Introduction
Full understanding of medical operations in Vietnam requires someappreciation of the nature of the country and of the war that has been wagedthere.
The Republic of Vietnam lies entirely within the Tropics. Saigon is halfwayaround the world from Washington, D.C. There is a 12-hour difference in timebetween the two cities. The nearest off-shore U.S. hospital is almost 1,000miles away at Clark Air Force Base in the Philippines. The nearest logisticalsupport base is about 1,800 miles away in Okinawa. The nearest complete hospitalcenter is in Japan, some 2,700 miles distant. Patients being evacuated to theUnited States must travel some 7,800 miles to reach Travis Air Force Base inCalifornia, or almost 9,000 miles to reach Andrews Air Force Base, nearWashington, D.C.
Because of these distances, even with modern air transport, the need forself-sufficiency in the zone of operations is greater than that normallyrequired within a combat zone. This fact is reflected by a higher ratio ofcombat service support troops (including medical) to combat troops than isnormally provided in more conventional situations. Vietnam is actually a combatzone combined with the advanced section of a communications zone. The distanceof Vietnam from the logistical support base also has an adverse effect on theefficiency and morale of troops newly arrived in-country.
Since 1954 Vietnam has been divided like Korea. North of the 17th paralleland Ben Hai River lies Communist North Vietnam and south is the free Republic ofVietnam. South Vietnam has a typically tropical climate of two seasons: hot anddry and hot and rainy. South Vietnam's continuously high temperature andhumidity, its monsoon climate, and perennial dust-rain cycle have an obviousimpact upon the types of diseases to be expected and upon the provision ofmedical care.
The majority of tropical diseases are both endemic and epidemic in SouthVietnam. The high ambient temperature and humidity adversely affect theefficiency and health of U.S. troops fighting in this area, and the medicalpersonnel supporting them. These also make it difficult to preserve and maintainmedical supplies and sophisticated medical equipment. South Vietnam's terrain,with its waterways and jungles, impedes patient evacuation and supplydistribution, even without the interference of combat operations.
The Republic of Vietnam is less than half the size of California and long andnarrow like that state. It stretches some 700 miles from north to south, and isonly 125 miles at its widest, It occupies the eastern and southern part of theIndochinese Peninsula in Southeast Asia, and borders the South China Sea and theGulf of Siam. Near neighbors to the west are Laos, Cambodia, and Thailand.Several good ports along the eastern shore form the bases for logistical supportof combat forces deployed inland and, in turn, affect the disposition of medicalinstallations, The peninsular nature of Vietnam facilitates the employment ofU.S. Navy hospital ships offshore in the South China Sea.
The conflict in Vietnam is a limited war as well as a counterinsurgencyoperation with the essential characteristics of both. Mere has been no ground orair confrontation between major powers. There has been no enemy aerial bombingof friendly troops, and artillery and rocket bombardment has been sporadic. Thetour of duty in Vietnam is limited to 12 months, and forces in Vietnam enjoy arelatively high priority for all U.S. military resources.
The Republic of Vietnam is a sovereign nation, U.S. forces are there at theinvitation of the host government to help maintain this sovereignty. Economic,political, and sociological factors affect the conduct of military operations.Vietnam, like most developing nations, suffers a paucity of medical resources.Through various medical civil assistance programs, the Army Medical Departmenthas helped achieve national objectives in all facets of stability operations.Similarly, medical advice provided to the medical department of the Republic ofVietnam Armed Forces, has played a vital role in increasing the department'scompetence, capability, and self-reliance.
Guerrilla and terrorist operations throughout the country, interspersed withsporadic organized unit assaults against cities and military bases, characterizeenemy tactics. There is no defined main line of resistance. The battle has beenfor popular support and stability, rather than for terrain, per se. Casualtiesoccur anywhere at any time. There are no secure ground lines of communicationsoutside of base areas.
The conflict has involved highly mobile, small tactical units, and has notbeen a war of mass movement of major military formations. Search and destroyoperations by small units from relatively secure base areas and for relativelyshort periods of time have been characteristic. There has been a high relianceon organic Army air mobility for the conduct and support of these operations.
The Army Medical Department's deployments and procedures have reflected thesetactical realities. Treatment facilities located in base areas receivecasualties by air from operating combat elements. Because there was no need tomove frequently, it was practicable to construct semi-permanent medicalfacilities, thereby allowing the utilization of more
sophisticated equipment andproviding a general upgrading of the level of medical care.
At the beginning of 1965, the USMACV advisory effort was predominant, almostto the exclusion of all other U.S. Army medical support functions in Vietnam.There were some 20,000 U.S. troops in-country receiving medical support fromtwo 100-bed hospitals (the U.S. Navy Hospital in Saigon and the U.S. Army's 8thField Hospital in Nha Trang), plus some miscellaneous small medical detachmentsproviding air evacuation and dispensary, laboratory, dental, and veterinaryservices.
The planning and implementing of medical support for the tactical andlogistical buildup of Army forces in Vietnam have been challenging tasks. Manyimponderables existed, mostly related to the nature of the country, the natureof the conflict, and the nature of the medical problems to be met. Estimates andplans based upon previous experience had to be modified to fit the uniquesituations in Vietnam as valid information was developed and a highly effectivemedical service created.
