CHAPTER XV
The China-Burma-India Theater
BEGINNINGS OF MEDICAL SUPPLY ACTIVITIES IN 1942
Theater Background
The CBI (China-Burma-India) theater,1which evolved from the American Military Mission to China established in October1941, did not become fully organized as a theater until 22 June 1942, when theWar Department ordered Lt. Gen. (later Gen.) Joseph W. Stilwell to issue ordersrelieving all units under his command from assignment to Army Group, Washington,D.C., and reassigning them to the American Army Forces, China, Burma, and India.By 6 July, General Stilwell had set up the command structure for his theater.From a small task force organized to support China and encourage largerparticipation and effort on the part of the Chinese Army, this mission of theCBI theater developed to include the operation of airbases for actions againstJapan and the organization of various types of American units to wage guerrillawarfare against the Japanese.
Organization of Services of Supply and the Supply System
In the spring of 1942, efforts had been made by the TheaterSurgeon, Col. (later Brig. Gen.) Robert P. Williams, MC (fig. 132), to organizethe Chinese Medical Service, to deploy the small Seagrave medical unit, and torelieve the inadequacy which existed. Supplies had been stored in depots atMandalay and Lashio, Burma; Calcutta and Karāchi, India; and in China.
Having reached the theater in late March 1942, Lt. Col.(later Col.) John M. Tamraz, MC (fig. 133), was designated Surgeon, SOS(Services of Supply), and his headquarters was established at Karāchi. Theprimary responsibility for organizing a medical supply program fell on ColonelTamraz, and on 1 April 1942, he asked for the establishment of a medical supplydepot at Karāchi with 2 officers and 10 enlisted men.
Effort was made by Colonel Tamraz to locate a source ofsupplies which could be substituted for unavailable shipments from the UnitedStates. The British Army's medical supply depot at Karāchi had sufficientstores of many items to supply the American troops in India through ReverseLend-Lease. The surgeon was also allocated $3 million to purchase medicalsupplies on the
1(1) Stone, James S.: Organization and Development of Medical Supply in India and Burma, 1942-46. [Official record.] (2) Romanus, Charles F., and Sunderland, Riley: Stilwell's Mission to China. United States Army in World War II. The China-Burma-India Theater. Washington: U.S. Government Printing Office, 1953.
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FIGURE 132.-Brig. Gen. Robert P. Williams.
local market; yet, during 1942, various supply problemsplagued the Medical Department. The 500 tons of medical supplies reportedly onthe way to the theater were slow in arriving. Six hospital units arrived in Mayand June without any equipment and placed a heavy demand on the medical supplysystem. Supplies allocated to the U.S. Public Health Service and designated forthe treatment of personnel involved in the construction of the Yunnan-BurmaRailway, Chinese Defense supplies, and American Red Cross supplies all had to beused by Services of Supply.
Much material designated for China could not be used in Indiaor Burma to the regret of Colonel Tamraz who stated that these supplies wouldoften stay on the Calcutta docks and would gradually deteriorate.
When medical supplies began to arrive in late May 1942,warehouse space was hard to find, and when found, it had to be cleaned andreconditioned.2
The American Medical Supply System, during 1942 and 1943, wasbased on the automatic issue of the 10,000-man, 30-day MMU's (medicalmaintenance units). In July 1942, Charleston, S.C., was designated as the portof embarkation for the China-Burma-India Theater, and a theater supply level wasestablished at 180 days.
2Diary, Col. John M. Tamraz, MC, Chief Surgeon, Services of Supply, China-Burma-India Theater. [Official record.]
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FIGURE 133.-Col. John M.Tamraz, MC, SOSSurgeon.
The previously requested medical supply detachment reached thetheater by July, and a Medical Supply Section was established in the generaldepot at Karāchi (map 49).
Despite the arrival of several shipments of medical supplies,a shortage of sulfaguanidine, Atabrine (quinacrine hydrochloride), Plasmochin (pamaquinenaphthoate), and nicotinic acid was revealed when a request for these items froma training center at Rāmgarh,India, was by necessity turned down.
A major problem in the CBI theater during the first year ofoperation was lack of the medical supply personnel required to plan for andcarry out the distribution of supplies.
Because Chinese medical treatment facilities were relativelylimited in scope, it was initially decided that the medical maintenance unitsfurnished to the forces in Yunnan (Y-Force) should be modified by eliminatinglaboratory, dental, X-ray, and elaborate hospital equipment, and specialsupplementary drugs and chemicals. This modification of the standard unitestablished two noninterchangeable MMU's within the system.
The biggest problem of 1942 seemed to be the lack of a supplyprogram with uniform policies and systems. This problem plagued the theater forthe next year and a half.
GROWTH OF MEDICAL SUPPLY
Early in 1943, Maj. Walter J. Newton, DC, was placed in chargeof the Medical Supply Section, Surgeon's Office, SOS. During January andFebruary 1943, the movement of material into the Ledo area in preparation for
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MAP 49.-Medical supply depots, CBI theater,1943-43.
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the beginning of road construction in March was the principalmedical supply project. Special MMU's were lined up to supply the Seagraveunit which had been active in Burma during the first Burma Campaign of 1942 andhad been providing medical care for the Chinese at Rāmgarh.The Karāchi medical depot andits subdepot at Chābua, India,had been ordered to assemble medical maintenance units designed by Lt. Col.Gordon S. Seagrave, MC, and ship them to Ledo. Supplies were funneled into Ledo,which was to serve as a receiving area for 30,000 troops being sent from theUnited States to launch the construction program. A request for equipment andsupply units for hospitals of 250 beds, 100 beds, and 50 beds was approved, butconsolidation of hospital beds was impossible, making it necessary to placesmall hospital units at widely scattered points.
The SOS Surgeon, while on an inspection tour during April andMay 1943, discovered that most depots were below supply levels. The worstsituation was at K'un-ming, China, because of the difficulties in gettingsupplies over the Hump by air.
Although the supply depot at Ledo was scattered in severalwarehouses, it seemed to be accomplishing its purpose. The depot at Chābua(map 49), in contrast, was quite low on surgical supplies, sulfonamides, anddental equipment.
Support of Chinese Forces
According to surveys of Chinese troops in the CBI theater,the Y-Force had sufficient supplies and equipment on hand for 6 months ofcombat. Only a shortage of vehicles for the transportation of equipment andsupplies handicapped their supply operations (fig. 134). Action was taken by theChief Surgeon, SOS, to provide for automatic replacement of depleted medicalsupplies. For the eastern group, the Zebra or Z-Force, the necessary requisitionto provide 30 Chinese defense supply medical maintenance units per month wasbeing prepared. A shift of responsibility for Chinese defense supplies torear-echelon headquarters at this time relieved the theater surgeon of anonerous task.
Supply of Antimalarial Drugs
With the approach of summer and the malaria season, shortages ofmalaria control supplies and equipment appeared. Delays in requisitioning, lossof supplies due to sinkings of cargo vessels, and the rapid growth of troopareas, caused an emergency situation. As late as July 1943, no antimalarialsupplies of U.S. origin had reached Assam. Only British and Indian equipment,generally considered by Americans to be inferior, was available, but this wasalso being depleted rapidly.
The large number of Chinese soldiers and Indian cooliesemployed in construction and maintenance enlarged the antimalarial supplyproblem since they had to be provided for as well. Approval for additionalsupplies was received too late to produce the supplies in time for the malariaseason. To
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FIGURE 134.-Typical pack train fording ariver near Nasin, Burma.
alleviate this situation, all equipment and supplies in theantimalarial category were concentrated in the Medical Supply Section of theBase General Depot at Calcutta under the supervision of a malaria control supplyofficer. Assistant theater malariologists, in cooperation with depot officers,approved distribution of these supplies. This system of depot control permittedthe most economical supply distribution.
Plans for Increased Support for Chinese Troops
During July 1943, plans were formulated for supplying Chinese troops in bothIndia and China. Full delivery of table of basic allowances equipment formedical units of the Y-Force was guaranteed by 30 medical maintenance units permonth beginning in March 1944.
Shipment of Medical Maintenance Units to the CBI Theater
The CBI theater's supply program was set back in midsummer 1943 by thearrival of broken or partially complete assemblies, which the subdepots had toreconstitute as MMU's before requisitions could be filled. This problem
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was aggravated by lack of personnel qualified to handle theseincomplete units. When ships were sunk en route to the theater, MMU componentswere lost, thus delaying the schedule several months. Theater stocks remainedunbalanced until repeat shipments could be made.
Army Air Forces Medical Supply
In August 1943, the Army Air Forces proposed a supply systemof its own, which would interpose Air Service Command medical supply points as"wholesalers" between Services of Supply depots and the using units.The Air Forces proposed to stock these depots with a 90-day level of common-usemedical supplies and to handle all special items of equipment peculiar to theAir Forces. Services of Supply would thus act only as a feeder to the AirService Command depots and cease issuing directly to AAF (Army Air Forces)units.
With the Air Forces taking over responsibility for supply toits units, Services of Supply would be relieved of an extra burden, but ColonelTamraz and his medical supply officers agreed that the AAF proposal wouldestablish a duplicate system of medical supply distribution and further depletethe already short stocks. By September, a compromise had been worked out wherebya 30-day supply was to be stocked by air depot groups, a 30-day supply by AirService Centers, and a 10-day additional supply by tactical organizations.
The Medical Depot System in 1943
During the final quarter of 1943, many problems of themedical supply system were in the process of being solved. There was a mixtureof optimism and misgiving by medical supply authorities. The medical supplyofficer, SOS, recorded a 117-day level of supplies in September which wassomewhat below the authorized 180-day level. The antimalarial supply level wasreduced from 60 to 90 days to 30 days because considerably more supplies were enroute to the theater.
By November 1943, general depots with medical sections werelocated at Karāchi and Calcutta. An intermediate general depot was located atNew Delhi, with the 100th Station Hospital serving as a subdepot for troops inthe vicinity of the theater headquarters.
Advance general depots were located at Gayā, India;Chābua,the transshipment depot for supplies going by air to China; K'un-ming, theChina depot; and Kuei-lin, China, which served the advance bases of theFourteenth Air Force. Seven additional depots were operated by the Army AirForces in eastern India to serve the Air Transport Command and the Tenth AirForce bases. Special depots for Chinese defense supplies were located at Karāchi,Sukkur, Calcutta, Chābua, and K'un-ming. A railhead depot served theLedo area with a 45-day stockpile in the Advance General Depot at Chābua (map49).
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Early Supply Procedures
Late in 1943, the Surgeon's Office, SOS, was developing asystem of stock control and inventory for medical supplies in the theater. SOSheadquarters was the final authority for processing all requisitions before theywere sent to a depot. They also controlled hospital equipment assemblies andreplacement items and were the responsible agents for procurement of priorityitems.
Emphasis on Experienced Personnel
Despite the optimistic outlook of the SOS Surgeon concerningthe availability of supplies, general concern was felt over the nonavailabilityof trained supply personnel.
At the close of 1943, only two small medical supply unitswere in operation in the CBI theater. Sections of Medical Supply Detachment No.2 staffed the depots at Karāchi, Calcutta, andChābua, with the help of localpersonnel. The Ledo supply point was manned by a section of the Advance DepotPlatoon, 7th Medical Supply Depot. A personnel shortage was expected to remainuntil sometime in 1944 despite the fact that two depot companies were onrequisition.
Elimination of the Medical Maintenance Units
In October 1943, the War Department announced that automaticshipment of medical maintenance and medical reserve units would be discontinuedby 1 January 1944. Estimates made by the Los Angeles Port of Embarkation showedthat a 160-day supply of MMU's was either in the theater or en route, and a178-day supply was on order. It was estimated that a 66-day supply of medicalreserve units was either in the theater or en route, with a 77-day reserve onorder.
Beginning in 1944, requisitions were to be submitted formaintenance to provide an 80-day supply in the theater as well as a 210-daysupply to cover timelags. The Los Angeles Sub-Port, which became a port ofembarkation for this theater in May 1943, recommended that requisitions besubmitted once a month for a 30-day supply that would be required 210 dayslater, meaning that supplies requisitioned in November 1943 would not arriveuntil June 1944.
Following this change in procedure, the medical supplyofficer, SOS, planned to consolidate all theater requisitions each quarter andto submit special requisitions as necessary. His records were to show the statusof all items stocked in the theater, and his procurement policy would bedirected by a three-phase estimate system which calculated the stocks on handfor the current quarter, stocks due from the port of embarkation for thefollowing quarter, and stocks to be requisitioned at the beginning of the firstquarter for use during the third and fourth quarters. It was contemplated thatMMU's would continue to be issued for 2 of the 3 months in each quarter,
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with the quarterly item-by-item requisitioning being used to balance theaterstocks. The first requisition was scheduled for dispatch on 1 January 1944. Theemphasis of the new system on proper accounting procedures resulted in timidityon the part of SOS medical officers. The medical supply officer, Major Newton,was relieved of his supply duties in October so that he might devote full timeto dental service. His replacement, Maj. (later Lt. Col.) Claud D. La Fors, PhC,was experienced in medical supply, but his arrival was delayed. In theinterval, no advance requisition was placed sufficient to maintain adequatestock levels between the close of automatic supplies and the date at whichrequisitioned supplies would be received.
Failure of British Supply
At the end of 1943, one of the major flaws still existing in the CBI supplysystem was the failure of Chinese forces in India, the X-Force, to be supportedby the British and by the Government of India. Only approximately 25 percent ofrequested medical support requirements were received, and these were not up toestablished standards or familiar to U.S. medical personnel. To take up theslack, it was necessary to divert MMU's from other forces for the use of theChinese Army in India.
MEDICAL SUPPLY DURING 1944
Inspection of the Supply System
When the new theater medical supply officer finally arrived, an inspectiontrip of supply facilities was arranged to familiarize him with the existingsituation. Almost complete collapse was discovered at K'un-ming, where onlythe bare necessities were available. No reserve existed and many items werecompletely out of stock. The medical supply officer had files of requisitionswhich had been disapproved by the SOS Surgeon. Bad flying weather also hindereddelivery of requested items over the Hump.
After inspection at one end of the supply line, Major La Fors and the AAFmedical supply officer inspected the depot at Chābua, the final base formedical supply points in China and a key link in the chain of supply leading toLedo and Burma. There, expendable supplies were nearly depleted andnon-expendable supplies were scarce. Only Chinese defense supplies, notavailable for U.S. use, were in quantity, and these were scattered in poorlyconstructed, poorly managed warehouses.
At Ledo, special efforts were made to push medical supplies forward intocombat areas. Supplies for American medical units were adequate, but suppliesfor Chinese combat troops were at a low level. Consumption was 100 percent overestimated requirements because of losses connected with airdropping of suppliesas well as wasteful habits of the Chinese. As a result, supplies were
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being depleted rapidly while the replacement system stillfunctioned at the old standard.
At General Depot No. 2, in Calcutta, the medical supplyofficer found a large but unbalanced stockpile of supplies in the MedicalSection. It was estimated that if these supplies had been properly distributedto the field, the theater supply situation would have been nearly adequate. Itwas ascertained, however, that the flow of supplies from the Zone of Interiorwas interrupted by failure to requisition supplies as soon as automatic shipmentof medical maintenance units was discontinued.
The biggest defect in the theater supply system wasmaldistribution. The general depot in Karāchi had only a 48-day supply on handfor 25 percent of the theater personnel; the general depot in Calcutta, whichsupplied 75 percent of the theater strength, had only a 70-day supply in stock.At the Chābua depot, all that was available was 63 days of a 90-day supply forChinese troops and a 45-day supply for troops in Burma.
Corrective Action
Faced with the task of reconstructing the medical supplysystem, the Medical Supply Section personnel requisitioned needed supplies forimmediate shipment to the theater, requesting at the same time that MMU'ssufficient to maintain supply levels be sent for use until the requisition wasreceived.
The theater medical supply officer directed discontinuance ofall unauthorized methods of procuring or issuing supplies and also strictadherence to theater policies. This policy was designed to eliminateleapfrogging requisitions to the SOS Surgeon or even directly to the port ofembarkation in the Zone of Interior. Supplies were to be procured only from theSOS depot in the immediate vicinity. Army Air Forces supply officers weredirected to put requisitions through the air depot and Air Service Command, asauthorized by SOS Memorandum No. 187 of 1 November 1943.
To fix responsibility in the field, medical supply officersof the general depots were designated as area supply officers and directed toestablish and maintain authorized levels of supply at all supply points withintheir respective areas. Stocks on hand were to be surveyed and suitablerequisitions sent to adjust discrepancies. They were also directed to editand fill requisitions for units in their areas.
As a result of frequent inspection, these area supplyofficers were ordered to eliminate hoarding of supplies and to make certain thatexcess and unauthorized equipment was returned to depot stocks. The Stock RecordCard System was adopted, and the standard revised requisition form was put touse. Despite the unfamiliarity of medical supply officers with the newprocedures, they began at once to institute the new system.
To further invoke the provisions of new theater directives onsupply procedures, it was necessary to improve the personnel involved in theprogram's
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operation. The medical supply officer outlined the staff hewanted to develop in the Surgeon's Office, SOS, to maintain control of thesupply system. It was recommended that three officers deal with procurement,malaria supply control, and other theater supply matters. It was alsorecommended that an attached officer from Air Service Command establish liaisonbetween Services of Supply and Air Service Command on medical supply matters.
None of these recommendations was adopted. Instead, themedical supply officer had three commissioned assistants, two of whom, beingvery inexperienced, were poorly qualified for a responsible role. An AAF liaisonsupply officer was borrowed from Army Air Forces headquarters.
With the arrival of new medical supply officers from theStates, a new officer was assigned as assistant to the chief of the section, andhe and the chief handled most of the supply matters. This system lasted untillate 1944 when the two officers were replaced by one Medical AdministrativeCorps officer. The Air Forces liaison officer remained until midsummer.
Medical Depot Companies Organized
Personnel problems evident at the command level were alsoexisting in the field. Of the two medical depot companies requisitioned in 1943,only one had reached India by December 1943. After almost a year of basic andunit training, the 14th Medical Depot Company arrived in India and was assignedto General Depot No. 2, Calcutta, to relieve the provisional detachment (fig.135). Plans were made at that time to send advance detachments to K'un-ming,Ledo, and Chābua. No separate medical supply units had been functioning in thatarea before detachments of the 14th arrived. At Ledo, the 14th detachment, ofone officer and six enlisted men, augmented Section 1, Advance Depot Platoon,7th Medical Supply Depot, which had been there since the depot was establishedin November 1943 (map 50).
Valuable time was lost at the general depot when, because ofdisagreement over who was in authority, the depot company was not able to deployits full strength and time on the distribution of medical supplies.
Supply Shortages in the Field
To avert serious shortages at Chābua, 10 medical maintenanceunits were planned to be shipped there immediately. Chābua was the key point forthe supply of the Ledo and K'un-ming depots, and this shipment helped torelieve a serious shortage. By 10 January, the level of supplies had dropped to1.5 MMU's. Emergency arrangements provided for the transportation of criticalitems to balance the stock level until March.
As the depot at K'un-ming was nearly out of supplies byJanuary, two MMU's were prepared for air shipment to the depot (fig. 136).
The uncertainty of transportation between Calcutta and Chābuawas a real handicap, and little could be done about it at that time.
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MAP 50.-Medical supply depots, CBI theater,1944.
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FIGURE 135.-Native laborers carry and stack medical suppliesat the Medical Depot, Calcutta, India.
The medical supply officer at Ledo had not been able to buildup his supplies to the authorized 45-day level. Actually, he could not evencount on a 10-day level, particularly in class I items. Combat troops wereconsuming medical supplies at an unexpectedly rapid rate. Besides losingsupplies in the airdrop procedure, requisitions submitted by Chinese forces orby the Seagrave unit were not properly screened (fig. 137).
The hospitals in the field had serious supply problems.Shortages of equipment, lack of replacement parts, and scarcity of many drugsand laboratory
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FIGURE 136.-C-47 transports lined up on the airstrip at Myitkyina, Burma.
supplies occurred. General dissatisfaction with the medicalmaintenance unit was common because of its failure to include many drugs usedlocally in the treatment of disease.
Supply Support for Chinese Troops in India
To add to the already mounting problems in early 1944,British support of the Chinese troops in India was dwindling rapidly. Because ofthe inability of the British to meet the overwhelming demands for certaincritical drugs and chemicals, these items were diverted from Chinese defensesupplies and already critically short U.S. Army stocks.
The Chinese defense supplies were not complete, and BritishArmy supplies did not coincide with U.S. standards. The procedure under whichfield medical units with Chinese troops received Chinese-type medical suppliesexclusively, while fixed American hospitals received Chinese-type supplies inproportion to the number of Chinese who would be occupying hospital beds, wascriticized by American medical officers who found it difficult to use Britishmedical items, which were of poor quality and scarce in quantity of criticalitems.
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FIGURE 137.-Men in a C-47 shove out supplies to fellowsoldiers in the field in Burma, 1944.
A firm recommendation was made by the theater surgeon inMarch 1944 to abandon the existing system and pool all medical supplies for theChinese obtained through normal U.S. channels with American stocks in thetheater, and issue as required.
Lack of Supplies in Depots
Medical supplies at Chābua were stored in a poor "basha"construction without cement floors; therefore, much deterioration occurred as aresult of the climatic conditions. Because supplies were shipped to China inbulk rather than on an items-needed basis, stocks were enormously unbalanced.
At Ledo, lack of personnel and inadequate and widelydispersed warehouses hampered operations. To support the Chinese Army in India,this depot, commanded by Capt. Warren R. Lee, MAC, relied on air supply. Afterholding conferences with the base surgeon, the base medical supply officer, andthe base commander, a new area was secured, with 50 percent more warehouse spaceand an adequate refrigeration vault for biologicals. Thus, the Ledo depot waschanged and refurbished for more systematic operation.
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IMPACT OF THE VOORHEES MISSION
Background
With the numerous problems of medical supply mushrooming intocrises and no immediate solution available, strong voices of concern emanatedfrom all quarters. At a most opportune time, July 1944, a group of medicalsupply specialists, under the direction of Col. Tracy S. Voorhees, JAGD, wasdispatched from the Surgeon General's Office to the China-Burma-India theaterto make a comprehensive survey of the entire supply program.3 Thistrip was prompted by specific complaints made by the Air Forces regardingmedical supply.
To satisfy the Air Forces, a compilation of its reportedneeds was included in a special requisition prepared in July to balance incomingstocks. Fortunately, 50 tons of air cargo space to be used for medical suppliesfrom the United States was made available at that time. Heavier items were tocome by water, but were given a high priority.
Specific Failures in Medical Supply
Following that action, the Voorhees team conducted a thoroughsurvey of the depots in all base and advance sections of the theater. Fourprincipal causes of the breakdown in supply were identified.
Before 1 January 1944, medical supplies had been received inthe theater in the form of medical maintenance units, which consisted of 700barely minimum items. There was no systematic way to supplement these items and,as a result, theater stocks were generally unbalanced, with some items badlydepleted.
Failure to take action to avoid shortages after the automaticsystem of supply terminated also hurt. The SOS Surgeon and his chief medicalsupply officer had failed for 90 days to place any substantial requisitions tocontinue the flow of supplies.
Because of the inadequacy of automatic supply and the failureto file supplementary requisitions by the spring of 1944, there was a generalshortage of medical supplies in the theater. No adequate stocks of nonexpendableitems existed.
General Depot No. 2, over a long period of time, failed tosort, place in stock, and make available for issue a large quantity of medicalsupplies which were stored in bulk in a 28,000-sq.-ft. warehouse in the Hobokensection of the depot. Even after the arrival of the 14th Medical Depot Companyin early January 1944, the stock was not moved until March. Failure to properlyutilize the services of the 14th Medical Depot Company caused this problem.
The mishandling of 80 MMU's in Base Section No. 2(Calcutta) and Advance Section No. 2 (Chābua) was the fourth identified reasonfor the
3Voorhees, Tracy S.: Visit to the China-Burma-IndiaTheater to Survey Medical Supply, 11 Sept. 1944, together with attachments and inclosuresthereto. [Official record.]
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supply difficulties of the theater. These units, intended forthe Y-Force, were to be moved forward to Chābua at the rate of 20 units permonth. The entire 80 units were sent in one shipment without advance notice andwith no warehouse space available. As a result, the goods were dumped in a fieldand were not sorted for 2 months. No proper selection of the items to go forwardto the Y-Force could be made and misshipments ensued. Not until June, when a newliaison officer for the Y-Force came to Chābua, was the pile of supplies sortedout and proper shipments made. This whole problem stemmed from lack ofcoordination between the action of the Y-Force authorities in seeking theshipment and their arrangements for its trip over the Hump. A more clearlydefined authority in the Surgeon's Office, SOS, seemed necessary to prohibitthe recurrence of this condition.
After authorities visited most of the larger station andgeneral hospitals and studied their needs for extra equipment, requisitions tomeet such needs were placed, specifying the most rapid form of shipmentavailable.
Recommendations of the Voorhees Survey
As a result of the Voorhees survey, constructive steps weretaken to alleviate the serious problems that existed. Recommendations were madeto change the organizational setup in Services of Supply to clarify authorityand divide responsibility between the SOS Surgeon's Medical Supply Section andthe base sections or advance sections.
By the end of August, 40 tons of medical supplies had reachedCalcutta by air, and the flow of supplies to the interior had become continuousas a result of emergency requisitions sent to The Surgeon General by the surveyteam. It was anticipated that stock would be balanced by October with theassistance of the Voorhees mission. The solving of personnel problems alsobegan. The 14th Medical Depot Company was assigned a more experienced depotcommander, and Maj. Arthur Gallagher, MAC, an officer experienced in medicalsupply stock control, was brought in to establish a centralized system of stockcontrol and requisitioning.
To strengthen the weak depot system, a second medical depotcompany, the 25th, under the command of Lt. Col. Robert E. Selwyn, MAC, arrivedon 27 August 1944 and was assigned to take over the supply operations for allAmerican and Chinese troops in Upper Assam and Burma.
On 1 August 1944, upon recommendation of the medical supplyofficer, SOS, and the Voorhees mission, the Medical Section of General Depot No.1 was closed, thus releasing personnel for redistribution. The responsibilityfor medical supply in the Karāchi-Bombay area was assumed by the 181st GeneralHospital in Karāchi, which served as a subdepot.
Realinement of Depots
As a result of personnel consolidations, the 69th MedicalDepot Company was organized and stationed at Chābua, and the detachments of the14th Medi-
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cal Depot Company at Chābua and K'un-ming werereconsolidated at Calcutta to take on an ever-increasing load of supplies.The 14th, under command of Major Gallagher, was outstanding in its handling ofsupplies which poured in at a tremendous rate. The limited personnel availableoften worked around the clock to keep supplies moving during a most criticalperiod. As a consequence, essential supplies were distributed and an adequatemedical supply service was made possible sooner than expected (fig. 138; map50).
IMPROVEMENT OF THE SUPPLY SYSTEM AND ITSPROCEDURES
Personnel Shifts and Changes
During the last half of 1944, it was necessary, asrecommended by the Voorhees mission, to obtain better qualified personnel tohandle large-scale depot operations and to establish and maintain a soundinventory and stock control system. Medical depot companies had obtained betterqualified commanders. Excess officers were absorbed into other medical supplyinstallations, such as those in the larger hospitals. Within the SOS Surgeon'sMedical Supply Section, experienced officers were drawn out to serve in fieldinstallations, and a smoothly running team of well-qualified officers was broughtin to replace them.
Inventory and Stock Record Changes
Stock records at the time of the Voorhees mission were keptin General Depot No. 2 and in SOS Headquarters. As a followup of the survey,the 14th Medical Depot Company was instructed to develop a system ofdistribution to forward depots based on consumption rates. These data were to betranslated into the necessary statistics by the Medical Supply Section in theSurgeon's Office. Before 1944, none of these records had been kept and only limited progress had been made to show the gross needs of the theater and setup a full-fledged inventory control system.
A new system, based on those being used successfully in theUnited States and in the European theater, was recommended by the Voorheesmission. The first step would eliminate the duplicate set of records in theSurgeon's Office, and assign all requisitioning to an inventory controlofficer located in a Calcutta branch office. This officer would be solelyresponsible for the satisfactory operation of the new stock control plan. Astock level was to be set for each item carried in theater stocks. Reorderpoints were to be calculated on the basis of stock level plus the amount to beissued during a 6-month period. An accurate due-in record would show the currentstock status of each item at all times. Monthly review of records would followfor adjustment of stock levels on the basis of actual experience and the pickingup of all items which had fallen below the reorder point. Requisitions would besubmitted as necessary when indicated by stock records and by due-in recordcards.
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Together with members of the Voorhees group, the SOS medicalsupply officer set up initial stock levels for all items needed in the theater,to be reviewed by the inventory control officer, and integrated with depot stockrecords at Calcutta. A comprehensive requisition was prepared by the inventorycontrol officer for submission in September. Chinese, as well as American,supplies were brought under the system.
As the medical supply situation began to improve, theinventory control officer reviewed stock levels of forward depots in the lightof theater levels. The plan was gradually put into effect throughout the medicalsupply system, and all requisitioning was coordinated and unified.
Changes in the Chinese Supply Program
The Voorhees mission in June had backed up the earliertheater recommendation that supplies for the Chinese Army in India no longer beprocured from the British. Unification of procurement and distribution ofChinese supplies through SOS channels was a basic necessity. This action wasapproved by the War Department in August 1944. With the standardization ofprocedures, Services of Supply received authority to take over all supplies forall forces in China, except AAF technical equipment and supplies.
Supplies, formerly designated as Y- and Z-Force material,were brought into the stock and inventory control plan at Calcutta and Chābua.By October 1944, Chinese procurement was included in the American medical supplyprogram, thus consolidating theater medical supply requisitions. This meant thatthere was a single method of procurement, intratheater receiving, storage andissue, stock control, and accounting under Services of Supply.
The reorganization proved to be even more timely and valuablewhen, on 24 October 1944, the China sector of the CBI theater was constituted asa separate theater with Col. (later Maj. Gen.) George E. Armstrong, MC, as itssurgeon (fig. 139). The India-Burma theater became the supply and administrativebase for the new China theater.
MAJOR ACCOMPLISHMENTS OF 1944
Improved Organization
At the end of 1944, the whole supply program of the China andIndia-Burma theaters was working smoothly and efficiently. Critical shortageshad been eliminated, both in the depots and in the field. A compact and betterfunctioning supply organization which capably handled requirements for Chineseand American troops in China, Burma, and India had been established. Stock andinventory control procedure had been instituted at all levels of medical supply,thus eliminating many serious imbalances of stock. Automatic supply had beenreplaced by a process of continuous requisitioning which maintained propersupply levels. Personnel problems were almost entirely eliminated despite thesplit into two theaters. Transportation, particularly air transport, improvedgreatly, enabling a much more efficient distribution of supplies.
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FIGURE 139.-Col. George E. Armstrong, MC, Surgeon,China theater.
PROGRESS IN 1945
Support for Two Theaters
The year 1945 was placid in the field of medical supplycompared to the previous year. Despite the planning for peak operations inanticipation of continued combat in Burma and a combat and logistical program inChina climaxing in the final assault on Japan, seizure of the Burma Road earlyin 1945 and the sudden surrender of Japan in August reduced the medical supplyoperation progressively and hastened its end.
In carrying out the basic program of providing medicalsupplies for Chinese and American forces, the first phase of operations was thesupply program for the China theater. Emphasis was shifted to an area whichheretofore had been only a sector of an entire theater. However, no new burdenwas imposed on the supply program since the supply of troops in China hadalready been a part of the overall responsibility of the entire theater.Included in the program had been the supply of the Chinese Y- and Z-Forces, andthe Fourteenth Air Force and its subordinate units, as well as a small number ofAmerican troops in support of Chinese training and operations. Supplying theChinese sector had been simplified in late 1944, and every effort was made to
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extend to China the same principles of supply managementwhich had been instituted in India and Burma. The fact that the principalconsumers were the Chinese Y- and Z-Forces made it impossible to carry out therefinements of the system. Despite efforts to advise and develop in the Chinesemilitary organization the same operational methods which were standardized forAmerican troops, it was impossible to achieve complete uniformity of policy andprocedure.
Planning Precedes Changes
To work out details of the China theater supply program, theSurgeon of the China theater, Colonel Armstrong, conferred with the staff of theSurgeon, India-Burma theater, in November 1944. During those conferences, a planwas adopted continuing the system which had developed during the previousmonths. Maintaining a 90-day level of medical supplies for American andAmerican-sponsored Chinese forces, Services of Supply was to procure, store, andissue all commonly used medical supplies and equipment using the intermediateGeneral Depot, Chābua, as its base. Army Air Forces items, however, were to beobtained by the Air Service Command through the AAF supply depots in India.
By 1 January 1945, initial organizational equipment for theChinese troops was authorized by the International Aid Division, ASF, inWashington, and stocks for the China theater were divided between Calcutta (90days), Chābua (45 days), and K'un-ming (45 days). By February, in accordancewith the War Department's reduction in supply levels, the level was reduced to45 days at Calcutta and 30 days at Chābua. The 45-day level was retained atK'un-ming.
Development of the Chinese Supply System
In January 1945, Maj. (later Lt. Col.) James S. Morgan, MAC,was assigned as Medical Supply Officer, China theater. Having two medical supplyofficers in the China and India-Burma theaters helped to coordinate medicalsupply activities.
Many of the old procedures were carried over as still beingsuitable. In the China theater, Services of Supply began to take over all supplyorganizations which provided service to the Chinese components of the Y- andZ-Forces. Services of Supply became responsible for all the operations necessaryto procure material from India for Americans and Chinese in China. During thefirst few months of 1945, a system of base depots was organized at the entranceto China and at key points in the China theater. The maintenance levels of theIndia-Burma theater were initially accepted and later revised as experienceindicated.
The inability to set levels and stabilize the rate ofstockage, issue, and requisitioning prevented an even requisition of suppliesfrom the India-Burma base. Periodically, larger than usual demands for medicalsupplies in the India-Burma theater necessitated air priority shipment from theUnited
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States. Humps in the flow of medical supplies from theIndia-Burma theater to China were caused by unexpected changes in operationalsituations in China, the need to stock adequately newly established depots, andthe modification of usage tables based on actual experience. Improvement in thesupply program resulted from the mutual exchange of correspondence, roundtablediscussions at the Second Medical Supply Conference in May, and the loan of theIndia-Burma theater inventory control officer to the China theater for a briefperiod.
End-of-the-War Curtailment
As the end of the war approached, it became necessary tocurtail the supply program for the China theater. The India-Burma supply linecould be shut off when China's ports were opened for more direct supply to thetheater. The supply level for the China theater was reduced to 60 days withmedical supplies distributed equally between the Calcutta, Chābua, and Chinadepots. The discontinuance of lend-lease brought no change in the policy ofproviding maintenance, supplies, and equipment for U.S.-approved Chinese forces.Tonnage allocations for shipment of medical supplies from Chābua to China werecanceled for October 1945, and only emergency shipments by air were madethereafter as the bulk of the supplies went over the Stilwell Road or by waterfrom Calcutta. On 31 December 1945, the supply responsibility for China wastransferred from the India-Burma theater to the Pacific Area Command.
Disposal of Medical Supplies
With the end of the war, immediate steps were taken to setaside sufficient medical supplies to support the terminal theater activities andto declare excesses and surpluses. Agreements were reached with the Governmentof India for the disposition of a number of hospitals, and certain otherequipment was sold to foreign governments.
By 31 December 1945, great progress had been made in thedisposal of supplies:
Tonnage determined excess | long tons | 11,887.00 |
Tonnage shipped to date | long tons | 3,074.51 |
Tonnage declared surplus to F.L.C. (Foreign Liquidation Commission) | long tons | 5,209.00 |
Value of surplus tonnage | dollars | $7,319,093.35 |
Tonnage disposed of by F.L.C. | long tons | 843.00 |
Value of tonnage disposed of by F.L.C. | dollars | $1,010,897.45 |
Because of the considerable labor entailed in disposal activities, both the 25th and the 14th Medical Depot Companies remained in the theater until January 1946.
