CHAPTER X
The Balkans and Hungary
Richard T. Shackelford, M.D.
The Balkan States comprise most of the former territory ofthe Ottoman Empire in Southeast Europe, generally considered to be Romania,Bulgaria, Yugoslavia, Albania, Greece, and European Turkey. Hungary has beenadded to this chapter because of its geographic position and similar World WarII situation (map 10). The location of the Balkan Peninsula has made it subjectto invasion throughout its history, and the intense nationalism of itsinhabitants has resulted in almost continuous internal discord.1
Conflicts in the Balkans.-In this century, theBalkan nations have been involved in three major conflicts-the Balkan Wars(1912-13), World War I, and World War II. There was a sharp split among them inWorld War II; Yugoslovia, Albania, and Greece were attacked and occupied by theAxis powers while Bulgaria, Hungary, and Romania allied themselves with Germanyand provided more than 1.4 million troops to her cause. Turkey remained neutraluntil February 1945, when she finally declared war on Germany and Japan but tookno active part in the fighting.
As the Axis Armies were forced to withdraw from Yugoslavia,Albania, and Greece, these were designated "liberated" countries, andtheir legitimate governments were restored. Since no armies of occupation orcontrol commissions had to be established for them, and no armistice agreementsor peace treaties had to be written, these liberated countries will not bediscussed in this chapter. Bulgaria, Hungary, and Romania, classified as"enemy" countries, had to be dealt with by the Allies when hostilitiesceased.
It became obvious to Bulgaria, Hungary, and Romania in thesummer of 1944 that their defeat was inevitable, and, as Russian troops advancedfurther into their territory, these countries sought to make peace with theAllies. Romania was the first to do so, signing an armistice in Moscow on 12September 1944, followed by Bulgaria on 28 October. Hungary was the last to cometo terms, doing so only after the Red Army had occupied a large part of herterritory. This armistice was signed on 20 January 1945.2
Postwar agreements.-Anglo-American troops were onlyslightly involved in the fighting in the Balkans; Russia had done the greaterpart of the fighting and had suffered most of the casualties there. The Britishwere willing to concede that Russia should predominate in postwar arrangements
1Wolff, Robert Lee: The Balkans in Our Time. Cambridge, Mass.: Harvard University Press, 1956, pp. 10-24, 92-95.
2Werth, Alexander: Russia at War, 1941-1945. New York: E. P. Dutton & Co., Inc., 1964, pp. 816-826, 868.
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MAP10.-Hungary, Romania, and Bulgaria.
there, just as Great Britain and the UnitedStates predominated in Italy where Russian troops had not been involved.
Winston Churchill accepted this in his meeting with JosephStalin in Moscow on 9 October 1944. They arrived at a so-called"percentages agreement" in which Russia would have 90 percentpredominance in Romania, as compared with 10 percent for the other Allies.Russia would predominate 75 percent to 25 percent in Bulgaria, with a 50-50split in Hungary. The United States did not have a representative at thismeeting. President Franklin D. Roosevelt wired Stalin before the meeting,declaring that in his view the Churchill-Stalin talks were merely preliminariesto a three-power conference.3
When this conference was held at Yalta in February 1945, theUnited States sponsored a "Declaration on Liberated Europe" in whichshe expressed her firm belief that no major power should establish a sphere ofinfluence in Europe and that all liberated and former enemy nations should beallowed to "create democratic institutions of their own choice." After
3See pages 259-262 of footnote 1, p. 343.
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some argument, the Soviets agreed to this outwardly, and theDeclaration was made part of the official Yalta communiqu? issued on 11February 1945. Russia, however, demonstrated from the beginning that sheintended to disregard the spirit of this declaration and, instead, use thepercentages agreement as justification for her arbitrary actions in EasternEurope.4
Allied Control Commissions.-Allied ControlCommissions were established by the terms of the armistice agreements signed byeach of Germany's former allies. For example, in the agreement between theUnited States of America, the Union of Soviet Socialist Republics, the UnitedKingdom, and the Government of Romania of 12 September 1944, paragraph 18stated: "An Allied Control Commission will beestablished which will undertake until the conclusion of peace the regulation ofand control over the execution of the present terms under the general directionand orders of the Allied (Soviet) High Command, acting on behalf of the AlliedPowers." Similar agreements were signed with the Bulgarian and HungarianGovernments. These three-power commissions were to oversee the activities of thegovernments of the former enemy nations until formal peace treaties were drawn,and to assure that provisions of the armistice were carried out.
Since Russian troops had occupied Romania, Bulgaria, andHungary and were present there in large numbers, the Americans and Britishconsented to having Soviet officers serve as chairmen of the Allied ControlCommissions in these three countries. Neither of the Western Allies initiallytook exception to the Russian view that the actual operation and administrationof the Commissions should be in the hands of the Red Army, just as the Americansand British, whose troops had seized and occupied Italy, operated the ControlCommission there. This was considered to be expedient as long as hostilities withGermany continued, but the United States hoped to have the Allied ControlCommissions become tripartite after the defeat of Germany, with all three Allieshaving equal representation.5
After the surrender of Germany on 8 May 1945, Russia showedno inclination to curtail her dominance over the Control Commissions inBulgaria, Hungary, and Romania. Despite Allied protests, she continued to makearbitrary decisions without consulting the British or Americans and oftenwithout even informing them of the decisions after they had been made. Russianauthorities and, to a lesser degree, provisional governments in the occupiedcountries engaged in harassing American and British personnel by restrictingtravel, refusing entrance visas, intimidating natives who demonstratedpro-Western sympathies, and by other more subtle annoyances.6Since these countries were occupied by the Red Army, the
4See pages 265-266 of footnote 1, p. 343.
5Foreign Relations of the United States. Diplomatic Papers, 1945. Volume V: Europe. Washington: U.S. Government Printing Office, 1967, pp. 238-240, 245, 512-515.
6(1) History of Allied Control Commission, Bulgaria, United States Delegation (to 31 March 1946), pp. 2, 19-34, 83, 86, and 87. (2) Final Report of the United States Military Representation on the Allied Control Commission for Romania, 15 Oct. 1947, pp. 7-8, 19-23, 27, 33-36. (3) Commanding General's Narrative Report of Operations, United States Military Representation on the Allied Control Commission for Hungary, 4 Sept. 1946, pp. 1, 4, 24, 48, 79, and annexes 124 and 130.
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Americans and British could do little to dissuade theRussians, particularly during the immediate postwar period when demobilizationdominated American policy.
During 1945-47, Russia was successful in bringing Romania,Bulgaria, and Hungary into her sphere of influence by establishingCommunist-dominated governments. The devices of manipulated elections, falsearrests and other police-state tactics, highly developed propaganda methods, andeconomic pressure were used to achieve these objectives.7
Formal peace treaties with Germany's allies were drafted ata meeting of the Big Four Foreign Ministers in New York and were signed in Parison 10 February 1947. The Allied Control Commissions were disbanded under theprovisions of these treaties, which were proclaimed on 15 September 1947.American and British personnel departed from the three countries well within the90-day limit specified in the peace treaties, thereby ending their formalmilitary participation in the Balkans and Hungary.8
FUNCTIONS OF U.S. ARMY MEDICAL OFFICERS
ON ALLIED CONTROL COMMISSIONS
The U.S. military representation on each of the three ACC's(Allied Control Commissions) in the Balkans included one or more U.S. Armymedical officers (usually only one was assigned, but there were exceptionalperiods when two were simultaneously present for a short time). These officerswere usually lieutenant colonels or colonels. Professional qualifications forthe position apparently were not considered. One was a trained public healthphysician; the others had had experience in general medical practice or in asurgical or internal medicine specialty before their assignment. They receivedno briefing or special training on the historical background of the country,armistice terms, or political problems, either before or during their tour ofduty.
Duties.-The designated duties of these officers were(1) to organize a dispensary and to provide or arrange for medical, surgical,dental, and preventive medical care for the members of the U.S. Representationon the Allied Control Commission and of the U.S. diplomatic mission in eachcountry; (2) to make the routine periodic reports on personnel health requiredby the U.S. Army Medical Department; and (3) to requisition, store, and dispensethe medical and surgical supplies required for performing these duties.
In all three countries, medical care for the personnel of theU.S. military and diplomatic missions required very little of the medicalofficers' time as the units were small, the incidence of disease was unusuallylow, and the ailments were minor. The medical officers treated those illnesseswhich they were equipped to handle, and referred the others, on a contractbasis, to
7See ch. 9 of footnote 1, p. 343.
8See footnote 6, p. 345.
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local physicians, surgeons, and dentists whose ability hadbeen investigated and found to be satisfactory. In only two or three instancesin all three countries were patients transferred for medical reasons to U.S.medical installations abroad or sent home. Required medical reports andrequisitioning supplies took up more time.
Other activities.-Since in the Balkan countriesthere was no section for health, welfare, or education in the organization ofthe Allied Control Commissions, nor any official relationship with the healthagencies, the medical officers had little designated contact with the Russian,British, or local officials. Because the medical officers had much free time ontheir hands, some of them, on their own initiative, gathered information on thehealth and welfare problems of the occupied country. They then reportedsignificant information to the chiefs of the U.S. Representations on the AlliedControl Commissions, who often used these reports to make appropriaterecommendations at the ACC meetings. These reports were also useful in informingthe War Department in Washington of significant health and welfare developmentsin the occupied country or those which might affect either the health ofneighboring countries or the entire European Continent.
The gathering of accurate information for reports about thehealth and welfare of the occupied countries was time consuming and interesting.The Russian-controlled Allied Control Commissions and, in some instances, thelocal Communist-dominated government appeared purposely to block the release ofthis information from official sources. In all three countries, the officiallyreported statistics often were inaccurately compiled, deceptively presented,made inaccessible to the U.S. medical officer, or not compiled at all.
To obtain this information, the medical officers often had torely upon unofficial sources. Frequently they contacted local physicians whowere not in the government, but who were recognized authorities in theirparticular fields, and learned from them all they could about local conditions.Then, when permitted by the Allied Control Commission, they visited the areareported to have a significant health or welfare problem so that they couldpersonally observe and evaluate the accuracy of what they had been told. Oftensuch a trip or visit was prohibited, and the information could be checked onlyby conversations with other local residents, any or all of whom might give aprejudiced and even completely different opinion. This sequence of eventsinevitably led to broad contacts with the medical profession and institutions inthe country, important official and nonofficial persons (both medical andnonmedical), members of the Russian and British Military Missions, and a crosssection of the native population. These persons were variously friendly orhostile, procommunist or anticommunist, honest or dishonest, reliable orunreliable, seeking personal gains or trying to be unselfishly helpful.Evaluating their reports accurately was difficult and required experience.
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As a result of these contacts, and because of their Westernmedical education, the American medical officers were in great demand forprofessional consultations on patients or members of military or diplomaticmissions of other nations affected with puzzling or critical medical conditions,particularly if there was any possibility that the condition might be amenableto treatment by the new "wonder drug," penicillin. Antibiotics werecompletely unknown in the Balkans until they were introduced by the American andBritish medical officers. American medical officers also lectured to the localmedical societies and schools which had been isolated from international medicalliterature since before the war. This work was valuable in giving the localphysicians an insight into recent Western medical advances.
The activities mentioned differed in their scope in the threeenemy countries. The most work was done in Hungary; less was accomplished inRomania, and least of all in Bulgaria, for reasons which will be described.
BULGARIA
Medical and health conditions in Bulgaria9by 1944 had regressed from merely inadequate to deplorable. There were severeshortages of virtually every ingredient of even a minimally successful programof medical care, including physicians, nurses and related personnel, drugs andsupplies, and hospital facilities.10
The first contingent of American troops to staff the AmericanSection of the Allied Control Commission, four officers and seven enlisted men,arrived in Bulgaria on 14 November 1944, followed by the commanding officer ofthe delegation, Maj. Gen. John A. Crane, who assumed his command in Sofia on 26November. The medical officer, Maj. (later Lt. Col.) William H. Gronemeyer, MC,was flown in on 29 December. Major Gronemeyer served until 16 November 1945,when he was replaced by Capt. John A. Love, MC, who served as commission medicalofficer until the commission was dissolved in September 1947.
Mission of the Medical Section.-The primary missionof the Medical Section was the care of American personnel assigned to themission, which numbered between 40 and 50 men during most of the 1944-47 period.According to reports by Captain Love, their health was excellent; only two casesof serious illness required base hospitalization during a typical 6-month periodending 31 March 1946. There were no serious epidemics of any kind except theusual colds and sore throats in the winter months. The incidence rate ofvenereal disease was also very low; only one case was reported during the same 6months. The Medical Section also provided treatment for Bulgarians employed bythe American Section of the Allied
9Unless otherwise cited, the information in this section is derived from footnote 6 (1), p. 345.
10War Department Technical Bulletin (TB MED) 58, 28 June 1944, subject: Medical and Sanitary Data on Bulgaria.
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Control Commission; about 10 Bulgarians were seen and treateddaily. In addition, Capt. Blagio Angelov, a Bulgarian medical officer on liaisonduty with the commission, helped to arrange for Captain Love to see a number ofcivilians not connected with the delegation, in consultation with their ownphysicians. Possibly as a result of this, Captain Angelov was eventuallyarrested by Bulgarian authorities and relieved of his duties.
Food and water supplies.-The usual Army sanitaryprecautions were applied to the water and food supply. The water was drawn fromtwo sources, the city of Sofia and the enlisted men's billets at AmericanCollege, an institution located about 6 miles southeast of Sofia, which had beenoperated by American educators before the war. Water obtained from the citysystem had to be filtered and chlorinated, but the American College water wasderived from a mountain spring and underwent a natural filtration process. Dailytests were conducted in a laboratory in Sofia and, as an extra precaution, amonthly test was done at the 300th General Hospital in Naples.
Most of the food for the troops was obtained from localsources. Government slaughterhouses provided meat which was carefully inspectedby local veterinarians. Farms in the Sofia area were called upon to supplybutter, milk, and fresh vegetables. Pasteurized butter was available for tableuse, and unpasteurized butter was deemed adequate for cooking purposes. Since nosufficient facilities for milk pasteurization were available, milk was boiledbefore use to kill bacteria. Vegetables were thoroughly washed in hot water toremove impurities.
U.S. medical assistance.-American medical officershad little opportunity to assist the Bulgarians in matters of public health orpreventive medicine. This can be attributed mainly to two factors:
First, travel by American personnel was severely restrictedby the Russians and the Bulgarian Government. Americans were permitted toventure out of rigidly defined areas only if they were accompanied by Sovietescort officers. In July 1945, after repeated American complaints, this policywas eased somewhat to allow officers to travel without being accompanied byRussians if they submitted their proposed itineraries to Soviet Headquarters andwere issued "propusks," or passes. However, the passes often were notgranted, not delivered until the last minute, or not honored by Russiancommanders in the field.
Second, the Soviets and Bulgarian Communists intimidatedthose citizens who associated with Americans by refusing them clothing or foodpermits, bringing them in for questioning, and generally making life miserablefor them. This naturally inhibited professional contacts between U.S. medicalpersonnel and their Bulgarian counterparts, and caused Bulgarians to be somewhatreluctant to ask for or to accept medical assistance from the Americans.
These restrictions notwithstanding, the Bulgarian Government,hospitals, and private individuals did call upon the American delegation for
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medicine and medical supplies. Even before the war,Bulgaria's public health program and medical facilities were highlyinadequate, and the care of almost 30,000 military battle casualties, inaddition to civilian casualties, added an even greater burden to her alreadyovertaxed medical capacity.
Shortages of drugs and medical supplies.-Bulgariahad always imported most of its drugs and pharmaceuticals but, because of thewar, was cut off from many suppliers. Although Bulgaria was still able toreceive shipments from Germany and Hungary, these countries had severe wartimeneeds of their own. A black market in drugs, bandages, cotton, and medicalinstruments flourished both during and after the war.11
In view of this situation, the American delegation wassympathetic to requests for medicine. Most solicitations were for penicillin,sulfadiazine, and DDT, although there were many requests for other types ofdrugs. At the request of the Bulgarian Ministry of War, about 200 bottles ofpenicillin were furnished to individuals and 42,000 sulfadiazine tablets weredistributed. The American delegation cooperated with the Ministry of Health inlending 1,000 bottles of penicillin to the Bulgarian Government, whicheventually repaid the loan in full. As another American-Bulgarian cooperativeproject, 100 pounds of DDT compound were contributed to aid in combating atyphus epidemic, and later, another 500 pounds of DDT compound and 5,000immunizations of typhus vaccine were given.
In summary, it can be said that U.S. medical personnel gaveas much medical help to the Bulgarian people as the circumstances permitted. Inthe other former enemy countries, Hungary and Romania, where travel was not sorestricted and freer association with Americans was permitted, American doctorscould be, and were, more active in public health and preventive medicine.
ROMANIA
As in Bulgaria, the assigned duties of the U.S. Army medicalofficers in Romania12wererelatively easy and took little time. In all, five medical officers served inRomania at different times. They were only required to run a dispensary whichprovided treatment for American military and diplomatic personnel, make routinereports on the health of these personnel, and dispense the medical supplieswhich were sent in from higher headquarters.
During the early period of occupation, the medical sectionsupervised the removal of U.S. airmen who had been shot down over Romania andhad been liberated later by the Russians, or who had been forced down behind theRussian lines. Until 1 April 1945, these evacuees were brought
11Report of U.S. Section, Allied Control Commission for Bulgaria, 13 Apr. 1945, subject: Medical Supply Situation, Bulgaria, p. 1.
12Unless otherwise cited, the information in this section is derived from (1) the personal observations and records of the author, who served as medical officer for the U.S. Representation on the Allied Control Commission for Romania from 16 October 1945 to 1 March 1946, and (2) footnote 6 (2), p. 345.
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to Bucharest, usually by a Russian liaison officer, and weregiven food, clothing, lodging, and medical care until they were flown to Italy.The commanding officer of the Russian military hospital in Bucharest offered hisfacilities, but the American authorities preferred to house the evacueeselsewhere because of language differences and because the Russian facilitieswere considered substandard. However, those airmen who were sent directly to theRussian hospital did receive the utmost in consideration and courtesy from thehospital staff.
Beginning in April 1945, these evacuees were routed by trainto Ploesti and Odessa, and then by boat to Italy because of a clause in theYalta Agreement of 4 February 1945 which stipulated that all personnel beingevacuated from Russian to American territory should go through Odessa. TheRussian authorities insisted upon a literal interpretation of this clause untilthe end of the war despite its impracticality and despite American protests.
There were no epidemics or serious diseases among UnitedStates personnel. The venereal disease rate was extremely low; there were nocases from 1 June 1946 to 1 March 1947. Medical and dental cases which could notbe handled at the dispensary were referred on a contract basis to Romaniandentists and physicians whose qualifications had been investigated by themedical officers. Therefore, they had time to engage in other medical activitiesbeyond their assigned duties.
Health problems.-The American medical officers oftenaided and advised Romanian physicians who requested their help and, lessfrequently, Russian medical officers. Lt. Col. Richard T. Shackelford, MC, whoserved as medical officer for the U.S. Representation on the Allied ControlCommission for Romania from 16 October 1945 to 1 March 1946, reported thatmedicine and surgery in Romania were of poor quality even though there weretalented individual Romanian physicians and surgeons. He observed that theirhospitals used outmoded methods and equipment, mainly because they had beenisolated from Western medical advances since 1939.13
After the Communists gained power, the public healthsituation worsened. Key health positions were filled by Communists, many of whomwere unqualified. The public health department received very few funds withwhich to operate. There were no drugs or institutions to treat syphilis ortuberculosis, and victims of these contagious diseases were allowed to wanderfreely and spread their diseases widely.
Colonel Shackelford, who was a surgeon, was horrified at thehundreds of patients he saw who could have been cured by modern surgicalmethods. Blood transfusions were used sparingly, and two patients were seen whohad not been transfused and who later died of hypovolemic shock in the earlypostoperative period.14
13Shackelford, Richard T.: Red Regime Coming to Romania: Observations of a U.S. Surgeon of the Allied Control Commission During the Critical Years of 1945-47. Mil. Med. 117: 530-537, December 1955.
14See footnote 13.
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Penicillin.-As in the other Axiscountries, antibiotics were unknown in 1945; sulfonamides were used foreverything. American medical officers introduced penicillin to Romania. The drugwas extremely successful in the first few cases in which it was used, curing aseemingly fatal case of meningitis in a Romanian child. This caused Romanianphysicians to exaggerate the usefulness of antibiotics, and brought many morerequests for antibiotics than the medical officers could handle with their smallsupply.
Penicillin was authorized for non-American use only ininstances of diplomatic requests or extreme emergencies. For example, ColonelShackelford was called personally by the Prime Minister, Dr. Petru Groza, lateone night to examine one of his cabinet ministers who was suffering from lobarpneumonia. The medical officer agreed to treat the official with penicillin, andhe recovered. He also treated the Minister of Trade of the Communist Governmentof Poland for an infected foot.
Other medical aid.-The case of a Romanian girlparalyzed from neck to feet by poliomyelitis came to the attention of themedical officer, who, in turn, notified Brig. Gen. Cortland V. R. Schuyler,Chief of the U.S. Representation on the Allied Control Commission, of the needfor an iron lung. An improvised respirator was obtained from Italy, and this wasused to keep the girl alive until the American Red Cross in New York shipped astandard respirator. The girl lived in this for more than 2 years before shedied of pneumonia. The iron lung and poliomyelitis were both unknown in Romaniaat the time. This case aroused considerable interest and much favorablepublicity for the Americans and helped to establish friendly relations withleading Romanian private physicians and medical authorities.
Colonel Shackelford was called upon several times toprescribe for the Royal Family of Romania. He also lectured on Western advancesin medicine and surgery to the local medical society and hospital staffs,receiving favorable publicity in the Bucharest newspapers before they becamecontrolled by the Communist Government. These efforts created much good willamong the local population.
American and British medical officers maintained close andfriendly relations, but relations with Soviet medical officers varied fromrather friendly, easygoing social functions to several cold and formal meetingsin Soviet military hospitals. Colonel Shackelford treated several Russianpatients, including a general and a prominent politician, at the request ofSoviet medical officers. He used penicillin in both cases, and left instructionsfor its use along with a small supply. But he was never allowed to see eitherpatient again, and was closely guarded during his stay inside the Soviethospital.
American medical officers made frequent authorized tripsabout the country to gain information on health conditions as well as political,military, and economic conditions. These trips were limited until the summer of1945, when the Russians agreed at the Potsdam Conference to allow freer travelby American and British representatives. After that time, medical
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officers always checked in with the provincialrepresentatives of the Russian Army, most of whom proved to be courteous andcooperative. However, the medical officers were watched carefully, if notconspicuously.
Typhus.-One of the more serious disease problems inRomania was typhus. The American medical officer made several field trips inearly 1945 to study the Romanian health situation. He reported that a serioustyphus epidemic was raging in the northern and eastern provinces and recommendedimmediate preventive measures. General Schuyler immediately urged the ACC DeputyChairman, Lieutenant General Vinogradov, to have the ACC invite Brig. Gen. LeonA. Fox, MC, Field Director of the United States of America Typhus Commission,into the country to safeguard the health of both Romanian citizens and Russiansoldiers. General Schuyler asked that General Fox be allowed to travel freelyabout the country with his assistants and with the necessary medical supplies tocontrol the epidemic. The Deputy Chairman took no action. Twelve Russian womenphysicians and 48 sanitary agents did come to Romania; they had littleequipment, and their help seemed to have little effect in stemming the epidemic,which finally died out in early summer, after killing at least 5,000 Romaniansand an unknown number of Russians troops. In all, approximately 80,000 caseswere reported.
A second typhus epidemic struck during the winter of 1945-46.This time, the UNRRA (United Nations Relief and Rehabilitation Administration)offered aid if the Romanian Government would request it and would agree to UNRRAadministration of the program. Romanian health authorities were urged to acceptthis help because they did not have the resources to fight the epidemic.Finally, in April 1946, the Romanian Government asked just for supplies fromUNRRA, without general UNRRA assistance. The U.S. Representation of the AlliedControl Commission recommended the disapproval of this request because it wasthen too late to help fight the epidemic and the supplies would be used only forpolitical purposes by the Romanian Government; also, UNRRA would have no part inadministering the assistance. Therefore, neither the Typhus Commission nor UNRRAwas ever given the chance by the Allied Control Commission or the RomanianGovernment to fight typhus in Romania.
Famine.-A severe famine hit Romania during thewinter of 1946-47; it was caused by the severe summer drought and also by theSoviet policy of collecting all available surpluses for the use of their owntroops. As the situation became desperate, General Schuyler, through the ACC,demanded that an accurate report of the situation be given by RomanianGovernment officials. Despite numerous promises, these reports were neverfurnished. After a detailed survey by U.S. Representation field teams inFebruary 1947, General Schuyler asked the War Department to provide immediaterelief on a humanitarian basis. President Harry S. Truman took immediate actionthrough the American Red Cross, and a relief program was started. Even thoughRomanian citizens were dying of starvation throughout this
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critical period, the Romanian Government continued to supplythe Soviet forces with large quantities of food.
U.S. enlisted men and civilian clerks ate in a hotel diningroom throughout the existence of the Allied Control Commission. All officers anddiplomatic personnel had their own billets and dining facilities. Rations wereprovided by the Romanian Government, supplemented by U.S. rations from U.S.headquarters in Europe. Much work was needed at first to get the kitchen up toUnited States standards. However, no diseases or illnesses resulting from badfood or messing facilities ever occurred among U.S. personnel in Romania.
U.S. Army medical personnel in Romania did as much as theycould to improve health conditions during the existence of the Allied ControlCommission. Despite some obstruction from the Soviet Representation, positivesteps were taken, including the introduction of antibiotics and the respirator,the education of Romanian physicians in recent Western medical advances, and thetreatment of Romanian citizens without payment and without regard to socialstanding or political affiliation. These accomplishments helped to earn theappreciation and good will of the Romanian people.
HUNGARY
When the United States Representation on the Allied ControlCommission for Hungary15arrived in the country in February 1945, they foundmedical conditions in general to be "catastrophic." Sanitaryconditions were poor, and diseases of many different types were widespreadbecause of the movement throughout the country of large segments of thepopulation of both Hungary and neighboring countries. Units of the German Army,the Hungarian Army, and the Red Army had also moved rapidly around the country,both in combat and in returning to their homes. Food, medical supplies, andinstallations were virtually nonexistent, and trained medical personnel werescarce. The competing armies had stripped the farms, many crops were ruined orunplanted, and the little food that was produced could not be moved for lack oftransportation. The hospitals had so little equipment and so few supplies thatonly emergency operations were performed, and these under local anesthesia.Iodine was the only antiseptic available, and newspapers were used for surgicaldressings.16 Seriousepidemics threatened to erupt at any time. This was the situation confrontingthe medical section of the U.S. Representation when it arrived in Hungary.
15Unless otherwise cited, the information in this section is derived from (1) the personal observations and records of the author, who served as medical officer for the U.S. Representation on the Allied Control Commission for Hungary in August and September 1945, and as medical adviser to UNRRA from March 1946 to January 1947; and (2) footnote 6 (3), p. 345.
16Shackelford, Richard T.: Draping the Iron Curtain Over Hungary: Observations of a U.S. Surgeon of the Allied Control Commission During the Critical Years of 1945-47. Mil. Med. 117: 140-150, August 1955.
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Lt. Col. Harry C. McClain, MC, served as the medical officerfor the U.S. Representation in Hungary for the entire existence of the AlliedControl Commission from early 1945 to September 1947, except for August andSeptember 1945 when he was on temporary duty in the United States and ColonelShackelford replaced him. Later, from March 1946 to January 1947, ColonelShackelford returned to Hungary from Romania as medical adviser to UNRRA. Theonly other members of the medical section were one enlisted man and severalHungarian civilians.
Upon its arrival in Hungary, the medical section, along withthe other sections of the U.S. Representation, established headquarters inDebrecen. Colonel McClain worked with the Division for Public Health of theMinistry of Public Welfare of the Provisional Hungarian Government to gaininformation on health and sanitation conditions.
Aid to airmen.-One of the first duties of themedical section was to examine and give medical aid to American airmen who hadparachuted from their disabled planes and subsequently were hospitalized inSoviet military or civilian hospitals in Hungary, Yugoslavia, andCzechoslovakia. After being examined, these airmen were flown to U.S.installations in Italy.
Cooperation with Hungarian officials.-In March 1945,the U.S. Representation moved to permanent headquarters in the Bauxite Buildingin Budapest. The medical section set up a dispensary and inspected sanitaryconditions in the areas of Budapest where quarters, messes, and offices werebeing established. Colonel McClain found the officials of Budapest University tobe very cooperative; they made available facilities for hospitalization of anypersonnel who might require it.
Aid to Hungarians.-The health of American personnelwas generally excellent, and the efforts of the medical section were devotedmainly to bringing relief to the Hungarian people. Upon arrival in Budapest,Colonel McClain immediately made plans to cooperate with the Hungarian medicalprofession to fight the threat of widespread epidemics. The severe food shortagereceived intensive study as evidence of far-reaching malnutrition becameapparent. Typhus, a disease which was rarely encountered by Hungarianphysicians, became a threat, but was quickly controlled with the help ofpreventive measures which had proved successful previously for the Americanmedical service in Africa and Italy. One typhus epidemic did occur in the Szegedprisoner-of-war camp where the Red Army prevented U. S. help. At a time whenepidemics were probable in Budapest, no great outbreaks occurred because of thesteps taken by the American medical section and the Hungarian physicians andhealth authorities. Waterborne diseases were easily controlled because,fortunately, the water supply of the city remained potable.
It was obvious, however, during the spring and summer of 1945that a medical crisis existed in Hungary. Hospitals, which were formerly amongthe best equipped in Europe, were trying to function with the most primitiveequipment. Biologic laboratories, which had produced vaccines and anti-
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toxic sera, were closed because they lacked the necessaryequipment and stock animals. The new Hungarian Government was virtuallypowerless to handle the situation or to provide the needed medical supplies.Colonel McClain reported that changes in political personnel in the HungarianDepartment of Public Welfare had reduced the information which could be obtainedon sanitary conditions, and some obstacles were thrown in the path of U.S.efforts to aid deserving individuals and institutions.
Relief to Hungary.-The catastrophic medicalconditions forced the Hungarian Government to cooperate more closely with theU.S. Representation. Dr. Vikar, who proved to be more friendly and knowledgeablethan his predecessor, was appointed Health Minister. The victory of AlliedArmies in Europe also made the introduction of relief supplies an easier task.During the summer of 1945, a group of American citizens of Hungarian originformed the American Hungarian Relief, Inc., to raise money and buy reliefsupplies for Hungary which they asked the U.S. Representation to distribute.Maj. Gen. William S. Key, Chief of the U.S. Representation, assigned the job ofreceiving and distributing these supplies, including food, clothing, andmedicines, to Colonel McClain and the Chief of the Hungarian Liaison Section ofthe U.S. Representation. General Key instructed that this distribution would behandled only until the Hungarian Relief group could establish its ownheadquarters in Hungary; he could promise distribution of only such quantitiesas his limited staff could administer effectively.
The first shipment, consisting of $10,000 worth of medicinespurchased from the International Red Cross, was presented by General Key to theHungarian Red Cross in a ceremony on 27 July 1945. While Colonel McClain was inthe United States during August and September, he informed the AmericanHungarian Relief, Inc., of the specific needs. They immediately authorized anadditional $40,000 for medicines, and thanked General Key for giving the supportof the U.S. Representation to the relief program.
An almost complete lack of insulin made the treatment ofdiabetics a serious problem. In September, the Hungarian Relief Headquarterssent 2,000 vials, which were turned over to the Hungarian Ministry of Industryafter the U.S. Representation had carefully inspected that agency's means ofdistribution and found it to be well managed. American Hungarian Relief, Inc.,continued to supply insulin, and until April 1946, this supply, received anddelivered for distribution by the U.S. Representation, was the only source ofinsulin for Hungary.
In October 1945, General Key agreed to receive and distribute600 gift packages of food and clothing donated by American civilians. Thissupply arrived in time for Christmas, and General Key and his officers used thefood and clothing as the basis for a massive Christmas party throughoutBudapest. The officers contributed to the purchase of large quantities of fruitand candy, and set up Christmas trees in several sections of the city.
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Gift packages of food and clothing were distributed to sick,orphaned, and needy children. The American officers received many expressions ofgratitude from the people of Budapest and plaudits in the local press, which wasnormally hostile to every American action.
In early 1946, the Hungarian Government rescinded thereception and distribution of relief supplies from outside Hungary. When aSwedish "Save the Children" organization arrived in February withlarge quantities of badly needed powdered milk, cod liver oil, and drugs, andthe International Red Cross airmailed 23 additional boxes of mixed drugs,Colonel McClain went to see the Minister of Public Supply and the Minister ofPublic Welfare. They agreed to ignore the recent decree and to allowdistribution. The supplies were allocated to hospitals through Hungarianagencies, which were carefully checked by Colonel McClain. He was satisfied thatthe supplies were distributed fairly and reported that the contribution wasextremely beneficial to the health of the children in hospitals. Again,Hungarian authorities lavished praise on all responsible for the supply anddistribution of this valuable aid.
In May 1946, Mr. Martin Himmler, who was associated withAmerican Hungarian Relief, Inc., arrived in Budapest. General Key informed himthat the quantities of relief supplies arriving in Hungary were so large thatthey were an excessive burden on his small staff. Mr. Himmler then formed acommittee of Hungarians, comprised of representatives of the Government,churches, trade unions, Red Cross, and relief organizations, to receive anddistribute the supplies. On 27 May, this committee relieved the U.S.Representation of these activities which had, in the words of General Key,"greatly enhanced the prestige of the United States Representation and ofthe United States among all Hungarians."
UNRRA.-Another source of relief aid was the UnitedNations Relief and Rehabilitation Administration. In August 1945, ColonelShackelford wrote a detailed report on the serious health conditions in Hungary.General Key and Mr. H. F. Arthur Schoenfeld, the American Minister in Budapest,used this report to ask for UNRRA aid even though Hungary was technicallyineligible because it was an "enemy" country. In December, General Keyreported to the Allied Control Commission that UNRRA aid would be given if theHungarian Government requested it. Acting on the ACC's recommendation, theHungarian Government requested aid, and UNRRA allocated $4 million in reliefsupplies for Hungary. The knowledge of Hungary's medical problems, acquired byColonel Shackelford while compiling his report, prompted the U.S. Army to assignhim to UNRRA as the medical adviser on Hungary.
Mr. Stanley Sommers, an American, led a staff of American andBritish UNRRA representatives into Budapest in the spring of 1946 to survey theneeds and order supplies. UNRRA quickly provided fats, sugar, milk, cannedmeats, some medical supplies, and trucks to transport the supplies. After theHungarian Government officials argued about the distri-
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bution of the supplies, Colonel Shackelford and Brig. Gen.George H. Weems, who had replaced General Key as chief of the U.S.Representation, arranged to borrow a nutrition team from the U.S. Army inGermany. This team instructed the Hungarians how to make nutrition surveys sothat supplies brought in would be in scientifically gaged proportions, that fooddistribution would be on an impartial and scientific basis, and that politicalfavoritism for certain districts or groups of people would be avoided. Thenutrition team proved successful in improving the distribution system, and thesupplies were generally allocated fairly. UNRRA did a commendable job inHungary. More than 60 percent of the UNRRA funds came from the United States.17
Penicillin.-From the beginning of his service inHungary, Colonel McClain realized that Hungarian physicians, who included someof the best in the world, were poorly informed about the medical and surgicaladvances which had been made since the beginning of the war, when a scientificbarrier was thrown up between Hungary and the West. They were especiallyinterested in penicillin, expressing surprise that the drug really did exist andhad been proved worthwhile. Colonel McClain held frequent discussions withHungarian physicians and medical officers in the Red Army to inform them ofWestern medical advances.
While the war was still in progress, it was impossible to usepenicillin for anyone but Allied military personnel. However, on 31 May 1945,the Acting Secretary of State informed the U.S. mission in Hungary, which inturn informed the U.S. Representation, that controls on the distribution ofpenicillin were being relaxed. In August, Colonel Shackelford noted that thehealth of U.S. personnel was excellent, and penicillin stocks were accumulating.He asked General Key and U.S. Minister Schoenfeld for authorization to usepenicillin on critically ill Hungarian civilians. This request was forwarded toWashington. On 14 September 1945, the Department of State authorized General Keyto use his own discretion in distributing penicillin to Hungarian civilians andto Russian and Hungarian wounded in Hungarian hospitals.
Limited amounts of penicillin from U.S. Army stocks were usedfrom September 1945 to January 1946 to help treat Hungarian soldiers andcivilians and Russian soldiers. The American medical officers personallyexamined each case and closely watched the distribution system to preventseepage of the drug onto the black market. Each case was followed up tocompletion.
Meanwhile, Colonel McClain conferred in the United Stateswith officials of American Hungarian Relief, Inc., who agreed to send acontinuous supply of penicillin and insulin when these drugs could be purchasedand exported. When the war against Japan ended, the ban against private
17See footnote 16, p. 354.
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export of these drugs was lifted, and American HungarianRelief began sending shipments.
Penicillin became an overnight sensation in Hungary. Duringthe initial period from September 1945 to January 1946, approximately 100 cases,all emergency patients, were treated personally by the American medicalofficers. Hungarian physicians were amazed at the results, and the drug receivedextensive publicity in the press. Penicillin acquired the reputation of a"miracle drug," and people with a wide variety of illnesses inundatedthe U.S. Representation with requests for consultation and treatment. TheAmerican medical officers decided that interviews would be given only tophysicians who gave detailed case histories of their patients. Requests,averaging from 75 to 100 a day, came not only from Hungarian civilians, but alsofrom the U.S. Legation and American civilians, the British MilitaryRepresentation and British Legation, the Soviet ACC Representation and the RedArmy, the missions of Czechoslovakia, Yugoslavia, Sweden, and France, and allthe departments of the Hungarian Government.
The small staff of the U S medical section was burdened withan almost impossible workload. They visited hospitals to insure the proper useof the drug and to instruct Hungarian physicians. Colonel McClain estimatedthat, from October 1945 to May 1946, 2,000 patients were treated, 500 of whomwere seen personally by the American medical officers. Many more persons wereexamined and were refused penicillin treatment. About 1.4 billion units ofpenicillin were issued for the use of the 2,000 patients being treated in thehospitals.
The U.S. Representation hired private detectives to keeppenicillin off the black market. These investigators reported that all thepenicillin confiscated from the black market came from other countries incentral Europe and not from U.S. supplies. The Hungarian Government dealtseverely with two physicians who were found guilty of misapplication of thedrug, and the U.S. Representation did not intervene or offer advice in thesecases.
In late January 1946, a special penicillin ward was set up infacilities offered by the University of Budapest. The clinic had a three-roomward, with 18 beds, complete laboratory facilities, and an exceptionallycompetent staff. Patients were chosen carefully, with no discrimination as torace, religion, or political affiliation, and detailed records were kept ofevery case. About 300 patients were treated at the clinic, which was designatedthe clinic for receipt of direct aid from American Hungarian Relief, Inc. Itsstaff was able to use the detailed reports and publish papers which werevaluable in instructing the medical profession of Hungary in the use ofpenicillin.
Honors received.-The American medical officers,Colonels Shackelford and McClain, also aided the education process by deliveringfrequent lectures at medical schools throughout Hungary and to the HungarianMedical Society. Both officers were awarded honorary membership in this society.
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In addition, Colonel McClain was awarded medals from theUniversities of Budapest and P?cs in appreciation of the humanitarian work andthe furthering of medical science accomplished by the American medical officers.
These medals were only a few of the testimonials received.The Hungarian Government, the press, American Hungarian Relief, Inc., UNRRA, andthe State Department all praised the work of the U.S. Representation in thehighest terms. In addition, hundreds of letters of appreciation from Hungariancitizens were received by the American Mission. There is no doubt that themedical and relief activities of the U.S. Representation on the Allied ControlCommission for Hungary greatly improved the prestige of the United States in theeyes of the Hungarian people at a time of great suffering.
SUMMARY
The many and varied activities carried out by U.S. Armymedical officers in Bulgaria, Romania, and Hungary, beyond their assignedduties, proved to be very valuable and worthwhile in several ways. First, andmost importantly, the medical officers were able to bring great relief andmedical aid to the people of these countries at a time when they desperatelyneeded this help. By studying the health needs of these countries, by orderingand distributing medicines and relief supplies to meet these needs, byintroducing antibiotics which were unknown in these countries, and byinstructing the local medical professions in the latest advances in Westernmedicine, the American medical officers were able to make a significantcontribution to the public health of the area.
These activities and reports were also of considerable valueto the economic and other sections of the U.S. military and diplomatic missionsin these countries; and, with time, the medical officers who made the effortsattained increasing stature in the deliberations of the U.S. Representation. Itwas a most satisfying assignment for the medical officers of the U.S. Army whoserved in Bulgaria, Romania, and Hungary.
