CHAPTER XII
Planning and Preparations for the European Theater of Operations
Stanhope Bayne-Jones, M.D., and
ThomasB. Turner, M.D.
EARLY PLANNING
The Predecessor Commands (1941-42)
Events in the British Isles in 1941 marked the commencementof the active phase of the planning of civil affairs/military government andassociated public health activities for future application on the continent ofEurope. These events arose against a background of previous developments in thesame general field in Washington.
Executive Branches including the War Department.-Even beforethe United States declared war on Japan on 8 December 1941, the highest officesof the Executive Branch of the Government, including the War Department and theDepartment of State, anticipated the possibility of the involvement of theUnited States in the war in Europe. These offices and their chiefs, from thePresident to the War Department staff officers, became concerned with makingplans for civil affairs, public assistance, public health, and administrativecontrol in countries which might at some future time be liberated and occupiedby the military forces of the United States and the United Kingdom. Theconsequent development of ideas, policies, plans, and agencies has been setforth in many publications and reports,1 and has been summarized inchapters I-III. In the event, Civil Affairs/Military Government plans wererequired for the control ultimately of approximately 100 million people.
Civil Affairs in the ETO an Allied undertaking.-In ETOUSA(European Theater of Operations, U.S. Army) which, from a military point of viewincluded all of Western Europe, Civil Affairs became an Allied enterprise. Boththe United States and the United Kingdom made large and important contributionsto it. It is natural, in the telling, that British historians are mainlyconcerned with the British portion of this joint endeavor. Similarly, the maintheme of these chapters is the work and contributions of agencies of the UnitedStates. The two national contributions were not equal, and the territories andproblems within the purview of each differed
1(1) Report, Lt. Col. Ira V. Hiscock,SnC, and Lt. Col. A. W. Sweet, SnC, to The Surgeon General, U.S. Army, 26 June 1940, subject: A Plan for the MilitaryAdministration of Public Health in Occupied Territory. (2) War Department Field Manual 27-5, MilitaryGovernment, 30 July 1940 (pp. 6-10 of Sec. III).
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in many ways. Donnison, in explaining the reasons for theseinequalities, has stated frankly: "It is true that the great Anglo-Americanheadquarters that was later to be set up for the conduct of the war againstGermany in north-west Europe was in the event more American than British incharacter. It could hardly be otherwise in view of the comparative resourceswhich the two countries would in the long run bring into the common pool."2
On 19 May 1941, the War Department established the nucleus ofa theater called SPOBS (Special Observers Group) in London, under Maj. Gen.James E. Chaney, USA. The name of this organization was changed to USAFBI (U.S.Army Forces in the British Isles) in January 1942. The title continued untilETOUSA's activation on 8 June 1942. It should be recalled that USAFBI includedno special section to handle civil affairs.
In May 1942, USAFBI received a civil affairs unit bytransfer. Into its area came the Civil Affairs Section of the V Army Corps. ThisCorps (Reinforced) composed the MAGNET FORCE which was transported from theUnited States to relieve British divisions then garrisoning Northern Ireland.Advance headquarters of V Corps was established near Belfast on 23 January 1942,soon became known as USANIF (U.S. Army, Northern Ireland Force), and formed apart of USAFBI. When the main headquarters arrived on 20 May 1942, Maj. Gen.Russell P. Hartle, USA, assumed command. With the main headquarters, V ArmyCorps, came a small Civil Affairs Section which had been established on 4February 1942 when the Corps headquarters was staging at Camp Beauregard, La.;Lt. Col. (later Col.) Arthur B. Wade, FA, served as chief of the section.3 Thiswas the first Civil Affairs Section in the U.S. Army in World War II, andColonel Wade became the first Civil Affairs Officer in the European theaterwhen, on 8 August 1942, he was assigned to Headquarters and designated Chief,Civil Affairs Section, ETOUSA.
Reports of the activities of Colonel Wade and the CivilAffairs Section in England during this period are meager. Apparently, theseactivities arose chiefly from the presence of U.S. troops in England andNorthern Ireland. The small Civil Affairs Section at ETOUSA headquarters fromAugust 1942 until January 1943 was "almost exclusively concerned withrelations between the U.S. forces and the people of Britain and liaison withU.K. authorities."4 These involved public health matters such ashousing, water supply, waste disposal, sewerage, venereal disease control, andhygiene and sanitation. Colonel Wade was relieved as Chief of the Civil AffairsSection on 30 May 1943 and returned to the United States.
2Donnison, F. S. V.: Civil Affairs andMilitary Government, North-West Europe, 1944-46. History of the Second WorldWar. United Kingdom Military Series. London: Her Majesty's Stationery Office,1961.
3(1) Manuscript, Lt. Col. John W. Bailey, SnC, 1 July 1945,subject: An Outline Administrative History of Civil Affairs in the ETO. (2)General Orders No. 4, Headquarters, V Army Corps, Camp Beauregard, La., 4 Feb.1942, subject: Staff Officers, V Army Corps.
4See page 12 of footnote 2.
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Civil Affairs Section, ETOUSA (1942-43)
From the beginning, the European theater was disturbed bydisputes over organization, jurisdictional authority, conflicts of ideas, andclashes of personalities. Effects of these trials and tribulations of theoverall command permeated its subordinate parts. Among these, civil affairs ingeneral, and its public health department in particular, suffered frustrations,confusion, and definite disabilities.5
Activation of ETOUSA and planning for BOLERO.-When theEuropean theater was activated on 8 June 1942, superseding USAFBI, it was placedunder the command of General Chaney. On 24 June 1942, the command passed to Maj.Gen. Dwight D. Eisenhower.
At this time, in England, there was active concern with therelation of the war effort of the United States to future European developments.In April 1942, the British and American Governments agreed that, for thecomplete defeat of Germany, an overwhelming Allied invasion of western Europe,across the English Channel, was required. The first tentatively approved planfor the buildup, designated BOLERO, developed during the next 2 years intoOperation OVERLORD, the actual invasion, which struck the Normandy beaches onD-day, 6 June 1944. Planning along many lines was intensified by BOLERO, but theCivil Affairs Section, ETOUSA, did not take a significant part in these matters.
Invasion of North Africa (TORCH).-On 24 July 1942, theheads of government and the Combined Chiefs of Staff decided to proceed with theplanning for the invasion of northwestAfrica (Operation TORCH) with an Allied Force of all arms, to be led by anAmerican commander. On 8 August 1942, President Franklin D. Roosevelt and PrimeMinister Winston Churchill agreed that General Eisenhower should command TORCH.For the next 3 months, General Eisenhower and his staff in London had theadditional task of organizing and landing this Allied Force. As one consequence,other planning and operations in progress were made more difficult, or diverted,and many activities in the European theater were affected, including work inpreventive medicine and public health. At Allied Force Headquarters, GeneralEisenhower was engaged in the campaigns in North Africa, Sicily, and Italy from5 November 1942 until 16 January 1944 (except for a short visit to Washington).On the latter date, he returned to London and assumed the post of SupremeCommander, Allied Expeditionary Force. In his absence, a succession ofcommanders had had charge of theaffairs of ETOUSA, a progression of top-level personnel which added variables toan already hectic situation. Ultimately, however, General Eisenhower'sexperiences during the period 1942-44, when he was in the
5(1) Report, Lt. Col. Carl R. Darnall, MC [CivilAffairs Public Health Officer], to Lt. Col. Sanford V. Larkey, MC, Historical Division, Office of the Surgeon, 31 Oct. 1944, subject:Report on Medical Civil Affairs Planning and Organization [in the ETO]. (2) Coakley, Robert W.: Organization andCommand in the European Theater of Operations. MS. (two vols.) Historical Division, UnitedStates Forces, European Theater. March 1946.
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North African and Mediterranean theaters, had somefar-reaching effects upon Civil Affairs and its related public health activitiesin Europe. He was deeply impressed by the importance ofCivil Affairs/Military Government, which he readilyunderstood embraced "providing government for a conquered [or liberated]population," and that this included the supervision and direction of"public health, conduct, sanitation, agriculture, industry, transport, anda hundred other activities, all normal to community life." He recognizedthat the task for the Army was new and difficult, "but vastly important,not merely from a humanitarian viewpoint, but to the success ofour armies." He insisted that civil affairs/military government in a combattheater of operations must be under the control of the theater headquarters. Inassessing the accomplishments he wrote: "* * * in spite of natural mistakes it [the new job] was splendidlydone. We gained experience and learned lessons for similarand greater tasks still lying ahead of us in Italy and Germany."6
Another outcome of this experience had a bearing on astrenuous controversy in planning Civil Affairs in G-5 SHAEF (SupremeHeadquarters, Allied Expeditionary Force): bringing to London (in January 1944)for a high position Brig. Gen. Frank J. McSherry, USA, who had been concernedwith the policies and operation of AMGOT (Allied Military Government of OccupiedTerritory), particularly in Italy.
By January 1943, some 6 months after its establishment, theCivil Affairs Section in the European theater expanded itsstaff and was able to undertake some planning for future operations on theContinent. In July 1943, the section was enlarged further, and Col. (later Maj.Gen.) Cornelius E. Ryan, Inf, USA, became the Civil Affairs Officer. In August,Lt. Col. Carl R. Darnall, MC, was assigned as Chief of the Civilian Relief Branch,which included departments of public health, welfare, and agriculture. On 4August 1943, Colonel Darnall submitted to his superiors a memorandumproposing alternate plans for the organization of civil public health activitiesfor the forthcoming operations. One plan called for an elaborate Public HealthDepartment, a largely self-sufficient group operating more or less independentlyof the Chief Surgeon's office. The other plan called for a small public healthgroup in the Civil Affairs Section, using the existing technical and operatingfacilities of the theater and lower echelon medical services in applying publichealth measures to occupied territories. The latter plan was favored by ColonelDarnall and also by Brig. Gen. (later Maj. Gen.) Paul R. Hawley, MC, USA, ChiefSurgeon, ETOUSA.
While these plans and policies were being debated, theheadquarters of the Chief of Staff to the Supreme Allied Commander began toassume a degree of responsibility for overall planning for Civil Affairs,including the public health aspects.
6Eisenhower, Dwight D.: Crusade in Europe. Garden City, N.Y.:Doubleday & Co., Inc., 1948, pp. 191-192.
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Civil Affairs Section, COSSAC
At the Casablanca Conference inJanuary 1943, the Combined Chiefs of Staff concluded that the time had come tobegin the detailed development of the European invasion plan, OVERLORD. Lt. Gen.Sir Frederick E. Morgan, KCB, was selected to head the Allied Staff, composed ofBritish and American officers who had assembled in London for this work. Histitle was Chief of Staff to the Supreme Allied Commander (designate), and theinitial letters of this title, COSSAC, came to stand for his headquarters, whichwas established in London on 23 April 1943. As the Supreme Commander had not yetbeen appointed, the difficulties of the tasks assigned to General Morgan and hissubordinates were increased by the necessity to anticipate decisions of a futurecommander and to convince the military and political heads of two governments ofthe soundness of those decisions. Civil affairs began to beconsidered extensively in the staff studies of the RANKIN C Plan (completecollapse and surrender of Germany). General Morgan has written that the problemsof Civil Affairs, "the active service forerunner of Military Government andthe Control Commissions," included "problems of refugees and DisplacedPersons, of disarmament and of post-hostilities business generally. We had begunto become aware of the vast problems presented by the liberation of all ourvarious Western European friends."7
Upon the establishment of the Civil Affairs Section of COSSACin April 1943, there began an interval of uncertainty, jurisdictional conflicts,and off-the-record arguments concerning the responsibilities of the variousheadquarters with reference to civil public health. Regrettably, the troubles ofthis period, in one form or another, beset the undertaking until the end of thewar.
Opinions and actions strongly influenced planning, such asthe following:
1. Visit of Colonel Hiscock; views of the Chief Surgeon. On16 September 1943, Col. Ira V. Hiscock, SnC, Public Health Officer on the staffof the Civil Affairs Division, War Department Special Staff, arrived in Englandfor a month's visit and study at headquarters of the European theater. Thisrelatively new division8wasbecoming increasingly concerned with plans for Civil Affairs in Europe andneeded information that could be collected on the spot by its public healthrepresentative. Many conferences were held by Colonel Hiscock, among them aparticularly significant one with the Chief Surgeon, ETOUSA. At this meeting,General Hawley made it clear that, if he had no control over Civil Affairsmedical policies and no additional personnel and facilities to carry out thework, he could not assume
7Morgan, Sir Frederick [E.], KCB (COSSAC): Overture toOVERLORD. With a foreword by General Dwight D. Eisenhower. London: Hodder &Stoughton, Ltd., 1950, p. 125.
8History of the Civil AffairsDivision, War Department Special Staff, World War II to March 1946. MS., 5vols., pts. 1-6.
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the responsibilities.9 The questions involved in this difference between the Office of the Chief Surgeon, ETOUSA, and the Civil Affairs headquarters with respect to medical and public health activities were never entirely, or satisfactorily, settled during the war.
2. The low estate of Public Health in COSSAC. In the initialorganization of Civil Affairs Section, COSSAC, and indeed until the end ofOctober 1943, Public Health was accorded a relatively minor position. It wasgrouped in a relief and supply branch along with welfare, rationing, and fueldistribution. Colonel Darnall protested vigorously against the subordination ofPublic Health in this organizational plan.10
In the important planned reorganization of COSSAC CivilAffairs on 30 October 1943, Public Health was inadvertently left out entirely,to the profound shock of the Public Health Department. The 3 weeks of planningin which this omission occurred had been carried out during October by anexclusive group under the direction of Col. Karl R. Bendetsen, Chief CivilAffairs Officer (U.S.) at COSSAC, who had been connected with Civil Affairs inthe European theater since early in 1943. Apparently, the omission was anoversight of the exclusive planning group; nevertheless, it was protestedstrongly by both British and American representatives. Notably, on 31 October1943, Colonel Darnall wrote a forceful memorandum11to Colonel Bendetsen,outlining public health functions in civil affairs, and emphasizing that thedismemberment of public health and medical activities would cause irreparabledamage. He recommended, as he had in the past, that a separate Public Healthdivision or branch be established in COSSAC Civil Affairs. The error wascorrected and, ultimately, Public Health became established as a separate Branchof G-5 SHAEF.
3. Some consequences of the President's concern withrelief. On 10 November 1943, President Roosevelt wrote a letter to the Secretaryof War. He called attention to the possibility of the collapse of Germany, tothe resulting demands the United States would have to meet in supplying theneeds of the liberated peoples, and the need to provide for a certain amount oftheir care and rehabilitation. This letter authorized and directed the WarDepartment to formulate and effectuate a large program for relief activities inEurope. It stimulated extensive activities in organization and planning in theArmy; and in the efforts to implement the War Department's portion of theprogram, existing agencies were strengthened and new ones were created.
The Civil Affairs Division Board, which had been establishedby The Surgeon General on 28 June 1943, became increasingly engaged in mattersof civilian supplies for use in Europe.
9See page 23 of footnote 3 (1), p.406.
10Memorandum, Lt. Col. Carl R.Darnall, MC, Chief of Public Health, U.S., COSSAC Civil Affairs Staff, to ChiefCivil Affairs Officer, U.S., COSSAC, 7 Oct. 1943,subject: Position of Public Health Department in the COSSAC Civil AffairsOrganization.
11Memorandum, Lt. Col. Carl R. Darnall, MC [Chief of PublicHealth (U.S.)], Supply Division, COSSAC Civil Affairs Staff, to Col. Karl R.Bendetsen [Chief Civil Affairs Officer (U.S.) COSSAC], 31 Oct. 1943, subject:Public Health Functions in Civil Affairs.
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Brig. Gen. James S. Simmons, MC, Chief of the PreventiveMedicine Service of the Surgeon General's Office,recommended the establishment of a Civil Public Health Division in that Service. This wasdone on 1 January 1944,12 and Col. Thomas B. Turner, MC,was appointed Director, influencing the planning, organization, and staffing of Civil AffairsPublic Health in the European theater.
Ultimately, COSSAC absorbed most of the personnel andfunctions of the Civil Affairs Section, ETOUSA, and what informal liaison therehad been between the public health group in this Section and the Office of theChief Surgeon largely lapsed. On 28 November 1943, the Civil Affairs Sectionwas discontinued and all civil affairs activities were transferred to the CivilAffairs Center established on 1 December 1943 within the American School atShrivenham, England. Colonel Darnall was transferred to headquarters of theFirst U.S. Army on 6 December 1943. The situation remained essentially unchangeduntil after the establishment of SHAEF in January 1944.
Office of the Chief Surgeon, ETOUSA
In the late summer and fall of 1943, there was a closeliaison in the European theater through Colonel Darnall between the CivilAffairs Section and the Chief Surgeon (General Hawley) and the Deputy Surgeon(Col. (later Brig. Gen.) Charles B. Spruit, MC). The prevailing philosophy amongplanners during this period was that a small nucleus of medical officers wouldadvise the Chief Civil Affairs Officer in policy matters pertaining to civilpublic health, but that the major planning and operational activities would becarried on through the facilities provided by the Office of the Chief Surgeon,ETOUSA. No directive was issued by higher authority to confer upon the ChiefSurgeon the necessary powers of control, and no additional personnel orfacilities were provided for such work; consequently, the Chief Surgeon couldnot assume the responsibilities.
With the establishment of COSSAC, the transfer of ColonelDarnall, and the breakdown of effective liaison between the Public HealthBranch, COSSAC, and the Office of the Chief Surgeon, ETOUSA, little attentionwas given in the latter headquarters to matters of the officially designatedcategory: Civil Affairs Public Health. Certain questions regarding supply werean exception to this as was also a detached but natural interest on the part ofthe Chief of Preventive Medicine Division, Col. John E. Gordon, MC.
Later, with the establishment of the Public Health Branch, G-5SHAEF, liaison improved, and on 1 July 1944, a Civil Affairs Branch, with Lt.Col. Walter L. Tatum, MC, as Chief, was activated in the Office of the ChiefSurgeon. Eventually, a rather hazy division of responsibility was worked outbetween the two headquarters. It is interesting to speculate on what might havebeen the results of a full implementation of the proposal
12SGO Office Order No. 4, 1 Jan. 1944.
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which was originally recommended strongly by Colonel Darnalland concurred in by General Hawley.
ESTABLISHMENT OF G-5 SHAEF
Initial Developments
On 15 January 1944, COSSAC was redesignated "SupremeHeadquarters, Allied Expeditionary Force," and on 16 January, GeneralEisenhower became Supreme Commander. In point of time, the COSSAC staff cameunder the control of SHAEF, and COSSAC was transformed into SHAEF, on 14February. On that date, General Eisenhower received the directive of 12 Februaryfrom the Combined Chiefs of Staff on "his duties as Supreme AlliedCommander, Allied Expeditionary Force, which will invade the European continentto destroy German armed forces. Target date is set as May 1944."13
Organization and top staff-In February 1944, the CivilAffairs Division was designated "G-5," in accordance with U.S.practice, and its chief was titled "Assistant Chief of Staff for CivilAffairs, G-5." The first incumbent was Maj. Gen. Sir Roger Lumley(British). The central portion of the former Civil Affairs Division of COSSAC,with advisory and policymaking functions, became the General Staff Division, thefirst head of which was Brig. Gen. Julius C. Holmes, USA, Deputy Chief of Staff,G-5 SHAEF. The remainder of the establishment (operational units, trainingschools, and the country sections or country houses which became the SHAEFmissions) was designated as the Special Staff and was placed under the commandof General McSherry, Deputy Chief Civil Affairs Officer, G-5 SHAEF. Lt. Col.Leonard A. Scheele, MC, USPHS [later, 1949-56, Surgeon General, USPHS], was incharge of the Public Health Subsection, Government Affairs Section, SpecialStaff, G-5 SHAEF. These three officers had had previous experience in civilaffairs in the Mediterranean theater.
The AMGOT concept-Earlyin 1944, the development ofCivil Affairs "machinery" was complicated by strong differences ofopinion among responsible officers and between British and U.S.representatives. Drawing upon their experience in the AMGOT operations in Italy,General Holmes, and General McSherry especially, attempted vigorously toestablish a separate Civil Affairs channel of communication and command, asystem of military government which, in operations on the Continent, would be toa great extent independent of the normal military structure. The proposedarrangement was based upon a territorial organization rather than upon themilitary formations. "This conception of military administration as anorganism standing on its own feet and divorced from military command
13Williams, Mary H.: Chronology, 1941-1945. In United States Army in World War II. Special Studies. Washington: U.S. Government Printing Office, 1960, p. 172.
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except at the highest level was known as the 'AMGOT theoryof Civil Affairs' or the 'AMGOT concept.' Differences in points of view onthis question led to a cleavage between the G-5 General and Special Staffsthat seriously hindered agreement or decisions on important issues."14
In March 1944, after strenuous debate, this proposal wasrejected by Lt. Gen. Walter Bedell Smith, USA, Chief of Staff, SHAEF, and Lt.Gen. H. M. Gale, Chief Administrative Officer, SHAEF. Some time later, a renewedattempt was made by General McSherry to get the AMGOT concept established. Itwas rejected again by Lt. Gen. W. B. Smith, and Maj. Gen. (later Lt. Gen.) SirArthur E. Grasett (British) who, on 22 April 1944, had succeeded General Lumleyas Assistant Chief of Staff, G-5 SHAEF.
Report and recommendations on Public Health-At aboutthe time Generals Holmes and McSherry arrived at G-5 SHAEF, inFebruary 1944, the unsatisfactory condition of Civil Affairs Public Health inthe European theater had come to the attention of the Office of the SurgeonGeneral, U.S. Army, in Washington. To determine the facts and to secure advice,The Surgeon General arranged to have Colonel Turner go to England, study thesituation, and report his findings and recommendations. Colonel Turnerarrived in London on 24 February. During the next 2 weeks, he held manyconferences with most of the officers and civilian officials, British andAmerican, who were concerned not only with public health affairs in G-5 SHAEFbut also with broad aspects of civil and military public health. Colonel Turner'sreport to The Surgeon General was rendered on 9 March 1944.15
From this long and detailed report, the following excerptswere selected by its author to present the main ideas and substance of thedocument.
2. a. I have to report that the situation asregards civil affairs public health in this theater is in an exceedinglyunsatisfactory state at the present time. It is expected that the SupremeHeadquarters Allied Expeditionary Force (SHAEF) will have to assume, through itscivil affairs sections at various echelons, responsibility for decisions andactions affecting public health in most of western Europe. It is unprepared toassume that responsibility. This is not intended as a reflection on presentdirecting personnel, since many of these officers have only been recentlyassigned. Nevertheless, prompt action is imperative.
b. In Great Britain and in the United Statespublic health is administered by eminent specialists who devote full time to thetask, yet at the moment there is no one qualified specialist charged withresponsibility for planning or operation in these matters for the Allied Forces.At neither the G-5 level nor the special staff level is public health accordedthe status of a major division. * * * Yet on the basis of history and presentknowledge of Europe there is a real threat of serious epidemics of contagious orof nutritional diseases occurring in the wake of returning refugees and forcedlaborers in hygienically deteriorated environments.
c. The War Office in London and the WarDepartment in Washington have shown
14(1) Pogue, Forrest C.: The SupremeCommand. In United States Army in World War II. The European Theater ofOperations. Washington: U.S. Government Printing Office, 1954, pp. 66-97. (2)See footnote 2, p. 406.
15Report, Col. Thomas B.Turner, MC, to The Surgeon General, U.S. Army, 9 Mar. 1944, subject: Report on Plans for Civil Affairs Public Health in theEuropean Theater of Operations.
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foresight in assembling medical supplies with which toimplement public health and medical care in occupied and liberated countries,but the organization to ensure that these supplies will be used effectively doesnot exist.
d. Local physicians and medical facilities must be reliedupon largely in caring for the civilian population, but until governmentalstability is achieved the Allied Army must provide a minimum of directingpersonnel, in public health as in other main fields. Medical personnel isextremely short in both Great Britain and the United States. It is essentialtherefore that the few physicians available for civil affairs be wisely used.This can best be insured by establishing a clear cut chain of technicalresponsibility for those who must shape public health policy and influenceaction at various levels. The utilization of medical personnel in non-medicalfields cannot be justified.
3. I have just recently had the privilege of reviewing civilpublic health activities in the North African Theater of Operations. [Report ofthis review was attached as Inclosure 2.] After much field experience and somemistakes a comparatively satisfactory pattern of civil public health activityhas gradually been evolved. It seems imperative that we profit by thisexperience. The following comments and recommendations are based upon theItalian operation modified to fit anticipated conditions in Europe in thelight of overall policy and plans as known to me at this time. If some of therecommendations made seem to conflict with present concepts of Civil Affairs asa whole, it is respectfully suggested that what may be sound organization forthe civil public health field may also be sound for certain other aspects ofcivil affairs.
4. Organization on a functional basis.
a. Most of the difficulties in organization arise from thefact that civil affairs must be administered through existing civilorganizations which are deployed according to territorial boundaries, while thedifferent echelons of the Army often function without respect to politicalboundaries. This makes it necessary to conceive of the Civil Affairsorganization as one paralleling the field forces and supply services. Althoughit must be tied in administratively as tightly as possible with those forces,its functional operation is determined primarily by territorial needs.
b. Public health inevitably will be an important aspect ofcivil affairs. It should therefore be accorded major status in the civil affairsorganization. This will make it practicable to assign well qualified officers asadvisors to the Chief Civil Affairs officers and give the public health officerdirect access to his Chief.
c. The health of the Army is dependent in part on the healthof the civilian population among which it operates. The two cannot be entirelyseparated and the field force surgeon rightly has an interest in civil health.It is absolutely essential that the civil affairs public health officer at everylevel maintain the closest possible liaison with the field force surgeon, andrecognize a degree of technical responsibility to him. Some mature officers holdthat the civil affairs public health officer should be on the staff of the fieldforce surgeon and assigned to civil affairs activities. I believe that thiswould create more problems than it would solve and would limit deployment ofthese officers on a territorial basis. However, we all belong to the sameMedical Department and must work in harmony and good will. [The remainingsubdivisions of the above par. 4, and the pars. 5, 6, and 7 are omitted.]
8. Specific recommendations.
a. That at every level of the civil affairs organizationpublic health be designated as a major division (coordinate with Legal andFiscal) with the chief public health officer directly responsible to the chiefcivil affairs officer.
b. That instructions be issued to the effect that at everylevel, the chief public health officer will initiate and maintain the closestliaison with the surgeon of the field forces.
c. That a request be made to the War Department for theassignment of a highly qualified medical officer to be director of the publichealth division and principal advisor
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to the top operating officer of Civil Affairs SHAEF; thatthis officer be responsible in technical matters to the Chief Medical Officer,SHAEF, and that the Surgeon General honor a request for such an individual atthe earliest practicable date. This officer should preferably be a generalofficer.
d. That the director of civil public health be provided withan adequate specialist staff, * * * [The detailed staff list which was attachedas an inclosure is omitted here.]
e. That a request be made by SHAEF for the following keypersonnel for civil affairs: [Details omitted.]
f. That SHAEF issue a directive that except under veryunusual circumstances Medical Department officers or officers of the R.A.M.C.will be used only in bona fide Medical Department activities. This will apply tomembers of the Veterinary Corps but upon approval of the director of publichealth these officers may be assigned for duty with groups other than medical,such as agriculture.
g. That the assignment of all civil affairs public health andmedical officer personnel be made only upon the advice of the director of publichealth or his designated representatives at various levels.
h. That for any country technical responsibility for civilpublic health be centralized at the earliest practicable date after occupationin one individual, regardless of whether he is attached for administrativepurposes to the communications zone, to a field army, or to an Allied Mission.
i. That increased attention be given to training in technicalmatters for public health personnel awaiting field duty, and that this trainingbe developed with the advice of the director of public health or hisrepresentative.
j. That close liaison be maintainedbetween the medical staff of the United Nations Relief and RehabilitationAdministration and civil public health officials in both England and America.
k. That in the presence of heavy louseinfestation with a threat of typhus in any area for which SHAEF is responsible,the USA Typhus Commission be requested to survey the situation, makerecommendations and if necessary initiate a controlprogram.
1. That medical supplies for civil affairs be handled throughseparate requisition and stock control channels under the public health divisionof Civil Affairs. This will not preclude use of the physical facilities of thecivil affairs general storage depots.
Information copies of this report were sent by Colonel Turnerto the Chief of Staff, SHAEF (through G-5), the Chief MedicalOfficer, SHAEF, Maj. Gen. Albert W. Kenner, the Deputy Chief Civil AffairsOfficer, SHAEF, General McSherry, and the Chief of Staff,ETOUSA(through the Chief Surgeon, ETOUSA, General Hawley).
Establishment of Public Health Branch
Generals Holmes and McSherry were sympathetic to the points ofview and recommendations expressed in Colonel Turner'sreport, and they set in motion actions which resulted in the reinforcement andelevation of Public Health in G-5 SHAEF. Before the end of March 1944,Public Health was raised to the status of a major branch, the staff was enlargedand strengthened in competence, and civil public health supply planning wastransferred from the Supply Section of G-5 SHAEF to the Public Health Branch.
An interesting sidelight is cast on the temporarycomplexities arising from the jointBritish-American character of this headquarters. For reasons
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FIGURE 52.-Lt. Gen. Sir Arthur Edward Grasett, KBE, CB, DSO, MC (British), Assistant Chief of Staff, G-5 SHAEF.
related to the equitable distribution of branch chiefs in G-5,General Grasett, Assistant Chief of Staff, G-5 SHAEF (fig. 52), originallyproposed that the chief of Public Health should be a British officer. Whenadvised of this by Maj. Gen. John H. Hilldring, director of Civil AffairsDivision, War Department Special Staff, The Surgeon General took exception tothe move on the basis that, since the overwhelming majority of medicalofficers assigned to Civil Affairs duties were to be American because of theinability of the British War Office to supply its quota, it would be unwise (and perhaps unfair) to appoint a British officer as chief of this branch.Following an exchange of telegrams, Generals Holmes and Hilldring agreed thatthe Chief of Branch would be an American general officer, to be recommended byThe Surgeon General.
Appointment of chief.-Because all senior Army medicalofficers with competence in this field were already holding highly importantposts, The Surgeon General turned to the U.S. Public Health Service. In aconference
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FIGURE 53.-Maj. Gen. Warren F.Draper, MC, AUS (USPHS), Chief, Public Health Branch, G-5SHAEF.
between Dr. Thomas Parran, then Surgeon General of the PublicHealth Service, and General Simmons and Colonel Turner, of the Office of theSurgeon General of the Army, Dr. Parran agreed to release his Deputy, Dr.Warren F. Draper (fig. 53), for this assignment. This was formalized by anexchange of letters, dated 20 and 26 April 1944, between the Secretary of Warand the Administrator of the Federal Security Administration. It was agreed alsothat Dr. Draper should have a regular officer of the Medical Corps of the Armyas Administrative Deputy and Col. William L. Wilson, MC (fig. 54), was selectedfor this post. These recommendations were acceptable to SHAEF. Dr. Draper wasdetailed to the Army with the rank of brigadier general on 26 April 1944, andwas promoted to major general on 1 July 1944. General Draper and Colonel Wilsonreported for duty at SHAEF headquarters in London on 8 May.
Organization.-With the arrival of General Draper at SHAEF,the Public Health Branch was organized on a functional basis as follows:
Chief-Maj. Gen. Warren F. Draper, MC, AUS (USPHS)
Deputy Chief-Brigadier Thomas F. Kennedy (British) (fig. 55)
Deputy Chief, Administrative-Col. William L. Wilson, MC
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FIGURE54.-Col. William L. Wilson, MC, USA,Deputy Chief, Administrative, Public Health Branch, G-5 SHAEF.
Preventive Medicine-Lt. Col. Leonard A. Scheele, MC, USPHS
Medical Supply-Col. Stuart G. Smith, MC
Assistant to the Chief-Lt. (later Capt.) H .V. Myers, WACConsultants:
Nutrition-Col. Paul E. Howe, SnC
Venereal Diseases-Lt. Col. William A. Brumfield, MC
Sanitary Engineering-Lt. Col. Francis B. Elder, SnC
Veterinary Diseases-Lt. Col. Frank A. Todd, VC
Narcotics Control-Maj. Frank A. Smith, Jr., AGD; succeeded by Capt. William F. Weatherwax, MAC
Public Health Nursing-1st Lt. Marie J. Stone, ANC
General Field Inspection-Col. Walter P. Davenport, MC.
Other specialists were attached to the branch ascircumstances required; for example, three nutrition teams of three members eachwere recruited by The Surgeon General upon request of the branch and assigned towork under the direction of Colonel Howe for 90-day periods. In addition, 11enlisted personnel were assigned permanently to the branch. With thereorganization and permanent assignment of specialist personnel, morale
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FIGURE55.-Brigadier Thomas F.Kennedy (British), Deputy Chief, Public Health Branch, G-5 SHAEF.
in the Public Health Branch became high and remained so throughout the restof the war.16
Mission.-Within 2? monthsafter the establishment of the Public Health Branch, basic statements of itsmission, expressed in terms of the duties of the chief officers, were issued ina directive which reads as follows:17
1. The Chief, Public Health Branch, under the A C of S, G-5, will assure:
(a) Submission of recommendations for and proper establishment of policies and
16(1) Summary Report, Dr. Warren F. Draper, Chief ofthe Public Health Branch, European theater, May 1944-June 1945, to The Surgeon General, U.S. Army, subject: The PublicHealth Branch, G-5 SHAEF-Observations and Comments Upon Its Organization, Operation andRelationships. (2) Draper, W. F.: Public Health Experiences in the European Theatre of Operations. Proc.Am. Philos. Soc. 90: 289-294, 1946.
17Letter, Supreme Headquarters, Allied ExpeditionaryForce, G-5 Division, to All Branches, G-5, 27 July 1944, subject: Organization and Missions of Public Health Branch,G-5.
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procedures for coordinated Civil Affairs Public Healthoperations within the areas for which SCAEF [Supreme Commander, AlliedExpeditionary Force] is responsible.
(b) Plans for and coordinated provision of all resourcesrequired within areas for which SCAEF is responsible for preventing orcontrolling those diseases among civilians or animals which might interfere withmilitary operations.
(c) Properly obtained, evaluated, and disseminated authenticdata concerning prevailing diseases, existing or threatened epidemics, andavailable indigenous resources for Public Health operations within areas forwhich SCAEF is responsible with particular attention to personnel, facilities,equipment, transport and operational systems; military medical services at alllevels will be kept fully informed in order to insure maximum safeguard tomilitary forces.
(d) Coordination of Civil Affairs Public Health operationswith operations of the military medical services of the Allied ExpeditionaryForce in all areas by continuous and close liaison with the Chief MedicalOfficer, SHAEF [Maj. Gen. Albert W. Kenner, USA]; and will insure efficientutilization of all available resources to maximum relief of military forces fromattention to or involvement in Civil Affairs Public Health operations.
(e) Timely availability and distribution of medical suppliesand advice with reference to nonmedical supplies required for prevention orcontrol of diseases among civilians or animal populations which might betransmitted to the military forces, might interfere with military operations, ormight fail to actually promote those operations.
(f) Maintenance of proper relations with, obtaininginformation or support from, and coordinated activities requested of British andAmerican non-military Government or civilian agencies which might contribute aidto or support SCAEF in all Civil Affairs Public Health plans or operations.
In addition, the directive contained an elaborate catalog ofthe duties of all the other chief officers and consultants on the staff of theBranch. Listing all for completeness, these were: the Chief; the Deputy,Professional Consultant; the Administrative Deputy; the Chief, PreventiveMedicine Section; the Chief, Medical Supply Coordination Section; the FieldOperations Consultant; the Sanitary Engineer Consultant; the NutritionConsultant; the Nursing Consultant; the Veterinary Consultant; additionalconsultants as required; and personal assistants.
The directive was not entirely clear, specified theperformance of some impossibilities, and was interpreted variously. Historically,the most satisfactory and realistic summary of the mission is the onegiven in a final report of the chief of the branch to The SurgeonGeneral, as follows:18
The more important duties of the Public Health Branch were:
To make field inspections when necessary to insure thatSHAEF policies and directives were carried out.
To advise the SHAEF G-5 Supply Branch as to therequirements of the civil population regarding medical, sanitary and foodsupplies in the interest of military operations, including quantities, kinds,and the times and places at which needed.
To advise the Displaced Persons Branch regarding the medicaland sanitary phases of its work.
To coordinate its actions with the Medical Department of theArmy through the Chief Medical Officer (Maj. Gen. Kenner) and the Chief Surgeon,European Theater of Operations (Maj. Gen. Hawley).
18See footnote 16 (1), p. 419.
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To advise the Personnel Section SHAEF as tothe number and qualifications of personnel required for G-5 public health fieldactivities and the areas where needed.
To aid the Personnel Section in the selectionand securing of public health personnel from any source available.
To establish a system of communicable diseasereporting throughout the European Theater of Operations.
To disseminate information regarding theincidence of communicable diseases.
To work out agreements and maintaincooperative relationships with other agencies-U.S. [United States of America]Typhus Commission, American and British Red Cross, UNRRA, British Ministry ofHealth.
It is apparent from the foregoing that thePublic Health Branch was in the main a policy forming, advisory, andinformational agency. It could control public health operations in the fieldonly to the extent that it was able to convince the over all authorities atSHAEF that policies permitting such control would add materially to theefficiency of military operations as a whole. It was necessary constantly tobear in mind the fact that the success of military operations was the primeobjective, and that policies which seemed desirable from the public healthviewpoint would not be adopted if they tended to curtail personnel or authoritywhich were deemed essential for the military.
Although the Public Health Branch was, in the main, anadvisory agency, it occasionally acted as an operating body. This wasill-advised and accounted for some of the misunderstandings that arose. In fact,G-5 SHAEF was never intended to "operate" by exercise ofauthority outside its own organization, and its Public Health Branch wasregarded as presumptuous in trying to do so.
GENERAL AND SPECIAL STAFFS FOR CIVIL AFFAIRS
Before proceeding with accounts of planning and certainevents relative to civil affairs public health activities in the European theater,it is advisable to review the staff structure in which public health came to berecognized as of sufficient importance to warrant the establishment of aseparate Public Health Branch at SHAEF headquarters.
Certain staff functions of Civil Affairs, such aspolicymaking, review, and coordination were General Staff functions. These wereincorporated in the organization designated "G-5 SHAEF," under theAssistant Chief of Staff for Civil Affairs, G-5.
Other staff functions of Civil Affairs were technical innature and, therefore, required a technical Civil Affairs Section on the levelof the Special Staff. The field operations would then be performed by CivilAffairs detachments under the staff supervision and direction of these two CivilAffairs Sections (General and Special Staffs), and under the direct authority ofa local commander when assigned temporarily to combat units..
The overall scheme of Supreme Headquarters provided for theinstitution of a Civil Affairs staff structure similar to that in SHAEF in themajor commands and formations of the U.S. and British Allied ExpeditionaryForce; namely, in army groups, armies, corps, divisions, and in communicationszones (advance and rear sections or echelons). The staff structures, as theyevolved, were not all alike, did not observe the same policies and
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practices, and placed different interpretations on identicaldirectives. These differences, together with the climactic events of thecampaign in Europe, the enormous burdens suddenly imposed, and the vast andintricate problems to be solved, greatly affected plans, arrangements, andcapacities for public health activities by both the SHAEF organizations and theregular establishments within the field forces. In the U.S. components of theseforces, one result of major importance was the necessity for the MedicalDepartment to take over those public health functions which the SHAEF groupswere incapable of performing among civilians, both in the liberated and theoccupied enemy countries in northwest Europe.
During October and November 1943, Col. (later Brig. Gen.)Cuthbert P. Stearns, Cav, USA, who had arrived in the European theaterfrom Africa, was busily engaged in setting up a so-called tacticalorganization for Civil Affairs in the combat or mobile phase. His workresulted in the establishment of the Civil Affairs Training Center atShrivenham on 1 December 1943 and the establishment of ECAD (European CivilAffairs Division) on 7 February 1944. This Division was composed ofCivil Affairs regiments, companies, and detachments.19
Personnel for G-5 SHAEF Public Health and MedicalActivities
Medical personnel pool-In January and early February 1944,U.S. Army Medical Department personnel destined for activities inpublic health, and in certain organizational medical activities under G-5SHAEF, began arriving in the European theater. The officers had been selected bythe Office of the Surgeon General and trained at the Provost Marshal General'sSchool of Military Government at Charlottesville, Va. They, along with otherCivil Affairs officers, were assigned to ECAD, the G-5 SHAEF agency created tohold, train, prepare, and replace Civil Affairs personnel of all categories foractive field duty as called for by the military commanders. ECAD maintained itspersonnel in England in several groups located at Shrivenham (nicknamed"Shiveringham" by medical officers stationed there in the winter of1944), Manchester, Easthampton, and Eastbourne. Most of the medical officerswere assigned to the Civil Affairs Center at Shrivenham. The enlisted personnelwere assigned chiefly to the center at Manchester. During the early months of1944, while organization training was in progress, personnel were transferredfrequently between these two locations.
Morale-Before the invasion of France, morale among thesemedical officers was extremely low, largely because of lack ofopportunities for professional work and the "made work" which theywere required to do. Many of the same problems existed in the holding center atTizi Ouzou in North Africa and at the Presidio of Monterey, the holding centerfor the Far East. While a degree of boredom in similar situations is probably
19See page 28 of footnote 5 (1), p.407.
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inevitable, organization, leadership, and better planningwould reduce some of these undesirable features in future operations.
Sorting, appraisal, and assignment.-By limiting attentionto the handling chiefly of public health personnel, it is possible to cutthrough masses of records of misconceptions, mismanagement, and finalcorrections. The concept that Medical Department personnel were in the status of"branch immaterial," and the concept that all medical officers werequalified to perform public health functions, had to be abandoned so thatgeneral and special capabilities could be recognized and properly utilized.Sorting and appraisal were the necessary bases for decisions on assignments. Atthe Civil Affairs Center, three boards were set up to interview all officers forassignment. Furthermore, in consultation with representatives of the PublicHealth Branch, appropriate authority at ECAD made available certain publichealth personnel as consultants, selected some for duty as public healthadvisers to the SHAEF Missions, and placed others as public health staffofficers at Army groups and armies. The majority, however, became members of theCivil Affairs Detachments to be deployed by field commanders as operationsrequired. Some officers were designated to furnish medical care and sanitarysupervision to ECAD.
European Civil Affairs Division
The European Civil Affairs Division (U.S. contingent) ofSHAEF was established at Shrivenham on 7 February 1944.20
The main function of the Division was to serve as a tacticalunit for G-5 SHAEF, Special Staff, in relation to U.S. Civil Affairspersonnel. It was the agency for holding, training, and preparing all categoriesof such personnel for active duty under field commanders of U.S. combatantforces. Public health personnel, and some personnel for rendering medicalservice and medical processing to ECAD, were included in the composition of theDivision from the start-somewhat inconspicuously at first but in a compactmedical organization by September 1944. The Division maintained its headquartersin England until 14 September 1944, when it moved to France. Before that date,however, starting with the invasion in June, several of its medical detachmentshad joined units of the First U.S. Army in Normandy.
In addition to its Headquarters and Headquarters Detachment,the Division formed four Civil Affairs Regiments during the 2 months followingits establishment: the 6901st, 6902d, 6903d, and 6906th ECA (European CivilAffairs) Regiments. The 6906th was a training and replacement regiment. On 6June 1944, these units were renumbered 1st, 2d, 3d, and 4th ECA Regiments,respectively, with regimental medical detachments. These detachments with publichealth functions served in the field in connection
20(1) General Orders No. 13,Headquarters, ETOUSA, 7 Feb. 1944. (2) For additional relevant historical detailand copies of basic documents, see Annual Report, European Civil AffairsMedical Group, European Civil Affairs Division, 1944.
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with Civil Affairs Detachments when called for by fieldcommanders. When in the field, they served under the local military commander.The authoritative statement of the plans for their duties and activities wasissued on 1 May 1944, as follows:21
PUBLIC HEALTH
122. CA Detachments will work in close cooperation with theArmy Medical Services. They will assist in ensuring that measures are taken toorganize or re-establish local medical relief and hygiene services so that thehealth of our forces is not endangered and the military administration is notimpaired. They will take such measures in conjunction with the Army MedicalServices as personnel and facilities permit, and will endeavour to prevent thespread of disease in occupied territory. CA Staffs will work in closeco-ordination with Army Medical Services/Surgeons at Formation HQs/HQs in thedevelopment of an inclusive public health plan.
123. Local agencies, both voluntary and official, will berequired to render maximum assistance. Reconnaissance of the general publichealth and hygiene problems will be the duty of CA Detachments. Suchreconnaissance parties will include, where possible, engineer and medicalpersonnel. They will collect data on the existence of medical and hygiene storesand equipment in the area; on the number of doctors, nurses and other medicalpersonnel available locally; the location and numbers of distressed personsrequiring such aid; and the existence and extent of epidemics and disease. Theywill then send back through command channels an estimate of immediate medical,hygiene and hospital requirements in personnel and materials.
Medical Group, ECAD
Late in March 1944, a Division Surgeon's Office and Officesof Regimental Surgeons were established in the European Civil Affairs Division,and medical services for ECAD and its four ECA Regiments were developed andorganized. The first Division Surgeon was Maj. Stanley J. Leland, MC. Lt. Col.(later Col.) James P. Pappas, MC, Capt. (later Col.) Leonid S. Snegireff, MC,and Maj. Edward V. Jones, MC, were appointed Surgeons of the 1st, 2d, and 3d ECARegiments, respectively. Within a short time, Colonel Pappas became DivisionSurgeon.
The Division became increasingly engaged in both medicalaffairs and preparatory public health activities. Numerous occurrences andconsequent problems, described in various reports,22 indicated that,for control and effective action, all the medical and related ECAD personnelshould be placed in one compact cohesive unit under the command of a MedicalDepartment officer. Colonel Pappas appreciated this fully; with intelligence,foresight, and vigor, he succeeded in bringing all of the medical and publichealth personnel of the Division into a single organization which was officiallyauthorized by Headquarters, SHAEF, and established within ECAD as the EuropeanCivil Affairs Medical Group on 14 September 1944. The letter of reorganization,dated 27 August 1944, states: "Medical Group-Includes all MedicalDepartment personnel in the division. It will have CA [Civil
21Standard Policy and Procedure forCombined Civil Affairs Operations in North West Europe. Supreme Headquarters,Allied Expeditionary Force, 1 May 1944.
22See footnote 20 (2), p. 423.
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Affairs] operational functions in the field of public health,as well as medical care of the command and medical supply. Its personnel will bedistributed and redistributed among CA detachments according to changingneeds."
On 14 September 1944, Colonel Pappas assumed command of thenewly formed ECA Medical Group while retaining his assignment as ECA DivisionSurgeon. Simultaneously, Group Headquarters was opened and, within 2 weeks, astaff was selected which included Capt. (later Col.) Edward J. Dehn?, MC, asExecutive Officer. On this date, the ECA Division was located at the Chateau Rochefort,Rochefort-en-Yvelines, Seine-et-Oise, France.23 The account of theactivities of the ECA Medical Group in the field will be continued in chapterXIII.
Training in England
In England, training for Civil Affairs/Military Governmentbegan before the entry of the United States into World War II and, after thatevent, was continued by established British schools and by a newlyestablished American military school. The training program comprised bothgeneral phases and special professional and technical courses. For U.S.personnel, after 1 January 1944, it was conducted by the European Civil AffairsDivision at the American School of the Civil Affairs Training Center atShrivenham.
Included in the broad program were painstaking research,study, and planning over many months in preparation for operations inconjunction with field forces on the continent of Europe. The branches concernedwith matters of public health, law, finance, currency, economics, displacedpersons, and other subjects wrote and rewrote their directives; the handbook forGermany underwent nine revisions. Many untested theories were formulated,amplified, and discarded. Absence of a duly constituted medical organizationwithin the European Civil Affairs Division during the first 6 months of 1944, ora central coordinating agency with responsibility and authority for developingpolicy or for effecting coordination of professional and technical public healthmatters, left a void that hindered progress and the proper preparation of thescarce medical personnel in duties for which they were intended.
Medical Department officers, assigned to this work soonrealized that they would be engaged in considerable staff procedure and inactivities of a planning and operational nature, and would be dealing withnonmedical staff officers concerned with such Civil Affairs functions asutilities, law, economics, and food and agriculture-to name but a few. Theyunderstood that they would be having official relations with the Medical Department
23(1) Letter, Col. H. McE. Pendleton, Cav, Headquarters, European Civil Affairs Division, to Supreme Commander, AlliedExpeditionary Force, 27 Aug. 1944, subject: Reorganization of European CivilAffairs Division. (2) General Orders No. 36, Headquarters, European CivilAffairs Division, Sec. II, 13 Sept. 1944, subject: Establishment of a CertainUnit Within European Civil Affairs Division. (3) General Orders No. 1,Headquarters, European Civil Affairs Medical Group, European Civil AffairsDivision, 14 Sept. 1944.
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staffs and other staff agencies of tactical commands. Thefunctions of a Civil Affairs Public Health Officer were not specified in WarDepartment doctrine or directives at that time, but it was generally understoodthat his primary duty was to coordinate and facilitate the administrative andprofessional solutions of problems involving the health of civilians in occupiedareas.24
The training included indoctrination in Army procedures,elements of drill, and some physical exercises. Information on certain aspectsof medical care was provided. Instruction, which often proved to be inadequate,was given in the rudiments of public health practice as it would apply toconditions in Europe, as far as they could be estimated.
Although much was accomplished, there were serious defects inthe arrangements and activities of Civil Affairs training, especially withrespect to public health. In general, there was a lack of responsibility for theprogram. There were frustrations, mistakes, and wastage of personnel at a timewhen medical officers were needed urgently. Competent health officers, then inuniform, were needlessly sidetracked for elementary training. The errorscommitted in this phase of training in the European theater should not beglossed over but should be analyzed frankly and evaluated for future guidance.
MEDICAL AND SANITATION SUPPLY
Policy.-To all concerned with the relief and rehabilitationof civilians in European countries that would be liberated and occupied byAllied Forces after the invasion of France, it was obvious that vast amounts ofmedical and sanitation supplies, including food, would have to be made availablefrom three main sources. These would be (1) indigenous supplies, (2) suppliescaptured from the German Army in military depots, and (3) supplies providedthrough British and United States military sources. The contribution from theUnited States was expected to be predominant, especially after PresidentRoosevelt's letter of 10 November 1943 to the Secretary of War, dealing withthe obligations for relief activities that would fall upon the United Statesduring and after the defeat of Germany. Consequently, both British and Americanhigher commands and subordinate and cooperating agencies gave serious andeffective consideration to matters of medical and sanitation supply for CivilAffairs.
The G-5 SHAEF supply program.-G-5 SHAEF could not, anddid not, have any independent control over sources of supply. Naturally, as apart of the military organization, its basic dependence was upon the logisticaland supply system of the U.S. Army, the Army's control of captured supplydepots, and the Army's relations with relief agencies such as the AmericanNational Red Cross and the United Nations Relief and RehabilitationAdministration. In addition, it also received supplies of typhus vaccine,
24See footnote 20 (2), p. 423.
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DDT, and dusters from the United States of America TyphusCommission which also relied upon the logistical and supply system of the U.S.Army for this materiel.
In the organization of G-5 SHAEF, provision was made for aSupply Branch25withsections for procurement, storage, and distribution. This Branch, however,conducted its basic affairs through the regular Army medical supply service. Directivesoutlined supply operations.26 The theater medical supply service wascentered in the Office of the Chief Surgeon, ETOUSA, Maj. Gen. Paul R. Hawley,USA, about whom it has been recorded that he "was not only chief surgeon ofthe theater, but he also headed the medical service of the Communications Zone.As the war progressed, he had tremendous medical resources-personnel andmaterial-under his control. General Hawley, a man of great ability and drive,was strong enough and wise enough to use them effectively. The fact that theentire medical services for the U.S. forces in the European theater was underone chief aided immeasurably in the successful medical support of the war."27From the records, it is evident that G-5 SHAEF alone could not havehandled its supply problems, and that the planning had been wise, allowing forvaluable liaison between G-5 SHAEF and the Office of the Chief Surgeon,ETOUSA, and the medical establishments of armies, army groups, andcommunications zones.
Inadequacies and changes.-The U.S. Expeditionary Forceitself suffered from shortages of supplies and food in the early months of 1945;this affected the capacity of G-5 SHAEF units (European Civil AffairsDetachments) to deal with problems of need, distress, and undernutrition amongthe many thousands of displaced persons and refugees who had to be cared forafter the victorious armies advanced across the Rhine. In brief, by March andearly April 1945, it became clear that the G-5 organization, lackingpersonnel, facilities, and supplies, would not be able to meet its commitments.Because of a cable dated 28 March 1945, a directive was issued on 14 April 1945,which turned over total responsibility within army groups and armies in occupiedenemy territory to commanding officers of commands and their staff medicalofficers in the 6th, 12th, and 21st Army Groups and the Communications Zone,European theater.28
THE SHAEF MISSIONS
Before the United States entered World War II, the planning in England for Civil Affairs in occupied and liberated countries included con-
25See footnote 21, p. 424.
26Manual, Supreme Headquarters, Allied Expeditionary Force, G-5 Division, 24 Aug. 1944, subject: Technical Manual for Military Government Public Health Officers.
27Medical Department, United States Army. Medical Supply in World War II. Washington: U.S. Government Printing Office, 1968, p. 28.
28Action letter, Supreme Headquarters, Allied Expeditionary Force, to Headquarters, 21 Army Group; Commanding Generals, 6th and 12th Army Groups, and Communications Zone, European Theater, 14 Apr. 1945, subject: Public Health Functions in Occupied Enemy Territory.
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sideration of problems of relief and rehabilitation among thecivilian populations of European states which had been under the control ofGermany. From 1939 on, the organization for Civil Affairs contained divisionsknown at various times as "country houses," in which these problemswere studied, among which those of public health were of prime importance, incountries expected to be liberated from German oppression, and in portions ofthe German Reich that would be occupied through conquest by the Allied Forces.These countries were France, Luxembourg, Belgium, the Netherlands, Denmark, andNorway. Germany was to be handled as conquered enemy territory subject tomilitary government. The Governments of the other countries would be regarded assovereign and friendly. Upon them, military government by the AlliedExpeditionary Force would not be imposed. In other words, the operation of CivilAffairs/Military Government in these countries was to be on the basis ofconvention, negotiation, and cooperation, in the presence of Allied militaryunits with police powers and powers of requisition and regulation according tomilitary needs.
British 21 Army Group.-The Headquarters of the British 21Army Group in London was the center of most of the planning for Civil Affairs inBelgium, the Netherlands, Luxembourg, Denmark, and Norway. These countries werealmost the exclusive concern of the 21 Army Group. France and a portion ofGermany were almost the exclusive concern of the 21 Army Group. France and aportion of Germany were allocated to the Americans and became the responsibilityof the U.S. contingent in G-5 SHAEF.
From Country Houses toMissions.-The "country houses," or state-divisions, in CivilAffairs became definitely organized in the early months of 1944 under thedesignation: SHAEF Missions. The Missions were destined to serve as liaisonbodies between the national governments of the liberated countries and theAllied military authorities so that each might help the other to the extent thattheir common interests required in the prosecution of the war and in works ofrehabilitation. Each Mission was administered by an especially selected Americanor British officer with a staff of expert advisers on the major activities ofcivil government, including public health.
Directives.-Fromthe time of the invasion of France until after the occupation of Germany in1945, detailed directives for the conduct of Civil Affairs/Military Governmentwere issued by Supreme Headquarters, Allied Expeditionary Force, by U.S. Armygroups, and by other major U.S. military organizations in the combat zone ofEurope. They contained direct references to public health requirements andprocedures and, in a number of instances, specified the utilization of medicaland public health sections of European Civil Affairs Detachments. The directive of 25 August 1944, the resultof prolonged study, addressed to field commanders, covered Civil Affairs operations in France and isquoted here because it conveys an idea of the basic philosophy on which theseoperations were projected and be-
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cause it refers specifically to public health. Similar basicdirectives were issued by other SHAEF Missions on the Continent.29
[From SHAEF Headquarters to Commander in Chief, 21 ArmyGroup, and Commanding General, Twelfth Army Group, 25 August 1944.]
1.You will insure that such measures are taken to control communicable diseaseamong the civilian population as the safety of your Forces and the conduct ofyour operations require.
2. Civilian Public Health isprimarily a matter for French authorities and in general such action as isrequired, including examination and treatment, will be taken by and throughthose authorities. In the Forward Zone in emergencies affecting militaryoperations, or where no French authority is in a position to effect the measuresdeemed necessary by commanders to protect the health of the troops, commandersmay as a temporary and emergency measure take such action as military necessityrequires. Moreover, in Military Zones, similar action may be taken by commanderswhen necessary to the conduct of operations.
3. You will beresponsible for calling forward and distributing medical and sanitarysupplies/stores required for civilian use. The scale/basis of supply will bethat necessary to maintain minimum standards imposed by the character ofoperations.
4. High priority will be given to civilianrequirements in the allocation and disposition of captured enemy military medicaland sanitary supplies and equipment. Medical and sanitary supplies and equipmentwhich are in the hands of civilians and already intended for civilian use willnot normally be requisitioned, but if requisitioned will be requisitioned inaccordance with French law and through the French authorities. However, in theForward Zone, in the circumstances in par. 2, commanders may directlyrequisition such supplies and equipment.
Germany.-Withthe exception of Germany, these directives were predicated upon friendlyrelations between the Allied military forces and the Governments and peoples ofthe liberated countries.
In planning for CivilAffairs/Military Government and its associated public health activities inGermany, however, this relationship involved a clear difference since civiliansof an enemy country were involved. While the directives reflect this difference,as military government was to be imposed and enforced, in practice the ideals ofthe medical and allied professions tended to make the distinction between friendand enemy largely artificial in matters of health.30
29(1) Directive, Supreme Headquarters, Allied Expeditionary Force, to Commander in Chief, 21 Army Group, and Commanding General, Twelfth Army Group, 25 Aug. 1944, subject: Revised Directive for CA Operations in France. Annex 10. (2) For a more detailed directive in this area, see Administrative Instructions No. 1, Headquarters, Ninth U.S. Army, 30 Nov. 1944, Sec. V: Military Government.
30Memorandum, Supreme Headquarters, Allied Expeditionary Force, Office of the Chief of Staff, 9 Nov. 1944. Annex III, Military Government Policy Directives, Germany. Sec. IX, Public Health.
