HEADQUARTERS, 102D EVACUATION HOSPITAL (SM)
APO 230, U. S. ARMY
31 December 1944
Subject: Annual Report of Medical Department Activities
To : Surgeon General, U. S. Army, Washington, D.C.
l. In compliance with Circular Letter No. 181, Office of the Surgeon General, 30 October 1943, and AR 40-1005, the following report of the Medical Department Activities in the United States and in the European Theater of Operations of the 102d Evacuation Hospital (SM), for the calendar year 1944, is submitted. This unit was activated at Camp San Luis Obispo, California, 12 March 1943, and the report of its early training at Camp San Luis Obispo California, and in the California-Arizona Maneuver area was submitted in a previous report on 31 December 1943.
2. FUNCTION AND ORGANIZATION: The unit was under the command of Colonel CARLTON D. GOODIEL from 1 January 1944 to 28 December 1944. Colonel JOHN F. BLATT then assumed command of unit on 28 December 1944. From 1 January 1944 to 9 March 1944 this unit completed its maneuver training, and the preparation for overseas movement, in the California-Arizona Maneuver Area. A cadre of one officer and thirty-four enlisted men was sent to the 112th Evacuation Hospital at Camp Barkley, Texas on 18 February 1944. On 9 March 1944 the unit moved by rail to Camp Kilmer, New Jersey, and arriving there 13 March 1944 for its final staging for overseas. The unit departed from the New York Port of Embarkation on 6 April 1944 on the British Merchant Marine Ship, Tamara, for the United Kingdom. Other than for a few days of rough weather, and a few cases of sea-sickness, the voyage was uneventful. We docked at Avonmouth, England on 19 April 1944, and were transported by rail to Southport, on the Irish Sea above Liverpool, arriving there 20 April 1944. Headquarters were procured in the Bold Hotel in Southport, and messing and training facilities were obtained in the Botanical Garden of Churchtown, a suburb of Southport. The personnel were billeted in private homes in Churchtown. This gave our officers, nurses, and enlisted men an opportunity to observe the English people closely, and the hospitality of the English people was well appreciated by all. On 10 July 1944 we moved by rail and motor to Tidworth for concentration, prior to crossing the Channel. On 13 July we moved to the Marshalling Area, near Winchester; and on 17 July left for Southampton, and crossed the English Channel on the British Ship, Lairds Isle. The crossing was uneventful, and we landed at Utah Beach on 18 July 1944. After a short bivouac, for the purpose of reassembling near Barneville, we moved by motor on 23 July to Guetteville, Normandy, where we were
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attached to the First United States Army, and where we set up a tent hospital, and performed our primary mission for the first time in combat. We operated in this locality for seven days, and on 1 August 1944 reverted to control under Third United States Army. On 3 August 1944 we established our hospital near St. Pierre, Langiers. The advance of the Third Army was so rapid following the St. Lo campaign that we were able to function at this site thirteen days. We were then assigned to follow the VIII Corps in its clean-up drive of the Brittany Peninsula. Bivouac stops were made at Dinan and Guingamp, and on 18 August 1944 we established our hospital in an apple orchard at Ploudaniel, about 15 miles from Brest. On September 1944 the VIII Corps was absorbed by the Ninth United States Army, and we were assigned to Ninth Army, likewise. After a long and strenuous operation of forty-four days, the Brest campaign was concluded. After a brief rest period, the unit moved by rail and motor to Bastogne, Belgium. This trip took four days, and on 2 October 1944 we into bivouac in the German Youth Movement Barracks in Bastogne. With a view of obtaining buildings for winter operations, a reconnaissance was made in the vicinity of Bastogne and the Chateau de Roumont, near St. Hubert, was obtained for our use. It proved to be an ideal place to live, but not very suitable to operate a hospital. We operated at this site from 6 October 1944 to 20 November 1944, but admissions were light during this period as the ambulance haul from the clearing stations proved excessive. In order to reduce this distance we moved to Ettelbruck, Luxembourg on 20 November 1944, and were fortunate in, obtaining the Ettelbruck Agriculture College for our use. This building was ideal for our needs and wants. It contained sufficient space for both the personnel to be quartered, as well as our needed four-hundred ward bed space. The building was lighted by municipal current; had central heating; excellent black out curtains; twenty-three shower heads with ample hot water; and ample hard surface stand for ambulances and, other vehicles. It offered 73,000 square feet of floor space for the hospital proper, and was within six miles of the front line so that ambulances carry was minimum. In fact the Division Clearing Station was in the same city. This site was ideal for winter operation, but the enemy had other ideas about our comfort and when the counter-offensive started on 16 December 1944 it was necessary for us to withdraw. On 18 December we moved to Huy, Belgium, and established our hospital in the Normal School in Huy. We started operation at this site on 21 December and the next week was our heaviest as far as reception of patients was concerned. During this period we served an entire Corps of four divisions, plus attached troops, and frequently had five-hundred to six-hundred admissions per day. In the move to Huy, we were fortunate to get almost 100% of our equipment evacuated, but a withdrawal of this nature is an experience that all the personnel will long remember. From the point of view of an Evacuation Hospital, the organization of the Army Medical Service is highly satisfactory and economical. No unnecessary delays have occurred in the receipt of casualties or their evacuation, to higher echelons. No serious shortage in personnel has been felt, because support from Medical Groups and Auxiliary Surgical Groups has been forthcoming and meet periods of stress. Of course, the T/O of an evacuation Hospital
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does not render it self-supporting to meet highly active periods without augmentation by litter bearers from medical groups, and surgical teams attached from the Auxiliary Surgical Groups. However, since it is adequate for average employment, it is more efficient to pool surplus surgeons and enlisted men to keep them mobile and to rush them to the point of greatest need Also it would appear from our experience that, with the present distribution of Field and Evacuation Hospitals, per type army, four-hundred beds is the ideal capacity for the Evacuation hospital. Even during the period when we received five hundred and six hundred patients per day, evacuation was simple, so that only four hundred beds are needed. Although equipment is designed for field use under canvas, and personnel are so trained, we have found that it is well adapted for use in permanent buildings. Under winter conditions, there is no question of the advantage of operating in buildings, but for economy of personnel, litter carry, etc., the operation under tentage is the better.
See Annex 1 for diagram of operational set up under tentage.
3. MILITARY AND CIVILIAN PERSONNEL:
a. Officer strengths: This unit is still organized under T/O 8-58l, 26 July 1943. With available support mentioned under Paragraph 2, our experiences do not permit conscientious recommendations for a numerical increase in either officers or nurses.
b. Enlisted strength: - As long as a unit such as this can count upon support from medical groups or upon the employment of civilian help, no increase in enlisted strength is demanded. Litter bearers, if not supplied from Group Collecting Companies, would present a problem. The four litter bearers provided by the T/O would be ridiculously inadequate and the assumption that they can be drawn from motor pool personnel or our ten basics is based upon false premise. Drivers have been required to not only move our own unit and maintain their vehicles but to assist in the movement of other units, and when most needed are absent on such duties. The basics are continuously employed in necessary guard, police, sanitation, and kitchen police. Litter bearing is an extremely strenuous and fatiguing duty and we have found that a minimum of 32, 16 per 12 hour shift, are essential to move patients within the hospital.
c. It is suggested that one man qualified as a barber be substituted for the bugler on the T/O. We have found no practical use for a bugler as such in combat. A thunder whistle serves as well. However, we keep two barbers busy, one on our detachment and one on patients. At present, these represent sacrifices from among surgical or medical technicians.
d. Certain other observations are noteworthy. Whereas, the T/O sets down technical qualifications to be met by the enlisted personnel, these should
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in many cases be thought of only as primary prerequisites and not as sole qualifications. For instance, Headquarters clerks must also learn enough sick and wounded to take turns as clerks in Receiving. Both surgical and medical technicians must be well trained in the alternate field, because at times nine-tenths of the patients may be surgical and at others, medical.
e. There have been times daring pressure of activity when police and sanitation would have suffered had it not been for the availability of 20 civilian employees.
4. TRAINING OF PERSONNEL; EQUIPMENT, LITERATURE, AND TRAINING AIDS:
a. This unit was basically ready to perform its mission in combat by 1 February 1944, after eleven months of training. I believe that, without lost motion or marking time pending developments, this could have been ideally reduced to eight months. However, the time in England from 20 April to 13 July 1944 was put to good advantage by a limited number of our officers, nurses, and technicians placed on temporary duty in General and Station Hospitals. There they added to their experience or maintained their interests in their chosen fields. For the rest, it amounted to continued physical conditioning. Training facilities in England were very poor. Space was not adequate enough. Training aids had to be devised and all together the training was carried out under obstacles. Several officers and enlisted men did gather excellent experience while serving on LST`s during the original invasion of the continent.
5. EQUIPMENT-SUPPLIES-TRANSPORTATION: Our overall appreciation and respect for our equipment continues to be great. Numerous items have been increased or added as experience proved their need and I believe that our most urgent needs have been embodied in the new ETO revised equipment list. Further recommendations would include: - dropping the bath tables and washing machine, the latter being inadequate for any purpose to which it might be applied. Important items desired include: (1) Twelve field tables, folding for clerical sections; (2) Five light weight, knock-down, waterproof, portable latrines; and (3) three hundred feet of durable hose or piping with elbows and fittings. Packing boxes are inadequate in clerical sections and it has been necessary to amateurishly construct a less satisfactory type than could be issued. Though perhaps not essential, we have deemed quartermaster latrine boxes so important to a unit of this type that we have constructed our own. Had we the hose or pipe, we could pipe hot water from the shower bath-disinfecting unit combination to the operating room and mess. The hands of the surgeons truly suffer from the use of cold water during cold months. Three radios instead of one would provide; one for the patients in the Red Cross hut, one for the enlisted mans` recreation tent, and one for the officers` recreation tent. Either distilled water should be supplied in larger quantities or the T/E distilling apparatus should be doubled. Intravenous therapy, irrigation of wounds, and cleansing of rubber tubing and glassware place heavy demands upon it, especially where all water supplied is so hard that it provides an unsatisfactory substitute.
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Transportation has been highly satisfactory and no recommendations are advanced.
Expendable supplies have been generally adequate and the critical items of whole blood, plasma, penicillin, biologicals, and sulfas, have been forthcoming when needed.
See annexes 2 and 3 for field expedients for surgeons scrubbing facilities and for bed pan cleansing,
6. CONSERVATION OF MATERIALL AND MANPOWER: No remarks.
7. PROBLEMS AND THEIR SOLUTION: See other headings.
8. HOUSING, WATER SUPPLY, BATHING FACILITIES, AND LAUNDRY:
a. HOUSING: - See Paragraph 3 - Function.
b. WATER: In the field all water for whatever use is procured from Engineer water points. In permanent buildings, all water for internal consumption is still hauled from such sources. For bathing and cleaning, tap water is used but is regularly tested from specimens submitted to the Army Medical Laboratory. No poisons or serious contamination have been discovered in France, Belgium, or Luxembourg. It has been uniformly hard water, and has required an extravagant use of soap.
c. BATHING: In the field the six head issue shower unit, heated by the disinfecting units still supplied from the collapsible Engineer water tank, has proved adequate for 400 patients and unit personnel. We have even been able to extend shower courtesy to limited numbers of neighboring combat units. In one of our two permanent building operations, this shower unit was still needed because only bath tubs were available in the Chateau. These were uneconomical upon water use and were inadequate in number. At Ettelbruck and Huy we had adequate indoor shower baths heated by school furnaces, operated by the city and with city water supply. We have been able to supply showers to numerous neighboring units in these localities. They are important not only from a preventive medicine viewpoint, but as a great morale factor. The disinfestor is one of our most valuable pieces of equipment, supplying, heat for the water, permitting disinfestation of clothing and bedding, and acting as a much needed accessory for hospital linens.
d. LAUNDRY: Hospital and personnel laundry has been adequately handled by Quartermaster Laundry Companies, either attached or serving several hospitals.
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9. FOOD AND MESSING SEWAGE AND WASTE DISPOSAL:
a. FOOD: Adequate in all respects. From the viewpoint of desirability, menus could be made more appealing by supplying cooks with a greater amount of seasonings and the wherewithal to make more sweet doughs and pastries. These are a great morale factor to young Americans whose sense of taste runs more to these than to canned fruits and desserts.
b. SEWAGE AND WASTE DISPOSAL: Standards as prescribed in FM 21-10 have been followed to the satisfaction of all. See Equipment and Supply, Par 5. Considering the personnel organization and patients, it is highly desirable to provide overhead as well as side wall shelter to latrines by the use of pyramidal tents or flies. Bed pan wishing can be a problem. This we solve by having an oil, drum divided longitudinally in half by the Engineers and having them weld an iron pipe longwise through each half, and a handle on the side of each. The former serves to suspend each half on notched 2 x 4`s driven into the ground. They are set up side by side and overlying a soakage pit into which then solutions are dumped when sufficiently contaminated. The Sanitary Technicians maintain a 2% cresol in one and clear rinse water in the other. Bed pans are placed in the cresol solution for 20 minutes, and rinsed in the other drum. (See Diagram - Annex 3).
10. INSECT CONTROL: No problem has arisen. No insects have been proliferant except flies which were controlled by approved methods.
11. VENEREAL DISEASE CONTROL: Only one new case reported in this unit during the period `ant this was at the Port of Embarkation. No remarks or recommendations on this subject.
12. MANEUVER EXPERIENCE: - See Paragraph 2 and previous Annual Report.
13. WELFARE SOCIAL SERVICE AND RECREATION: - This unit has continued to devote much attention to these matters in its second year of existence as it did in the first. The call of duty and work has eliminated many of the possibilities for athletic recreation but programs are carried out during lulls and rest periods. Touch football, softball, and volleyball and passing of hard baseballs are favorites of this unit. Literature and writing materials have been adequate and are provided for the patients in the Red Cross Tent, or room, and for the enlisted men and officers and nurses in their respective recreation tents or rooms. The unit radio is used by the enlisted men and we have .been able to procure through private resources one for the Red Cross and Officers and Nurses. Three radios are the minimum needs for a hospital. Ping pong is a favorite indoor game among patients and personnel. Checkers, chess, chinese checkers, and cards and darts are heavily used. The most appreciated of all indoor
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recreational facilities is the movies. Since we had the forethought to purchase a 16 mm projector before leaving the States, it not being an item of issue to units of this type, we have been able to show films almost nightly. Special Service shows have reached us on an average of twice a month and they have been of excellent caliber. The Red Cross workers and Chaplain visit the sick, distribute cigarettes and needed toilet articles, and write letters for the disabled. We have learned to appreciate them so much that we regard their services as indispensable. The Chaplain conducts services each Sunday, acts as counsellor on many personal and religious problems and above all else brings all of his ministrations to the patients` bed side.
14. MEDICAL AND DENTAL SERVICE: See Annex 4.
15. OTHER SUBJECTS OF INTEREST: None.
[signed]
JOHN F. BLATT
Colonel, MC
Commanding
ANNEX 1 OPERATIONAL SET UP UNDER TENTAGE
ANNEX 3 BED PAN STERILIZATION AND WASHING UNIT
ANNEX 4 MEDICAL AND DENTAL SERVICE
1. Total Admissions (23 Jul 1944 to 31 Dec 1944, incl) 9074
2. Direct Surgical Admissions (23 Jul 1944 to 31 Dec 1944, incl) 3784
3. Anatomical Classification of Wounds of cases admitted to surgery:
|
a. Wounds other than burns: |
Admissions |
Deaths |
|
(1) Abdominal |
158 |
19 |
|
(2) Thoracic |
446 |
28 |
|
(3) Maxillo-Facial |
290 |
1 |
|
(4) Neurological | ||
|
(a) Head |
350 |
34 |
|
(b) Spine |
53 |
3 |
|
(c) Nerve |
5 |
0 |
|
(5) Extremities | ||
|
(a) Upper |
769 |
3 |
|
(b) Lower |
1278 |
16 |
|
(6) Buttocks |
152 |
1 |
|
(7) Other |
136 |
1 |
|
Sub-Total |
2636 |
106 |
|
b. Burns - All locations |
40 |
3 |
|
Total |
3676 |
109 |
c. Number of Patients with Multiple Wounds 394
d. Number of cases of Gas Gangrene 23
e. Number of Amputations:
Upper 38
Lower 35
Total 73
f. Anesthesia Cases:
Ether 129
Gas-Oxygen-Ether 159
Regional 616
Intravenous 1871
Total 2775
ANNEX 4 (CONT``D) MEDICAL AND DENTAL SERVICE
g. Number of Transfusions.
Whole Blood Transfusions 348
Plasma Transfusions 984
Total 1332
h. Medical Admissions:
Medical 1641
NP Admissions 374
Total 2015
i. Dental Admissions (Other than Maxillo-Facial)
Patients 788
Sittings 1622
SOURCE: National Archives and Records Administration, Record Group 112, Records of the U.S. Army Surgeon General, World War II, 102d Evacuation Hospital, Annual Reports, 1944-45, Box 406.
