CHAPTER II
Selection and Training of Civil Public HealthPersonnel
Thomas B. Turner, M.D.
The entire civil affairs program was carried out with aminimum of military personnel. This was particularly true of the medical andother public health aspects of the program because of the overall shortage ofspecialized personnel in the United States and in Great Britain. Both countriesneeded medical personnel to meet civilian needs at home, including public healthand hospital services, as well as the needs of the military services. Thus,provision for the health program of liberated and occupied areas had to beseverely limited. Such a situation is likely to recur in any major conflict. Thetotal number of persons who were engaged officially in the work of civil affairsand military government during World War II will never be known. One estimateplaces the number of officers as close to 7,000. Writing about the situationexisting in England and in Europe in late 1945, the chief of the Public HealthBranch of the Civil Affairs Division at SHAEF (Supreme Headquarters, AlliedExpeditionary Force) stated: "Into Civil Affairs were recruited some six thousandofficers and enlisted personnel carefully selected on the basis of theirknowledge or aptitude in the various fields of civil administration-administrators,financial experts, legal advisors, economists, supply officers, security andpolice authorities, public welfare officers, public relations officials, andothers."1
Against this background must be judged the manner in whichthe civil health program was planned and carried out. For the same reasons, itfollows that relatively few individuals must play a disproportionately importantrole, and they should therefore be carefully selected on an individual basis forthese assignments. On the whole, the selection and assignment of personnel werewell done in World War II. The few instances in which performance was poor canbe attributed to individual shortcomings rather than to a breakdown in thesystem of selection.
The following is quoted from "Crusade in Europe,"by Gen. Dwight D. Eisenhower:2
From the beginning of the conquest of Sicilywe had been engaged in a new type of task, that of providing government for aconquered population. Specially trained "civil affairs officers," someAmerican, some British, accompanied the assault forces and con-
1Draper, W. F.: Public HealthExperiences in the European Theatre of Operations. Proc. Am. Philos. Soc.90: 289-294, 13 Sept. 1946.
2Eisenhower, Dwight D.: Crusade in Europe.Garden City, N.Y.: Doubleday & Company, Inc., 1948 pp.191-192, 434.
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tinuously pushed forward to take over fromcombat troops the essential task of controlling the civil population.
The American contingent had been trained inthe school established at Charlottesville, Virginia. Later, groups of bothBritish and American military government officers received further training inNorth Africa. They operated under the general supervision of a special sectionof my headquarters.
Public health, conduct, sanitation,agriculture, industry, transport, and a hundred other activities, all normal tocommunity life, were supervised and directed by these officers. Their task wasdifficult but vastly important, not merely from an humanitarian viewpoint, butto the success of our armies. Every command needs peace and order in its rear;otherwise it must detach units to preserve signal and road communications,protect dumps and convoys, and suppress underground activity.
The job was new to us but in spite of naturalmistakes it was splendidly done. We gained experience and learned lessons forsimilar and greater tasks lying ahead of us in Italy and Germany.
* * * * * * *The life of a military government officer wasnever dull. * * *
While features relating to medical affairs require continuingstudy, it is noteworthy that, as combat units undergo reorganization andtactical doctrine is brought into balance, the general staff is expanded toprovide a civil affairs military government officer on the general staff level.3
As the war progressed, the need for more specialization amongcivil public health personnel became apparent; requirements were established forsuch specialities as communicable disease control, nutrition, venereal diseasecontrol, sanitary engineering, veterinary service, nursing, narcotic drugcontrol, and medical supply.
Despite the need to conserve medical manpower and theimportance of using each individual to the limit of his capabilities, civilaffairs health officers were frequently placed in positions where, for lack ofadequate transport, they were immobilized. This situation was particularlyevident in the Italian campaign; it improved considerably in Northwest Europeand, by the time Germany was reached, adequate transport was usually available.
Another major development during the war was the increasinguse of Medical Department enlisted personnel to supplement the activities of thespecialized officers, always in short supply. In the Italian campaign, noenlisted personnel of the Medical Department were included; in the campaignsunder Supreme Headquarters, Allied Expeditionary Force, enlisted men were usedin limited numbers to great advantage; and in the plans for the invasion ofJapan, they were included in larger numbers to assist Medical Departmentofficers.
Early in the formulation of plans for personnel, the need forskilled medical supply officers, public health nurses, veterinarians (especiallyfor laboratory and food services), nutritionists, and narcotic drug control
3(1) Department of the Army FieldManual 101-5, Staff Officers Field Manual. Staff Organization and Procedure,18 Nov. 1954. Par. 21, p. 18, et seq., outlines the duties and responsibilities of the CivilAffairs/Military Government Officer, Assistant Chief of Staff, G-5. (2) Mrazek, J. E.: The Fifth Staff Officer. Military Review, U.S. ArmyCommand and General Staff College, Fort Leavenworth, Kans. 36: 47-51, March1957.
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consultants, among others, was anticipated. Special policiesand measures were instituted to make such officers available.
SPECIAL TRAINING
In the spring of 1942, a program of training civil affairsofficers was developed under the general direction of The Provost MarshalGeneral, Maj. Gen. Allen W. Gullion, USA. Later, in January of 1943, Lt. Col.(later Col.) Ira V. Hiscock, SnC, a public health trained officer and a graduateof the second class of the School of Military Government, Charlottesville, Va.,was assigned to serve in a liaison and advisory capacity to the Provost MarshalGeneral's Office. The Surgeon General's Office was requested to assist inrecruiting Medical Department personnel and to provide lecturers and medicalintelligence data.
In view of the character of the projected civil affairsactivities, it seemed appropriate to employ in the program U.S. Public HealthService officers whose training and experience had been primarily in the fieldof civilian health. Accordingly, as a result of a request to Dr. Thomas Parran,The Surgeon General, U.S. Public Health Service, a number of officers wereassigned for duty with the U.S. Army. These officers held corresponding rank tothose in the Army and were, for all intents and purposes, on the same status asother commissioned personnel of the Medical Department.
For specialized training in civil affairs, the School ofMilitary Government was organized at the University of Virginia (fig. 3), inMarch 1942, under the specific direction of Brig. Gen. Cornelius W. Wickersham,with the first class entering on 11 May 1942. Courses of 3 months were arrangedfor the first three classes, but in December 1943, they were reduced to 2months. Table 1 shows course attendance of Medical Department and U.S. PublicHealth Service officers enrolled in six of the seven classes during 1942-43.
The curriculum was devoted largely to a study of foreignlanguages and of the history, culture, and social and governmental organizationof the countries to which the program was oriented. No attempt was made toinclude public health and medical matters in the curriculum except on an
TABLE 1.-Enrollment in the School of Military Government,Charlottesville, Va., 1942-43
|
|
| Officers enrolled | ||||
| MC | SnC | VC | MAC | USPHS | ||
| 1st | 4 | 2 | 1 |
| 1 |
|
| 2d | 7 | 4 | 3 |
|
|
|
| 3d | 11 | 3 | 4 | 0 | 0 | 4 |
| 4th | 9 | 3 | 2 | 0 | 0 | 4 |
| 5th | 18 | 6 | 3 | 1 | 0 | 8 |
| 6th | 9 | 6 | 0 | 0 | 0 | 3 |
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FIGURE 3.-Students gather between classes at the School of Military Government, Charlottesville, Va., August 1943.
elementary basis directed to the nonmedical members of theclass. The school maintained medical intelligence reports, public healthmanuals, medical bulletins, and medical and sanitary supply lists. At least onepublic health lecture was given to each of the early classes, supplemented byroundtable conferences with the health officers.
An increase in the public health content of the curriculumand the establishment of a committee for special functional studies wererecommended, but they were not favorably considered by school authoritiesbecause of an already crowded schedule. In the light of experience, however, itseems clear that officers who were to carry the principal administrativeresponsibilities of civil affairs activities in the field were not sufficientlyaware of the extent to which health problems would constitute one of their majorresponsibilities and, in general, were not prepared for the staff work necessaryto cope with these problems.
The general consensus among Medical Department students wasthat much of the time spent in studying such problems as finance and education,even for orientation purposes, could have been used to better advantage in
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developing seminar discussions around public health problemsof interest to the professionally trained student.
Twenty-two civil affairs public health officers, trained atthe School of Military Government, were sent to the North African (laterMediterranean) Theater of Operations, U.S. Army, during 1942-43; theseincluded one colonel, four lieutenant colonels, eight majors, and nine captains,most of whom subsequently played an active role in the Italian campaign, in theBalkans, or in Western Europe.
CIVIL AFFAIRS TRAINING SCHOOLS
With the increasing requirements for civil affairs personnel,the Charlottesville training facilities were supplemented by the establishment,on 1 July 1943, of a series of civil affairs training schools located at thefollowing 11 other universities: Boston, Chicago, Harvard, Michigan,Northwestern, Pittsburgh, Princeton, Stanford, Western Reserve, Wisconsin, andYale.
Officers selected for civil affairs training were usuallysent first to a school of military government at Fort Custer, Mich., for a6-week orientation course, then to one of the various universities for foreignlanguage training and area studies for a 10-week period. A total of 49 MedicalCorps, 38 Sanitary Corps, and two Veterinary Corps officers were trained in thisprogram, besides two Army Nurse Corps officers who were also graduates of theCharlottesville School.
Additionally, the Provost Marshal General's Office selecteda number of Medical Administrative Corps and Sanitary Corps officers and oneDental Corps officer to train for civil affairs duties other than public health.
The curriculums of the civil affairs schools again providedfor a few lectures on public health, but these were too elementary to be of morethan refresher and orientation value to the professionally trained individual.Because of continuing concern on the part of Medical Department personnel in theprogram, an effort was made in November 1943 to develop a more extensive publichealth curriculum at the Yale University Civil Affairs School, New Haven, Conn.,under the direction of Dr. C. E. A. Winslow, professor and chairman of theDepartment of Public Health. Limitations of time continued to be a problem whichwas recognized by all concerned. Nevertheless, military observers returning fromoperations in Africa and Italy brought back their experiences to the schools,and the curriculums at Yale and Michigan, during the latter part of 1943, wereamended to include a considerable increase in specific public health instructionrelating to Germany.
PRECOMBAT TRAINING IN THEATERS OF OPERATIONS
When armies operate far from their home base, the logisticsituation often requires long waiting periods in overseas theaters for certainkinds
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of units and personnel. This is particularly true of medicalgroups, whose principal activities occur at the time of actual fighting, and ofcivil affairs/military government personnel, who must await the conquest of aterritory to have a job to do. The resulting morale-shattering boredom,especially among Medical Department personnel during World War II, was onlyaggravated by inadequate or misdirected provision for "made work"during this waiting period.
In preparation for the invasion of Italy, the MilitaryGovernment Holding Center was established at Chr?a and later was moved to TiziOuzou, about 60 miles from Allied Force Headquarters, in Algiers. Initially, thecivil affairs group at this center consisted of a small nucleus of British andAmerican planning officers, including medical officers, who arrived in May 1943.The group was augmented steadily by the arrival of other contingents from theCharlottesville School and from the various civil affairs training schools. As arule, Medical Department officers were assigned to teams organized for projectedcivil affairs operations in Italy. While this arrangement was helpful forplanning purposes, it led to a loss of flexibility in the use of scarcepersonnel since organized teams were reluctant to release their public healthofficers for more immediate health care use elsewhere.
One of the lowest points in the morale of the civil affairspublic health group occurred at the Civil Affairs Center at Shrivenham, England(fig. 4), during the months preceding the invasion of continental Europe. Somecivil affairs public health personnel were held there for 4 or 5 months withvirtually nothing to do. What training there was had little bearing onprofessional activities, and it was difficult for these officers to bephilosophical about what they considered to be an unnecessary waste of time.While this situation was a relatively minor problem, it probably had an adverseeffect on recruitment for these assignments and could have been largely avoidedby better provision for the intellectual needs of this professional group.
PERSONNEL SHORTAGES IN THE EUROPEAN THEATER
From D-day, 6 June 1944, until the surrender of Germany on 8May 1945, the personnel situation in regard to Medical Department officersavailable for civil affairs and military government activities becameincreasingly stringent. The British were able to provide only a small fractionof the medical personnel whom they had hoped to assign to civil affairsactivities. The problems faced were tremendous, especially in the care ofdisplaced persons and refugees. Several approaches to the problem were:
1. Arrangements were made with UNRRA (United Nations Reliefand Rehabilitation Administration)4wherebyUNRRA medical personnel were loaned to the Army until needed by UNRRA.
4UNRRA was an outgrowth of the U.S. Office of ForeignRelief and Rehabilitation Operations, organized in 1942 under the direction ofGov. (later Sen.) Herbert H. Lehman with a committee on public health under thechairmanship of Dr. Thomas Parran.
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FIGURE4.-American School Center, Shrivenham, England, 1944. Top: CivilAffairs Center. Bottom: Officers' Mess.
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2. In many instances, the armiesfurnished Medical Department personnel from their own organizational strength.
3. Requests were made to the British for personnel, but onlya few additional officers were provided.
4. Requests were made to the War Department for additionalpersonnel. Personnel could not be supplied from the Zone of Interior to meet themajority of these requests. However, from time to time, a few Medical Corpsofficers and some Sanitary Corps and administrative officers were made availableto the European theater. The War Department took the view that sufficientqualified public health officers were already in the theater to meet the civilaffairs requirements. Hence, at the request of SHAEF, a list of 25 Medical Corpsofficers qualified in public health and already in the theater was forwardedwith the recommendation that these officers be used.
Public Health Personnel From Other Agencies
In addition to the employment of members of the U.S. PublicHealth Service, the civil affairs program was able to use effectively personnelfrom the Rockefeller Foundation, the United Nations Relief and RehabilitationAdministration, and, to a limited extent, the American National Red Cross.
Early in the occupation of Italy, the Rockefeller Foundationsent certain members of its International Health Division to that country towork on various health problems. These men, although they had no officialconnection with the Army, rendered valuable service in several instances,notably in the control of typhus during the Naples epidemic and in malariacontrol measures.
In February 1944, the director and several members of thePublic Health Subcommission of the Allied Control Commission expressed thedesire that the Rockefeller Foundation personnel continue working with them ontyphus control and, later, on malaria control. However, they desired that theirconnection with the Army be formalized. Although, in practice, the Rockefellerstaff members had been given messing facilities, furnished transportation, andaccorded certain Army privileges, they had no official standing with the Army.
During April 1944, the Rockefeller Foundation approvedcollaboration with the Allied Control Commission for typhus and malaria controland placed Dr. Fred L. Soper in charge of the International Health Divisionactivities in Southern Europe and in Italy.
A memorandum of 6 April 1944 to the Chief, PreventiveMedicine Service, Surgeon General's Office, suggested that these men beappointed as consultants to The Surgeon General and called to active duty whenneeded by the theater surgeon. Since their salaries were paid by the RockefellerFoundation, it was thought they might be appointed as "dollar-a-year-men,"with the Army paying their expenses while they were on active duty.
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On 25 April, a memorandum was sent to the Director, CivilAffairs Division, War Department Special Staff, incorporating thissuggestion and asking for approval. A first endorsement, dated 27 April,approved the recommendation. A cablegram sent on 8 May to Headquarters, NorthAfrican theater, stated that, although the War Department did not approveblanket recognition of the Rockefeller Foundation as a collaboratingorganization, it did approve using selected Rockefeller staff members ascivilian consultants to The Surgeon General at $1 per year, with assignment uponrequest of that theater.
In a memorandum on 12 May 1944, the appointment of fivephysicians under this agreement was requested. The Office of the Secretary ofWar objected to their appointment as "dollar-a-year-men" as contraryto War Department policy. The physicians were finally appointed, on 6 June 1944,as consultants without compensation but with payment of travel and $10 per diemin lieu of subsistence.
Six staff members of the Rockefeller Foundation wereappointed for service in the Mediterranean Theater of Operations, U.S. Army,under this management: Dr. Austin Kerr, Mr. F. W. Knipe, Dr. Floyd S. Markham,Dr. Louis A. Riehl, Dr. Stuart S. Stevenson, and Dr. Bruce Wilson. Two werealready in Italy, and the others arrived under War Department orders requestedby The Surgeon General. The arrangement worked satisfactorily; the group wasattached to the Public Health Subcommission of the Allied Control Commission(later Allied Commission) and rendered valuable service, especially in thecontrol of malaria and typhus.
United Nations Relief and Rehabilitation Administration
The relationship of the Civil Public Health Division,Preventive Medicine Service, to the United Nations Relief and RehabilitationAdministration was maintained by close informal liaison. This arrangement wasadvisable because it was evident that, in at least some of the countries inwhich the Army was engaged in public health activities, UNRRA would be calledupon to continue these activities when military control ended.
In a meeting on 25 March 1944, Dr. Thomas Parran of the U.S.Public Health Service; Dr. James Crabtree and Dr. E. R. Reckie of UNRRA; Brig.Gen. James S. Simmons and Col. Thomas B. Turner, MC, of the Surgeon General'sOffice; and Colonel Hiscock of the Civil Affairs Division, Special Staff, agreedthat close collaboration between civil affairs and UNRRA in public healthmatters was desirable. This conclusion was communicated to the appropriate Armyand UNRRA officials in Europe.
Cooperation in public health matters was implemented furtherby a mutually beneficial plan between SHAEF and UNRRA under which UNRRA medicalpersonnel were to be detailed to the Army for civil affairs duty, therebygaining valuable experience working in areas in which they
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might later serve as UNRRA representatives. Meanwhile, theArmy would acquire the services of additional public health personnel.
An agreement was signed in London, on 28 July 1944, by Maj.Gen. Warren F. Draper, Chief, Public Health Branch, Civil Affairs Division,SHAEF; Lt. Gen. Sir Arthur E. Grasett, Assistant Chief of Staff, G-5 SHAEF;Dr. Wilbur A. Sawyer, Director of Health, UNRRA; and Sir Frederick Leith-Ross,Deputy Director General, UNRRA. It provided that UNRRA medical officers would beattached to the Army until needed by their own organization and released by G-5SHAEF. While so attached, the officers would communicate officially with UNRRAonly through appropriate military channels. A radiogram from SHAEF, dated 9August, modified the original agreement to provide that these medical officersshould "be ordered to UNRRA-London for attachment to Public Health Branch,G-5, SHAEF." This agreement was approved by UNRRA on 21 August and by theU.S. Public Health Service on 24 August.
In November 1944, a further agreement signed by GeneralEisenhower and Herbert H. Lehman, Director General of UNRRA, established closeliaison and cooperation between SHAEF and UNRRA.
SELECTION AND ASSIGNMENT OF PERSONNEL FOR MILITARY
GOVERNMENT IN GERMANY
With the surrender of Germany on 8 May 1945, plans werecompleted rapidly for assignment of medical personnel to the USGCC (U.S. GroupControl Council), which, together with the British, French, and Russians, was totake over the government of Germany. The intention to use principally officerswho had been in the civil affairs program under SHAEF was carried out whereverthe rotation policy made it possible.
When hostilities ceased, the U.S. Public Health Servicerequested the return of General Draper and other officers at the earliestpracticable date. Upon the dissolution of SHAEF on 16 July 1945, General Draperreturned to the United States.
Public Health and Welfare was organized as a major divisionof the U.S. Group Control Council, and because of its policymaking functions,the selection of a director was regarded as of prime importance. Therefore, TheSurgeon General, upon the advice of General Simmons and Colonel Turner,recommended to Maj. Gen. John H. Hilldring that Maj. Gen. Morrison C. Stayer,then chief surgeon of the Mediterranean theater, be selected as the director ofthe Public Health and Welfare Division, USGCC. This recommendation was acceptedand General Stayer assumed his duties in May 1945, when the Group ControlCouncil was still in the planning phases at Hoechst, a few miles from Frankfurt,Germany.
Lt. Col. Joseph A. Bell and Maj. Edgar B. Johnwick, two U.S.Public Health Service officers on assignment to the Army, who composed theoriginal USGCC medical planning group, returned to the United States
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shortly thereafter. For his deputy, General Stayer selectedCol. William L. Wilson, MC, who had served in a similar capacity in the PublicHealth Branch of G-5 SHAEF; he also selected Lt. Col. (later Col.) William A.Brumfield, Jr., MC, also from G-5 SHAEF, as the consultant in venereal diseasecontrol.
General Stayer desired other consultants, and the SurgeonGeneral's Office arranged to procure the services of several civilianspecialists to go to Germany for periods of 3 to 6 months. The followingcivilians proceeded to Germany in August 1945 to act as special advisers toGeneral Stayer:
Judge Fred L. Reese (legal matters); Dr. Wilburt C. Davison,Dean, Duke University School of Medicine (rehabilitation of German medicalschools); Dr. John J. Phair, School of Hygiene and Public Health, The JohnsHopkins University (public health laboratories); Dr. William A. Hagan, CornellUniversity (veterinary matters); and Mr. Samuel H. Breidenbach, Bureau ofNarcotics Control, U.S. Treasury Department (narcotics control).
PERSONNEL FOR THE FAR EAST
On 5 April 1944, a conference was held in the Surgeon General'sOffice to discuss the personnel requirements for the Far East civil affairsprogram. Representatives of the Surgeon General's Office, the Civil AffairsDivision of the Special Staff, and the Provost Marshal General's Office werepresent. A requirement for some 1,500 civil affairs officers for Japan alone wasanticipated, the estimate for the medical officers being 5 percent. Ofapproximately 75 Medical Department officers, 32 were to be assigned from theMedical Corps.
On 25 September 1944, besides this original allotment of 75officers, The Surgeon General, at the request of the Provost Marshal General'sOffice, allotted an additional 18 officers, nine of whom were in the MedicalCorps. After a brief training period at the U.S. Navy Far Eastern Civil AffairsTraining School at Princeton University, Princeton, N.J., these officers weretransferred to the Pacific where they were assigned to the Tenth U.S. Army andlater served on Okinawa.
At the request of the Commanding General, Southwest PacificArea, another group of 20 officers was assigned and sent immediately to thePhilippines. As of 20 January 1945, The Surgeon General had agreed to assign 113Medical Department officers for civil affairs in the Far East.
University of Chicago School-The first MedicalDepartment officers sent to the Far East were trained in the first class of theCivil Affairs Training School established at the University of Chicago, Chicago,Ill., on 24 August 1943. This class included four members of the Medical Corpsand three members of the Sanitary Corps. The course was essentially one oflanguage and area study and not until the last months was attention directed topublic health matters. Maj. James G. Telfer, a U.S. Public Health Serviceofficer assigned to this class, developed a program in
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coordination with the Provost Marshal General's Office andwith the cooperation of the City Health Department of Chicago. MedicalDepartment members in the class made weekly visits to municipal public healthand sanitary installations in Chicago. These field trips were supplemented by anoccasional lecture by a member of the City Health Department to the entire CivilAffairs Training School class. In April 1944, Major Telfer submitted to theCivil Public Health Division, Preventive Medicine Service, an "Outline ofPublic Health Functions for District Civil Affairs Officers in Japan," thepreparation of which represented the combined efforts of the Medical Departmentofficers. Medical Department officers were not trained at the University ofChicago following this first class, which ended in February 1944.
Princeton University School-The U.S. Navy conducted aFar Eastern Civil Affairs Training School at Princeton University in 1944-45.Particular emphasis for Medical Department officers at this school was placed onpublic health problems on Taiwan. The courses were of 3 months' duration, andthe first class reported on 1 October 1944. A number of U.S. Army MedicalDepartment officers were enrolled in this school, and others were included onthe faculty. The first medical officers enrolled in the second class whichstarted on 1 November 1944. A total of three lieutenant colonels, three majors,and nine captains were trained at Princeton.
Yale University School-The Provost Marshal General'sOffice, in coordination with the Surgeon General's Office and the CivilAffairs Division, Special Staff, developed a plan by which all MedicalDepartment officers who were to receive public health instruction in civilaffairs would be enrolled at Yale University. A proposed curriculum for publichealth officers at this Far East civil affairs training school was approved bythe Surgeon General's Office on 3 June 1944.
The Civil Affairs Training School at Yale was under thedirection of Prof. A. Whitney Griswold of the Yale University faculty, and Col.Calvin B. Garwood, Cav, was named associate director. Instructors were Lt. Col.Roland Murphy, Maj. Fred Hackett, Maj. Joel Ernest, and Maj. James B. Gillespie,MC. This last officer was assigned from the Civil Public Health Division,Preventive Medicine Service, as liaison officer for the Medical Departmentgroups.5 The responsibility for supervision of the public healthprogram was assumed by the School of Public Health under the supervision ofProf. C. E. A. Winslow.
After completing the 6-week indoctrination course at theSchool of Military Government, the first group of officers who were scheduled toattend the course at Yale was assigned for 1-day temporary duty in the SurgeonGeneral's Office, where the functions of the various divisions in thePreventive Medicine Service were explained. Also, a series of conferences washeld at which comments and expressions on the work at Charlottesville
5War Department Special Orders No.207, 29 Aug. 1944, par. 10.
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were invited from various student officers. In general,student officers lacked information concerning the role of public health incivil affairs because there was no medical officer on the School of MilitaryGovernment faculty and because of the limited time devoted to this function.Little or no time was given to the public health aspects of military governmentin the field.
The curriculum at Yale consisted of intensive training inJapanese language and area studies; in addition, Medical Department officersattended special seminars on diseases, epidemiology, sanitation, and publichealth subjects of importance in Japan. The seminar program was devoted to suchproblems as control of epidemic and communicable diseases of the Far East,including animal diseases, organization of local hospital and medical care,problems of feeding and nutrition, narcotics control, and restoration offacilities for sanitation of the environment including water supply, wastedisposal, and housing and food hygiene.
During each course, one week was devoted to field visits andinspections of city and State hospitals, special clinics, health departments,and local water supply and sewage disposal installations. The veterinary andsupply officers of the first class at Yale spent one day at LederleLaboratories, Pearl River, N.Y. Special attention was given on this trip toproduction, storage, and packaging of biologicals.
Medical and public health topics and lecturers for the civilaffairs seminars at Yale were selected by Colonel Hiscock, Civil AffairsDivision, Special Staff, and Colonel Turner, Director, Civil Public HealthDivision, Preventive Medicine Service, in coordination with the Civil AffairsTraining Branch, Provost Marshal General's Office, The specialists wholectured and conducted seminars were faculty members of the Yale School ofMedicine or were procured through the Surgeon General's Office, the Navy'sBureau of Medicine and Surgery, the U.S. Public Health Service, and otheragencies. Unfortunately, with few Medical Department officers available who hadfield experience in the Far East, there was little firsthand information ofexisting conditions in that area.
All facilities of the Yale Medical Library were placed at thedisposal of the Medical Department officers. All recent publications on medicaland public health subjects from the Medical Intelligence Division, PreventiveMedicine Service, Surgeon General's Office, the Provost Marshal General'sOffice, and other sources were made available for reference work. Films andpictures showing public health activities in the Marshall Islands, Saipan,Okinawa, and other Pacific areas were available and proved useful. Personalcopies of two publications, ASF (Army Service Forces) Manual M 354-13,"Japan Public Health and Sanitation," and War Department Pamphlet 31-2, "Civil Affairs Handbook, Public Health in the Japanese Empire,"were provided for each Medical Department officer. In May 1945, ASF Manual. M354-13 was superseded by TB MED (War Department Technical Bulletin (Medical))160, "Medical and Sanitary Data on Japan," a publication prepared inthe Medical Intelligence Division. A display of civil affairs medical
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supply items from the basic medical and dispensary units wasset up in the medical library to familiarize officers with supplies.
The training of Medical Department officers at Yale wasdiscontinued after August 1944. In a memorandum dated 7 April 1945, from thedirector of the Civil Affairs Division, Special Staff, to The Surgeon General,the Deputy Chief of Staff authorized The Provost Marshal General to train 1,000additional civil officers for the Far East. This group was to include 100 Medical Corps, 20 Medical Administrative Corps, 50Sanitary Corps, and two Veterinary Corps officers. However, Medical Departmentofficers procured for civil affairs assignments after 14 August 1945 did notattend the School of Military Government and were assigned directly to the CivilAffairs Holding and Staging Area, Presidio of Monterey, Calif.
After completing their work at Yale, Medical Departmentofficers were permitted 10 to 14 days for special assignments on temporary dutybefore reporting to the Civil Affairs Holding and Staging Area. Theseassignments varied and followed a 5-day period at the Medical Field ServiceSchool, Carlisle Barracks, Pa. A number of medical officers from the first Yaleclass were assigned to temporary duty in the Preventive Medicine Service; someof the sanitary engineers from this class were assigned to the same office whileothers requested assignment to Fort Belvoir, Va. Supply officers had temporaryassignments to various medical supply depots. In the first and second classes, anumber of the medical officers had short assignments in tropical and militarymedicine at the Army Medical School, Washington, D.C. Veterinarians in the firstand second classes, following short periods at the Veterinary Laboratory of theArmy Medical School, spent several days at the Army Medical Nutrition Laboratoryin Chicago. In several instances, by special arrangement, officers were assignedto temporary duty at civilian institutions selected because of particularfacilities important in public health.
CIVIL AFFAIRS HOLDING AND STAGING AREA
The Civil Affairs Holding and Staging Area was established atFort Ord, Calif., on 27 June 1944. On 10 February 1945, it was moved to thePresidio of Monterey. Col. Wilson C. Williams, MC, was assigned to the CivilAffairs Holding and Staging Area in August 1944,6 and was designated surgeon.The first commanding officer of the Civil Affairs Holding and Staging Area wasCol. Hardy C. Dillard, MC. On 24 January 1945, Colonel Williams reported at theSurgeon General's Office for a short period of temporary duty during whichconferences on medical supplies were arranged for him with representatives ofboth the U.S. Navy and the International Division, ASF. In addition, conferenceswere held on civil affairs personnel, immunization of civil affairs personnel,and training programs. A visit to the Medical Field Service School enabledColonel
6War Department Special Orders No. 208, 30 Aug. 1944, par. 10.
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Williams to observe field equipment improvised for messsanitation, water purification, excreta and garbage disposal units, delousingequipment, and other demonstrations. Following this visit, he suggested that allmedical and sanitation officers in civil affairs training schools be sent to theMedical Field Service School for a few days.
On 26 February 1945, Colonel Turner and Colonel Hiscockreported for temporary duty at the Civil Affairs Holding and Staging Area.During the period of their visit, conferences were held with Colonel Dillard,the Commanding Officer; Capt. W. S. Voeder, USN, Deputy Commanding Officer; andofficers in charge of major staff divisions. Numerous conferences were held withColonel Williams, the Chief Public Health Officer, and with the public healthand medical staff. Various aspects of the training program were observed,including panel discussions, field demonstrations, unit exercises, physicaltraining, language training, and staff conferences. Particular attention wasgiven to health organization and public health training. As a result of thisvisit to the Civil Affairs Holding and Staging Area, certain problems requiringclarification were noted, including:
1. Integration of training in public health in the variouscivil affairs training schools and at the Civil Affairs Holding and Staging Areato insure continuity and to avoid duplication.
2. Early determination of responsibility between Army andNavy for procurement, storage, and issue of medical supplies for a projectedoperation for which civil affairs officers were being staged at the CivilAffairs Holding and Staging Area.
3. Early determination of the degree of Civil Affairs Holdingand Staging Area responsibility for indoctrination and unit training ofpersonnel in G-6 Naval Hospital Units7 scheduled for military governmentactivities in the Far East.
In May 1945, a training program for public health officers atthe Civil Affairs Holding and Staging Area was submitted to the Director, CivilAffairs Division, Special Staff. This document, containing course outlines, wasconcurred in by the Civil Affairs Division and the Surgeon General's Office.The program covered basic instruction in personal hygiene, water sanitation,first aid, excreta disposal, messing and mess sanitation, insect and rodentcontrol, field sanitation, and medical supply. A special study was made ofcommunicable diseases occurring epidemically and endemically in the Far East.The training schedule included both a basic and a functional section. The basicinstruction schedule was the same for all trainees regardless of the individual'sservice, branch, or type of team or detachment to which he was assigned. Thefunctional training schedule was designed for medical officers, sanitarytechnicians, and related specialists only.
All instruction periods proposed were for 2 hours ormultiples thereof. Each instructor prepared a syllabus covering material anddemonstrations
7The G-6 Naval Hospital Unit was a 100-bed advance base typehospital, an item in the Navy's Functional Component System.
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for which he was responsible. Teaching aids, such as films,equipment, and supplies, were listed at the end of each syllabus. The basicinstruction was given during the first 4 weeks of training, with some additionaltime being devoted to field demonstrations during the fifth and sixth weeks oftraining in the field. After the 4-week period of basic instruction, theSurgeon, Ninth Service Command, and the director of health of California,arranged for the assignment of Medical Department officers to certain Army,State, and municipal medical and sanitary installations which providedadditional training in line with the particular specialty and interest of thevarious officers. These temporary-duty assignments were in such facilities asthe Ninth Service Command Laboratory, Fort Ord; the Los Angeles and San JoaquinCounty Health Departments; and the Los Angeles City Health Department. In theearly fall of 1945, several officers attended the Navy School of TropicalMedicine at Treasure Island, San Francisco, Calif.
At the Civil Affairs Holding and Staging Area, eight militarygovernment headquarters groups were formed. The table of organization for eachincluded one Medical Corps officer. In addition, 56 military governmentcompanies were organized, each with a table of organization which included oneMedical Corps and one Sanitary Corps officer.
In the early fall of 1945, these units were transferred tothe Pacific theater. Since Medical Department officers with Far Eastern trainingfrom the School of Military Government and civil affairs training schools wereinsufficient to fully staff these units, 35 Medical Corps officers and 42sanitary engineering officers without special training were procured fromvarious commands in the Zone of Interior to make up this deficit.
Colonel Williams departed from the Civil Affairs Holding andStaging Area in May 19458and wasreplaced as chief public health officer by Col. Charles K. Holmes, MC.
SUMMARY
The civil affairs/military government public health trainingprogram was organized and put into operation hastily and under great pressure.Consequently, many aspects of the program as it related to Medical Departmentofficers can be criticized as less than the best. And yet, on the whole, thetraining activities were probably as well conceived and as well carried out ascould be expected in the circumstances.
Two difficult problems were inherent in the program andprobably will be encountered in any future ventures of this kind. The first isthe problem of achieving a balance between professional and nonprofessionaltypes of training; and the second is the extent to which it is possible to trainfor service in a particular area.
The School of Military Government at Charlottesville, whichinitially
8As in other operations, lists ofmedical, nursing, and sanitary personnel from liberated and occupied territories, who had received training in public health in the United States in earlieryears, were supplied to appropriate officers before invasion operations, andsuch a procedure proved helpful in numerous instances, including Japan.
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concentrated on problems anticipated in the combat phases ofcivil affairs, provided virtually no training of a professional nature forMedical Department officers. From the standpoint of the latter group, however,there were real advantages in studying and training as part of a civil affairsgroup, where some understanding of problems other than medical was acquired andwhere cooperative planning was featured.
At the Yale School, the amount of instruction in publichealth was greatly increased under the direction of nationally known teachers;at the same time, the content was integrated with the area studies being pursuedby the entire class. Since this plan was the latest in the evolution of thetraining program, it is perhaps natural to regard it as the most successful fromthe standpoint of Medical Department officers.
In a rapidly changing world war, it is difficult to train menfar in advance for service in a particular country, or even a particular area ofthe world. For example, in 1942, recent graduates of a British Skiing School inLebanon were rushed to take part in the defense of Java and, in 1943, the mainunit selected for the recapture of Attu was the 7th Infantry Division, freshfrom training in the Mojave Desert. So also, men who had become fluent inItalian and familiar with the details of Italian life and culture frequentlyfound themselves deeply engaged in civil affairs problems in Germany or in theFar East, while others trained in the Japanese language saw service in thePhilippines.
Perhaps in the future, much of the basic training in theconcepts and principles of civil affairs and military government operations and,to a certain extent, in area studies can be given more leisurely on a reservetraining status so that, if a wartime problem is eventually confronted, thisbasic type of training can be limited to a relatively short orientation andrefresher course.
Unit training and intensive area study can probably best becarried out at places closer to the area of operation.
In the final analysis, however, civil affairs is an activityin which the results reflect to a unique extent the quality of the relativelyfew individuals assigned to these duties. This point of view was expressed inthe words of Maj. (later Lt. Col.) Henry T. Rowell, MC, as submitted in a reportof a review of military government operations in Sicily in August 1943:
An organization in the last analysis is only as good as themen in it. This is particularly true of a new organization that has to functionwithout the cohesive force of experience and tradition. Each man, to a certainextent, must feel his own way and make his contribution to the whole structureon the basis of what he has learned himself.
In this AMGOT [Allied Military Government of OccupiedTerritory] was most fortunate. The great majority of its officers proved byachievement that they possessed the intelligence, flexibility, and characterwhich were needed for the job. They not only made a good plan into a livingreality but improved it in the process. It is not a contradiction to say thatthey were hardheaded and humane at the same time. These are highly desirablequalities in military government. In conjunction with good will and a capacityfor work, they produced a notable example of Allied cooperation and the kind ofmilitary government which does credit to the armies and men of both Allies.
