CHAPTER VI
The North Atlantic Area
Captain William D. Church, MSC
As Adolf Hitler's plans for world conquest becameincreasingly clear in 1938, the United States realized that it must takeimmediate steps to prevent the establishment of enemy bases in the WesternHemisphere. Though many secondary aims were stated at various times, the entireprewar strategy was based on the need "to reduce to a minimum thelikelihood of accepting war upon our own territory."2
The fall of France in June 1940 and the threat to GreatBritain and its North Atlantic lifeline focused American military attention onthe North Atlantic area. In late 1940 and in 1941, a series of agreements wasworked out which sent U.S. forces into Canada, Newfoundland, Greenland, andIceland. Canada and the United States agreed to work together in the OgdensburgDeclaration of 17 August 1940. Under terms of the Destroyer-Base Agreement withGreat Britain of 2 September 1940, the United States was given the right tolease bases in Newfoundland, a British colony until 1947, when it became aprovince of Canada. Agreements with the Danish Government in exile in April 1941sent U.S. troops to Greenland, and in July, the Icelandic Government agreed toUnited States relief of British forces on that island.
By 1942, the North Atlantic bases had become the supportersof overseas offensives by protecting the sea routes and serving as steppingstones in the air ferry operations by which American airplanes were rushed tothe scene of battle under their own power. In both the defensive and offensiveoperations of the United States, the northern bases were vital.
1A manuscript concerning Civil Affairs and Military Government Public Health Activities in Greenland, Iceland, Newfoundland, and Canada was written previously by Frank A. Todd, DVM, formerly Lieutenant Colonel, Veterinary Corps, U.S. Army, and Chief, Veterinary Section, Iceland Base Command. Since the submission of his manuscript to The Historical Unit, U.S. Army Medical Department, much additional material on public health activities in these countries was acquired. The chapter, therefore, was rewritten entirely by Captain Church, and the new material incorporated. In addition, the revision has given the author the opportunity to elaborate on Dr. Todd's own fine contributions to public health administration in Iceland.-Col. R. S. Anderson, MC, USA, former Director of The Historical Unit.
2The story in detail of U.S. military activities in Canada, Newfoundland, Greenland, and Iceland is found in the following volumes-(1) Conn, Stetson, Engelman, Rose C., and Fairchild, Byron: The Western Hemisphere Guarding the United States and Its
Outposts. United States Army in World War II. Washington: U.S. Government Printing Office, 1964. (2) Conn, Stetson, and Fairchild, Byron: The Western Hemisphere. The Framework of Hemisphere Defense. United States Army in World War II. Washington: U.S. Government Printing Office, 1960. (3) Dziuban, Stanley W.: Special Studies. Military Relations Between the United States and Canada, 1939-1945. United States Army in World War II. Washington: U.S. Government Printing Office, 1959. Additional information is also found in-(4) Craven, Wesley Frank, and Cate, James Lea: The Army Air Forces in World War II. Volume I: Plans and Early Operations, January 1939 to August 1942. Chicago: The University of Chicago Press, 1948. (5) Morison, Samuel Eliot: History of United States Naval Operations in World War II: Volume I: The Battle of the Atlantic, September 1939-May 1943. Boston: Little, Brown and Co., 1964.
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The various bases in the North Atlantic and in northwestCanada were organized under independent commands. The necessary medical supportfor them had to be sent in, and this was directed by command surgeons.3
To protect the health of the troops, medical officers had tobecome involved with public health problems; therefore, the potential existedfor disagreement between Army medical officers and local civilian healthofficials. It must be remembered that U.S. troops were not moving into warzones. Except to rout a German weather detachment off the Greenland icefieldsand fight off German seapower in the waters around Iceland, U.S. forces in theNorth Atlantic bases defended areas where the people carried on their normallives. American troops were visitors through detailed diplomatic agreements, notthrough occupation; therefore, even though public health problems threatened thehealth of U.S. troops, Army medical officers could not impose their willunilaterally. The problems had to be worked out with the cooperation of localhealth officials. As this chapter will depict, the work of U.S. Army medicalofficers in diplomacy, as well as in medicine, was exceptional.
CANADA
One writer on United States-Canadian relations4calls the collaboration of the two countries during World War II, "a recordof solid accomplishment with only minor notes of discord."5The North American neighbors combined both to defend the continent and theNorth Atlantic and to aid in the offense against the Axis by making it easier torush airpower into action against the enemy. This joint effort brought intobeing expensive and wide-ranging projects on Canadian soil, such as the AlaskaHighway (commonly known as the Alcan Highway), the Canol Project in theNorthwest, and the CRYSTAL and CRIMSON airbase network in central and easternCanada.
Canada and the United States did not rush into an alliance.President Franklin D. Roosevelt first pledged defense assistance to Canada atChautauqua, N.Y., on 14 August 1936, but the significance of the speech wasmissed by most Canadians. During the next several years, the President andCanadian Prime Minister William L. Mackenzie King talked several times aboutmutual defense problems. Then, on 18 August 1938, in a speech at Kingston,Ontario, President Roosevelt stated U.S. intentions in terms that could not bemisunderstood. He vowed that "* * * the people of the United States willnot stand idly by if domination of Canadian soil is threatened by any otherempire."6
3The details of Army Medical Department operations in the North Atlantic area are in: Wiltse, Charles M.: The Medical Department: Medical Service in the Mediterranean and Minor Theaters. United States Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1965, pp. 7-26, 30-34.
4The best sources for details of U.S.-Canadian relations are footnotes 2 (2) and 2 (3), p. 159.
5See footnote 2 (3), p. 159.
6See footnote 2 (3), p. 159.
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Finally, on 17 August 1940, Canadian-United Statescollaboration became a reality when the President and Prime Minister MackenzieKing met at Ogdensburg, N.Y. A brief press release the next day announced thatthe two leaders had decided to set up a Permanent Joint Board on Defense tostudy "sea, land and air problems including personnel and material."The board was to "consider in the broad sense the defense of the north halfof the Western Hemisphere."7
The Ogdensburg Declaration was very popular on both sides ofthe border, but naturally, there were to be differences of opinion during thewar years. Many United States citizens poured into Canada to work on defenseprojects, and U.S. forces built and operated bases and facilities as if theywere on U.S. soil. Many Canadians felt that these troops operated much tooindependently of Canadian jurisdiction. In addition to these militaryarrangements, there were smaller irritants, such as occasional cases of soldiermisbehavior, competition for scarce housing and rationed supplies, and some fearthat U.S. commercial enterprises in Canada might have an advantage after thewar. It must be remembered that Canada was remote from the combat areas, andU.S. troops were intruding on territory where Canadians were trying to liverelatively normal lives.8
The problems proved to be minor, however, and the jointeffort was highly successful. Perhaps the best proof of this is that, when thewar ended, there was never any question that the alliance would continue evenwhen other wartime partnerships were breaking up. Today, our agreements withCanada are more extensive than with any other country.
Liaison between medical personnel of Canada and the UnitedStates on common problems was very valuable to the armed forces of bothcountries. An officer of the Royal Canadian Army Medical Corps, Capt. (laterMaj.) A. H. Neufeld, acted as liaison officer to the U.S. Army Surgeon General'sOffice. He provided medical information from Canada, including reports of theNational Research Council of Canada. In addition, Major Neufeld was authorizedin April 1945 to coordinate all medical administrative matters for both theCanadian Army and Air Force directly with the U.S. Army Surgeon General. Thishelped to reduce delays in action on these administrative matters.9
Public Health
When the Army moved into Canada, it found a well-developedpublic health system already in operation. Canadian public health activitieswere divided between the health departments of the Dominion and of theindividual provinces.
The Dominion Government was responsible for public healthmatters
7See footnote 2 (3), p. 159.
8See footnote 2 (3), p. 159.
9Office Order No. 81, Office of the Surgeon General, U.S. Army, 13 Apr. 1945.
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which were clearly international, national, andinterprovincial. During the first few years of World War II, health activitieswere administered by the Dominion Department of Pensions and National Health. In1944, the Canadian Parliament replaced this with a new agency, the DominionDepartment of National Health and Welfare. However, the functions of the twobodies in the field of public health were quite similar. Both were responsiblefor preventing the entrance of infectious disease, screening out immigrants whocould become a "charge" on the country, overseeing the medical care ofworkers on public construction projects, controlling food and drugs, workingwith the provinces to improve public health, conserving the health of Governmentemployees, and conducting research in public health problems.
Each body included a Division of Quarantine and ImmigrationMedical Service. This section was charged with preventing the introduction ofcontagious diseases, such as plague, cholera, yellow fever, smallpox, andtyphus. However, to insure the quick completion of defense projects in Canada,the U.S. War Department assumed responsibility for all quarantine measuresconcerning Americans, in accordance with pertinent provisions of Armyregulations dealing with control of communicable diseases.10
The Dominion Council of Health coordinated the activities ofthe various provincial health bodies. In general, the Provincial Governmentsadministered local public health activities. Municipalities, societies, andindividuals carried on charitable and humane programs under the supervision andcontrol of the Provincial Governments. The Dominion Government made grants tothe provinces and to private voluntary organizations engaged in public healthwork.
Local municipalities usually built and supported the publichospitals. Treatment was "free of charge to all deserving applicants"whose resources were "so limited as to prevent them from receiving propermedical attention otherwise."11
Northwest Canada
Before December 1941, the American military effort had beendirected toward the protection of the North Atlantic area, but the Japaneseattack on Pearl Harbor forced Canada and the United States to plan more activelyfor defense on the west coast.
The first task was the completion and maintenance of theNorthwest Staging Route-a series of airfields built by Canada, spanning thenorthwest-to connect the United States and Alaska. They were thought to be in
10(1) War Department Circular No. 276, 1 Nov. 1943. (2) Army Regulations No. 40-210, 15 Sept. 1942.
11Details on the Canadian public health system as it existed during World War II may be found in: Dominion Bureau of Statistics, Department of Trade and Commerce, Canada: The Canada Year Book. Ottawa: Edmond Cloutier, King's Printer, for the following years: 1941, pp. 900-901; 1942, pp. 887-890; 1943-44, pp. 954-960, 969-972; 1945, pp. 820-828; and 1946, pp. 805-816, 827-830.
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FIGURE16.-Members of the 648th Engineer Battalion working on the Alaska Highwayin -37? weather, March 1942.
good condition, and Canada agreed to use of the facilities bythe United States.
In January 1942, the first effort to reinforce Alaska by airproved disastrous as 13 of 38 planes crashed on the way. The idea of a highwayto Alaska was not new, but to improve and supply the air facilities, to providea ground guide for pilots flying the route, and to create a ground link withAlaska, the highway plan was reconsidered and approved by both the United Statesand Canadian Governments in February and March 1942. The highway and the stagingroute were tremendous engineering achievements which fulfilled the majorpurposes for which they were constructed. It was an enormous task to cut throughvirgin lands while overcoming the handicaps of landslides, freezingtemperatures, sudden thaws, and other weather problems. The successfulcompletion of the task was a tribute to United States-Canadian cooperation.
The Alcan Highway, when completed, linked Big Delta in southcentral Alaska and Dawson Creek in eastern British Columbia, a distance of 1,428miles. A pioneer road was hacked out by U.S. Army Engineers (fig. 16); in thelatter half of 1942, they were joined by a civilian construction organiza-
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tion working under the U.S. Public Roads Administration. Thehighway remained a U.S. military road throughout the war, and on 1 April 1946,it was turned over to Canada.
Canol, a contraction of Canadian oil, became one of the mostcontroversial projects of the war. Without the Japanese threat in the north, theplan to get petroleum supplies from the Norman Wells oilfield in the NorthwestTerritory would have been economically unsound. But the need for oil on thestaging route and the highway brought the idea to life, and in an exchange ofnotes in June 1942, Canada agreed to let the United States proceed with theproject.
The original Canol Project, later known as Canol 1, linkedNorman Wells, in the heart of the oilfields around the Mackenzie River innorthern Northwest Territory, with a refinery in Whitehorse, southern YukonTerritory. Subsequently, other projects came into being: Canol 2 provided apipeline between Whitehorse and Skagway, in southern Alaska; Canol 3 involved agasoline pipeline between Carcross, south of Whitehorse, and Watson Lake, insoutheastern Yukon Territory; and Canol 4 linked Whitehorse with Fairbanks,Alaska.
Most of the work was done by U.S. citizens because there waslittle local help available in this barren area, more than a thousand miles fromany settlement.12 Tobuild the needed facilities, U.S. citizens were sent into northwest Canada inlarge numbers, and by June 1943, more than 33,000, both military and civilian,were stationed in the Northwest.13
Planning medical support for this extensive area was a bigtask. During 1942, U.S. Army Medical personnel cared for both U.S. troops andcivilian employees of the PRA (Public Roads Administration), privatecontractors, and Northwest Airlines, Inc. The PRA employees were entitled tomedical care as beneficiaries of the U.S. Employees' Compensation Commission.By 1943, four different U.S. medical elements were operating in the area:(1) the medical branch of the Northwest Service Command cared forthe military, (2) the U.S. Public Health Service attached to the Public RoadsAdministration and the U.S. Engineer Department Health Service cared forcivilians, (3) civilians requiring extended hospitalization, many emergencycases, and dental cases were sent to Northwest Service Command StationHospitals, and (4) the Alaskan Wing of the Army Air Force provided medical carefor its personnel (map 4).
Close liaison was maintained among these agencies to avoidduplication of medical service and to care for both military and civilianpersonnel in the most efficient manner.14Civilian doctors were sometimes employed when
12Manning, Frank G.: Preventive Medicine in the Northwest Service Command, Northwest Division, United States Engineer Department, and Northwest District, Sixth Service Command, 6 May 1946. [Official record.]
13For the story of U.S. operations in Northwest Canada in more detail, see footnotes 2 (2) and 2 (3), p. 159.
14The work of the U.S. Public Health Service in the area is covered in Williams, Ralph C.: The United States Public Health Service, 1798-1950. Washington: Commissioned Officers Association of the United States Public Health Service, 1951, pp. 735-737.
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MAP 4.-U.S. Army hospitals in Northwest Canada, 1943-45.
no Army medical officers were available, but thiswas not a common practice.
The last elements of the Public Health Service left inJanuary of 1944; and in March of that year, the personnel and facilities of theEngineer Department Health Service were absorbed by the Northwest ServiceCommand Medical Branch. This consolidation was in accordance with Letter,Headquarters, Army Service Forces, dated 10 February 1944, subject: Curtailmentof Operations and Reduction of Military Personnel and Equipment, NWSC. Thedirective ordered that civilians, both Canadian and American, should be hired toreplace military personnel.15
15Annual Report, Surgeon, Northwest Service Command, 1944.
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The effect of this directive was to increase the number ofcivilians in the command and to make the medical branch of the Northwest ServiceCommand the only agency left to treat them. The civilians were not in as goodphysical or mental condition as the soldiers had been. Because of severemanpower shortages, the disadvantages of age and some physical infirmities hadbeen overlooked by those who had hired them. The result was an increased patientload and a greater diversity of cases to treat.16
The U.S. Army hospitals also treated patients from theCanadian armed services, under reciprocal agreements of 24 March 1943 and 22March 1945. These agreements provided for the use by either country of thehospital facilities of the other.17
Public health.-The provinces of Alberta and BritishColumbia already had extensive public health services when U.S. troops arrived.In addition to the usual services, Alberta maintained a system of 16 RuralHealth Districts to provide for country areas and 36 Provincial District Nursesto give a wide-ranging medical and public health service to the outlying areas.
British Columbia used different types of local healthservices, including large city health departments, health units, public healthnursing services, and, in outlying areas, private-practice physicians who wereappointed as part-time health officers and school medical inspectors. The HealthUnit, made up of a full-time physician medical director, public health nurses,several trained sanitarians, and a statistical clerk, was the basic unit oforganization. Each section of the province was served by a health unit.18
Public health matters were of little concern in YukonTerritory and the Northwest Territories because of the sparse population. Theterritories contained less than 1/700 ofCanada's total population. Municipal governments handled some public healthmeasures, but matters affecting the general public health were directed by theDominion Government.19
Sanitation.-The large increase in war productionbrought many more Canadians to the cities, putting a heavy burden on watersupplies, sewage disposal, housing, and entertainment facilities in the settledareas. But it had very little effect on American troops because the Armysupplied all these facilities except in Edmonton, Alberta, where local water andsewage facilities were used with no adverse effects on either the localpopulation or the U.S. troops.20
Because of the wide area under control of the NorthwestService Command, it was impossible to impose overall sanitary regulations. Thevarious sections required individual attention because of their locations anddiffering
16Annual Report, Station Hospital, Whitehorse, Yukon Territory, Canada, 1944.
17(1) War Department Circular No. 83, Sec. VI, 24 Mar. 1943. (2) War Department Circular No. 91, 22 Mar. 1945.
18Dominion Bureau of Statistics, Department of Trade and Commerce, Canada: The Canada Year Book, 1945. Ottawa: Edmond Cloutier, King's Printer, pp. 826-827.
19See footnote 12, p. 164.
20See footnote 12, p. 164.
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problems. Medical officers made occasional area and districtinspections, and 12 Sanitary Corps officers worked full time in the Command area.
Although sanitary standards were generally high, some settledcommunities did not meet Army standards until they received assistance. Inseveral areas, American assistance cut down intestinal disease rates that hadbeen major problems for years.
Obtaining safe water was a varied problem since it involvedproviding for camps with as few as five men as well as for areas where up to10,000 troops were stationed. In most instances, supplying water for the Armydid not entail any work with local civil officials. Only in Edmonton and GrandePrairie, Alberta, did the Army use water from a municipal system. In the othercamps along the highway, water was obtained from wells, lakes, and streams, andthen treated by Army personnel.
The Veterinary Service did not begin inspection of local foodresources until the summer of 1943. During the first months of operation, thetroops had eaten mainly "C" and "K" rations. When theveterinarians started inspections of local food, the diet of the men improvedconsiderably. With good local cooperation in most areas, food establishmentswere inspected by U.S. Army and Canadian inspectors, and the list of approvedrestaurants and food stores grew rapidly.
The Army Veterinary Service accepted the meat productionstandards already in force at Canadian meatpackers under the supervision of theVeterinary Division, Health of Animals Branch, Dominion Department ofAgriculture. Army personnel did inspect the plants for quality of the productsduring production and accuracy of weights. The Army Veterinary Service alsopersuaded civilian contractors working on the Canol project to procure theirmeats through Army channels in Edmonton instead of from the extremely unsanitaryplants in the Mackenzie River area.
During 1944-45, the Edmonton Quartermaster Market Centerpurchased 22,500,000 pounds of frozen poultry throughout Canada. VeterinaryService inspections were praised by Canadian Government and poultry industryofficials, and resulted in improved production and better sanitation.21
At Edmonton, the biggest city in the Northwest ServiceCommand area, the Army had most of its contacts with local officials. All healthmatters of mutual interest were studied by a special board, which included theSurgeon for the Edmonton District representing the Northwest Service Command,provincial and city health officials, and representatives of the U.S. Army AirForce and the Canadian armed services.
Edmonton was the major supplier of fresh milk for the Army. Three dairies with modern equipment were approved in May 1943 to supply about 150 gallons a day for the troops. In July 1943, the Veterinary Service dis-
21Medical Department, United States Army. United States Army Veterinary Service in World War II. Washington: U.S. Government Printing Office, 1961, pp. 227-231.
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covered that the milk was not being inspected properly by thecity for milk-borne diseases and quality. Edmonton did not require testing ofcows for Bang's disease (Brucella abortus) which can cause undulantfever in man. An estimated 25 percent of the cows were infected. The city'stest for bacterial content was considered inadequate; more effectivepasteurization could have overcome the danger. Because of the relatively laxpublic health control over dairy production in Edmonton, Army veterinaryofficers established quality control testing of both raw and pasteurized milk.22
In the Edmonton area, troops were supplied directly by thedealers. In addition, some milk was shipped by plane to hospitals and by trainto several railheads where neither fresh milk nor powdered milk prepared in a"mechanical cow" was available. Not until late 1945 were Armyveterinary and sanitary officers able to arrange for shipment of fresh frozenmilk in quart fiber containers, the safest means of transport. Small, extremelyunsanitary sources of milk were found at all the railheads. Troops wereprohibited from using this milk, but some did so when they could not getapproved milk from Edmonton.23
Edmonton was the only major post where the Army obtainedwater from a municipal source and used a municipal sewerage system. Cooperationwith local water officials was excellent. Even though the city purificationplant was operating at 50 percent over designed capacity, the quality of thewater met Army specifications.24 The sewerage system was also modernand satisfactory.
The repeater station at Grande Prairie used unchlorinatedwater from wells which also supplied the town's population of 1,500. Raw watersamples sent to the Edmonton Station Hospital laboratory repeatedly provedsatisfactory.
The village of Whitehorse, Yukon Territory, presented themost serious problems of sanitation to the Army. The Whitehorse Station HospitalCommander, Maj. Mendel Silverman, MC, described sanitary facilities as"execrable" and called the town "one vast cesspool."25 Whitehorsewas an unincorporated town in a territory administered by a three-man councilwhich met just once a year. A modern hospital had been established and a healthofficer had been appointed in Whitehorse several years before the war; but thehealth officer, Frederick B. Roth, M.D., lacked assistance, and though he hadtried to improve sanitary conditions, especially in restaurants, he had notreceived support.26
Whitehorse had a population of about 600 before the war, ofwhich about half left for the winter. The town was not prepared for the flood of
22See footnotes 12, p. 164, and 21, p. 167.
23See footnote 12, p. 164.
24Letter, Headquarters, NorthwestService Command, to The Surgeon General, 12 Aug. 1944, subject: Special Sanitary Survey of Water Supply InstallationsCovering Headquarters and Headquarters Operational Area.
25Annual Report, Station Hospital, Whitehorse, YukonTerritory, Canada, 1942.
26Annual Report, Station Hospital, Whitehorse, YukonTerritory, Canada, 1943.
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military and civilian personnel into the area. Camps were setup all around the town. The station hospital was established in the only largebuilding available in the town, the community hall. This building was rented for$25 a month, and the local authorities gave the Army permission to fix it up andmake it into an adequate hospital.27
A survey of the restaurants was made by Dr. Roth, Armysanitary officers, and a representative of the Royal Canadian Mounted Police inSeptember 1943. They found that only two of the 11 restaurants met acceptablestandards. Only one had chlorinated water, dishes were not sterilized, andadequate refrigeration was lacking. Because Dr. Roth believed he lacked thelegal powers to take any positive steps and the Mounted Police simply took theirbusiness from one of the unsatisfactory restaurants to an acceptable one, theArmy was forced to act. In the absence of adequate local laws, sanitary officersdrew up standards for sanitation, discussed them with Dr Roth, and distributedthem to the restaurants. Then, deficiencies of each establishment were noted, andDr. Roth notified the individuals concerned. All proprietors were instructed inproper sanitary methods and the local officials were urged to enforce theregulations. When reinspection showed little improvement, the Army threatened toplace the restaurants off limits for military and civilian personnel of thecommand unless improvements were made. Most of the businesses complied; of threeeventually placed off limits, only one failed to be reinstated.
The Army sanctions brought a great improvement in theconditions of the Whitehorse restaurants. Just 3 months after the initialsurveys, all had water from approved sources, a cool place for food storage, anddishes were washed and disinfected.
Fresh foods for the messhalls were not bought locally; priceswere too high and only a limited quantity was available. All food for the Northwas imported except for an occasional supply of fish caught by the localIndians.
During 1942 and most of 1943, the water supply at Whitehorsewas tenuous and inadequate. It was obtained from the Lewes River and shallowwells, and then chlorinated.28 An epidemic of dysentery among thecivilian population of Whitehorse early in the summer of 1942 was traced to thetown's water supply by Army Medical officers in cooperation with civilianauthorities.
In October 1943, a new system using water from McIntyre Creekwas built by the Army and provided an adequate supply. Local inhabitants ofWhitehorse, working through the Canadian Department of Transport, requestedpermission to cut into the McIntyre Creek system. The Army could not approvethis request because the town's water and sewer lines were laid alongside eachother in the same trench. Several times each year, the ground water rose abovethe lines, which were made of wood-stove pipe,
27See footnote 16, p. 166.
28See footnote 26, p. 168.
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creating a health hazard since the water could be polluted bysewage. This condition was corrected by disconnecting the water line before itcame together with the sewer line and digging a new ditch for the water line.The town was then allowed to use the Army water system, and Army sanitaryofficers inspected it regularly.
The townspeople had an old custom of dumping garbage andrefuse just outside the center of town on the banks of the frozen Lewes River.When the ice broke up, the debris was carried downstream. The sanitary officerpersuaded them to end this practice and a new site was selected 3 miles fromoccupied areas.
Sewage disposal in the town consisted of privies, cesspools,septic tanks, and tile fields. The post used privies, but by November 1943, thenew sewerage system was in operation and was also extended to parts of the town.29
The village of Dawson Creek, British Columbia, also cut intoan Army water system in 1944. No problems were encountered and the system wasturned over to the town in 1945.30
Up in the far North at Camp Canol, a serious problem for awhile concerned the messhall which was staffed entirely by civilian cooks withlong experience in the North. Whenever the medical officer suggestedimprovements in sanitation, these cooks quit, causing a large turnover ofpersonnel.
Diseases.-Among the native population in western Canada,several outbreaks of cerebrospinal meningitis, diphtheria, and measles occurred.Tuberculosis was a major killer among the civilians, especially in the Indianvillages. An Army survey revealed a tuberculosis death rate of two to four aweek in several Indian villages. Tuberculosis rates were so high among theIndians around Norman Wells that military and civilian personnel were restrictedfrom associating with them.
The medical officer at Norman Wells helped curtail anepidemic of smallpox among Eskimo fishermen in 1944. His help was requested by anearby Canadian Government medical station, and he was flown by a Royal CanadianAir Force skiplane to the scene of the epidemic.31
Although bacillary dysentery was endemic among the nativepopulations in the settled area, especially during the spring and fall, the Armyremained virtually unaffected. Lt. Col. Walter L. Tatum, MC, surgeon of theWhitehorse Sector in 1942, credited the Army's potable water supply withprotecting his camp.32
These infections were not a serious problem to the Army evenwhile epidemics raged among the natives. On the contrary, the natives picked up
29See footnote 26, p. 168.
30See footnote 12, p. 164.
31See footnote 12, p. 164.
32Letter, Surgeon, Whitehorse Sector, Alcan Highway, toAll Unit Commanders, Whitehorse Sector, Alcan Highway, 7 Nov. 1942, subject:Winter Hygiene and Sanitary Measures.
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several diseases they had never had before. Dr. John F.Marchand, investigating for the U.S. Public Health Service, attributed this tothe influx of outside contacts, both military and civilian, who acted ascarriers. One remote Indian village in particular, on Teslin Lake in YukonTerritory, experienced successive attacks of measles, dysentery, jaundice,whooping cough, German measles, mumps, tonsillitis, and meningococcicmeningitis.33
Army medical personnel were quite willing to aid the nativesin coping with any diseases, many of which had been introduced by U.S.personnel. The Northwest Service Command Medical Laboratory was set up in August1943 with the major purpose of assisting in the control and prevention ofepidemic and endemic diseases. By a memorandum dated 16 September 1943, thelaboratory's commanding officer, Lt. Col. Harry E. Wright, MC, instructed allmedical officers to contact him immediately whenever any disease in the militaryor civilian population reached epidemic proportions.34
All U.S. military and civilian personnel entering the commandwere required to have up-to-date immunization records and to be free fromdisease. All personnel with contagious diseases were quarantined according toCanadian regulations. Dependents and visitors were the only Americans in thetheater not under Army control.35
During the summer of 1942, an outbreak of serum hepatitisstruck large numbers of troops working on the Alaska Highway. This was part ofan Armywide outbreak of homologous serum hepatitis following vaccination againstyellow fever.36 Many of the troops affected in Canada had beenvaccinated for yellow fever at Fort Ord, Calif., leading to the conclusion thatthe vaccine was the cause.
The 35th Engineer Regiment was the hardest hit of the unitsworking on the highway. The first case occurred in May 1942, about 90 days afterthe men had been vaccinated at Fort Ord. The number of cases increased steadilyuntil a peak was reached in mid-July. During July, the disease was obvious in anestimated 500 cases; and in numerous other cases, there was no jaundice but thepatients suffered from weakness and nausea. In August, there were only a few newcases; and after that, only a few recurrent cases in the fall of 1942 and thespring of 1943.
The exact beginning of each case was impossible to determinebecause the personnel of the 35th Engineer Regiment were scattered over a widearea. They were completely isolated by land although they had access to anairfield. Approximately 100 of the first jaundice patients were air-evacuated tothe Fort St. John Station Hospital, but after that, only gravely ill patientswere evacuated. Although the seriously ill were kept in camp
33Marchand, J. F.: Tribal Epidemics in the Yukon. J.A.M.A.123: 1019-1020, 18 Dec. 1943.
34(1) See footnote12, p. 164. (2) Annual Report, Northwest ServiceCommand Laboratory, 1943.
35See footnote 12, p. 164.
36Details of the Armywide outbreak may befound in Medical Department, United States Army. Preventive Medicine inWorld War II. Volume V. Communicable Diseases Transmitted Through Contact or ByUnknown Means. Washington: U.S. Government Printing Office, 1960, pp. 419-431.
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under a doctor's care, many jaundice patients, though weakand nauseated, continued the hard labor of building the road so that they couldfinish and get out of the wilderness. The Whitehorse sector of the highwayreported 38 cases in June and 77 in July, the most serious of which were sent tothe Whitehorse Station Hospital. Several other engineer regiments in the sectorwere affected.
Despite general agreement that the outbreaks were caused byyellow fever vaccine, one U.S. medical officer, Capt. George C. Cash, MC, at theSub Port of Embarkation, Prince Rupert, British Columbia, reported that hisjaundice patients had been vaccinated from three different lots of vaccine. Healso pointed out that there had been jaundice outbreaks among civilians andCanadian soldiers in his area who had not been inoculated against yellow fever.Captain Cash reported that work was being done in Vancouver to determine thecause of jaundice in the area, but no conclusion had been reached.37
Insects presented no disease problem. Mosquitoes wereplentiful, but not disease-carrying. Flies and cockroaches were the most serioushealth hazard, as in the United States.
Venereal disease was high on the list of communicablediseases in the Northwest Service Command, but it was not a serious localproblem because most cases were acquired outside the command. Before thegranting of furloughs, the occurrence of venereal disease was almost negligible.38
Syphilis and gonorrhea were the major venereal diseases inCanada, but the rates for both were somewhat lower than those in the UnitedStates. Control measures were the responsibility of the provinces, with liaisonbeing established with the Department of National Defence during the war.Generally, control measures were similar to those used in the United States, andreports from all posts indicated that excellent cooperation was given by localauthorities in tracking down contacts.39
Edmonton, the only large city in the command, naturally hadthe highest venereal disease rate. Prophylaxis stations were set up at thestation hospital, at the Army airbase, and in downtown Edmonton in cooperationwith the Canadian Services. In addition, the military and civilian authorities,working together, started a registration system for all women at publicdancehalls. This proved to be valuable in checking contacts. Although thecivilian authorities were very helpful in tracing contacts, their treatment wasnot always satisfactory because of their lack of facilities for cultures andtheir short supply of penicillin.40
In Whitehorse, the Royal Canadian Mounted Police and thelocal health officer, Dr. Roth, took strong measures against prostitutes anddiligently
37Jaundice, American Troops in Canada, 1942-43,Preventive Medicine Division file, Surgeon General's Office. [Officialrecord.]
38Essential Technical Medical Data,Northwest Service Command, for July 1943, dated 1 Aug. 1943.
39See footnote 12, p. 164.
40Annual Report, Station Hospital, SU2432, APO 722 (Edmonton Station Hospital), 1944.
173
checked suspected contacts, so that the probability ofinfection was kept small. To protect the local civilian population, all menreturning from furlough were held at their organizational areas for medicalexamination before returning to their units.41
Venereal disease became a problem in the village of DawsonCreek, BC, for a short time in the spring of 1943. However, Canadian authoritiesacted quickly to close a local house of prostitution when it was reported tothem by U.S. Army personnel, and all men coming back from furlough were checkedfor venereal disease.42 Outside the villages, venereal disease wasalmost unknown.
In summary, the relations of U.S. Army medical officers andcivil public health officials in northwest Canada generally were smooth. Theyworked together to protect the health of troops and civilians, and localsanitation usually was improved by the work of U.S. personnel in establishingnew facilities or adding to already existing ones.
Central and Eastern Canada
Large numbers of American military personnel came to easternand central Canada during 1941 and 1942 to help build and operate facilities forthe North Atlantic air ferry operations. American military strength in Canadaincreased quickly to a peak of 17,000 in August 1942, but by the spring of 1943,need for bases had diminished because of the much greater range of aircraft andan improved shipping situation, and the military strength decreased to anaverage of 1,350.43 The ferrying plans were designed to speed aircraft to Europewhere they were critically needed. The quickest way to deliver them was undertheir own power.
Air ferry operations had begun in 1940 between DorvalAirport, near Montreal, through Newfoundland, and then 2,100 miles to Prestwick,Scotland. This route was for heavy and medium bombers. In 1941, after U.S.personnel had made several studies and conferred with Canadian and Britishofficials, it was decided that more bases would be needed to ferry short-rangeaircraft and to relieve congestion at Newfoundland Airport. A route wasestablished using Greenland and Iceland as intermediate stops, and in late 1941,the Canadians began construction of an additional base at Goose Bay, Labrador.In addition, the United States received Canadian approval in August 1941 toconstruct much-needed weather stations at Fort Chimo, Quebec (known as CRYSTALI), at Frobisher Bay, on Baffin Island (CRYSTAL II), and at Padloping Island,east of Baffin Island, just above the Arctic Circle (CRYSTAL III).
41(1) See footnote 26, p. 168. (2) Sanitary Report, Surgeon, Whitehorse Sector, Alcan Highway, for March 1943, dated 12 Apr. 1943.
42Sanitary Report, Railhead Surgeon, Dawson Creek, British Columbia, for March 1943, dated 1 Apr. 1943.
43Complete details on the ferry can be found in (1) footnotes 2 (2) and 2 (3), p. 159. (2) Milner, S.: Establishing the Bolero Ferry Route. Military Affairs 11: 213-222, winter 1947.
174
In the fall of 1942, to provide medical care in centralCanada, station hospitals were set up in The Pas (131st) and Churchill (4th),Manitoba, along with a dispensary on Southampton Island. The theater surgeon wasbased at the Winnipeg headquarters of the U.S. Army Forces in Central Canada. Ineastern Canada, small station hospitals were set up at Fort Chimo (133d) andFrobisher Bay (134th), with a few medical personnel scattered around at theother small stations.44 At Goose Bay, Labrador, the 6th StationHospital was activated in the spring of 1943. Until this time, American troopshad used the RCAF (Royal Canadian Air Force) hospital there (map 5).
Public health in Manitoba and Quebec-Both Manitoba and Quebec Provinces had developed public health systems. Manitoba'sDepartment of Health and Public Welfare provided the usual services insanitation and preventive medicine. In addition, a new Division of Local Healthand Welfare Services supervised local part-time health officers, set up localhealth units, and offered consultative services to the province's municipaland local health departments.
Quebec reorganized its public health program in 1941 andestablished a Department of Health and Social Welfare to provide public healthservices. The province used a system of "county health units" tosupervise public health work on a local level. Consultations, lectures, schoolinspections, investigations, immunizations, and sanitary improvements wereoffered to the local communities. A total of 21 antituberculosis dispensariesand 70 baby clinics was added to local public health programs.45
Medical treatment of the natives.-The members of the armedforces in eastern and central Canada had relatively few health problems. Theylearned to adjust to the cold, adopting the Eskimo mukluks or heavy felt shoesof the Hudson Bay Company. Severe snowstorms frequently arose with littlewarning, and the troops simply did not venture out for fear of getting lost.46Even respiratory infections were less frequent than expected, and whenthey did occur, the patients made uneventful recoveries.
In contrast, the natives and Eskimos in remote parts ofcentral and eastern Canada had many health problems and few civilian doctors tohelp them. The Army medical personnel performed a great service in treatingthese people, many of whom previously had never received medical care. Moreover,Army medical officers also had a certain responsibility to the natives becausethe rates of some of the diseases, such as influenza, were greatly increasedwhen U.S. military and civilian personnel moved into the northland. Col. Jack C.Hodgson, AC, the commander of U.S. Army Forces in Central Canada, encouragedthis aid to the natives, and the medical department of the command expressedgreat pride in its achievements.
44See footnote 3, p. 160.
45Dominion Bureau of Statistics,Department of Trade and Commerce, Canada: The Canada Year Book, 1945. Ottawa: Edmond Cloutier, King's Printer, pp. 825-827.
46(1) Annual Report, Surgeon,U.S. Army Forces in Central Canada, 1944. (2) Essential Technical MedicalData, U.S. Army Forces in Central Canada, for November 1943, dated 13 Dec. 1943.
175
MAP 5.-U.S. Army hospitals supporting North Atlantic bases, 1 June 1943.
176
Finally, early in 1945, the Manitoba College of Physicians,Surgeons, and Dentists issued temporary licenses to practice to the Army medicalofficers to guarantee legalprotection and to express appreciation for their services.47
The post surgeon at each of the major posts in centralCanada also served as medical inspector. In this capacity, he not only inspectedthe sanitary conditions but also paid particular attention to any diseaseoutbreaks among civilians which could threaten the command.48
Capt. Werner Lehmann, MC, Surgeon, U.S. Army Forces inCentral Canada, was very active in this treatment of the natives, oftentraveling to the various posts, including Southampton Island, the most isolatedbase. His highly informative report told of the problems and rewards of treatingthe natives. The Eskimos were reluctant at first to seek medical aid, preferringto heal themselves and their families unless the illness or injury became veryserious. In bad weather, it was sometimes impossible for the natives to reachArmy medical personnel; consequently, treatment was delayed.
Successful treatment of the first Eskimos who sought Army aidled to a large increase in the number of native patients. Word spread quicklyamong the Hudson Bay villages. Native patients were required to obtainpermission from the Royal Canadian Mounted Police before coming to the Armyposts. Captain Lehmann had great praise for the work of the Mounties who madepossible the good relations between the Army and the natives, and handledseveral difficult liaison situations with tact and diplomacy. The police wouldgo out in any weather to remote villages to answer calls for medical help.Although their supplies and medical knowledge were limited, they did a fine job.In addition, they sometimes calledby radio to the Army medical officers, describing the symptoms of a patient andasking for a possible diagnosis and suggested treatment. Captain Lehmannreported several instances where this method was highly successful.
The Eskimo patients possessed remarkable ability to endurepain, which made their treatment easier. A 20-year-old Eskimo walked 8 miles tothe 4th Station Hospital at Churchill on a broken leg. The bone was penetratingsoft tissue around the fracture. He withstood the reduction of the fracture andthe application of a cast without the slightest show of pain. Capt. GeorgeBenstock, DC, the theater dental surgeon, traveled widely to treat natives, andmarveled at their stoicism during painful tooth extractions.49
A tragic episode in the Army's program of helping thenatives occurred in June 1944. A severe epidemic broke out among the natives ofEskimo Point, about 200 miles north of Churchill, and almost 50 percent of thenatives of the area died. Colonel Hodgson authorized 1st Lt. Oliver Austin, MC,Churchill Post Surgeon, to fly to Eskimo Point. Lieutenant Austin, suspectingdiphtheria gravis, administered sulfonamide drugs and diph-
47Medical History, U.S. Army Forces in Central Canada, 1945.[Official record.]
48See footnote 46 (1), p. 174.
49Annual Report, Surgeon, U.S. ArmyForces in Central Canada, 1944. Enclosure 4, subject: Medical Experience in theFar North, by Capt. Werner Lehmann, MC, AUS.
177
theria antitoxin and hurried back for laboratory tests. Whenthese proved that his fears were correct, he hurriedly loaded a plane with largeamounts of diphtheria antitoxin, even leaving behind the radio equipment, andwith the pilot, 2d Lt. Robert Hyde, AC, took off for Eskimo Point. The planenever arrived; it crashed along the shoreline, killing both officers. Thenative population's actions in this tragedy showed their true gratitude forthe work of the Army medical officers. They came from a radius of hundreds ofmiles around to search for the plane and, when it was found, expressed extremesorrow and sent condolences to Colonel Hodgson and to the families of the deadofficers.50
An epidemic of measles in Churchill in August 1944 amongwhites and natives alike provided a threat, but quarantine of the post andprompt preventive measures by the medical officer curtailed the danger. Also,the 4th Station Hospital cared for civilian employees of the constructioncompany working on the base.51
In April 1945, several Eskimo children on Southampton Islandcontracted tuberculosis. Medical officers made a survey of the island with thecooperation of the Mounted Police. The Canadian Government sent up plates andchest X-rays were taken; many showed signs of active tuberculosis. During aninfluenza epidemic, the military dispensary on the island treated many of thecases.52
Tuberculosis was a serious problem among the Eskimos in thedesolate areas under the jurisdiction of U.S. Army Forces in Eastern Canada.Here again, medical aid was given, and the Eskimos came to depend on the medicalpersonnel of the Army for help. Practically all the Eskimos suffered from upperrespiratory diseases and seemed to have no natural immunity. The coming of U.S.personnel greatly increased the incidence of influenza among the natives. In oneoutbreak around Fort Chimo, 22 Eskimos died in a total population of 150 to 200.53
The work of the Army Medical Service among the natives ofeastern and central Canada was a real achievement in civil affairs publichealth. Though U.S. troops added somewhat to the native disease problems, Armymedical personnel helped bring a general improvement in the health of thenatives. This work was carried on in spite of great distances, bad weather, anda language barrier, but the effort did much to cement good relations between theUnited States and Canada.
Liaison with Canadian officials.-Liaison with Canadianmedical officials was usually cordial. Under the reciprocal agreements for useof hospital facilities (p. 166), U.S. Army medical officers used Canadianmilitary hospitals in the Winnipeg area. The services of these facilities werealways quickly and skillfully given. Hospitalization for U.S. troops of
50See footnote 46 (1), p. 174.
51Annual Report, 4th Station Hospital, 1943.
52History of MedicalDepartment Activities, APO 693, 18 Aug. 1945.
53Annual Report, Medical Department Activities,U.S. Army Forces in Eastern Canada, 1943.
178
the command and for transients was frequently provided aswere medical treatment, general and special surgical procedures, radiologicaland laboratory service, and eye, ear, nose, and throat care.
Canadian medical officers also helped out in unusualcircumstances, such as holding sick call when Captain Lehmann was out touringthe other posts. The most outstanding case was the flight of Squadron Leader M.W. Nugent, an ophthalmologist in the Royal Canadian Air Force, to The Pas tosave the eyesight of a U.S. enlisted man. The U.S. Army Surgeon Generalcommended this officer for his help.
Canadian civilian officials in the Manitoba Ministry ofPublic Health were also extremely helpful in safeguarding the health of Americantroops in Manitoba. The Command Surgeon used the modern facilities of theProvincial Laboratory for bacterial examinations, complement fixations, andvarious chemical tests and analyses. Specimens were flown to Winnipeg from theoutlying posts and immediately given to the Provincial Laboratory for analysis.54
In The Pas, the Army used the facilities of St. Antoine'sHospital and received the utmost cooperation from local professional personnel.55
Venereal disease.-In central Canada, venereal disease was aproblem for a time, being localized in The Pas, where almost all contacts andcases occurred. Some transients to and from the isolated northern bases, inaddition to some of the men stationed at the airbase just outside of town,contracted venereal disease in The Pas.56 Canadian military andcivilian authorities, working with U.S. venereal disease control officers,traced contacts, set up prophylactic stations, and brought about a generalimprovement by 1945.
In Winnipeg, the problem was not so great, and an ArmedServices-Civilian Liaison Committee kept the danger in check. This committeetraced and treated local contacts, policed local dancehalls, hotels, andrestaurants, and obtained venereal disease legislation and publicity. By 1945,almost all new cases occurred among transients or men just returning from leavein the United States.57
In eastern Canada, venereal disease was never a problembecause of the absence of contacts. All cases were transients or returnees fromfurlough.58
Sanitation.-Extensive surveys showed that nodisease-carrying insects were present in central and eastern Canada. During thewarm months, mosquitoes and flies were a nuisance, and control measures were ofthe passive type. Headnets, gloves, and screened buildings reduced theirritation somewhat. The natives were often infested with body lice, butproper control measures kept the troops from being affected. In addition, aprogram was
54See footnote 47, p. 176.
55Annual Report, 131st Station Hospital, 1943.
56(1) Annual Report (Final), U.S.Army Forces in Central Canada, 1 Jan.-29 Sept. 1945. (2) See footnote 46 (1),p. 174.
57See footnotes 41, p. 173, and 47, p. 176.
58See footnote 53, p. 177.
179
instituted to disinsectize all planes coming from areas whereinsectborne diseases were found. No federal, provincial, or municipal programsfor insect control existed in Canada.59
Water for U.S. troops in central and eastern Canada wasobtained principally from lakes, rivers, springs, and, in the winter, from snowmelting machinery. Canadian officials were not involved in this water supply. AtChurchill and The Pas, U.S. troops were able to obtain water from existingmunicipal and privately owned water plants. The Army delivered the water fromthese plants, usually in heated trucks, because pipes were not feasible in thepermanently frozen ground. Water was chlorinated on the posts. The system wasacceptable at most of the posts; only northern Southampton Island and FrobisherBay had serious problems. In winter, the men there cut ice on the lake with asaw and then melted it. No epidemics caused by unsafe water occurred in thecommand. Latrines were all chemical or pail-type, again because pipes could notbe used. Laundry was done on most of the posts. In The Pas and Goose Bay,civilian laundries on contract were satisfactory. In Mingan, local families tookin laundry, but their work was unsatisfactory.60
Food.-United States troops did not eat much food of localorigin. In The Pas, troops sometimes used local restaurants, and a limitedamount of food was obtained from local markets. Also, a dairy in The Passupplied fresh milk. Insufficient transport facilities greatly limited theamount of milk which could be carried to the other posts until 1945, when aweekly plane supplied fresh milk to the major installations. All supply sourcesof food and milk in The Pas were inspected regularly by the post medical officerwith the help of the Royal Canadian Mounted Police.61
The Canadian-United States partnership in World War II provedto be a very successful undertaking. The North American neighbors worked welltogether to protect the continent. This friendly cooperation was very evident inthe field of civil affairs public health. U.S. Army medical officers foundCanadian health officials, both civilian and military, very willing to help.Officers of the Army Medical Service performed a great service by treatingCanadian civilians scattered over vast areas of the barren northland. Workingtogether, Canadian and United States doctors and sanitary officials provided ahigh level of public health in Canada for both United States troops and Canadiancivilians.
NEWFOUNDLAND
United States troops moved into Newfoundland in January 1941under the provisions of the historic Anglo-American Destroyer-BaseAgreement.
59(1) See footnotes 46 (1), p. 174,and 53, p. 177. (2) Essential Technical Medical Data,U.S. Army Forces in Central Canada, for May 1945, datedJune 1945.
60(1) See footnotes 46 (1), p. 174,51, p. 177, 53, p. 177, and 55, p. 178. (2) History of Preventive Medicine forU.S. Army Forces in Central Canada, 29 Sept. 1945.
61Medical History, U.S. Army Forces inCentral Canada, 1944. [Official record.]
180
Acting under this agreement, the Newfoundland Commission ofGovernment, on 14 June 1941, leased to the United States several parcels ofland. One, at Quidi Vidi, on the east coast near the capital, St. John's,later became Fort Pepperrell, headquarters of the Newfoundland Base Command.Another, 75 miles west, near Argentia, later became Fort McAndrew. On the westcoast near Stephenville, Harmon Field was built. A fourth U.S. installation wasat the Newfoundland Air Base, near Gander in the northeastern part of theisland. This airfield was already occupied by units of the Royal Canadian AirForce.62
These were the major U.S. posts in Newfoundland. Medical carewas established at all four in 1941 and 1942, and, finally, on 1 April 1943, thefour Army hospitals were designated the 308th-311th Station Hospitals (see map2).63
Newfoundland is a rugged, bleak island about the size ofVirginia. Most of its population of about 300,000 lived either on the AvalonPeninsula in the east or in the lower Humber River Valley in the west. Theweather was just slightly colder and windier than in New England.
The oldest of England's colonies, the island had been adominion after World War I, but severe financial problems forced theNewfoundlanders to relinquish their dominion status in1933 and suspend their Parliament. When U.S. troops arrived in 1941, the island'slegislative and executive power was still held by a governor appointed by GreatBritain, acting with the advice of a six-man royal commission.
This governmental arrangement resultedin complete centralization; all services, including publichealth, were directed from St. John's by the Governor and Commission. St. John's,the capital and largest city, with a population of about 40,000, had a more orless autonomous local government with a mayor and municipal councilors, but itdid not have a municipal health department.
Public Health
The Newfoundland Department of Public Health and Welfare wasestablished as an independent autonomous unit in 1933 after the governmentreorganization; it administered hospital, medical, and nursing services, reliefto sick and able-bodied poor, allowances to widows, orphans, and the infirm, oldage pensions, war pensions, and vital statistics.
Sir John C. Puddester, a layman, headed the department asCommissioner, but the top-ranking, full-time medical man was the Secretary, Dr. H. M. Mosdell. Other professional personnel included twomedical health officers and a general health inspector. The headquarters staffnumbered 59, including various specialists. In addition, 50 generalpractitioners in the city and country districts workedpart time for a set fee, receiving extra
62Details on United Statesoperations in Newfoundland and the background andnegotiations leading up to the Destroyer-Base Agreement may be found infootnotes 2 (2) and 2 (3), p. 159.
63See footnote 3, p. 160.
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pay for antituberculosis activities, immunizations, andvenereal disease treatments. Their normal duties ingeneral public health included sanitation, medicalattention to the poor and the warpensioners, and maritime and shore quarantine.
The Department of Public Health also maintained a publichealth laboratory in St. John's which provided laboratory service for doctorsand hospitals throughout the island.64
In anticipation of the movement of large numbers of Americantroops to Newfoundland, several surveys of the health and sanitary situation onthe island were made in November 1940. Lt. Col. (later Col.) William A.Hardenbergh, SnC, studied environmental sanitation and generalhealth conditions. Assistant Surgeon General Raymond A.Vonderlehr and Past Assistant Surgeon Roger E. Heering, of the U.S. PublicHealth Service, investigated specific health problems and available healthservices as they would affect an armed force. Both concentrated on the St. John'sand Argentia areas on the Avalon Peninsula where it was expected that most Americantroops would be located.
Both surveys revealed that problems could be expected inNewfoundland. The U.S. Public Health study pointed out that the provision formedical care at public expense was developed more administratively than in theUnited States, but because of the widely scattered population, poortransportation, lack of competent physicians, and insufficient funds, theNewfoundland Government was not able to cope with all the medical problemsit faced.65 Colonel Hardenbergh suggested that, "because thelevel of environmental sanitation and of health conditions is lower than in theUnited States, it will be necessary to undertake a greater responsibility forhealth than is normally needed. * * * Sincethe administration of health in St. John's (and in Newfoundland generally)does not rank with United States standards, Medical Department personnel shouldinclude officers who (a) are familiar with health needs and conditions, and (b) areable to cooperate helpfully with local authorities."66
Most hospitals were provided by the state. Medical facilitieswere not sufficient for local needs in St. John's. The Public Health Servicesurvey reported that the medical services in St. John's seemed to be good butwere handicapped by outdated physical facilities. At Argentia, one young physicianran a 20-bed government cottage hospital. He worked hard and did good clinicalwork, but he did not have the background and experience to carry on "aneffective general health program."67
64(1) Report, Lt. Col. W. A.Hardenbergh, SnC, U.S. Army, subject: Sanitary Survey of Newfoundland, 2-17 Nov. 1940. (2) Report, Assistant Surgeon General R. A. Vonderlehr and Past Assistant Surgeon R. E. Heering, U.S. Public Health Service, subject: Survey onCivil Health Services as They Relate to the Health of Armed Forces in Newfoundland, 3 Dec. 1940.
65See footnote 64 (2).
66See footnote 64 (1).
67See footnote 64 (2).
182
Venereal Disease
All the surveys made before U.S. troops moved intoNewfoundland pinpointed specific disease problems among the natives and ratedtheir general health as poor. Throughout the war, most of these problemsremained in the civilian population. American military personnel were notseriously affected, with one outstanding exception-venereal disease.
The initial surveys of the Public Health Service had warnedthat venereal disease would be the major problem, especially in St. John's.The public health officers, Drs. Vonderlehr and Heering, reported that theattitude of the people of St. John's toward venereal disease control was 10years behind that found in United States cities of comparable size. Personsafflicted with venereal disease were burdened with a moral stigma rather thantreated as carriers of a highly communicable disease. While all the healthservices of the island needed some improvement, venereal disease control was thepoorest of all. Lack of funds and trained personnel, inertia, and publicindifference seemed to keep the Department of Health and Welfare from attackingthe problem even though syphilis and gonorrhea were the most prevalent of thecommunicable diseases. Dr. Mosdell, the Secretary of the Department of Healthand Welfare, admitted this.
The only St. John's physician employed to control venerealdisease was a part-time employee of the Sudbury clinic, described by Dr.Vonderlehr as the worst venereal disease clinic he had seen in 20 years from thestandpoint of facilities. The physician held four afternoon sessions a week.None of the accepted methods for the treatment of syphilis was used nor were thesulfonamide compounds use to fight gonorrhea. In addition to this clinic, familydoctors were given the necessary supplies and were paid $3 an injection to treatpatients who elected this treatment.
Casefinding and case-holding were not done, and even though25 public health nurses worked on the Avalon Peninsula, they devoted all theirtime to clinical, rather than public health, nursing. Actually, facilities atthe Sudbury clinic were so bad that effective case-holding was impossible. Lackof privacy stopped many persons from seeking treatment, but attendance doubledin the winter when the sessions were held after dark.
Prostitution flourished in St. John's even though it didnot seem to be an organized operation. The girls were mostly young, ignorant,and irresponsible streetwalkers. They were scattered throughout the city, therebeing no "red-light" district as such.68
As U.S. troops came to Newfoundland in large numbers during1941-42, the feared increase expressed in the original surveys came to pass.By October 1942, the venereal disease rate among American soldiers had climbedto 35 per 1,000 per annum for the entire command.69 Fort Pepperrell,Fort McAndrew, and Harmon Field all had high rates. Pepperrell, of
68See footnote 64 (2), p.181.
69See footnote 3, p. 160.
183
course, was near St. John's. McAndrewand Harmon had somewhat of a local problem, but many oftheir cases were picked up in St. John's. Venereal disease was nonexistent atisolated Gander Field except for personnel coming back from leave in St. John'sor in the United States.
The fast-rising venereal disease rate brought action in late1942, with the formation of an Allied Venereal Control Board, through theefforts of Maj. (later Lt. Col.) Gunnar Linner, MC, base surgeon at FortPepperrell, and Capt. (later Lt. Col.) Morton H. Flaherty,MC. Medical representatives of all the United States and Canadian serviceshaving forces on the island met and recommended improvements of the situation. Ina letter to all commanders of the Allied Forces in Newfoundland, the medicalofficers appealed to the Newfoundland Government for vigorous and immediateenforcement of the Newfoundland Health and Public Welfare Act of 1931.70Provisions of this law, if enforced, could practically eradicate the menace,they said. The Board also recommended immediate establishment of facilities forthe compulsory treatment and detention of infected civilians.
The commanding officers of the Allied Forces actedimmediately, and Maj. Gen. G. C. Brant, Commanding General of the NewfoundlandBase Command, wrote the appeal to the Newfoundland Government. Weekly meetingswere set up with Dr. Mosdell and Sir John Puddester, the Commissioner of Health,who promised to remodel an old building and staff it for use as a treatment anddetention center for venereal disease patients.71 In addition tothese appeals to civil authorities, the armed forces started an extensiveeducation program for their troops. Prophylactic stations were established andthe recreation programs of the posts were expanded.
As in the past, the Newfoundland Government continued to moveslowly. Until July 1943, Army medical personnel continued to report only"average" cooperation from local authorities. The venereal diseasehospital, promised for January, finally opened in July. It was a 35-bed facilityin St. John's.72 Finally, by late 1943, definite progress was made.The Government suddenly stepped up its efforts by establishing a venerealdisease department with a full-time doctor in charge. The base surgeon at FortPepperrell, Lieutenant Colonel Linner, reported that "identification andlocation of suspected sources in the civilian community improved markedly."73The Government's new detention hospital worked well. Furthermore, a newlaw, "An Act for the Prevention of Venereal Disease," was drawn up,giving the health department complete control of the situation.
Conditions also improved at the other posts in late 1943. AtFort McAndrew, local doctors were very cooperative in treating known local
70Report, Thomas Parran, subject:Civil Health Services in Newfoundland as They Relate to Problems Likely toAffect the Health of the Armed Forces of the United States, 16 Dec. 1940.
71Annual Report of MedicalActivities of All Units, Newfoundland Base Command, 1942, Part 1.
72Essential Technical Medical Data, Newfoundland BaseCommand, for July 1943, dated 29 July 1943.
73Annual Report, 308th Station Hospital, 1943.
184
contacts and examining vagrants.74 At HarmonField, after the Army's venereal disease control officer was given a licenseto practice medicine by the Newfoundland Government, he was able to ordersuspected civilian contacts to report for examination and treatment. This helpedgreatly to reduce to a new low Harmon's rate for the last 6 months of 1943.75
The year 1944 saw continued good work by the Newfoundlandhealth authorities. Contact histories were taken on all patients, and routineblood tests of food handlers, job applicants, and visa applicants turned up morevenereal disease cases. In all instances, the civilian control officer workeddiligently to locate suspected sources and bring them in for treatment. As aresult of this smooth-working civilian-military cooperation, the rate at FortPepperrell was brought down to 13.11 per thousand for the year.76 Thecommand as a whole reported that many of their patients contracted the diseasewhile on leave in the United States. A small flareup of the venereal diseaseproblem occurred again in Newfoundland in the summer of 1945, but by this time,the control program was so efficient that the menace was quickly overcome.
Other Diseases
Generally poor economic conditions played a part in thespread of other diseases among the civilian population of Newfoundland. Ofthese, tuberculosis was the mostserious. Drs. Vonderlehr and Heering in their original survey had deduced thatthe relatively poor state of nutrition had a bearing on the high tuberculosisrate. There were not sufficient hospital beds for the number of patients. Also,housing on much of the island was poor, making isolation of the tuberculosispatient at home difficult. Under these conditions, the mortality rate fortuberculosis had climbed to approximately 200 per 100,000 population by the timeU.S. troops arrived. This rate compared with 40 per 100,000 in the population ofthe United States.
Here again, the Department of Health and Welfare washandicapped by lack of funds and facilities. In the entire colony, there wasonly one tuberculosis sanatorium of 250 beds, located near St. John's.Sanatoriums in the outlying districts were needed desperately, as were travelingclinics. There were no facilities for a comprehensive casefinding program basedon X-ray studies and tuberculin tests.
Other diseases prevalent in the civilian population werediphtheria, scarlet fever, typhoid fever, smallpox, meningitis, and dysentery.The diphtheria menace was fought by immunizations in the areas where it was mostcommon, and about 50 percent of the school children were also immunized.However, there was no program of immunization against typhoid fever, scarletfever, or smallpox.77
74Annual Report, 309th Station Hospital, 1943.
75Annual Report, 311th Station Hospital, 1943.
76Annual Report, 308th Station Hospital, 1944.
77See footnote 64 (2), p. 181.
185
With all these highly communicable diseases on the island, itis remarkable that the military was generally unaffected. Immunizations,excellent sanitary conditions on the posts, good diet, and trained personnelseemed to protect the troops even while tuberculosis, scarlet fever, anddiphtheria raged in nearby communities, especially St. John's. The soldierssuffered mainly from upper respiratory troubles in the winter. From May toSeptember 1942, an outbreak of postvaccinal hepatitis struck all the bases ofthe command. Fort Pepperrell was especially hard hit with 298 cases. However,only one person died, at Gander Field; the rest of the patients of the commandmade routine recoveries. The outbreak was traced to yellow fever inoculations,with no relation to the civilian population.78
Medical Treatment of Civilian Workers
The Army Medical Department was concerned by the relativelypoor health of the Newfoundlanders because of the large number of nativesemployed on Army projects. Up to 82 percent of the construction workers, mostlycommon laborers, were Newfoundlanders who were not in the best physicalcondition and suffered especially from dietary deficiencies.
The contractors established high physical standards forAmericans to be employed on the projects and, although these standards had to belowered somewhat for natives, no one was hired who might become a burden on thecontractor. Both Americans and natives were immunized against smallpox andtyphoid, and some of the dependent children of native workers were immunizedby injections of diphtheria toxoid.
Initially, civilians were cared for by medical personnelassigned to the U.S. Engineer Department, the first of whom had arrived at St.John's in February 1941.79 When construction work neared completion and theEngineer Department left the island, all civilians employed on the bases becamethe responsibility of the Army station hospitals. As late as June 1944, almostall Army service organizations still used more than 50 percent native workersinstead of service troops.80
At Fort Pepperrell, Army medical care included physicalexaminations for Newfoundlanders who were recruited to work in the United Stateson dairy farms and in mica mines. During 1944, nearly 2,000 were examined.81
At Fort McAndrew's 309th Station Hospital, extensive carewas given to civilian employees, and one dental officer was assigned to treatcivilians only. Because tuberculosis was a big problem here as on the rest ofthe island, and was a threat to military personnel, a survey was conducted
78(1) Annual Reports of MedicalActivities, Station Hospital, Fort Pepperrell, Fort McAndrew, Newfoundland AirBase, and Harmon Field, 1942. (2) See footnote 36, p. 171.
79Historical Monograph, U.S. Army AirBases, Newfoundland, Fort Pepperell, Fort McAndrew, Harmon Field, and AuxiliaryInstallations, North Atlantic Division, New York, N.Y., January 1946, Chapter6, pp. 5-6.
80G-4 PeriodicReport, Newfoundland Base Command, for period ending 30 June 1944, dated 13 July 1944.
81See footnote 76, p. 184.
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among the civilian employees in 1944. Chest X-rays disclosedthat nearly 4 percent had active pulmonary tuberculosis of the reinfective type.These were immediately sent to the tuberculosis sanatoriumin St. John's. Since there were nodentists in the area, emergency dental service was also offered.82
At Harmon Field, all employees received complete medical careat the 311th Station Hospital. Local medical facilities and doctors wereinadequate.83
Both McAndrew and Harmon Fields had trouble with thecivilians' disregard for sanitation and personal hygiene. The post surgeon atMcAndrew, Maj. Francis E. Utley, MC, closed the civilian messhall in 1944 untilimprovements were made. At Harmon, only constant diligence and close supervisionof the civilians kept their messhall up to standards.
Local Food Procurement
The major task of Army veterinarians in Newfoundland was theinspection of food, and to them must go much of the credit for the good healthof the American troops. Capt. Duane Cady, VC, Base Veterinarian, arrived withthe first troops in early 1941 and was appointed food inspector. The BaseSurgeon, Maj. (later Col.) Daniel J. Berry, MC, praised Captain Cady and hisassistant, Capt. (later Maj.) Philip R. Carter, VC, for "making theunhygienic city of St. John's and its environs a fit place for Americansoldiers to visit." These two men inspected restaurants, bottling plants,bakeries, and similar enterprises and, with good cooperation from theNewfoundland Department of Health and Welfare, succeeded in bringing thesebusinesses up to U.S. sanitary standards.84
During 1941, most food was imported from the United States.The only supplies secured locally were fresh milk and fresh fish. Dr. AlexBishop, a veterinary surgeon, was in charge of milk and food inspection for theDepartment of Health. The health surveys made before the troops arrived showedthat food and milk standards were not up to U.S. levels. The high tuberculosisrates, especially among the children of the island, were attributed by the U.S.Public Health Survey to tuberculous cattle.85
The two Army veterinarians worked for several months to bringthe local dairy industry up to acceptable standards. They outlined sanitaryrequirements, helped examine cattle, inspected dairies and pasteurizationplants, and ran laboratory tests. Finally, the Newfoundland Government adoptedthe Army standards, and seven dairy farms and two pasteurizing plants wereapproved. The first milk was issued to troops on 1 August 1941.86Throughout the war, regular inspections of farms,plants, and the
82Annual Report, 309th Station Hospital, 1944.
83See footnote 75, p. 184.
84Annual Report, Newfoundland Base Command StationHospital, 1941.
85See footnote 64 (2), p. 181.
86See footnote 84.
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final product continued. Repeated tuberculin tests were runon the cattle to be sure they remained acceptable.
In 1942, an agreement between the United States and Canadaresulted in the purchase of a great amount of fresh meats, eggs, and dairyproducts from Canadian sources.87 These products underwent both gradeand sanitary inspections by the veterinarians at the various posts.
An outbreak of diarrhea among the natives of St. John's inlate 1942 affected an estimated 10,000 to 12,000 persons. The soldiers wereordered not to eat or drink in St. John's during this period and, as aresult, very few were affected.88
During 1943 and 1944, more than 7 million pounds of food wereinspected each year, of which 3 million pounds were from Canada andNewfoundland.89 The quality of the Canadian meats in 1943 was ratedonly "fair" by Capt. (later Maj.) W. C. Jackson, VC, base veterinarianof the command, but in 1944, he was well pleased with the Canadian meat. Somefresh fish had been bought previously in Newfoundland, but the men requestedmuch larger amounts in 1944. Since fishing was Newfoundland's main industry,the supply was plentiful. None of the filleting plants could meet the Army'ssanitary standards, however, so the fish were bought from the boats as they camein, and carried directly to the messes where they were cleaned and served.90
At the outlying posts, most food was received from the BaseCommand Headquarters at Fort Pepperrell and from the naval base at Argentia. AtFort McAndrew, fresh cod were bought from local fishermen, who handled the fishin a sanitary manner after instructions from the Army veterinarian. Lack oftransportation kept the outlying posts from getting fresh milk from FortPepperrell. In late 1943, the post veterinarian at Harmon Field, Capt. NorbertA. Lasher, VC, arranged for a dairy in Corner Brook, the nearest largesettlement, to supply milk. He obtained improvements in the plant and barns, andfound the cows free of disease.91 Harmon Field also received someperishable meats and vegetables directly from Canada. Gander Field obtained allits food from the main depot at Fort Pepperrell and used reconstituted milk.
The Army tried to procure as much as possible from localsources, but, to insure against creating shortages in the civilian supply, theNewfoundland Government was always consulted before a purchase was made.92
Sanitation
Water and sewage.-The only U.S. post in Newfoundland whichused water from a municipal system was Fort Pepperrell where the water was
87Annual Report of Veterinary Activities, NewfoundlandBase Command, 1942.
88Annual Report of MedicalActivities, Station Hospital, Fort Pepperrell, 1942.
89See footnote 21, p. 167.
90Annual Report of Veterinary Activities,Newfoundland Base Command, 1944.
91Annual Report of Veterinary Activities, APO 864, HarmonField, 1943.
92See footnote 80, p. 185.
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purchased from the city of St. John's. The source was apatrolled lake near St. John's and the water was not treated by the city.After the water arrived at the post, it was chlorinated before being fed intothe post distribution system. St. John's did not have a sewage treatment plantso the Army built its own at Fort Pepperrell and the sewage was discharged intonearby Quidi Vidi Harbor.93 Supplying water and sewage facilities atGander Field was a function of the Royal Canadian Air Force; at the other bases,water and sewage were responsibilities of the Army, and Newfoundland authoritieswere not involved.
Insects.-Flies, mosquitoes, and sandflies were fairlyprevalent on the island during the summer and early fall; however, theypresented no disease problem to the troops. The biggest insect problem at FortPepperrell, Fort McAndrew, and Harmon Field involved heavy infestations ofbedbugs and cockroaches, especially in 1944.
At Fort Pepperrell, two civilians were trained to spray andapply insect powder where necessary at prearranged intervals. In some instances,they had to remove molding and framework to get at the insects; and in onebuilding, hydrogen cyanide gas was the only remedy which proved successful.94
The civilian barracks at Fort McAndrew and Harmon Field hadproblems with bedbugs. Clothing and bedding were disinfected and the workerswere moved to clean barracks. But the buildings were constantly reinfested bynew personnel and by those who went to their homes on the weekends and returnedwith the bedbugs on their clothing and luggage.95
Relations With Newfoundland and Canadian Physicians
Army Medical Service personnel had good relations withmedical officers of the Canadian services and with local Newfoundlandphysicians. Already mentioned were the joint efforts to fight venereal disease.At Gander Field, one ward of the RCAF Hospital was allotted to Americanpersonnel until the 310th Station Hospital was opened in December 1942. U.S.medical officers treated these American patients and were allowed to use thelaboratory and X-ray facilities of the hospital. Several U.S. medical officerswere invited by the Royal Canadian Air Force to attend a medical refreshercourse in Halifax and were provided air transportation. An Allied MedicalSociety held meetings to discuss professional problems. At Fort McAndrew,medical, veterinary, and dental officers and nurses of the Army and the Navy metonce each month with the two civilian doctors of the area, and formed theArgentia Medical Society. This resulted in excellent
93See footnote 84, p. 186.
94See footnote 76, p. 184.
95Essential Technical MedicalData, Newfoundland Base Command, for February 1945, dated 27 Feb. 1945.
189
cooperation in this area on such problems as venereal diseaseand tuberculosis.96
During the war, medical officers of the United States andCanadian armies and of the U.S. Public Health Service contributed to a generalrise in the health level of the people of Newfoundland. In cooperation with thegovernment, an effective venereal disease control program was initiated andsanitary conditions, especially in St. John's, were improved. ManyNewfoundlanders who worked on Army projects received good medical care andimmunizations against the common communicable diseases. The U.S. projectssignificantly raised the entire economic level of the island, thus indirectlycontributing to the health of the people.
The health of the natives was still only fair by the timemost of the U.S. troops left after the war. Even in 1946, the Base CommandSurgeon, Capt. Robert B. Wallace, Jr., MC, reported that the native populationneeded a "marked amount of medical attention." He termed the medicalcare provided by the Newfoundland Government "less than negligible."97
GREENLAND
United States troops in Greenland fought for the most partagainst nonhuman enemies. Except for a few skirmishes against German radio andweather stations, the enemies were the cold, the wind, and isolation. As Col.Bernt Balchen, a famous Arctic explorer, wrote: "The casualties were notvery glamorous: frozen lungs, a couple of missing fingers or toes, an amputatedleg."98 But these American troops performed a very importanttask in both the defense of North America and the offense against Germany.
The importance of Greenland was not recognized at first bythe United States. In May 1939, when the U.S. Senate considered purchase of theisland from Denmark, the War Department advised against it, saying thatstrategically it was of little value.
In the next 2 years, however, the United States changed itsopinion, and Greenland became valuable for several reasons. First, its mines onthe West Coast at Ivigtut were one of the most important natural sources ofcryolite, which was essential for the production of aluminum. Second, Greenlandbegan to figure prominently in the plans for ferrying airplanes across theAtlantic.99 Third, Greenland was the key location for forecasting Europe's weather because most North Atlantic storms originated in the windsand currents around it. Control of weather stations on Greenland could meancontrol of valuable information. All of these considerations were pointed out tothe United States by Canada, Great Britain, and the
96(1) See footnotes 71, p. 183, and74, p. 184. (2) Annual Report, Station Hospital, Newfoundland Air Base, 1942.(3) Annual Report, 310th Station Hospital, 1943.
97Medical History, AAF Station Hospital, 1383d AAF BaseUnit, Newfoundland Base Command, 1946.
98Balchen, Bernt, Ford, Corey, and La Farge, Oliver: WarBelow Zero. Boston: Houghton Mifflin Co., 1944, p. 37.
99For more details on the air ferry operation, see footnote 2 (4), p. 159.
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Greenlanders themselves, who feared a Nazi invasion. However,it took several years of diplomatic maneuvering before the United States agreedto undertake the defense of Greenland.100
On 9 April 1941, Secretary of State Cordell Hull and Mr.Henrik de Kauffmann, representing the Free Government of Denmark in Washington,signed an agreement granting the United States the right to construct, maintain,and operate defense facilities in Greenland. The United States was given widepowers, immediate use of the land, the right of exclusive jurisdiction over allpersons within the leased areas except Danes and Greenlanders, and exemptionfrom all customs duties on material and income taxes on American civilianworkmen and military personnel. In anticipation of the agreement, the UnitedStates sent a survey team in March to look for possible base sites in Greenland,the President allocated $5 million to start construction of the bases, and thefirst contingent of troops, mostly Engineer construction men, arrived inGreenland on 8 July 1941.101
Arriving with this first party were two medical officers and14 enlisted men of the Medical Department. From this beginning, medicalfacilities eventually grew into four station hospitals at the four major bases.Largest of the hospitals was the 188th Station, located at the main base, BLUIEWEST 1, in Narsarssuak on the southwest coast. The 189th Station Hospital waslocated at BLUIE WEST 7 at Ivigtut, not far from BLUIE WEST 1. BLUIE WEST 8,located at the head of S?ndre Str?mfjord about 15 miles inside the ArcticCircle, was served by the 190th Station Hospital. The 191st Station Hospital wasat BLUIE EAST 2, at Angmagssalik on the east coast, about 40 miles below theArctic Circle (see map 2). In addition, medical aidmen were stationed at each ofthe 12 weather and radio outposts, with medical officers at the five largest ofthese isolated installations.102
Greenland's unfriendly natural environment was a challengeto U.S. military and civilian personnel. It is the world's largestisland, but more than four-fifths of the country is covered by an enormoussheet of ice, whose thickness exceeds 2 miles in some areas. The ice sheetis contained by a range of high mountains which extends along the coastline,leaving only a narrow coastal strip fit for habitation.
American troops in Greenland found the weather extremelyunpredictable, sometimes changing suddenly from bright sunshine to dense fog ora heavy snowstorm. Conditions varied widely according to location and season ofthe year, but most of the bases experienced harsh cold, high winds, and longhours of darkness during the winter months. Greenland's tempestuous weatherand rugged terrain combined with almost complete isolation to make life hard forthe soldiers.
100A detailed study of these actions is in footnote 2 (3), p. 159.
101For a complete history of the United States involvement in Greenland, see footnotes 2 (1) and 2 (3),p. 159.
102For a discussion of the Army medical facilities inGreenland, see footnote 3, p. 160.
191
Relations With the Natives
Americans had little contact with the native population.About 16,000 persons lived on the island and, except for approximately 600 Danesand pure Eskimos, the remaining inhabitants were "Greenlanders"-Eskimos with some European blood.
The base at Ivigtut, BLUIE WEST 7, was the only American basenear a settlement. Other bases were within a reasonable distance of nativevillages, but transportation and communications were lacking. There were noroads, no railroads, and no telegraph wires. The only transportation was byboat, and this was limited by the weather.103
The isolation imposed by the environment was made complete byofficial decree in October 1943. The Government of Greenland charged that theU.S. Armed Forces had "introduced" prostitution and smuggling to theisland. Consequently, although the feeling was that the charges were notjustified, the Greenland Base Commander placed all native settlements off limitsto military personnel unless they were on official business.104 Asidefrom this one dispute with the Greenland Government, the Army's very limitedrelations with the natives were excellent. The natives were simple and friendlyand the Danish officials were generally willing to help the Americans establishbases.105
In the original 1941 agreement, the United States promised togive "fullest consideration consistent with military necessity ** * to the welfare, health and economic needs of thenative populations" and to give "sympathetic consideration to allrepresentations by the local authorities respecting the welfare of theinhabitants."106
Although American military personnel stood ready whenevernecessary to give aid in the form of expendable supplies or professionalconsultation, the demand for their services was much less than they expected.
Danish doctors in Greenland were always courteous andinformative when contacted by medical officers. They informed the Americans thatpulmonary tuberculosis was the greatest health problem among the natives andthat approximately 16 percent of the population suffered from the disease. Astudy of old skeletons revealed that the Eskimos had always been afflicted withtuberculosis: it was not introduced to the island by the white man.107 Mostof the patients in the small hospitals, located in the larger villages, weretuberculosis patients. One doctor told Lt. Col. Otho Hill, MC, Greenland BaseCommand Surgeon, that, from November 1943 to August 1944, all the nativepopulation had positive tuberculin tests by the time they were 15 years of age.108
103Report of Medical DepartmentActivities in Greenland, by Lt. Col. Otho R. Hill, MC, 6 Sept. 1944.
104(1) Annual Report, Surgeon, Greenland Base Command, 1943. (2) Seefootnote 103.
105See footnotes 2 (1), p. 159, and 103.
106See footnote 2 (1), p. 159.
107Report of Medical Department Activities in Greenland Base Command,by Lt. Col. Norman L. Heminway, MC, 14 Jan. 1944.
108See footnote 103.
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This serious native problem had no effect on Americanpersonnel because of the extremely limited contact with the local population.Colonel Hill did give supplies and professional consultation to Dr. A. LaurentChristensen in Julianehaab, not far from Greenland Base Command headquarters atNarsarssuak. Dr. Christensen, almost singlehandedly, attained excellent resultsamong the Eskimos by performing lobectomies under local anesthesia.109
Epidemics of several other diseases struck the nativepopulation during the late summer of 1944. The U.S. Coast Guard station at thesouthwestern village of Frederiksdal called in Colonel Hill to investigate adisease which had struck the natives, killing six; it was diagnosed as botulism,resulting from eating spoiled seal meat.
In Holsteinsborg, about 100 miles from the 190th StationHospital above the Arctic Circle, 18 Eskimos died in an epidemic diagnosed laterby Danish doctors as typhoid fever. The disease started like influenza, withheadache and stiffness of the neck. There were no laboratory facilities in thatarea, and, just from observing two convalescent patients, Colonel Hill suspectedmeningitis although he could not make a diagnosis. Since the village was distantfrom the American base and was off limits, there was no danger to U.S. troops.
At least 20 Greenlanders died on the east coast, in the areaaround Angmagssalik and ?k?teq where the 191st Station Hospital was located(fig. 17). Two cases were cared for by the Army surgeon there who made apositive diagnosis of cerebrospinal meningitis. His diagnosis was confirmed byDanish doctors at the Angmagssalik Colony Hospital. Natives were banned from thecamp except for medical treatment, and no Army medical personnel were infected.The Army supplied sulfadiazine to fight the epidemic.110
Several Eskimos were operated on in Army hospitals. InNovember 1943, a native hunter was shot in the arm. A doctor went out to thevillage from the 191st Station Hospital at ?k?teq, examined the man, andbrought him back to amputate the arm. The man lived, winning friends for theArmy medical personnel in the villages of the area. In March 1946, an aidman atthe Walrus Bay dispensary amputated the finger of a Greenlander who had beenshot. The aidman used instructions sent by wire from Capt. Charles G.Fullenwider, MC, Base Command Surgeon, and the wound healed successfully.111
Dentists at the Base Command headquarters saw more of the natives than did other Medical Department officers. The first Dental Surgeon, 1st Lt. (later Capt.) Benjamin Hoffman, DC, and his successors were fre-
109See footnotes 104 (1) and 107, p. 191.
110(1) Essential Technical Medical Data, Greenland Base Command, forAugust 1944, dated 1 Sept. 1944. (2) Essential Technical Medical Data, Greenland Base Command,for September 1944, dated 6 Oct.1944. (3) Annual Report, 191stStation Hospital, 1944.
111(1) Annual Report, GreenlandBase Command, 1946. (2) Essential Technical Medical Data, Greenland BaseCommand, for January 1944, dated 1 Feb. 1944.
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FIGURE17.-Two Eskimo patients atthe 191st Station Hospital, Angmagssalik, Greenland.
quently lent to the Greenland Administration to providedental care for the native villagers along the southwestern coast.112
Until the last of the civilian contractors left in February1944, their employees were the responsibility of Army medical personnel. At onetime, 3,200 civilians worked at the four bases. This group presented few specialproblems except a tendency toward arthritis because of their relatively olderage and the changeability of the weather.113
Diseases
For military personnel usually in good physical condition,Greenland presented no disease problems. Colds were less common than in theUnited States, and the occasional epidemics of respiratory ailments weredirectly traced to new arrivals on the island. Even these respiratory cases wereusually mild, and pneumonia was rare. The worst outbreaks of upper respiratorydiseases occurred in the winter of 1943-44 at the Arctic post where the190th Station Hospital was located. There were 206 cases of upper respiratorydisease at the main base over a 3-week period. Epidemics of folliculartonsillitis and influenza abated quickly, and both were traced to new arrivalsfrom the United States by way of Newfoundland.114
112Historical Record of the United States Army MedicalDepartment in Greenland, July 1941-February 1943, undated, p. 2. [Officialrecord.]
113See footnotes 103 and 107, p. 191.
114(1) See footnotes 103, p. 191, and 111 (2), p. 192. (2) EssentialTechnical Medical Data, Greenland Base Command, for December 1943, dated 1 Jan.1944.
194
Venereal disease was never a problem in Greenland because ofthe lack of contact between American troops and nativesand because of an agreement between the United States and Greenland in 1941.Under this agreement, the United States promised that no syphilitic personswould be sent to Greenland. If cases were detected en route to Greenland orafter they arrived, they would be shipped back immediately. The Danish doctorsin Greenland reported there was no syphilis in the native population, and theywanted none introduced. All cases of syphilis diagnosed in Greenland wereacquired elsewhere, mostly by U.S. Navy and Coast Guard personnel.115
One case of gonorrhea was traced back to a native woman. Themedical aidman at an outpost on the east coast treated the soldier and thenjourneyed to the native village to treat the woman.116
Insects presented no disease problems. They were a nuisanceonly during the summer months. Routine protections-screens, headnets, andrepellents-were used successfully.117
Surprisingly, cold injuries were kept to a minimum, thanks toexcellent arctic clothing furnished by the Army and adequate instructions incold survival.118 The worst cases of exposure resulted from airplanecrashes and from the torpedoing in February 1943 of a transport about 100 milesoff the coast from the main base. Aside from these special cases, most injurieswere fractures and sprains resulting directly from the rough terrain and icywalks and pathways. Wound infections were practically nonexistent, and Lt. Col.(later Col.) Norman L. Heminway, MC, the Greenland Base Command Surgeon in 1943,reported that the Greenland soil was probably tetanus-free. 119
Sanitation
The Army had no dealings with Greenland concerning watersupply or sewage and trash disposal. All posts obtained their water primarilyfrom lakes that filled in the winter with ice and snow and from wells sunk ingravel flats near a glacial river. The water was extremely pure, and notreatment was needed at the four main bases. At several of the outposts, waterwas chlorinated in Lyster bags. Those few Army personnel who visited nativevillages had to be careful of stream pollution. Several villages had dysenteryoutbreaks because of self-pollution of the water supply.
A central sewage system was operated at two bases. At theother two bases, pit latrines and chemical toilets were used. In all instances,sewage and garbage were emptied into fjords and trash was burned. No problemswere encountered with this system.
115(1) Seefootnotes 103 and 104 (1), p. 191. (2) Essential Technical Medical Data,Greenland Base Command, for June 1944, dated 1 July 1944.Enclosure 4, subject: Some Aspects of Medicine Observed at a Twenty-fiveBed Station Hospital in Greenland, by Capt. Sidney H. Tabor, MC.
116See footnote 110 (3), p. 192.
117See footnotes103 and 107, p. 191.
118See footnote 104 (1), p. 191.
119See footnote107, p. 191.
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No food or fresh milk could be bought locally by the Army. Inthe spring of 1944, Colonel Hill investigated thepossibility of buying mutton and lamb from the herds of several thousand sheepin southeastern Greenland. But a veterinary survey showed that refrigerationfacilities for shipping were inadequate. Occasionally, Army and Navy personnelshot and ate ptarmigan, a northern grouse. None of the birds was found to becontaminated. In addition, the servicemen caught salmon, trout, and cod, butusually not enough to stock an entire messhall.120
Isolation continued to be a major problem for Army medicalpersonnel in Greenland. Severe mental cases occurred at no greater rate than inthe United States-these would have had trouble no matter where they werestationed-but almost every soldier in Greenland suffered from a general apathyand low morale. The monotony was overpowering; the normal tour of duty was for18 months, during which the average soldier saw no women, no home or town, nochange of scenery, and no military action. Mail call was a major occurrence and,in the winter, even this was severely curtailed with delivery sometimes delayed4 to 8 weeks.121
Obviously then, the U.S. Army in Greenland had very fewproblems in the field of civil affairs and public health. Medical personnel didlend aid on several occasions to the native population. Usually the Army and thenative Greenlanders saw each other so rarely that there was little chance forproblems to develop.
ICELAND
Unlike Greenland, where U.S. troops were stationed afternegotiations with the Free Danish Government, Iceland122received U.S. troops with the consent of its owngovernment. Although tied to Denmark for centuries, Iceland had declared itsvirtual independence on 10 April 1940 when Germany seized Denmark. The Althing,Iceland's Parliament, declared that the Danish King, who was also King ofIceland under a 1918 treaty, was no longer able to exercise his royal power.Also, Denmark could not handle Iceland's foreign affairs. Therefore, theAlthing lodged the executive power, "for the time being," in the PrimeMinister of Iceland and his cabinet. This was the first time since 1264 thatIceland had been free of European ties, but this situation lasted only 1 month.123
On 10 May 1940, the British landed a force in Iceland whichgrew to more than 25,000 British and Canadian troops within a year. The Britishfeared German control of the island which would give the Nazis a base from
120See footnotes 103and 107, p. 191.
121(1) See footnote 115 (2), p. 194. (2) Essential Technical Medical Data, Greenland Base Command,for July 1944, dated 1Aug. 1944. Enclosure 4, subject: Neuropsychiatric Problems in Greenland, byCapt. Leon H. Manheimer, MC.
122The story ofAmerican involvement in Iceland may be found in footnotes 2 (1) and 2 (3), p.159.
123(1) Todd, Lt.Col. Frank A.: History of U.S. Army Veterinary Service, IcelandBase Command, September 1941-September1943, pp. 10-12. [Official record.] (2)Armed Guardians, One Year in Iceland, prepared by G-2 Section, Iceland BaseCommand, December 1942.
196
which to attack shipping to the British Isles. Iceland had noarmed forces to prevent such a German invasion, and although the peopleprotested foreign military intervention, they realized that British protectionwas preferable to a German occupation.124
The Governments of Iceland and the United States hadestablished direct relations in April 1940, and in July, Iceland inquired if itfell within the Western Hemisphere for purposes of the Monroe Doctrine. TheIcelandersapparently thought that a simple declaration from the United States would makeactual stationing of troops on the island unnecessary, and if U.S. troops wereneeded, they would not draw German attacks since the United States was not abelligerent. The United States was noncommittal.
By the spring of 1941, the beleaguered British, sufferingheavy losses in the Mediterranean area, badly needed the troops tied down inIceland. In late March, Hitler declared Iceland to be in the war zone. Thesedevelopments, together with Iceland's obvious advantages as a base for air andsea protection of the North Atlantic shipping routes and a link in the air ferryroute to Europe, caused President Roosevelt to order a survey of the island inApril.
In early June, the President decided to send troops toIceland if that government requested them. The Icelandic Parliament refused toapprove an explicit request, but a solution was worked out in an exchange ofnotes between President Roosevelt and Prime Minister Herman Jonasson of Icelandon 1 July. The Icelandic Government "admitted" the help of U.S. troopswas "in the interest of Iceland," and that the government was"ready to entrust the protection of Iceland to the United States."125 On 7 July, 4,100 marines landed in Iceland. The first Army ground combattroops arrived on 15 September, and by the next spring, most of the British andall of the marines had been replaced by the Army. In April 1942, command passedfrom the British to Maj. Gen. Charles H. Bonesteel, U.S. Army.
The strength of the Iceland Base Command increased steadilyto a peak of 40,712 ground, air, and service troops in May 1943. Then, as thethreat of German invasion subsided, the number of troops declined until, by theend of 1945, only 1,800 remained. To provide medical care for the Iceland BaseCommand, Army hospitals were set up close to the coastline on all sides of theisland. By late 1942, one general hospital and nine station hospitals wereoperating in Iceland (see map 2). As the number of troops declined, medicalfacilities were reduced to three station hospitals.126
Relations With the Icelanders
The first American troops arriving in Iceland found a windy,wet island, inhabited by people who were as cool toward them as the weather.
124See footnote 123 (1), p. 195.
125NarrativeHistory, Iceland Base Command, "Always Alert," 16September 1941-31 December 1945. [Officialrecord.]
126The story ofAmerican Medical Service in Iceland may be found in footnote 3, p. 160.
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Though Iceland had reluctantly agreed to U.S. protection,rumors circulated about high-living Americans, and some even discussed thepossibility of soldiers resembling Chicago gangsters invading their island.127
In fairness to the Icelanders, although they had lived apartfrom the rest of the world for more than 1,000 years, they were an intelligent,cultured, and hard-working people who had moved their country forward despiteadverse natural conditions. They feared that the arrival of large numbers offoreign troops would alter their old traditions and institutions and alsothreaten their newly asserted independence. The original note of 1 July 1941 accepting American protection emphasized that the UnitedStates must recognize the "absolute independence and sovereignty ofIceland" and must withdraw all troops at the war's end. The note askedthat only "picked troops" be sent because of the small population andthe "consequent danger to the nation from the presence of a numerousarmy." Finally, the United States had to promise "to ensure thegreatest possible safety for the inhabitants themselves," and that militaryactivities should be "carried out in consultation with Iceland authoritiesas far as possible "128
President Roosevelt agreed to all these conditions, andAmerican military personnel were warned to respect local institutions, torefrain from interfering with the rights of the civil government, and to handleall political questions through the American Consul. The American commander,General Bonesteel, a man of tact and diplomacy, eager to grasp and understandlocal problems, worked closely with the civil government and the AmericanLegation to solve the problems satisfactorily.129 Socialand cultural relations between the soldiers and the people improved considerablyas the two groups came to know each other better, and by the war's end, thePresident of Iceland praised the cooperation of the visiting troops on theisland.130
Cooperation in Medicine
The Army Medical Department played a major role in helping towin the good will of the people of Iceland. Medical and dental help was freelygiven to civilians in emergency situations. Natives injured near Army hospitalsor involved in accidents with Army vehicles and personnel were taken into theArmy hospitals for treatment. Army medical officers got along well with theIcelandic physicians. At the more remote camps, civilian doctors were called inemergencies until a medical officer could arrive from an Army hospital. On theother hand, Army physicians were sometimes called in by civilian doctors forconsultations on civilian patients. On several occasions, urgently neededbiologicals and drugs were supplied by the Army. Leading public health and otherdoctors were shown through the
127See footnote 125, p. 196.
128See footnote 125, p. 196.
129See footnote 2 (1), p. 159.
130See footnote 125,p. 196.
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FIGURE18.-Maj. Frank A. Todd, VC, obtaining asample of milk for laboratory analysis.
Army hospitals and invited to Army medical meetings and, inreturn, medical officers visited civilian hospitals and the homes of Icelandicphysicians. The policy of the Iceland Base Command Surgeon, Col. Charles H.Beasley, was to cooperate with Iceland's physicians and public healthauthorities at all times.131
The Army group that did more than any other to cement goodrelations with the Icelanders was the veterinary section of the Iceland BaseCommand, led by Maj. (later Lt. Col.) Frank A. Todd, VC (fig. 18). This group ofmen went beyond their assigned duties of food inspection to perform publichealth services which benefited not only U.S. troops, but also all the people ofIceland.132
The outstanding example of the Army veterinarians' work inpublic health was the improvement they made in the milk supply. This, of course,was not entirely an altruistic undertaking because a safe supply of fresh milkwas essential for both patients and troops. Nevertheless, with excellent
131Annual Report, Surgeon, Iceland Base Command, 1942.
132For the complete story in detail of the work of the Armyveterinarians in Iceland, see footnotes 21, p. 167, and 123 (1), p. 195.
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cooperation from governmental and dairy officials andfarmers, the work of the veterinarians enabled all Icelanders to obtain safemilk.
Army veterinarians began investigating the milk supplysoon after their arrival in late 1941. All farmers who sold milk belonged to acooperative which processed the milk in several dairy plants around the country.Icelandic laws prohibited the sale of unpasteurized milk, but the largepasteurizing plant in Reykjavik was found to be operating with old, worn-outequipment and producing a pasteurized milk supply which varied greatly inbacteria content from day to day. This plant supplied milk to the markets andeating establishments of the Reykjavik area, where many Army personnel shoppedand ate.
The veterinarians visited Secretary of State Vigfus Einarsson,Minister of Agriculture Jonasson (who was also Prime Minister), members of themilk control board, the medical research board, and the Iceland AgricultureSociety. These authorities enthusiastically endorsed their plans for a milkcontrol program. A laboratory was soon made available at the University ofReykjavik to do the required testing. The university supplied some equipmentwhile other necessary supplies and biologics were sent from the United States.
The Army veterinarians inspected farms with the help of theIcelandic milk technicians and native veterinarians. They found the farmersfriendly and eager to learn. The local newspapers requested that the Armyveterinarians write a weekly column on Iceland's public health problems, andthe first group of these articles offered suggestions on improving the cattle,the barn facilities, and the handling of the milk.
Iceland's cattle had never been tested for tuberculosis orbrucellosis. Eventually, all of the cattle on the island were tested under thedirection of Veterinary Corps officers. No tuberculosis was found, but therewere several reactors to the brucellosis tests.
Finally, in the spring of 1942, the Reykjavik pasteurizingplant was studied in detail to find the source of its problem. The trouble wasattributed to an old milk cooler. When dairy officials rearranged the equipmenton the advice of the Army veterinarians, the quality of the milk improvedimmediately. Regular tests on the milk from this plant, and all the other dairyplants on the island, continued to show that a safe supply of milk had been madeavailable through the cooperation of the Army, the Icelandic Government, and thedairy industry.
The Army veterinarians also studied the local supplies oflamb and fish. Slaughterhouses and lambs were inspected, and handling andstorage were constantly checked. Fishing was a major industry in Iceland. Thelocal dealers cooperated fully with all suggestions to improve sanitaryconditions.
At the request of the Icelandic Government, General Bonesteelauthorized the Army Veterinary officers to aid in the fight against animaldiseases on the island. Since agriculture was the major occupation, this workwas a
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FIGURE19.-Army veterinariansexamining a sheep suffering from jagziekte, a chronic lung disease.
large factor in winning friends for the United States. Thetesting of cattle has already been mentioned. In 1942, an epidemic of hogcholera spread rapidly. With serum flown in from the United States, the Armyveterinarians quickly brought the epidemic under control and demonstratedmethods for inoculating the pigs. This speedy victory made them famous on theisland and prompted an Icelandic humor magazine to suggest the veterinariansshould next attack the island's political problems and bring them undercontrol.
Most important to the Icelanders was the joint research byIcelandic research scientists and Army veterinarians into the serious diseasesof sheep. One condition of the lungs, known as jagziekte, caused large losses,and paratuberculosis also was a major threat. At an experimental farm nearReykjavik, these diseases were studied (fig. 19).
Throughout their stay on the island, the Army veterinarianstaught local professional groups and farmers the most modern methods oflaboratory testing and inoculation of animals. The regular column on thissubject in the newspapers was widely read and appreciated. In addition, they
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prepared an illustrated booklet, printed in Icelandic, whichincluded detailed instructions on milk production, disease control, and modernanimal husbandry. Far from resenting these suggestions from foreigners, theIcelanders were extremely grateful, and much valuable meat was saved.
In addition to these activities, Veterinary Corps officersacted as liaison with the local government on matters such as native claimsagainst the U.S. Government for losses of livestock in accidents. At Iceland'srequest, all fresh vegetable wastes were burned to prevent the introduction ofparasites unknown to Iceland
The work of the Army Veterinary Corps in Iceland was one ofthe most outstanding efforts of the war in civil public health. Icelandicofficials conveyed their thanks in many ways, including letters from the PrimeMinister to the American Legation which praised Major Todd and his associates"for the valuable services they are rendering to Icelandic economy and therural life of Iceland."133 Major Todd, Capt. (later Lt. Col.)Harry J. Robertson, VC, and Maj. (later Lt Col) Robert B. Meeks, VC, received theLegion of Merit for their work (fig. 20).134
Sanitation
Water, sewage, and garbage.-The Army in Iceland had notrouble obtaining a potable water supply. An abundance of lakes, streams, andwells supplied water to most camps and posts Several camps, including those inthe Reykjavik area, drew their water from civilian mains. The capital city'swater supply did not require chlorination, and monthly checks showed that only afew stations had to chlorinate their water. No diseases were caused by thewater.135
The sanitation program was carried out in cooperation withthe civil government and supervised by the sanitary officer. Capt. EarleGibson, SnC, was sanitary officer until 1942 when he was put in charge of theArmy laboratory. The Veterinarian, Major Todd, then assumed the duties ofsanitary officer in addition to his other activities. Because most camps werenear the ocean, the disposal of wastes presented little problem. Most camps hadeither flush toilets or pail-type latrines. The sewerage systems emptied directlyinto the sea or into settling tanks. Pail-type latrines were emptiedregularly by civilian laborers who dumped the waste into the ocean at designatedpoints, where the tides could carry it out to sea.
Civilians also handled most of the garbage by either dumping it into the sea or feeding it to pigs. Iceland did not have many swine, and this practice was not extensive. The use of garbage for feed was strictly super-
133Letter, Mr. Lincoln MacVeagh, U.S. Minister to Iceland, to Commanding General, U.S. Forces in Iceland, 19 June 1942.
134(1) General Orders No. 16, Headquarters ETOUSA, 12 Feb.1944. (2) General Orders No. 47,Headquarters ETOUSA, 12 May 1944.
135See footnote 131, p. 198.
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FIGURE 20.-Maj. Frank A. Todd, VC, receiving Legion of Merit from Brig. Gen. (later Maj. Gen.) Paul R. Hawley, Chief Surgeon, European Theater of Operations, in February 1944.
vised by both civilian and military authorities. A policy wasalso enforced barring the use of human waste for fertilizer on farms andgardens.136
Rats and insects.-By dumping the garbage into the sea, cityofficials were able to clean up the city dumps, which were made into sanitaryfills. Wiping out the places where rats lived and propagated was a major stepin reducing the large rat population. The rats had been a nuisance on the islandfor many years although there was no evidence that they spread disease amongeither the civilian or the military population. The Icelandic health authoritieswere very eager to cooperate with the Army in a program of rat extermination.Over the course of several years, this was carried out by using traps and poisonbait and by cleaning up rat breeding areas. The Army provided Red Squill andbarium carbonate poisons imported from the United States. Iceland, in turn,provided facilities for preparing the bait,
136(1) Seefootnote 131, p. 198. (2) Todd, Lt. Col. Frank A.: Civil Affairs-MilitaryGovernment, Public Health in Greenland, Iceland, Newfoundland, Canada, 5 Apr. 1963.(Unpublished manuscript on file at TheHistorical Unit, U.S. Army Medical Department, Fort Detrick, Frederick, Md.)
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civilian manpower, and supervision of the campaign incivilian areas. This program greatly reduced the ratpopulation, with a corresponding saving of food andmilitary supplies which formerly had been destroyed.
Iceland's cold climate, lack of trees, and complete absenceof temperate or tropical vegetation kept insects to a minimum. There were nodisease-bearing insects of any kind. Flies were found only in towns nearfish-canning factories and dumps, and for only a short period each year.137
Diseases
The high sanitary standards enforced by the Army and civilianhealth officials and the absence of disease-bearing insects and rodents combinedto keep the disease rate of American troops in Iceland extremely low. Thenoneffective rate dropped steadily from 29.5 per 1,000 in 1942, to 25.37 in1943, and to 16.28 in 1944.138 Abouthalf of all admissions were for the common respiratory diseases; these alwaysincreased when a new shipment of troops arrived.
An outbreak of hepatitis hit the command in the summer of1942, at the same time a similar epidemic was occurring Armywide.139 Asin the other commands, the cause was not determined definitely at that time, butyellow fever inoculations were suspected. In Iceland, all but seven of theaffected patients had been inoculated from the same lot of yellow fever vaccine.There were no deaths.
Aside from this incident, there were no epidemics among thetroops during the entire time they were in Iceland though several outbreaksoccurred in the native population. An epidemic of mumps in Reykjavik in 1942caused the soldiers to be prohibited from going to town except on business.There were no local public health restrictions on persons with the disease. Only134 sporadic cases occurred among Army personnel.140
In the town of Borgarnes, near the 72d Station Hospital, aninfluenza epidemic in March 1943 and a measles outbreak in May affectedtwo-thirds of the civilian population. Here again, strict isolation andsupervision of the military kept the diseases from affecting Army personnel.141An epidemic of infantile paralysis in Reykjavik in 1945 was met successfully bykeeping the soldiers away from public places.142
Venereal disease was never a major problem in Iceland. TheIcelandic health officials were extremely cooperative and efficient in trackingdown girls who infected American soldiers. All persons suspected of having ortransmitting a venereal disease were put in a hospital at Government expense forexamination. If found to have the disease, they were treated until cured orbelieved to be noninfectious. The strict enforcement of this
137See footnote 131, p. 198.
138See footnote 3, p. 160.
139See footnote 36, p. 171.
140See footnote 131, p. 198.
141History, 72d Station Hospital, 1943.
142See footnote 125, p. 196.
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law resulted in a low venereal disease rate. Also, there wasvery little prostitution on the island. Much of the disease in existence wasbrought in by merchant seamen or soldiers returning from England; very littlecame from the United States.143
Cooperation With Allies
U.S. Army hospitals in Iceland served many personnel of otherU.S. services, U.S. civil service workers, American National Red Cross workers,and members of the armed forces of Great Britain, Canada, Norway, Sweden,Greece, and Russia. Cooperation with the British was especially smooth. At CampTripoli, in 1941, all United States soldiers with serious illnesses werehospitalized in British facilities.144 During 1942, both the 208thGeneral Hospital and the 11th Station Hospital shared quarters with a Britishhospital at Camp Helgafell on the southeast coast.145 One of the mostvaluable services of Army hospitals was the treatment of shipwreck victims, bothbelligerent and nonbelligerent. Numerous attacks were made on vessels inIcelandic waters, other ships collided, and several ran aground. U.S. Armypersonnel took part in many mercy missions, and survivors often found haven inU.S. Army hospitals.146
From a beginning in which relations between U.S. Armypersonnel and the native population were not too friendly, the Icelandexperience grew into an outstanding example of civil-military cooperation in allfields, especially in public health. By working together, military and civilianhealth officers kept communicable diseases to a minimum. Together, theymaintained high sanitary standards in water supply, sewage and garbage disposal,and in the fight against rats. Together, they provided a high level of medicalcare for both civilians and military. And together, they fought disease inanimals, thus providing a much needed source of safe food and milk during thewar years. The American defense of Iceland proved to be a mutually beneficialendeavor for both the U.S. Army and the people of Iceland.
SUMMARY
The history of the Army Medical Department's civil publichealth work in Canada, Newfoundland, Greenland, and Iceland is generally a storyof achievement. The major task of the Army medical officers was, of course, toprotect the health of American troops. This was the reason behind the efforts toraise sanitary standards and prevent the spread of disease. But this vital workcould not have been carried out as effectively as it was without the activecooperation of local health officials and physicians in
143See footnote 131, p. 198.
144Annual Report, Surgeon, Iceland Base Command Air Force,Camp Tripoli, 1941.
145See footnote 3, p. 160.
146For an account of thehospitalization of survivors of sinkings and other disasters off Iceland, see footnote125, p. 196.
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each country. Although in several instances pressure had tobe applied by Army medical officers to achieve their objectives, this was theexception to the usual exceptional relationship. In almost every instance wherethe help of local medical and health officials was needed, it was quickly andeagerly given.
This medical cooperation did not benefit the U.S. Army alone.Wherever Army medical personnel were stationed, the general health levels andsanitary standards of the civilian population were raised; in many instances,Army medical officers went far beyond their required duties to aid the localpopulation. The work of medical officers in caring for natives in thewilderness of northern Canada far from any Army base and of the veterinariansin Iceland which brought significant advances to the Icelandic livestockindustry are examples of deeds which won many friends for the United States.When Army medical officers returned from their posts, they left behind them alegacy of improved public health for the northern neighbors of the UnitedStates.
