Part III
MEDICAL SUPPLY IN THE WAR AGAINST JAPAN
CHAPTER XII
Pacific Medical Supply in the Period ofDefense
MEDICAL SUPPLY IN THE MIDDLE PACIFIC
Preparation for War
As international tensions increased in the summer and thefall of 1941, every effort was made to strengthen U.S. defenses in the PacificArea. Handicapped by lack of modern material, the War Department, nevertheless,sought not only to reinforce or establish bases on Midway, Wake, Guam, Christmasand Canton Islands, and on other islands, but also to assemble 500,000 tons ofsupplies and 20,000 troops for use in the Philippines.
In the Hawaiian Department, located at Fort Shafter on theisland of Oahu, T.H., medical preparations for war were coordinated by thedepartment surgeon, Col. (later Brig. Gen.) Edgar King, MC. Honolulu, T.H., waszoned with 20 aid stations strategically established and supplied, while thePreparedness Committee of the Honolulu County Medical Society set up teams ofdisaster surgeons who would be ready for call by the U.S. Armed Forces. At thesame time, arrangements were made for ambulance service. A plasma bank, whichwas financed with a $4,000 grant from the Honolulu Chamber of Commerce, wasorganized by Dr. Forrest J. Pinkerton. Several collecting stations wereestablished, and the laboratory work was accomplished at the Queen's Hospital.Meanwhile, a group of women were making surgical dressings for the HawaiiChapter of the American Red Cross, under the immediate direction of Mrs. A. V.Molyneaux, chairman of the production unit, and supervised by Mr. John F. Gray,a field director of the American Red Cross. On 25 November and 4 December 1941,a total of 58,000 Army-type surgical dressings were sent to the station hospitalat Schofield Barracks, T.H., at the request of Colonel King.
Medical supplies stored at the Hawaiian Medical Supply Depotat Fort Shafter were considered suitable for the requirements of the HawaiianDepartment. A considerable amount of the reserve equipment had been made readyfor any emergency.1
Organization of the Medical Supply System for WarAt the outbreak of hostilities, war reserves of the HawaiianMedical Supply Depot were immediately picked up in depot stocks and utilized tobuild
1(1) Biennial Report of the Chief of Staff of the United States Army, 1 July 1941 to 30 June 1943, to the Secretary of War. Washington: U.S. Government Printing Office, 1943, pp. 3-5. (2) Annual Report, Surgeon, Hawaiian Department, 1941. (3) Memorandum, Brig. Gen. Edgar King, for Editor, History of the Medical Department, 22 Mar. 1950.
394
FIGURE 99.-Tripler General Hospital.
provisional hospitals and expand existing facilities. Thesestocks, in general, were grossly deficient in many respects. Hospitalassemblages stored as units were found to be only partially complete, and, insome instances, the equipment was of World War I vintage and of little realvalue. Available current depot stocks were utilized to offset these deficiencieswherever possible. Where items were not immediately available in depot stocksand time precluded requisitioning on the Zone of Interior, procurement of localcommercial stocks was effected to the greatest extent possible. This source waslimited, however, as most commercial stocks were also procured from the. Zone ofInterior. The Surgeon General's Office, meanwhile, made an estimate of therequirements that would be generated by the attack on Pearl Harbor.
In the meantime, shortly after the attack, 18,000 surgicaldressings were furnished to the Tripler General Hospital, Honolulu (fig. 99),and the U.S. Naval Hospital at Pearl Harbor in response to emergency calls tothe Red Cross. Also, on the same morning of 7 December 1941 and during the next2 days, 750 units of 250 cc. of plasma were provided to both Army and Navyhospitals. The major collection stations were bleeding donors at the rate of 50per hour. During the first 15 days, 3,400 donors were bled.
395
Located at Fort Shafter, the Hawaiian Medical Supply Depothad a complement of 6 officers and 32 enlisted men and was responsible forsupplying the Tripler General Hospital, the station hospital at SchofieldBarracks, the provisional hospitals established subsequent to Pearl Harbor, andthe dispensaries serving service and tactical units. All requisitions preparedby the depot were routed through the Surgeon's Office, Headquarters, HawaiianDepartment.
Arrival of the 5th Medical Supply Depot
On 16 April 1942, the 5th Medical Supply Depot, organizedunder TOE (table of organization and equipment) 8-661 and under the command ofLt. Col. James P. Gill, MC, arrived in the Hawaiian Department from the Zone ofInterior with 11 officers and 90 enlisted men. The Hawaiian Medical Supply Depotwas inactivated 2? months later, and all personnel and equipment weretransferred to the 5th Medical Supply Depot.
To supply the service commands on the islands of Maui, Kauai,and Hawaii, branch depots were established. The branch depot at SchofieldBarracks, designated Post Dispensary No. 2, was further enlarged by theconstruction of five additional warehouses serving 40,000 troops at its peak ofoperations. Another warehouse was added at Fort Ruger, T.H., making 11warehouses in all on the island of Oahu.
Many critical items of supply were dispersed for storage inthe various hospitals on Oahu and outlying islands. This move was consideredessential to minimize the destruction of supplies by enemy bombing. A newwarehouse was constructed on the north shore of Oahu outside Schofield Barracks,and plans were made to construct a receiving warehouse at Fort Shafter toreceive critical items and stores before dispersal. A subdepot at Hickam Field,Honolulu, was established in July to service Army Air Forces personnel only.This process reached its peak late in 1942 when the 5th Medical Supply Depot wasspread over 36 storage locations aggregating 185,000 square feet.
War reserve stock carried by the Hawaiian Medical SupplyDepot before 7 December 1941 was issued after the Pearl Harbor attack. Stocks in1942 thus consisted of 31 units of final reserve for the island of Oahu, 6 unitsfor the island of Hawaii, and 4 units each for the islands of Maui and Kauai.
At times, the supply of certain items was exhausted, butusually, a substitute item was available or local purchase was made untilradioed requisitions could be furnished from the mainland. Requisitions weregenerally filled within 7 days after receipt.
Plans for Overseas Action
The first established plan for supply of overseas combatoperations was transmitted on 22 January 1942. Concurrently, the San FranciscoPort of Embarkation was designated as the port to which all supply matters forthe
396
command would be referred. At that time, the maximum supplylevel was set at 70 days, based on requirements for the Army, plus the Navy andthe Marines, civilians, prisoners of war, and Allied Nations personnel, whereapplicable. In July 1942, the level was raised by the War Department to 90 days.By this time, the medical maintenance unit and siege unit were being used toautomatically supply the Hawaiian Department while requisitions were submittedto the San Francisco Port of Embarkation as a supplemental means of supply fornoncontrolled items.
Receipts of Supplies
During 1942 and 1943, before the War Department shippingdocument was in use or the later strict regulations governing the rapidforwarding of shipping documents from ports of embarkation to overseas bases hadbeen issued, it was a rare occurrence for the Medical Department to be advisedof the arrival of its supplies until they were actually discharged and lying onthe piers at Honolulu. As a consequence, it was impossible to furnish the meansof transportation to the dispersed warehouse facilities of the medical supplydepot. To overcome this possible source of confusion, it was necessary to assignan officer of the depot and a staff of four to eight enlisted men to work at thepiers in close liaison with the port authorities. Informed as to the supplies onorder and proposed storage locations, the detachment provided an invaluableservice in clearing the docks of medical supplies. This pier liaison sectionalso was responsible for handling similar responsibilities in shipments made bythe 5th Medical Supply Depot to forward areas and to outlying islands.
Requisitioning by Units
All using agencies and supply points obtained replenishment ofmedical supplies by monthly requisitions on the 5th Medical Supply Depot throughthe office of the base service command surgeon, where they were edited forauthorization and availability. Tactical organizations obtained supplies in alike manner, except that requisitions from subordinate units of higher echelonsrequired the approval of their surgeon. Moreover, supply sections weremaintained by the various divisions, and issues to subordinate units were madefrom the divisional supply points.
Organization Equipment
When tactical units were being staged in the command, a majorproblem was encountered in receiving and identifying organizational equipmentshipped from the Zone of Interior. Many tactical units arrived with incompletemedical equipment which had to be supplemented before their departure for combatmissions. Scarcity of stocks at that time inflated the problem. As a result, allorganizational equipment (hospital assemblies excepted) was picked up in depotstocks, and the units upon arrival were directed to submit requisitions to thedepot to cover any shortages in unit equipment. Hospital assem-
397
blies that arrived before the unit was deployed were storedintact in the depot pending issue. If a unit assembly did not arrive before theunit's departure, components were issued from depot stocks, and all shortageswere backordered. In such instances, the unit assembly upon arrival wasdismantled, and the components were picked up in depot stock.2
Support of Defense Units of the Hawaiian Department
Tripler General Hospital, the center for treatment of manybattle casualties of Pearl Harbor, reported a fair supply of sulfanilamidepowder on hand and a sufficient quantity of plasma donated by civilianphysicians. The problem of safe storage of such critical items was resolved byconstructing a large, stormproof warehouse and by using concrete storerooms inthe Farrington and Kamehameha areas of the hospital.
At the 1st Station Hospital, medical supplies were stackedinitially in tents and on platforms in the dock area; then, they were removed toa coconut grove, 2? miles from the hospital, and unpacked and classified. Aportable electrocardiograph machine, received on 15 October 1942, aided a greatdeal in diagnostic procedure. The lack of other equipment, however, was apersistent handicap.
The 148th General Hospital, because it had not been providedwith a consolidated shipping list of equipment, was unable to account for allitems of the 1,000-bed hospital unit delivered to the port of embarkation inmid-January 1942. It was only by constant checking with the office of the PortQuartermaster that many short items were discovered and supplied before the unit'sshipment to the Hawaiian Department in April. Upon establishment of the unitnear Mountain View, Hawaii, two small warehouses, each 50 by 20 feet, were used-one,as a utility storeroom and workshop, and the other, as an issue storeroom.Supplies in closed stock were kept in a larger warehouse located at Olaa, T.H.,6 miles away.
The 26th Station Hospital experienced similar unloading andstorage problems upon its arrival from the mainland. The supplies, consisting of1,763 crates, were manhandled mostly by hospital personnel and were stored inand filled seven hospital tents in the dock area. Because of misleading labelson the shipping boxes and limited storage space, unpacking was not systematic.The department surgeon caused the medical supply dump serving both the 26th andthe 1st Station Hospitals to be moved to a coconut grove 2? miles away. There,supplies were stored in tents and partially unpacked and classified. By April,tent warehouses were established in the hospital area where permanent warehouseswere being constructed. Repeated moves had caused unnecessary labor andpersonnel trouble; however, little loss or waste was experienced.
2(1) See footnote 1(2), p. 393. (2) Ronka, Enzio K. F.: History of Professional Experiences, World War II, in Central Pacific Base Command or Hawaiian Department. [Official record.] (3) Whitehill, Buell: Administrative History of Medical Activities in the Middle Pacific. [Official record.] (4) Annual Report, 5th Medical Supply Depot, 1942.
398
Because supplies were received directly from both Fort Mason,San Francisco, and the Hawaiian Department, there was some duplication ofequipment, but this situation was soon corrected.
The 24th Infantry Division had its full table of basicallowance of medical organizational equipment with very few items not available.Nonstandard medical equipment included a treatment and instrument chest, oxygenequipment, linen chest (towels, pajamas, and bathrobes), and a protectiveclothing chest. Emergency medical equipment was stored at the Kahuku Hospital,the Waialua Hospital, and at the two medical dumps. Supplies were stored in 9-by 12-foot houses at Pupukea Heights and Eucalyptus Forest. Essentialnonstandard items, such as Pentothal sodium (thiopental sodium) for intravenousanesthesia, dry plasma, and normal saline solution, were issued to largermedical units of the division. Mountain rescue equipment, consisting of a basketlitter
399
modified by a board bottom and supplemented by ropes, wasmaintained by the 24th Medical Battalion.3
Task Force 4591
Almost immediately after the Japanese struck, U.S. forces beganto spread to scattered islands in that area of the Pacific.
Before World War II, most flights over the vast areas of thePacific had been in sea-based planes. On 29 January 1942, slightly less than 2months after Pearl Harbor, Task Force (movement) 4591 slipped out of the SanFrancisco Harbor en route to Christmas and Canton Islands and Bora Bora in theSociety Islands-its mission being to help strengthen the bridge of airbasesacross the Pacific.
A section of this task force arrived at Christmas Island 10days later and, after a rather laborious delivery of the cargo, set up a 100-bedstation hospital which proved functional despite the obsolescence of the medicalchests which had been packed during World War I.
The medical supply officer for this pioneering task force was2d Lt. (later Capt.) Allan W. Phelps, MAC, who had been in the Army only 6 weekswhen he departed from San Francisco. His medical resupply point was the HawaiianMedical Supply Depot at Fort Shafter, and soon the deleterious effects ofoutside storage on precious medical stocks was realized. An excellent Polynesianthatched medical supply warehouse was contracted for and built, using as amedium of exchange unneeded red flannel bandage (fig. 100).
MEDICAL SUPPLY IN THE DEFENSE OF THE PHILIPPINES
Prewar Preparations
Before General of the Army Douglas MacArthur was appointedCommander, USAFFE (U.S. Army Forces in the Far East), the war plans for thePhilippine Department were being vigorously revised to meet war needs. Theinduction of Philippine Army troops into USAFFE and the possibility of aprolonged period of resistance to invading forces made it necessary to modifythe war plans by developing a large reserve of hospital beds in Manila, P.I.Toward this end, a general hospital was issued to the Manila Hospital Center,part of another was stored and used at Limay on Bataan, and two others were leftin the Manila depot. At the same time, officers and enlisted men of thePhilippine Army were trained in a special school for medical supply officers atthe Philippine Medical Supply Depot. Timely requests for medical equipment forhospitals and field operations resulted in the arrival of two general hospitals2 weeks before the war began as well as five
3(1) Letter, Col. A. C. Miller, MC, Commanding Officer, Tripler General Hospital, to Surgeon, Hawaiian Department, 15 Apr. 1942, subject: Supplemental Annual Report (attached to Annual Report, Tripler General Hospital, 1941). (2) Annual Report, 1st Station Hospital, Hawaiian Department, 1942. (3) Annual Report, 148th General Hospital, 1942. (4) Annual Report, 26th Station Hospital, 1942. (5) Annual Report, Surgeon, 24th Infantry Division, 1942.
400
(250-bed) station hospitals. Also, 90 regimental dispensaries either were inpreparation for shipment overseas or were already en route to the Philippines bythat date.4
Medical supply plans called for the enlargement of the medical supply depotin Manila which was to be relocated on the outskirts of the city to be lessvulnerable to air attack. Construction of subdepots at Tarlac, Los Ban?s, andCebu had not gone past the planning stage when the Japanese attacked.
Medical Supply Activities on Luzon
The reality of war reached the Philippines on 8 December 1941, with thebombing of Clark Field. The subsequent bombing of Nichols Field and the strafingof the McKinley area made it advisable to move medical personnel and patients tothe vicinity of Manila.
All available hospital supplies in Manila were hastily purchased anddistributed to all points of Luzon. With the order to evacuate Manila on 23December 1941, the Philippine Medical Supply Depot was located near GeneralHospital No. 1 on the Bataan-Mariveles Road, and by 29 December, a subdepot wasestablished at Orion on Bataan, to furnish frontline troops with supplies. Thisdepot was abandoned on 4 January 1942, when it was bombed.
From 23 December 1941 to 1 January 1942, personnel of the Philippine MedicalSupply Depot worked with very little rest. Every vehicle that left Manila forBataan reached its destination. The depot supplied General Hospital No. 2 withnecessary supplies which were supplemented by small shipments from Cebu andIloilo. The demand for quinine, sulfonamides, and vitamins was greater than thesupply.
Medical service in the field was greatly handicapped because of having torely on improvised 1917-type medical chests. Although new field equipment hadbeen ordered and was on the way, none had yet been made available despite theefforts of the department surgeon. There was practically no reserve of medicalsupplies for the Philippine Army units, and there was a serious lack oflaboratory equipment, such as microscopes, needed to help in the fight againstintestinal infections and malaria.
During the Bataan campaign, many Philippine Army units, which had reachedBataan without adequate organizational or individual equipment or withouttraining in the conservation of supplies, suffered unduly from various diseases.During the enemy breakthrough of 20 and 24 January 1942, medical companies losta large portion of their equipment. As the Japanese cut supply routes byinfiltration, serious shortages of litters and blankets occurred. Surgicalequipment became nonexistent. Because of the severe shortage of antimalarialdrugs, a maximum of 8 gm. of quinine was allowed for each case
4This section is based on Cooper, Wibb E.: Medical Department Activities in the Philippines from 1941 to 6 May 1942, and Including Medical Activities in Japanese Prisoner of War Camps. [Official record.]
401
of malaria. Every effort was made to prevent hoarding by unitsupply officers. The problem was somewhat eased by airshipment from Cebu ofsmall amounts of quinine and Atabrine. Unit supply officers were urged tosalvage dressings and bandages and to practice extreme economy in the use of alltypes of medical supplies.
On 30 January 1942, a subdepot was established on Corregidorto hold all supplies and equipment for Bataan above a 6-week level. Supplieswere stored in trenches to safeguard them from shell and bomb fragments and fromstrafing. Flammable materials were buried in pits.
On 8 April 1942, all critical supplies on hand at the mainBataan depot were removed to General Hospital No. 2, located east of GeneralHospital No. 1 on the Mariveles-Cabcaben Road. By evening, an attempt was madeto ship supplies from the Cabcaben dock, but it failed. Supplies finally reachedCorregidor on 9 April.
After the capitulation of Bataan, three shipments of quinine,sulfonamides, and vitamins sent from the south were received by plane andsubmarine. The majority of supplies of the Philippine Medical Supply Depot onCorregidor were stored in the Malinta Tunnel. On 22 April, the depot wasdestroyed by shellfire. Surrender to the Japanese followed on 6 May 1942.
Medical Supply of the Visayan-Mindanao Force
Having established headquarters at Cebu on 27 August 1941, sixAmerican officers established a training program for troops of the PhilippineArmy in the Visayan Islands and Mindanao. The medical service was handled by themedical detachments of the divisions. Before the war, plans were made not onlyto establish a medical base at Cebu with one general hospital, utilizing thefacilities and personnel of the Southern Islands Hospital as a nucleus, but alsoto establish another general hospital at Talisay. The promised equipment of onegeneral hospital was lost in the sinking of the U.S.S. Corregidor inManila Bay.
After combing the islands for medical supplies, it wasdiscovered that there were some drugs available from three wholesale drug housesin Cebu. Fortunately, a large amount of food and medical supplies wasconfiscated from the SS John Lykes docked at Cebu. A large quantity ofquinine tablets was located in the Koronadal Valley Project and in the hospitalof the North Negros Sugar Co., which had just received its semiannualrequisition.
One or two large consignments of quinine were flown in fromAustralia, but were forwarded to Bataan where, at the time, the need wasgreater.
Before surrender came, it became necessary to ration quinineand to use it only for treatment rather than as a preventive measure. Medicalofficers were ordered to discontinue its use as soon as the patient was able toreturn to duty.
402
MEDICAL SUPPLY ACTIVITIES IN AUSTRALIA-1941-42
Early Organization
On 12 December 1941, a convoy led by the cruiser U.S.S. Pensacolawas diverted from its Philippine Islands destination to Brisbane, Australia.Task Force, South Pacific, upon arrival in Brisbane became USFIA (U.S. Forces inAustralia) with Maj. Jesse T. Harper, MC, appointed surgeon. However, 2 weekslater, USFIA became USAFIA (U.S. Army Forces in Australia) with Maj. (later Lt.Col.) George S. Littell, MC, as surgeon.
Changing Mission Concepts
Until the U.S.S. Pensacola convoy was diverted toAustralia, the primary mission assigned to its commander was to get the convoyto the Philippines. It was not contemplated nor planned to station large numbersof U.S. troops in Australia. When USAFIA was established under the command ofMaj. Gen. (later Lt. Gen.) George H. Brett, its mission still was to organize aservice of supply to support the Philippines. The plan contemplated establishingbases in Australia for long-range aircraft operations, however, and GeneralBrett was instructed to make his command predominantly air.
Thus, the early efforts of USAFIA were directed toward theshipment of critically needed supplies-food, drugs, and ammunition-to thePhilippines and toward the preparation of bases for the reception of planes fromthe United States for transshipment to the Philippines. In addition, the generaland special staff sections of Headquarters, USAFIA, were operating the supplyand administrative services for all U.S. Army troops in Australia. By March1942, the strategic pattern in the Pacific Area had changed radically, and themission of USAFIA changed in consequence. There were three objectives under thenew mission concept: (1) to provide administrative and supply service for theU.S. Army troops already in Australia; (2) to deploy these troops strategicallyto meet the threat of enemy invasion; and (3) to plan for long-range buildup ofU.S. Army bases in Australia and for the reception of combat troops, of whichtwo divisions were en route. These threefold objectives continued to be theconcern of USAFIA, and later that of USASOS (U.S. Army Services of Supply),until early 1943.
Early Medical Department Activities
The activities of medical supply are always inextricably boundto those of the other activities of the medical service. Before the middle ofApril 1942, there was not much in the way of a formal medical supplyorganization in Australia. Despite this handicap and the burden of virtuallysingle-handed operation, the Surgeon (first, Major Littell, and then, Col.(later Brig. Gen.) Percy J. Carroll), USAFIA, accomplished much.
403
Before the fall of the Philippines on 6 May 1942, two maintasks were facing the surgeon: (1) The medical care, including hospitalization,for the rapidly increasing number of U.S. Army troops in Australia; and (2) theprocurement of, and shipment of, sorely needed medical supplies to thePhilippines. To these was added, later, the planning for a medical service forthe greatly expanded Australian supply base.
There was only one obvious solution to the task of medicalcare for U.S. Army troops. On 15 January 1942, as a result of a high-levelmeeting with Australian authorities, an agreement was reached for completemedical support, including hospitalization, by the Australians. It wascontemplated that this support would be needed for 3 to 4 months for 25,000 U.S.Army troops. Based on this agreement, U.S. Army medical units as they began toarrive and function would be authorized to requisition medical supplies directlyfrom Australian sources.
Although the immediate problem of hospitalization for U.S.Army troops had been temporarily solved by using Australian facilities, thesurgeon and his small staff continued to expend their energies trying to findsites for the U.S. Army medical units already in the theater and for those onthe way. Existing facilities in Australia to house hospitals of 100 or 200 bedswere just not available, much less for 500 to 1,000 beds. Later, this had amarked impact on medical supply activities because all current designs forhospital assemblages had to be modified.
Medical Organization
Meanwhile, the medical service had undergone parallelorganizational and personnel changes in rapid succession. From the arrival ofthe U.S.S. Pensacola convoy in Australia in December 1941 until 2February 1942, Major Littell, as surgeon, and a few medical officers hadoperated the entire medical service of the theater, including the medical supplyefforts for relief of the Philippines. On 2 February, Major Littell was replacedas Surgeon, USAFIA, by Lt. Col. (later Brig. Gen.) George W. Rice, MC, who hadbeen sent to Australia for this specific assignment by The Surgeon General. On 7February, just 5 days after his assignment, Colonel Rice was in turn replaced byColonel Carroll. The latter had just arrived in Australia after a medicalodyssey during which he had accompanied more than 200 seriously wounded patientsfrom the Philippines on the USAHS Mactan, a creaky Philippine interislandfreighter designated as a hospital ship. Being the ranking medical officer ofthe theater, he was appointed surgeon. The medical merry-go-round came to astandstill, at least temporarily.
After Major Littell, who also served as the surgeon'sexecutive officer, was appointed medical supply officer, he was also designatedcommanding officer of the first medical supply depot established in Australia on14 February 1942. The site of the 9th Medical Supply Depot was a former taxicabgarage in Melbourne (fig. 101).
404
Major Littell and his cohorts had carried on much medical supplyactivity before his appointment as medical supply officer. They had succeeded inrounding up a sizable mass of medical supplies even before the depot wasestablished. Now, they were finally able to assemble these under one roof and toproperly sort, pack, and inventory them. These supplies came from the U.S.S. Pensacolaconvoy, from local procurement, from borrowing from the Australians, andfrom other, sometimes unorthodox, means. For example, an order of the theatercommander enabled the medical supply officer to requisition 600 sorely neededmattresses from the U.S.S. West Point which docked in Melbourne on 6 June1942. Local requirements were also surveyed, and requisitions were submitted tothe United States blindly because neither medical supply catalog nor trainedsupply personnel were available.
Relief for the Philippines
During January, February, and early March 1942, the surgeon andhis staff put in many frustrating hours trying to obtain medical supplies forshipment over the long, tenuous supply lines to the Philippines (map 28).Requisitions for General MacArthur's hard-pressed forces arrived with pitifulregularity. Quantities needed were such as to swamp the capabilities of acountry like Australia with a population of less than 8 million. In addition,the difficulties of running the blockade either by air or by water wereformidable. Nevertheless, some 10 airshipments and 2 water shipments of quinine,
405
MAP 28.-Supply routes to the PhilippineIslands, 1941-42.
morphine, anesthetics, antihelminthics, vitamins, and othervital drugs did get through. Colonel Carroll, a nonsmoker, was infuriated byreports that pilots in trouble were dumping medical supplies rather thancigarettes.
The efforts by the surgeon and his staff to round up thequantities of medical supplies that they did were only short of miracles.Colonel Littell and Maj. (later Col.) John D. Blair, MC, scoured the cities ofMelbourne and Sydney, raided incoming vessels, gathered up distressed cargo,borrowed from the Australians, and purchased locally every bit of medicalsupplies they could find. Then, they personally packed it in boxes, loaded it ontrucks, and drove it to the airfields where they helped transfer it to planes.
In spite of all these efforts, the bottom of the barrel wassoon reached. On 27 February 1942, Colonel Carroll emphasized the severity ofthe situation in his diary: "The medical supply officer is having greattrouble getting together sufficient supplies to fill the radio requisitions fromPLUM [code for Philippines]. The Australians are short and we will have toreplace their
406
depleted stocks as soon as we can get things on theway." With the fall of Bataan on 9 April 1942, virtually all organizedefforts to aid the Philippines came to a tragic end.5
Reorganization of Headquarters
With the arrival of General MacArthur in Australia on 17 March1942, the entire organizational framework was redesigned by the creation of ageneral headquarters with General MacArthur as Supreme Commander, SouthwestPacific Area. Headquarters, USAFIA, now became the overall administrative andsupply headquarters for all U.S. Army Forces in Australia, being in effect atheater headquarters for U.S. troops.6
Arrival of Medical Supply Depot Personnel
On 6 April 1942, the first organized medical supply depotpersonnel arrived in Australia. This consisted of one section of the 4th MedicalSupply Depot (later redesignated the 9th), comprising 3 officers and 42 enlistedmen. The need for trained supply personnel was so acute that this group,pitifully small though it was, had to be shared. Accordingly, it was split intotwo groups. One group, comprising 1 officer and 13 enlisted men, was sent tostaff the depot at Melbourne, and the other, with the remaining personnel, wasassigned to Brisbane where an additional depot was being opened. Because of thecontinued shortage of supply personnel, this latter group was later again split,and an officer and small detachment were sent to open a depot in Townsville (map29).
This section of 45 men, constituting the entire medicalsupply depot organization for the theater for 6 months, operated three depotsefficiently during the buildup and did a superior job under very adversecircumstances. The three officers deserve mention as they continued to serve insupply capacities throughout the duration of the war. Maj. (later Lt. Col.)Arnold J. Woodman, DC, operated the Melbourne depot;Capt. (later Maj.)Leonard H. Kolb, MC, the Brisbane depot; and Maj. Edward T. Wolf, the Townsvilledepot.7
Organization for Medical Supply
On 12 April 1942, a group of 18 officers of the MedicalDepartment including 2 nurses arrived in Australia after a rugged 30-day tripfrom San
5This section on the early developments of medical supply activities in Australia is based on (1) Annual Report, Chief Surgeon, U.S. Army Services of Supply, Southwest Pacific Area, 1942. (2) Diary, Col. Percy J. Carroll, MC, December 1941-30 June 1942. (3) Daily Diary, Medical Service, U.S. Forces in Australia, 10 Dec. 1941-31 July 1942.
6Matloff, Maurice, and Snell, Edwin M.: Strategic Planning for Coalition Warfare, 1941-42, United States Army in World War II. The War Department. Washington: U.S. Government Printing Office, 1953, pp. 169-171.
7(1) See footnote 5, above. (2) Quarterly Reports, 9th Medical Supply Depot, Base Section 7, Southwest Pacific Area, 1 June 1942 through September 1943.
407
MAP 29.-Medical supply depots and basesections in Australia, April 1942.
Francisco on an unescorted Dutch freighter. Among this groupwas Maj. (later Col.) Alfonso M. Libasci, MC, who was trained in depotoperations but had had no staff experience. Only one other officer of the group,Col. Oscar P. Snyder, DC, was Regular Army. The others were newly activatedReserve officers. Major Libasci (fig. 102) was assigned as chief of the Supplyand Fiscal Section, relieving Colonel Littell.
Medical supply objectives-The newly created Supply andFiscal Section of the surgeon's office consisted of a chief and two MedicalAdministrative Corps officers-one of whom served as fiscal officer and theother as procurement officer; a second lieutenant who served as executiveassistant to the chief; and a few clerks. The new chief of medical supply faceda formidable task. Although much had been done by his predecessor and done well,there was still much to be done, little time to do it, and little to work with.Major Libasci brought into the theater in his personal baggage the onlyavailable copy of a medical supply catalog. It was months before additionalcopies were received.8
Theater medical supply plan-On 11 May 1942, just 1month after arriving in the theater, Major Libasci submitted his medical supplyplan for the theater to the Assistant Chief of Staff, G-4. The plan was approvedwith-
8(1) See footnote 5, p. 406. (2) Personal observations of Col. Alphonso M. Libasci, MC, USA (Ret.).
408
out delay and soon became the pattern for other supplyservices. It covered all phases of supply operations, including depot locationsand distribution areas, storage and issue procedures, classification of medicalsupplies, requisitioning procedures, procurement policies, and control of depotstocks.
The depot plan provided for base, intermediate, and advanceddepots. Base depots, planned for the port cities of Sydney, Brisbane, Townsville,and Adelaide, would ship to intermediate and advanced depots located in remoteareas. All medical supply depots were designated as branch depots under thetechnical control of the surgeon. This authority, given by G-4 with extremereluctance after a tough battle, was an essential requirement.
The supply plan delineated requisitioning procedures andclarified once and for all the existing confusion in connection with theclassification of medical supplies. There seemed to be universal confusionbetween the medical supply catalog classification into classes 1-9 and the G-4classification into classes I-IV. As a result, supply personnel had erroneouslysubmitted requisitions for medical class 4 supplies instead of G-4 class IV.This resulted in great shortages later.
Class I supplies were shipped to Australia from the UnitedStates without requisition in the form of medical maintenance units, each unitcomprising
409
a 30-day supply for 10,000 troops. The plan provided forreception of these medical maintenance units at the port depots, which, in turn,would automatically feed the intermediate and advanced depots. Medical units, inturn, could requisition only the items on the medical maintenance unit listinitially until stocks of other items arrived in the theater. The catalogcontained a mimeographed list of medical maintenance unit items.
Class II supplies were obtained by requisition from theUnited States, in quantities based on consolidated monthly reports of shortagesin unit assemblages reported by medical organizations as they arrived and wereset up in the theater. These supplies were issued to the medical units reportingsuch shortages in unit assemblages without requisition.
Class III supplies were fuels and lubricants.
Class IV supplies were those items that did not fall into anyof the other categories and later constituted the bulk of all medical items.These were to be obtained from the United States on a requisitioning basis andwere issued to units on a monthly requisitioning basis.
Other provisions of the plan outlined supply and storageprocedures in depots and base sections, inventory control methods, monthlyinventory reports for the medical supply officer, and so on. This basic planintegrated the entire medical supply effort and laid the foundation for futurepolicies and expansion.9
Medical supply progress-Great strides were made inmedical supply during the first few months. All assets were inventoried andconsolidated, and central stock records were established for the theater as wellas for each depot. Requirements of all classes were computed, and requisitionsbased on projected troop strength were prepared and forwarded to the UnitedStates. Procurement in Australia was thoroughly surveyed and coordinated throughthe appropriate Australian departments. Supply depot personnel needs weredetermined and requisitions prepared and submitted.
By June 1942, there was a medical supply depot in each activebase section and each had at least a 30-day level of class I supplies (medicalmaintenance unit items). Table of basic allowance items of class II suppliesalso had begun to arrive, so that by the end of the month, unit assemblages were92 percent complete. Stray shipments, coded boxes, distressed cargo, and soforth were sorted, repacked, inventoried, and placed in stock for issue.Supplies began to arrive from the United States in quantity, and medical supplybecame a going concern. But, at this stage, austerity prevailed because all thatwas available for issue were items received to provide for table of basicallowance shortages or medical maintenance unit items.
During late June 1942, the Australians proposed a merger ofmedical supply stocks into jointly operated and stocked medical depots, but analter-
9(1) Letter, Maj. A. M. Libasci, MC, to Assistant Chief of Staff, G-4, 11 May 1942, subject: Medical Supply Plan for Australia. (2) Letters, Colonel Libasci, to Colonel Tyng, dated 5 and 31 May and 2 July 1942, respectively. [This summary was presumably made at a later date since Major Libasci is consistently referred to as Colonel-a rank he did not attain until early in 1944.]
410
native proposal to permit reciprocal emergency requisitioningupon each other's depots was accepted. This system worked well throughout thewar.
On 20 July 1942, Headquarters, USASOS, was created and USAFIAwas inactivated. This was actually nothing more than a change in name; allexisting functions and directives remained the same.
Also, on 8 July 1942, the medical supply service was dealt abitter and almost disastrous blow. The freighter SS Rufus King carryingthe assemblages for nine station and three general hospitals-totaling 4,000beds (17,200 boxes)-broke up on the barrier reef just outside of BrisbaneHarbor. Early reports indicated that the ship had broken in half and that,although each half was afloat, the high seas made salvage operations impossible(fig. 103).
Fortunately, the seas subsided, and an Australian salvagecrew of more than 200 men aided by U.S. Army Medical Department personnel wentto work. Thanks to the skillful and daring efforts of these men more than 85percent of the supplies aboard were salvaged. Much credit for this feat is alsodue to the personnel of the Brisbane medical supply depot who worked long hoursrehabilitating the wet and damaged equipment. Had this salvage operation failed,it would probably have taken months to get replacements. Meanwhile, medical carewould have been hampered as medical personnel waited idly in Australia for theirassemblages.
During this early period, there was an incessant demand fromU.S. troops for vitamins to supplement the inadequate ration, especially inremote areas. Eventually, it became impossible to satisfy requests. It waspointed out to the command that vitamins were not a substitute for food and thatefforts must
411
be made to improve the ration. After much pressure, thisunderstanding was finally accepted.10
BUILDUP IN AUSTRALIA
After 5 months of uninterrupted victories, the enemy suffered asevere blow on 8 May 1942 in the Battle of the Coral Sea. As a result, enemystrategy was changed from heavy, overwhelming strikes to piecemeal efforts togain footholds in New Guinea, the Solomons, and New Hebrides and thus to isolateAustralia.
The U.S. strategy during the first year was purely defensiveand consisted of trying to stop the advances wherever the Japanese attacked.During this first year, the major effort was directed at buildup of the base inAustralia.
Base Section Organization
Because of the rural nature of the Australian mainland, it wasdecided early that decentralization of supplies would be necessary. Accordingly,the continent was divided into base sections roughly corresponding to the sixStates of Australia, except for the State of Queensland where two base sectionswere established because of its size and importance. At the height of thebuildup, there were seven Australian base sections in all, with headquarters inMelbourne, Sydney, Perth, Adelaide, Darwin, Brisbane, and Townsville (map 29).
The missions of the base sections were as follows: (1) Tooperate a service command for the administration of the several base sections,ports, and camps; (2) to receive and assemble all U.S. Army troops, supplies,and equipment arriving in Australia; and (3) to perform such services of supplyand administrative functions for combat troops as would enable them to movefreely and with a minimum of delay.
Base section commanders were charged with the responsibilityfor providing administration, quarters, supplies, hospitalization, andevacuation for all U.S. Army troops arriving in, or assigned to, theirrespective areas. To accomplish this, they were provided with complete staffs,including, of course, base section surgeons.
Early in this organization, a controversy occurred in regardto the degree of control which the base section commanders exercised over theoperations of the technical sections of their staffs. It was finally agreed thatbase section commanders would not interfere with technical operationalinstructions issued by the chiefs of services to their respective staff officersin the base sections.
10(1) Letter, Col. Lester S. Ostrander, AGD, Adjutant General, Office of the Commanding General, Headquarters, U.S. Army Forces in Australia, to Commanding Officer, Base Section No. 1, 30 May 1942, subject: Inventories of Medical Equipment in Base Sections. (2) Letter, Maj. A. M. Libasci, MC, to Base Section Surgeon, Base Section 4, 22 June 1942, subject: Instructions Reference Requisitioning of Medical Supplies. (3) Check Sheet, Chief of Medical Supply Section, Office of the Chief Surgeon, Headquarters, U.S. Army Forces in Australia, to G-4, Warehousing and Distribution Section, 19 June 1942, subject: Medical Supply Depots Operating in Australia. (4) See footnote 5, p. 406.
412
This assured the surgeon complete control of theater stockswherever they were stored.
As the military situation crystallized, the base sectionsassumed roles of varying importance. It became obvious that the most ideal sitesfor staging of troops, for hospitals, and for depots were near the large portcities of Melbourne, Sydney, Brisbane, and Townsville on the east coast.Accordingly, base sections in south and west Australia never reached large sizenor importance and were inactivated early. Similarly, Base Section 1 withheadquarters in the Darwin area, although strategically important, was neverbuilt up because of its extreme inaccessibility over large expanses of wastedesert with poor roads.
The surgeon of each base section organized his staff alongfunctional lines. As the base sections grew in size so did the functionsassigned and staff required. The larger bases in Melbourne, Sydney, and Brisbanehad individual officers in charge of personnel, supply, hospitalization,evacuation, nursing, dental, and veterinary activities, in addition to thesurgeon and a deputy or executive officer. Professional consultants were notavailable at this stage of organization.11
Medical Supply Organization
The original medical supply plan provided for a base medicalsupply depot at each of the six main port cities of Melbourne, Sydney, Brisbane,Townsville, Perth, and Adelaide. These depots were to ship to intermediatedepots farther inland, which in turn were to supply advance depots or dumps.This decentralization was deemed necessary because of the totally inadequaterail and road net. It had the further advantage of dispersing stocks so thatloss to the enemy of one or all of these ports would still leave reservesavailable elsewhere. Because of later developments, depots were not establishedin each base section. During the buildup in Australia, the important medicalsupply depots were located in Melbourne, Sydney, Brisbane, and Townsville.
In addition to personnel of the 9th Medical Supply Depot, amedical supply officer was on the staff of each base section surgeon. These wereusually officers of the Medical Corps. Their job was to edit stationrequisitions, issue supply instructions, coordinate all medical supplyactivities, work in liaison with the medical supply depot, aid the medical unitsto eliminate shortages, and render all assistance possible. The base sectionsupply officers worked directly with the theater medical supply officer andimplemented his policies and directives. Almost without exception, theseuntrained officers did a superior job as supply officers.12
Medical Supply Problems During Buildup
The first automatic shipments in the form of medicalmaintenance units were most useful. However, 6 months later, they had outlivedtheir usefulness
11(1) Medical Department, United States Army, Organization and Administration in World War II. Washington: U.S. Government Printing Office, 1963, pp. 410-431. (2) Memorandum, Col. William L. Wilson, MC, for General Kirk [TSG], 20 Oct. 1943.
12See footnote 9(2), p. 409.
413
as a sole means of support for theater stocks. The concept ofautomatic shipments is good (1) if shipments can be complete with no shortagesand (2) if replacement factors are carefully and continuously adjusted so thatexcesses and shortages do not develop. In the Southwest Pacific Area, neither ofthese two conditions prevailed, and the result was not good.13
In the first 6 months of operation, the average medicalmaintenance unit received was rarely more than 50 percent complete. Shortages,obviously, consisted of those items difficult to procure in quantity to meetdemands and were always the same items. Almost as bad were the overages thataccrued.
During the first few months of the medical buildup, one ofthe most frustrating problems was that of table of basic allowance shortages.Medical units were being sent overseas with their table of basic allowanceassemblages only 50 to 65 percent complete. The Zone of Interior medical depotsbackordered the shortages to the units, and as the depots received stocks, codedshipments were made piecemeal to the overseas units. Items were packed inbroken-lot boxes, making distribution cumbersome.
The 41st and 32d Infantry Divisions, the first divisions toarrive in Australia, had medical equipment which was not well suited for use injungle warfare. The substitutive equipment program involved some modification ofthe medical equipment for these divisions so that it could be used in theTropics. The experience of Dutch officers who had served many years in theTropics was invaluable in this matter.
Division surgeons redesigned their medical units for moreeffective utilization in the Tropics. Requisitions were submitted to the medicalsupply officer who consolidated them and forwarded them to the Zone of Interiorfor action. Special drugs and items needed to combat jungle diseases wereincluded. A few items were procured locally. This program took months forsuccessful completion. Mainly, the changes made the equipment more easilyportable and waterproof.
Practically all TOE medical units had to be redesigned foruse in the Southwest Pacific Area. Fixed hospitals of more than 200 beds wereimpossible to house in any available existing buildings. The 750-bed evacuationhospital was too large to deploy or transport and had to be broken down intothree units of 250 beds each. The medical regiment of World War I, designed tosupport a square division, had to be completely reorganized.
All this changing of design necessitated much swapping andrequisitioning of equipment and supplies. The program was extremely important asunits could not operate in many instances until they were reorganized. In spiteof exploiting all available local resources, in most instances, equipment had tobe obtained from the United States.
In addition to the alteration of existing TOE medical units,new types were adapted for use in this unusual theater. The first of these was a100-bed
13This section is based on a narrative account of medical supply activities in the Southwest Pacific Area prepared for a preliminary draft of this volume by Col. Alphonso M. Libasci, MC, USA (Ret.).
414
mobile station hospital. In early 1942, the enemy was makingsuch rapid advances in the islands north of Australia that it was feared thatthe continent of Australia would be invaded. If so, war would be fought in wideopen country where mobility would be of prime importance. The medical servicehad nothing to meet this threat. The 750-bed evacuation hospital required 27Australian freight cars to move, necessitating two trains. Obviously, somethingelse was needed. Thus, work was begun early in 1942 on a mobile hospital withvan units mounted on truck chasses. The unit was to function as a stationhospital, using ward tents, but was capable of moving over open country ifnecessary. If buildings were available, it could function as a fixed hospital.14
Much time and effort were devoted to this project. However,progress was slow, and by the time the mobile hospital was ready, the need nolonger existed. Australia was never invaded, and the unit was never used assuch. Its use in New Guinea was out of the question because of the lack ofroads. However, the project was not a total loss as some of the functional vanswere later used in New Guinea as fixed units; for example, laundry, generator,and sterilizing units, but on a very limited basis.
The other type of hospital specifically designed for theneeds of the theater was the portable surgical hospital. This unit, born ofnecessity, was designed to fill the need for definitive surgery as close to thefront as possible. Hand carries of even less than a mile to airstrip evacuationpoints over jungle trails were hazardous, time consuming, and often fatal to theseriously wounded (fig. 104).
General Carroll fathered the entire idea of the portablesurgical hospital. As originally conceived by him and his professional staff, itwould be a hospital that could be carried on the backs of men. When GeneralCarroll first described his ideas, most of the staff were not ready for such aradical and hitherto unheard of concept as carrying a hospital on the backs ofits operators! Ultimately, it was designed so that the personnel of 3 officersand 25 enlisted men actually carried the entire hospital on their backs or onlitters. The men were handpicked from among the finest and best conditioned inthe theater medical services.
Of these units, 36 were assembled from resources within thetheater by (1) levying on the larger hospitals both for personnel and forequipment and (2) procuring available items locally. The portable surgicalhospitals were an unqualified success in the New Guinea jungles. Later, theconcept of total portability was modified and more equipment was added. Theywere used very effectively in amphibious operations and by the Air Forces tomove to remote areas to provide hospitalization.
During early 1942, it was decided to design a so-calledjungle kit to be issued to each individual soldier. As finally developed, thiskit consisted of a small pouch to be carried on the belt. Components varied fromtime to time,
14A more detailed discussion will be found in Daboll, Warren W.: The Medical Department. The Medical Services in the Asiatic Theater. United States Army in World War II. The Technical Services. (In preparation.]
415
but they basically consisted of antimalarials, waterpurification tablets, salt tablets, skin disinfectant, insect repellant,vitamins, and so forth. After the kit had been designed and tried,specifications were sent to the United States for its manufacture andprocurement in large numbers. The jungle kit was useful and became a standarditem of issue (fig. 105).
Jeep litter brackets were developed to adapt jeeps to carrythree litters to displace long hand carries. These were extremely useful inforward areas where trails existed. As in all other local procurement endeavors,the Australian military and civilian authorities cooperated fully. Along thesesame lines
416
when the threat of enemy invasion was real, plans had been madeto convert existing civilian van-type trucks and buses to carry litters. Again,special brackets were designed.
It became obvious quite early in the war that it was poorlogic to use glaring white dressings in the jungle where all else was socarefully camouflaged. Accordingly, recommendations concerning the feasibilityof dyeing a certain percentage of dressings jungle green were forwarded to theUnited States. Eventually, the recommendation was accepted. However, thedressings were dyed olive drab instead of green.
When equipment for the portable surgical hospitals was beingdesigned, it was found that the U.S. Army forces had nothing that could be usedfor a lightweight, portable field sterilizer. The Australians had a small,aluminum, pressure-cooker-type sterilizer weighing 30 pounds with special 9-inchdrums that just suited the purpose. This was adopted and procured in quantity.In addition, to obviate the necessity for sterilized dressings in the field inadvance areas, dressings were furnished already sterile and sealed in tinplateddisposable drums. Three types were available: Basic operating unit, dressings,and gowns. The drums once opened were used as containers in the forward areas.
The weight of the standard litters precluded their use in theportable surgical hospitals. The first such hospitals carried lightweight polesand spreader bars that could be fitted into the loops of cot canvases. Thislitter weighed 11
417
pounds complete. Later, sleeves of light canvas, measuring 24inches in diameter and 84 inches in length with double seams and mattresscovers, narrowed by a seam to a width of 24 inches, were fitted over cut polesof various sizes. These were tried and found practical.
The requirements of the theater for lightness, protectionagainst moisture, and ease of portability were never fully met by the Zone ofInterior. Much repacking was done in the theater for supplies sent to NewGuinea. Many solutions, drugs, and dressings (other than those in waxedcontainers) were repacked in salvaged cans obtained from hospital pharmacies.The supply of good containers with tight-fitting tops was limited in Australia.Rectangular cans with hinged tops of 1- and 2-quart size and of coated, painted,heavy steelplate were designed and purchased in quantity. Plastic containerswould have been ideal. The Japanese used plastic extensively.
The standard Zone of Interior medical maintenance unit wasnot adaptable for use either in Australia or in New Guinea; therefore, extensivemodifications were made within the theater. The modified medical maintenanceunit was streamlined to a weight of 7 to 9 tons, instead of the original 15 to20 tons. The unit was stripped of most nonmedical items such as housekeepingitems-mops, brooms, kitchenware, wax, and so forth-of all dental andveterinary instruments, and of most laboratory glassware. The unit was alsomodified quantitatively, using actual theater experience for maintenancefactors.
Medical Supply in New Guinea
The establishment of U.S. Army bases in New Guinea, essentialbecause of its strategic location as a jumping-off place for offensive actionagainst Japan, was a slow and painful process. At times, the postcombat buildupwas even more frustrating than the acquisition had been. The first U.S. Armytroops arrived on 28 April 1942. Within a year, the organizational structureincluded the U.S. Advance Base at Port Moresby, with subbases at Milne Bay, OroBay, and Goodenough Island (map 30).
The medical supply organization in New Guinea paralleled thaton the mainland of Australia. Each base surgeon was provided with a medicalsupply officer who had to be an aggressive provider of equipment needed byhospital units to fill out their table of basic allowance shortages and providesuch equipment as lanterns, generators, and ice cream making machines. Forapproximately the first year, supply to New Guinea was from Australia. Lateralsupply within New Guinea was nonexistent except by a few fast supply boats (fig.106). As a result, once supplies were dumped into a base port, they remained inthat base indefinitely if not used. Thus, it was extremely important that theinitial distribution be made accurately and reliably. Needless to say, this ideawas never achieved.
Regularly scheduled runs from Australia were out of thequestion. Medical supplies were loaded on whatever ships became available andwhenever space was allotted. On such a catch-as-catch-can basis, things indeedwould
418
MAP 30.-Bases in Papua, New Guinea, 1942-43.
have reached a sorry state had it not been for the twoexpedients aggressively followed through: (1) A very liberal interpretation ofday level and (2) the use of regularly scheduled runs of the intratheaterhospital ships to carry cargo forward on return trips to New Guinea.
It became obvious early in the development of the New Guineabases that the authorized 30-day levels and later 60-day levels of supply wouldnot be adequate in the face of the shipping uncertainties. Therefore, it wasdecided to raise these levels as it would not involve very large shippingtonnages or warehouse space. Accordingly, more realistic levels were set up, andconditions improved materially.15
Early Medical Supply Facilities in Port Moresby
Storage facilities at Port Moresby were practically nonexistentbefore January 1943. The medical supply depot occupied several small buildingson Ela Beach, the principal dock area 1 mile from the downtown headquarters. Twoof these buildings were used for storage and loose-issue operations. Althoughthere were no space, tonnage, or occupancy reports at that time, it wasestimated that the total gross space was no more than 4,000 square feet withapproximately 80 tons of medical supplies on hand. Any excess amounts ofsupplies were covered by tarpaulins in open storage.
15(1) U.S. Army Services of Supply Bases in New Guinea. [Official record.] (2) Memorandum, Col. William L. Wilson, MC, Lt. Col. Charles G. Gruber, SnC, and Maj. Tolbert H. Belcher, MAC, for Commanding General, U.S. Army Services of Supply, Southwest Pacific Area, through the Surgeon, 27 Sept. 1943, subject: Determination of Maintenance Factors and Rates of Consumption and Expenditures.
419
FIGURE 106.-Troops loading on an Australiancorvette for transfer to New Guinea.
Security storage was, by necessity, improvised. Ethyl alcoholand whisky were stored in a small, detached building of not more than 200 squarefeet. Original packs of narcotics and other security-type items were stored inan old Army field safe. Refrigerated storage consisted of three or fourkerosene-operated refrigerators of the regular household type.
The receiving operations were always accomplished in an openarea. Large shipments, if delivered from dockside at a rate which would permittally-in as received, had to be stored in the open until the receiving crewcould segregate the items and remove them to storage. Shortage of personnel andlack of adequate facilities often caused supplies to be merely offloaded andstacked to contain the entire shipment within available space.16
Early Medical Supply Depot Operation
The 3d Medical Supply Depot, commanded by Maj. (later Col.)Stephen G. Asbill, VC, with all of its organizational equipment arrived atBrisbane (p. 406) in December 1942 (fig. 107). Less than 1 month after its
16Quarterly Reports, Headquarters, Office of the Surgeon, U.S. Advanced Base [New Guinea], 1 Oct. 1942-31 Mar. 1943.
420
FIGURE 107.-Interior view of a medical supplywarehouse in Brisbane, Australia.
arrival in the theater, the 1st Storage and Issue Platoon,comprising 3 officers and 42 enlisted men, sailed for Port Moresby. Uponarriving on 8 January 1943, it relieved a small detachment of the 9th MedicalSupply Depot which had been operating in support of combat elements.
A plan to further deploy the 1st Storage and Issue Platoon bysending one officer and five enlisted men to set up a supply point at Milne Bayand another officer and five enlisted men to do the same at Oro Bay caused asplit in the platoon which had been formed to operate as a unit. After a trialperiod at both Milne Bay and Oro Bay, it became apparent that more personnel andequipment were needed to operate effectively.17
MEDICAL SUPPLY IN THE SOUTH PACIFIC
Organization and Purpose
To protect the lines of communication to New Zealand andAustralia and to prepare a counteroffensive against the Japanese forces, Armygarrisons were established shortly after the Pearl Harbor attack at Auckland,New Zealand; New Caledonia; Efate, Esp?ritu Santo, and Fijis in the New
17Annual Reports, 3d Medical Depot Company, 1943-44.
421
Hebrides Islands; Tongatabu in the Tonga Islands; Bora Bora;and Tongareva and Aitutaki in the Cook Islands. The South Pacific Area wasorganized in April 1942, and by July, more than 60,000 troops were in thecommand.
Estimate of the Situation
Lacking firsthand information on conditions in the area, Maj.Gen. (later Lt. Gen.) Millard F. Harmon, commanding general of all U.S. ArmyForces in the South Pacific Area, and several officers had made frequent tripsnorthward to Esp?ritu Santo and to Guadalcanal in the Solomons to inspect atclose range the installations there. Everywhere he went, General Harmon wasstruck with the shortages in materiel and the inadequacy of facilities. BothGeneral Harmon and Brig. Gen. (later Maj. Gen.) Robert G. Breene, AssistantChief of Staff for Supply and Evacuation, G-4, realized the many problems inmaintaining a steady flow of men and materiel into the area because of the manywidely separated island bases.
One of the most serious problems was the shortage ofshipping. Unlike a continental theater of operations with debarkationfacilities, road nets, and railways, the South Pacific Area, except for NewZealand, had almost no communications or industrial development. In the entirearea, only Auckland and Suva in the Fijis had usable terminal installations, andof these, only Auckland could be considered adequate.
Before bases could accommodate large shipments of eithertroops or supplies, it was necessary to construct harbor and dock facilities.Many islands possessed only the most primitive facilities, or none at all.Roads, warehouses, and storage space so necessary to the operation of a largesupply base were nonexistent. To aggravate this situation, there was a notablelack of service personnel of all branches to handle specialized equipment. Theoriginal task forces that were hurriedly sent to the South Pacific Areacontained a disproportionately high percentage of combat troops who had to beutilized to effect minimum logistical support at each base. This shortage ofservice elements prevented the construction of adequate facilities for thehandling and safeguarding of supplies and resulted in a high degree of waste.
Services of Supply Established
Under normal conditions, the command control of supply of theU.S. Army Forces in the South Pacific Area probably could have been handledthrough the medium of a G-4 section in General Harmon's headquarters. With thegeographic peculiarities of the area and the necessity for close integrationwith U.S. Navy and Allied supply agencies, however, it was determined that adifferent type of organization would be required. General Harmon believed thatit would have to be large in size, highly executive in character, and headed bya general officer directly under his own command. After studying many planssubmitted by his staff, General Harmon established, on 10 November
422
1942, Headquarters, SOSSPA (Services of Supply, South PacificArea), with General Breene commanding. The original intention of the WarDepartment was to establish the headquarters for the U.S. Army Forces of theSouth Pacific Area in Auckland. General Harmon, however, chose to locate hisadvance echelon at Noum?a, New Caledonia, to be close to the scene ofoperations and the theater commander.
Initial Problems in Medical Supply
No table of organization medical supply units were sent tothe South Pacific Area during the first year of the war, and no officer trainedin medical supply was assigned to the staff of the Chief Surgeon, Col. (laterBrig. Gen.) Earl Maxwell, MC, USAF. Shortly before Headquarters, SOSSPA, wasorganized in Auckland, 1st Lt. (later Lt. Col.) Joseph C. Thompson, MAC, wastransferred from the 43d Infantry Division to Headquarters, USAFISPA (U.S. ArmyForces in the South Pacific Area), and assigned duties as the theater medicalsupply officer. At the time that the headquarters moved from Auckland to Noum?asome 45 days later, the medical supply staff in the surgeon's office consistedof Lieutenant Thompson and one sergeant; all files of this office were carriedin one briefcase. Nevertheless, this organization immediately took steps toorganize an orderly system. In the absence of table of organization supplyunits, provisional units were organized at Noum?a, Efate, and Suva by drawingpersonnel from medical units at these bases. Smaller provisional supplydetachments were established at Esp?ritu Santo and Auckland map (31). The firstmission of these provisional units was to call in all medical supplies(principally medical maintenance units) in the hands of the various task forcesto establish central medical depots.
With the exception of Auckland, Noum?a, and Suva, warehousesor other storage facilities were nonexistent, and storage of supplies wasnecessarily in tentage or in open storage covered by salvaged tents or whatevercanvas was available. Because of high humidity and exceedingly heavy rainfall,supplies at many bases were lost or deteriorated beyond use as a result of thislack of proper storage facilities. Labels became unreadable or fell off thecontainers entirely, leaving no choice but to destroy the contents. Metalcomponents of equipment became rusted or corroded, and fungus grew on certainoptical items.
Inexperienced supply personnel assembled from other unitsfrequently distorted the supply levels available at each base. All basesreceived medical maintenance units and, in general, were able to maintainadequate supply levels. Drugs for the most part were available although falseindications of shortages existed in certain bases due to the personalpreferences of many medical officers who were not accustomed to usingsubstitutes. There were, however, some items of special benefit in this areawhich were left out of the medical maintenance units or were included ininadequate quantities. This was especially noticeable in the many vitaminproducts and in most of the newer sulfanilamides, but to a lesser degree in thearsenicals. Clinic equipment, such as instru-
423
MAP 31.-South Pacific supply points, 1942.
424
ments for the eyes, ears, nose, and throat, and replacementsof surgical equipment were very short. Special technical equipment such asmicroscopes and ophthalmoscopes was not sufficiently plentiful in the earlystages.
Few of the medical organizations shipped to the South PacificArea were able to function without changes in their organization and equipment.The very nature of the theater-numerous small islands widely separated fromeach other and varying in climate from the Temperate Zone of New Zealand to thetropical areas of the Solomon Islands-made these changes mandatory. Revisionsvarying from minor items in some units to almost complete reorganization inothers were necessary. In many instances, a hospital would be the only medicalcomplement in a task force isolated by hundreds of miles. It, therefore, becamenecessary for this hospital to function as a collecting company, a clearingcompany, a general hospital, and, in some instances, as the task force surgeon'soffice. The most serious handicap in this situation was the lack of adequateequipment. Many times, evacuation hospitals were required to function as stationor general hospitals, and medical field units such as battalions or regimentswere forced to operate hospitals. This required provisional reorganization andequipping of these units.
To compound these problems, units arrived in the area withoutparts of their essential table of basic allowance equipment while many itemswere lost on the docks or beaches due to limited control of unloadingfacilities. If an item was hauled to the wrong unit, there was little or nochance of subsequently locating it. The small medical depots established on thevarious islands did not have sufficient stock or, in many cases, no stock at allof the items necessary to replace shortages. Other difficulties were encounteredwhen the equipment was placed on different ships than the personnel. Many times,the personnel were diverted to one island and the equipment arrived at another;due to lack of intratheater shipping, the final marrying-up of the unit and itsequipment sometimes was never accomplished.
Among the first medical supply installations to arrive inthis theater was one section of the advance depot platoon of the 10th MedicalSupply Depot. This organization originally arrived in Auckland on 22 November1942 and was soon transferred to Esp?ritu Santo. One section of the advancedepot platoon of the 17th Medical Supply Depot was activated on New Caledoniafrom personnel available within the command (fig. 108). A small detachmentdesignated as Medical Detachment No. 1 (Supply) was established at Suva. Thesewere the only officially organized supply units located in this theater in theinitial phase of its operation.
Medical Supply Levels
The supply facilities on Fiji, New Caledonia, and Efate, aswell as the smaller supply points at Esp?ritu Santo and Auckland, werereceiving automatic medical maintenance units and were able to maintain theirsupply levels between 100 and 200 days. Frequently, these levels varied becauseunits which
425
FIGURE 108.-U.S. Army medical supply depot inNew Caledonia, 1942.
had lost all their equipment had to be resupplied. Also, it washard to calculate exact supply levels because of certain shortages and excesses.18
Stock Control
The geographic conditions peculiar to the South Pacific Area andthe shortage of supervisory personnel in the headquarters element required thatdecentralization be the keynote for medical supply in the area. The advantage ofcentrally located issuing points was recognized, but their establishment in thistheater was clearly impracticable because of the chronic shortage of personneland intratheater shipping at the outset. As a result, until January 1944, mostsupplies were shipped in the form of medical maintenance units from the SanFrancisco Port of Embarkation directly to the island where they would beconsumed. Requisitions were transmitted to the
18(1) See footnotes 2(3), p. 397; and 14, p. 414. (2) Annual Report, Surgeon, South Pacific Area, 1942.
426
port for items not contained in the medical maintenance unitsor for inadequate quantities in them.
Because of the widely separated island bases and shortage oftransportation, frequent inspection trips for supervision by Headquarters,SOSSPA, were not possible. Therefore, all depots were placed under theadministrative control of the island base, and in many cases, each island basehad different ideas concerning the control of these supply installations. On oneof the infrequent inspection trips, however, Captain Thompson noticed that, inaddition to some shortages, excesses were accumulating on certain items in themedical maintenance unit. For example, on Guadalcanal, the supplies of bloodplasma, intravenous fluids, morphine Syrettes, and antidiarrheal drugs wereinadequate while cotton, glycerin, castor oil, ether, ammoniated mercury, andsalicylic acid had built up huge excesses.
Trips to the other island bases in this area confirmed thatcertain items supplied in the medical maintenance unit were accumulating largeexcesses, but the filing of reports proved an inadequate remedy. Afterconsiderable correspondence between the theater, the San Francisco Port ofEmbarkation, and the Surgeon General's Office, only token relief was received,and some excesses continued to accumulate.
The smaller and more eastern islands of the South PacificArea (Tongareva, Bora Bora, Aitutaki, and Tongatabu) were placed on arequisition basis in 1943. This was at the suggestion of the San Francisco Portof Embarkation because these islands were occupied by only one medicalinstallation and usually small task forces, and it was unsatisfactory to supplythem through the medium of fractions of a medical maintenance unit.19
Optical Activities
In the fall of 1942, one of the major medical supply problems ofthe South Pacific Area was that of replacement and fabrication of spectacles.Generally, prescriptions for spectacles were received at the medical supplysection of the surgeon's office, Headquarters, SOSSPA, and forwarded directlyto the Joint Purchasing Board in New Zealand, where arrangements had been madefor the fabrication of spectacles by civilian facilities. It soon became evidentthat the demand far exceeded the New Zealand capability and that optical-repairsections of medical supply depots were needed in the South Pacific Area.
The first such unit was the optical-repair section of theincomplete 17th Medical Supply Depot in New Caledonia. This unit was establishedlate in 1942 from personnel available to the command. Through the cooperation ofG-1 Division, Personnel, War Department General Staff, records of many unitswere screened, and men with optician's background were located. Anoncommissioned officer who was a bandsman assigned to one of the bands
19Essential Technical Medical Data, South Pacific Area, U.S. Army, initial report, dated 17 Sept. 1943.
427
in the Americal Division was found by this survey. It wassoon discovered that he possessed an ideal background in optical repair andfabrication and was subsequently commissioned a second lieutenant in the MedicalAdministrative Corps, becoming the first optical-repair officer in the SouthPacific Area. The depot, its equipment augmented by a spherical surfacer, wassoon repairing or fabricating an average of 800 pairs of spectacles each month.
The base platoon of the 11th Medical Supply Depot whicharrived in the theater in August 1943 included the personnel but not theequipment of an optical-repair section. When the platoon rejoined its parentunit in the European theater, these personnel were utilized to augment thealready existing optical-repair shop, and additional equipment wasrequisitioned. When the equipment arrived, however, it was shipped toGuadalcanal, and personnel were transferred there to operate an optical-repairshop.20
Maintenance and RepairBefore the arrival of the base platoon of the 11th MedicalSupply Depot, there were no maintenance and repair facilities within the theaterother than those organized provisionally on various island bases. For the firsttime, two trained enlisted instrument repairmen were available for utilization.However, lack of spare parts, particularly for sterilizers and X-ray equipment,greatly limited their utilization.
The lack of intratheater shipping also limited the ability toreturn items to this one source for repair, and many times, it was morepracticable to send repairmen to a forward base than to return the equipment tothe depot.21
MEDICAL SUPPLY ACTIVITIES IN ALASKA DURING THE DEFENSEPERIOD
Prewar Expansion of U.S. Forces
Early in 1940, the strategic significance of Alaska22was recognized, and by late June, additional troops were dispatched toFort Richardson, near Anchorage. The 1940 augmentation consisted of onebattalion of infantry, a field artillery battery, an engineer company, aquartermaster detachment, and an ordnance detachment. Medical support came from10 enlisted men who comprised the medical detachment of the 4th InfantryDivision and 20 enlisted men from Fort Missoula, Mont., and Letterman GeneralHospital, San Francisco. Three Medical Corps officers and one Dental Corpsofficer had been scheduled to accompany the group, but only the dental officerreceived orders
20See footnote 17, p. 420.
21Essential Technical Medical Data, South Pacific Area, U.S. Army, for February 1944, dated 7 Mar. 1944.
22This section on medical supply activities in Alaska during the defense period is based on McNeil, Gordon H.: History of the Medical Department in Alaska in World War II (1946). [Official record.]
428
in time to get to Seattle, Wash., for the embarkation.Consequently, several hours before personnel boarded ship, a medical officer onduty at the station hospital at Fort Lewis, Wash., was given verbal orders,later confirmed in writing, to proceed to Alaska with the movement; afterpacking a few personal effects, he joined the medical detachment as its surgeon.Medical supplies and equipment consisted of the following Medical Departmentchests: Two No. 1, one No. 2, one No. 4, and one No. 60 (dental), together withlitters, blankets, and special drugs and supplies.
Organization of Medical Supply Following Pearl Harbor
The medical service of the Alaska Defense Command was organizedon 12 December 1941, following the appointment of Lt. Col. (later Col.) LutherR. Moore, MC, as surgeon. The echelons of medical supply in the Alaskan theateroriginally were, as follows: Unit supply officer, post medical supply officer,and the Overseas Supply Branch, Seattle Port of Embarkation. From the SeattlePort of Embarkation or the Prince Rupert Sub-Port of Embarkation, Prince Rupert,Alaska, units arriving in the theater usually landed fully equipped withsupplies for the initial period, plus additions for a special tacticalsituation. At each station, the post medical supply officer also served as thestation hospital medical supply officer. Most items were furnished automaticallyby the medical maintenance unit. Those authorized items not included wererequisitioned directly from the Seattle Port of Embarkation.
Storage of Medical Supplies
The provision of adequate storage facilities was essentialbecause of the climatic conditions. Much loss was sustained at Adak (map 32),where large amounts of supplies were dumped on the wet ground and exposed to theelements because of a lack of storage space. It was often necessary to storemedical supplies in tents, which proved unsatisfactory because of wind, rain,and snow.
Once initial construction was completed at new stations,adequate warehouse space became available. Storehouses were generallyconstructed of wood, either as part of the hospital or as separate huts. Thequonset hut was also unsatisfactory because of sagging floors, leaky roofs, andlack of perpendicular walls. Each station hospital was authorized 35 square feetof storage space for each authorized bed.
Weather conditions made it necessary to store freezablesupplies in heated buildings, thus requiring constant supervision andmaintenance. At Naknek, supplies froze on the shelves despite the fact that thebuildings were heated. Tests were conducted in February 1943 to determine theeffects of freezing on medical supplies. Results of the tests, which showed mostitems were not affected, were reported to The Surgeon General.
Heavy rainfall and resulting dampness required additionalspecial consideration for medical supplies and equipment, X-ray films, andplaster of
429
MAP 32.-Supply points in Alaska, 1942.
paris bandages; other similar items often deteriorated andbecame mildewed, thus necessitating that buildings be heated intermittently toreduce dampness.
Dispersion of Supplies
Upon declaration of war, a policy of dispersion of reservesupplies was invoked. Later, all supplies were dispersed in a uniform manner.This dispersion was conducted in various ways. At Fort Richardson (map 32),established in June 1940, pyramidal tents, dugouts, basement rooms, and even theEklutna Indian School which was located 27 miles from the post, were utilizedfor storage.
Because of the distance between stations and the lack ofdependable transportation, often handicapped by bad weather, the medicalmaintenance unit proved valuable in supplying inaccessible spots. Ship sailingswere irregular, and air service was generally unavailable except for specialitems. These transportation difficulties made it necessary to improvise during1942 to make up for the shortage of field equipment.
Lack of a Medical Supply Depot
There was no regularly established medical supply depot in theAlaskan theater. Fort Richardson served as an unofficial depot. Stationspossessing ex-
430
cesses of critical items and medical chests shipped them toFort Richardson, where two buildings were designated as warehouses with twoofficers and eight enlisted men as depot personnel.
The Optical Program in Alaska
In February 1942, to speed up the procurement ofGovernment-issued spectacles, a procedure was inaugurated which equipped five ofthe larger stations with the necessary equipment and materials. Spectacle orderforms were prepared and forwarded to the American Optical Co., at Seattle, andthe spectacles were returned by the Seattle General Depot.
This system suffered several defects: (1) Excessive length oftime required to fill an order, (2) losses incurred because of movement ofpersonnel, (3) lack of control for procurement, (4) lack of prompt communicationon special cases, and (5) lack of trained personnel and equipment in thecommand. To remedy this problem, traveling optical teams were organized and sentto stations requiring their services. This became a rather complete service in1942.
The problem of filling prescriptions and providing a promptsupply of spectacles remained until a fixed-optical unit was assigned to FortRichardson in April 1943. By June, all initial issue, replacement, and repair ofspectacles for the entire command was accomplished by that unit.
