specified Command headquarters, and a medical staff section in all Specified Command headquarters established for operations involving employment of significant numbers of personnel. On 17 June 1960, the Joint Chiefs of Staff took necessary action to direct Unified and Specified Command implementation of the policies laid down by


the Secretary. At the close of the report period, the Department of the Army was actively engaged in promulgating these policies to the Army components of the various Unified and Specified Commands.

Important lessons learned in Lebanon included:

1.  Medical support, particularly preventive medicine support, must accompany the first contingent of troops, since medical problems are greatest at the onset of a campaign.

2.  Sanitary orders must be prepared for issue before troops are committed. These orders should be sufficiently comprehensive and detailed to to assure maximum protection from disease.

3.  Preventive medicine units included in the task force must have balanced and complementing organic elements reflecting all their capabilities when they are committed. Survey and control sections should be committed simultaneously to be effective.

4.  In planning phased shipment of organizational equipment, the provision of adequate insect and rodent control materiel in the early phases must remain the basic principle.

5. The Surgeon General must be provided with appropriate statistical and sanitary reports from any joint commands in which Army troops are involved.

6.  In planning for operations of this type, an appropriate medical staff must be assigned to assure preparation of adequate medical plans and to coordinate, control, and supervise the execution of these plans.

7.  Planning for any task force operation must provide for sufficient surgical capability concurrently with the arrival of troops in the area.

8.  Plans should be developed whereby individuals are not only designated for assignment to deployable units but are also indoctrinated and trained with the unit for their assigned mission.

9.  Careful study must be made to ascertain that the troops' lists and the equipment lists will satisfy anticipated requirements.

10. The automatic supply shipments must be augmented with adequate quantities of any unusual items that might be required because of the nature of the country in which the task force is to operate.

Mobilization Program

The Army Medical Service Mobilization Program FY 1959 was extended for use in fiscal year 1960. This program provides for the development of balanced AMEDS mobilization capabilities in terms of forces, personnel, facilities, and materiel requirements in support of the Army Strategic Capabilities Plan.


On 17 March 1960, The Surgeon General approved a study entitled 'Basic Organizational Concept for Army Medical Service Support for a Field Army,' which groups AMEDS units into direct support and general support elements, thus improving the flexibility and the responsiveness of AMEDS support to a field army. It provides an organizational structure which can be readily tailored to support forces of varying size, including those designed for special missions, in consonance with DCSLOG'S 'Principles of Administrative Support Within the Combat Zone.'

This concept of AMEDS support in the combat zone, which was approved for planning purposes, includes-

1.  The basic foundation from which future doctrinal and operational concepts can be extended.

2.  A fundamental statement of current organizational principles to assure a clear understanding by those concerned with medical planning.

3.  An established doctrine for use in Army service schools.

 Emergency Checklists

Action was taken during the fiscal year to include in the DCSLOG Checklist and the Chief of Staff Readiness Book those emergency measures which are pertinent to the Army Medical Service. Concurrent action was taken to revise the Office of The Surgeon General Emergency Checklist 1-59 to include triservice monitorship activities for which The Surgeon General has management responsibility-the Armed Forces Institute of Pathology and the Armed Services Medical Regulating Office:

 A System for Estimating the Medical Load in Nuclear Warfare

For the past year, The Surgeon General has been engaged in developing a system for estimating nuclear warfare casualties. An assessment of the potential number of casualties is considered to be the key to planning for nuclear warfare and of vital importance not only in determining the patient workload that would be involved in such an emergency but also the medical supplies, the organizational structure, and the number and types of personnel that would be required.

The system is being developed by the Department of Atomic Casualties Studies, WRAIR, which completed the initial draft of its study in December 1959. This draft has been approved by The Surgeon General for use in the Army Medical Service and for further development. The system includes both a 'regular' or standard method and


a "rapid" method of computing potential casualties. The regular method lends itself best to machine programming.

The project is a pioneer undertaking and is unique in that mathematical, scientific, and professional factors are all involved in estimating potential mass casualties. This system is considered to be an important step toward the goal of cataloging analogous situations and of developing planning data of the type to be used in FM 101-10, Organization, Technical and Logistical Data.