CHAPTER XI
The Pacific: August 1944 Through 1946
In the summer of 1944, shortly before the invasion of the Philippines,a major reorganization of U.S. Army forces in the Pacific Ocean Areas (Centraland South Pacific Areas) took place (map 9). It marked an attempt to makethe Army parallel with the Navy in the command structure there, as wellas a shift of troops to the west. Army forces in the Central and SouthPacific Areas were newly organized into U.S. Army Forces, Pacific OceanAreas, under Lt. Gen. Robert C. Richardson, with headquarters at Fort Shafter,Hawaii. The Central and South Pacific Base Commands were its major areacommands. Tactical elements formerly subject to Army commands in the SouthPacific Area, including the half dozen divisions and the Thirteenth AirForce which had comprised the bulk of its combat forces, had been movinginto the boundaries of the Southwest Pacific Area command since the NewGeorgia campaign of mid-1943. The newly created South Pacific Base Commandremained responsible for some months for the logistic support, includingmedical supply, evacuation, and rehabilitation, of some of its former troops,now in the northern Solomons. Army organization in the Southwest PacificArea remained unchanged at this date except for the acquisition of thetactical elements from the South Pacific.
The Air Transport Command continued to function throughout the Pacific.After 1 August 1944, its Pacific Division consisted of three wings, theWest Coast Wing with headquarters in California, the Central Pacific Wingwith headquarters at Hickam Field, Hawaii, and the Southwest Pacific Wing,which had headquarters first at Brisbane, then at Hollandia, and in 1945in the Philippines. The routes of the two last named cut across the territoryof the Pacific Ocean Areas and the Southwest Pacific Area. During 1944additional Air Transport Command bases were established in the SouthwestPacific Area-at Nadzab (New Guinea), Kwajalein, Saipan, Hollandia, andBiak. The three medical air evacuation squadrons which served the PacificWing transported patients thousands of miles by air eastward to fixed hospitalsat rearward bases and in western United States. During the period July1944- June 1945, air evacuees from the Southwest Pacific Area and the PacificOcean Areas totaled over 24,000, approximately a third of the evacueesfrom all oversea areas to the United States during that year.
A wing surgeon for the Central Pacific Wing and one for the SouthwestPacific Wing supervised medical and sanitary work at the bases of the routes.The medical staffs at the bases were responsible for sanitation, mosquitocontrol sick call, minor complaints, and care of all cases not requiringhospitaliza-
452-3
Map 9.- U.S. Army Commands in the Pacific,August 1944.
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tion. As in other areas, Army or Navy hospitals near the bases affordedhospitalization to Air Transport Command personnel.1
Although a single command with jurisdiction over all U.S. Army forcesin the Pacific was not established until April 1945, in 1944 the War Departmentand the Surgeon General`s Office tended increasingly to consider the Pacificas a whole when reviewing and reappraising medical problems. They attemptedto coordinate several phases of medical service for Army troops in thethree areas, amounting by the close of June 1944 to over 1 million. Latein 1944, The Surgeon General expressed concern over the lack of qualifiedconsultants in the Pacific and made efforts to have them sent to the theater.He also dispatched a medical supply mission,-headed by Col. Tracy S. Voorhees,JAGD, to the Pacific to attempt some integration of the procedures forhandling medical supplies throughout the three areas.
The mission noted the adverse effect which the complex Army commandsetup in the Pacific had had on the distribution of medical supplies throughoutthe region. Three separate Army area commands had prevailed, and no well-coordinatedsystem for redistributing any excess stocks on an equitable basis throughputthe three had been developed. Surplus medical stocks had accumulated inthe Central and South Pacific Base Commands; the 6 to 10 divisions whichhad trained in those areas during 1941-44 had left large stocks of medicalsupplies behind, being furnished new combat supplies for their advanceinto forward islands. The critical shortage of water transportation hadcontributed to the failure to ship these supplies forward.
The mission reported that the lack of unified command in the Pacificthwarted its efforts to transfer excess medical stocks from the PacificOcean Areas to the Southwest Pacific Area, as well as its efforts to transferexcess personnel handling medical supplies to areas where they were needed.Hence it failed to establish, as it had succeeded in doing in the Europeantheater, a coordinated system of medical supply for future operations inthe Pacific.2 The conclusions of the mission were corroboratedby The Surgeon General and his Deputy Chief of Plans and Operations (Col.Arthur B. Welsh, MC) when they visited the theater early in 1945. GeneralKirk reemphasized at that time the lack of coordination in the logisticplans of the South and Southwest Pacific Areas and the need for conceivingof the Pacific areas as a single theater of operations.
1 (1) Quarterly Report, Medical DepartmentActivities, Pacific Division, Air Transport Command, 3d quarter, 1944.(2) History of the Medical Department, Air Transport Command, May, 1941-December1944. [Official record.] (3) Correspondence between Col. Walter S. Jensen,MC, Head-quarters, Army Air Forces, Pacific Ocean Areas, and the Air Surgeon,August-September 1944. (4) Annual Report of the Air Surgeon, Fiscal year,1945.
2 (1) Letter, The Surgeon General, to Chief Surgeon, U.S. ArmyForces in the Far East, 25 Oct. 1944. (2) Report No. 35, Air EvaluationBoard: Medical Support of Air Warfare, Southwest Pacific Area. (3) Memorandum,Col. T. S. Voorhees, for The Surgeon General, 18 Jan. 1945, subject: ConfidentialNotes on Pacific Trip. (4) Voorhees, Tracy S. : Story of Pacific Trip,Oct.-Dec. 1944. in Colonel Voorhees` personal file. (5) Radio messages,War Department, to Commanding General, Central Pacific Area, and Commanderin Chief, Southwest Pacific Area, and replies, May 1944.
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PACIFIC OCEAN AREAS
At the time of its organization in August 1944, USAFPOA (U.S. Army Forces,Pacific Ocean Areas) comprised, in addition to its two area commands (Centraland South Pacific Base Commands), the Tenth U.S. Army and the Army AirForces, POA. The latter was created as a top air command when the generalreorganization took place. In April 1945, the Western Pacific Base Command(the Marianas, Iwo Jima, and the Palau Islands) was added as a major element.The combined Army-Navy command under Adm. Chester W. Nimitz, Commanderin Chief, Pacific Ocean Areas, continued to direct the operation of groundand air, as well as naval units. Two Army Medical Department officers remainedas liaison officers with his staff at Pearl Harbor, participating in thejoint Army-Navy planning. Late in 1944, they aided in formulating medicalphases of the plans for taking Iwo Jima and Okinawa. When Admiral Nimitz;established an advance headquarters on Guam in January 1945, one of theseofficers went there with the advance element of its medical section.3
Brig. Gen. John M. Willis, MC (fig. 101), became Surgeon, U.S. ArmyForces, Pacific Ocean Areas, in November 1944, relieving Brig. Gen. EdgarKing, who had been assigned to that position for a few months after holdingthe top Army medical assignment in the Central Pacific for about 5 years.General Willis served on the special staff of Lt. Gen. Robert C. Richardson,Jr., Commanding General, U.S. Army Forces, Pacific Ocean Areas, and CommandingGeneral, Hawaiian Department, at the latter`s headquarters at Fort Shafter(fig. 102).
Most of the staff of the former surgeon, Central Pacific Area- thoseofficers who had had typical base medical duties- were transferred to theoffice of the Surgeon, Central Pacific Base Command, Col. Paul H. Streit,MC (fig. 103). That portion of General King`s staff which had been engagedin operational planning-in estimating the medical troop and supply requirementsfor movement into the Marshall Islands, the Marianas, and the Western Carolines-was transferred with him to the office of the Surgeon, U.S. Army Forces,Pacific Ocean Areas. During the late months of 1944, several Medical Departmentofficers from the Central Pacific Base Command served on the staff of theSurgeon, U.S. Army Forces, Pacific Ocean Areas, in various capacities-as dental surgeon, veterinarian, laboratory consultant, and director ofnursing. Other posts-those of surgical consultant and neuropsychiatry consultant,for example- were filled by attachment from the South Pacific Base Command.The staff of the Surgeon, Pacific Ocean Areas, at this period was thusunorthodox, being made up in large measure of officers actually assignedto other commands. At the same time the number of occupied islands forwhich General
3 (1) Whitehill, Buell: Administrative Historyof Medical Activities in the Middle Pacific. [Official record.] (2) Historyof U.S. Army Forces, Middle Pacific, and Predecessor Commands During WorldWar II, 7 December 1941-2 September 1945. [Official record, Office of theChief of Military History.] (3) See footnote 2 (3), p. 454.
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Willis was responsible was increasing, and full-time consultants wereneeded to advise him.
In the course of his investigation of the status of medical supply inthe Pacific late in 1944, Colonel Voorhees obtained certain data on medicalorganization in the Pacific Ocean Areas for The Surgeon General, who wason the eve of a trip to the Pacific. Colonel Voorhees noted that only 18of the 34 officers requested for General Willis` office had been tentativelyapproved and that the 18 included several division malariologists chargedto the office because the table of organization for the Army division hadno place for them. Thus, a number of the 25 officers actually on duty werenot included in the official allotment. Colonel Voorhees considered GeneralWillis` allotment too small and the office of the Surgeon, Central PacificBase Command, also at Fort Shafter, overstaffed for the reduced scope ofwork facing it at the beginning of 1945. Although Colonel Voorhees calledattention to the similarity of the situation in the Pacific Ocean Areasto that which he had noted in the China-Burma-India theater, no such amalgamationas he achieved in the latter took place in the Pacific Ocean Areas. Onthe other hand, Col. Arthur B. Welsh, MC, who visited the Pacific OceanAreas command with The Surgeon General early in 1945, favored a largeroffice at Central Pacific Base Command headquarters.
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He did not consider an amalgamation of the two medical offices feasible,probably because a separate medical section handling details of administrationfor medical units and installations on the Hawaiian Islands freed the Surgeon,USAFPOA, for the large task of medical planning for forward areas.
What General Willis considered an adequate allotment for his officewas obtained only in the middle of 1945, when the War Department approved45 officers and 64 enlisted men for the office. Until that time the surgicalconsultant, the orthopedic consultant, and the neuropsychiatric consultantserved in General Willis` office oil detached service from the Centraland South Pacific Base Commands-the office had only the medical consultantactually assigned to it-while a sanitary engineer sent by the Surgeon General`sOffice was attached to the medical section in the status of "attachmentof officer for training."4
Central Pacific Base Command
The Central Pacific Base Command encompassed the islands of Hawaii andlater the so-called "Marshall-Gilberts Army Area." The officeof its surgeon, Colonel Streit, had a number of sections performing theorthodox duties of a base surgeon`s office; his staff also included eightpart-time consultants whose primary assignments were as staff officersin hospitals. Medical Department officers in Hawaii were now little concernedwith problems of de-
4 (1) See footnotes 2(1) and (3), p. 454; and3(1) and (2), p. 455. (2) Annual Report, Medical Section, Pacific OceanAreas, 1944. (3) Memorandum, Acting Chief, Preventive Medicine Service,Office of The Surgeon General, for Chief, Operations Service, Office ofThe Surgeon General, 3 Nov. 1944, subject: Medical Officers for Assignmentto Pacific Ocean Areas. (4) Report, Col. Arthur B. Welsh, MC, 7 Mar. 1945,and inclosures thereto, subject: Visit to Pacific Theater.
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fense; they were chiefly occupied with training and giving logisticsupport to the tactical units invading the Marianas and Ryukyus and tothe army garrison forces which settled on those islands. They providedfixed hospitalization for patients returned from the westward islands anddirected a reconditioning program in the larger hospitals in Hawaii. Asin the case of the base sections and bases in the Southwest Pacific Area,it was found feasible, in a Static situation, to give Medical Departmentofficers more direct authority over local installations. In August 1944,Colonel Streit was made Commanding Officer, Medical Service, Central PacificBase Command, and in this capacity had command control of all Medical Departmentunits and installations on Oahu and of their movements within its boundaries.Types of units and installations which he controlled included: General,station, field, and portable surgical hospitals; medical groups; medicalbattalions; collecting companies; clearing companies; veterinary detachmentsand hospitals; dental clinics; medical laboratories; medical supply depots;malaria control and survey units; sanitary companies; ambulance battalionsand companies; two Medical Department concentration centers; and a convalescentand reconditioning center. Numerous units which belonged to divisions stagingor training on Hawaii were placed under Colonel Streit`s command. Officerson Colonel
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Streit`s staff functioned, as he did, in a dual capacity. For the purposesof administering the Medical Service, Central Pacific Base Command, ColonelStreit`s office was organized in accordance with the usual staff pattern,with an S-1, S-2, S-3, and S-4.5
South Pacific Base Command
After August 1944, when the Services of Supply, South Pacific Area,was abolished and the U.S. Army Forces, South Pacific Area, was reorganizedinto the South Pacific Base Command, the area declined steadily in importance.However, the new South Pacific Base Command was still responsible for logisticsupport of the three Army divisions (the 37th, 93d, and Americal Divisions)under XIV Corps which had moved to the Solomon Islands and for supportof the 25th Division at New Caledonia until it left for the Philippinesin December 1944. It continued to afford hospitalization to these troopsfor some months. With the abolition of the Services of Supply, South PacificArea, the service commands on the various islands were absorbed by theisland commands, and some of the island commands were reduced to subbases.The Thirteenth Air Force had started moving to the Southwest Pacific Area.
As of August 1944, only a little over 110,000 troops (including thoseof the 25th Division which had a strength of 14,500) were in the SouthPacific Area. The great majority of this force was concentrated on NewCaledonia, Fiji, Espiritu Santo, Guadalcanal, Efate, and the Russell Islands.Of these, the first four had island commands with surgeon`s offices, whilethe last two were organized as subbases. The transfer of the former servicecommand surgeon (who had usually acted as an island surgeon on the staffof the commander of the island command as well) to the staff of the islandcommander had little effect on the responsibilities of the service commandsurgeon except that it gave him definite responsibility for supervisingthe dispensaries of ground force and air force units located at the base.On Guadalcanal, for instance, a dispensary officer in the island surgeon`soffice supervised the work of about 60 dispensaries in the fall of 1941.
Brig. Gen. Earl Maxwell remained as Surgeon, South Pacific Base Commanduntil November 1944, when Col. Laurent L. LaRoche, MC (fig. 104), succeededhim. Except for relief of the four original consultants and their partialreplacement by Medical Department officers already in the area, personnelof the office underwent little change until May 1945. At that date thesurgeon`s section of the South Pacific Base Command (including the consultants)was made the surgeon`s section for Army Service Command O, intended forlogistic support of the invasion of Japan and transferred to the Philippinesto await its mission. The office of the Surgeon, New Caledonia
5 (1) Annual Report, Medical Department Activities,Central Pacific Base Command, 1944. (2) See footnotes 3(l) and 3.2, p.455. (3) Interview, Col. Paul H. Streit, MC, 21 May 1945. (4) History ofthe Central Pacific Base Command During World War II. [Official record,Office of the Chief of Military History.]
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Island Command, took over the duties of the base command`s medical sectionin addition to those for New Caledonia.6
In late 1944, scenes of U.S. Army activity in the South Pacific BaseCommand had shrunk to three main locales at Nouméa and nearby areason New Caledonia, and on Espiritu Santo and Guadalcanal; troop strengthhad dropped below 100,000. Despite the decline, the South Pacific BaseCommand and the naval command in the area were continuing an aggressiveprogram of con-struction and were exhibiting a tendency to hang on to unitsand supplies which could be better used in the Southwest Pacific Area.Consequently hospitals in the South Pacific islands were only half fulland enormous surplus stocks of medical supplies were still there. On 1January 1945, a general hospital (1,500 beds), 5 station hospitals (totaling1,550 beds), and a field hospital were idle in the South Pacific islands.The Southwest Pacific Area. had an option on
6 (1) See footnote 3(2), p. 455. (2) Historyof the South Pacific Base Command During World War II. [Official record,Office of the Chief of Military History.] (3) Annual Report, Medical DepartmentActivities, South Pacific Base Command, 1944. (4) Quarterly Reports, MedicalDepartment Activities, Headquarters, XIV Corps, 1st and 2d quarters, 1944.(5) Annual Report, Surgeon, Headquarters, Island Command (Russell Islands),1944.
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surplus units and stocks, but the South Pacific Base Command was slowin declaring them surplus. The Pacific still did not constitute a singletheater in terms of Army command, and as late as February 1945 the SouthwestPacific Area command was uninformed as to what medical units it could obtainfrom the South Pacific Base Command.7
Another late-date problem in the coordination of higher command policywas noted by The Surgeon General`s inspection party which visited the basecommand early in 1945: the Navy was still failing to give adequate commandsupport to the program for inspection of food conducted by Army veterinaryofficers assigned to the Joint Purchasing Board in Wellington, New Zealand.This situation straightened out a few months later when arrangements weremade for assigning additional Army veterinarians to the Board to inspectthe foods bought in New Zealand, as well as for forwarding the veterinarians`reports direct to the office of the Surgeon, South Pacific Command.8
Tenth U.S. Army and Okinawa Island Command
Throughout 1944: several divisions, mostly attached to XXIV Corps, weretrained in Hawaii. Some, temporarily attached to various amphibious corps,took part in joint Army-Navy assaults on Saipan and Guam in the Marianas,as well as the Palau Islands in the Western Carolines. The XXIV Corps (the7th and 96th Divisions), originally scheduled for the Yap operation, wassent to Leyte and from the fall of 1944 to February 1945 came under thecontrol of the Southwest Pacific Area Command. From September 1944 on,the major ground combat command under the Commanding General, Pacific OceanAreas, was the Tenth U.S. Army, which had headquarters at Schofield Barrackson Oahu and invaded the Ryukyus in the spring of 1945. All Army divisionsin Hawaii not charged with defense of the islands, as well as three Marinedivisions, were assigned to the Tenth U.S. Army. Col. Frederic B. Westervelt,MC (fig. 105), who had been on the medical planning staff of Admiral Nimitz,became Surgeon, Tenth U.S. Army; by the end of August 1944 a surgical consultant,a medical consultant, a dental surgeon, a veterinarian, and a neuropsychiatristhad been assigned to his staff. An orthopedic consultant was assigned inFebruary 1945.
The XXIV Corps, now in Leyte, was placed under the Tenth U.S. Army forthe invasion of the Ryukyus and thus came under control of the CommandingGeneral, Pacific Ocean Areas. From the middle of February to April 1945,the small office of the Surgeon, XXIV Corps, on eastern Leyte was busywith readying troops medically for the invasion. It drew up a medical plan,and under its supervision vitamin tablets were distributed; troops wereimmunized for tetanus, smallpox, cholera, typhoid, and typhus; and troopunits
7 (1) See footnotes 2(3) and 2(4), p. 454.(2) Annual Report Medical Department Activities, South Pacific Area, 1945.
8 (1) Memorandum, The Surgeon General, for Commanding General,Army Service Forces, 10 Mar. 1945, subject: Report of Inspection. (2) Seefootnote 4(4), p. 457. (8) [History], Surgeon`s Section, U.S. Army Forcesin the South Pacific Area and South Pacific Base Command.
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were up to their full strength in medical officers. Malaria controland survey units were assigned to XXIV Corps during the planning period.
Several divisions of Tenth U.S. Army (in addition to XXIV Corps) trainedthroughout the winter of 1944-45 in Hawaii. During the planning periodthe Tenth U.S. Army Surgeon was aided by the surgeons of several othermajor commands with headquarters on Oahu: the U.S. Army Forces, PacificOcean Areas; the Army Air Forces, Pacific Ocean Areas; and various Navycommands. The joint planning of these headquarters for malaria controlmeasures to be adopted during combat, based on the experience of the SouthPacific Area, was a notable feature of the medical plans for the Okinawacampaign. Troops were given Atabrine during the preinvasion period andthe use of larviciding teams in division areas during combat materiallyreduced the mosquito population.
The medical consultant of the army was attached to III Amphibious Corps(consisting of three Marine divisions), which had been added as a secondcorps to the Tenth U.S. Army, and aided in coordinating medical policiesof the two corps. An island command was established for Okinawa on Oahuearly in January, and its medical section was provided with a nucleus staff.In addi-
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tion, 12 officers and 22 enlisted men of the Tenth U.S. Army medicalsection were placed on special duty with the island command medical section.
An "operational group" of the Tenth U.S. Army`s medical sectionleft Oahu for Okinawa on 5 March 1945; a corresponding group of the islandcommand medical section left on the same day. Practically all personnelof both medical sections were on Okinawa by the middle of April. All medicalunits landing during the early days of April were under control of thetwo corps of the Tenth U.S. Army. Then ensued a period during which additionalunits landing were controlled by the island command. In the early daysof May, the Tenth U.S. Army assumed control of a majority of medical unitsashore and was responsible for hospitalization and evacuation from divisions,through hospitals, to surface and air holding stations, while the islandcommand retained control of air and surface evacuation from the island.On 7 May, Headquarters, Medical Service, Tenth U.S. Army, was establishedunder the command of the Surgeon, Tenth U.S. Army, and to it were assignedall the combat medical units except those under XXIV Corps and those concernedwith supply and sanitation, which remained under island command control.Island Command, Tenth U.S. Army, had full responsibility for all evacuationfrom Okinawa and established an evacuation center made up of divisionalmedical units. By the close of the Okinawa campaign at the end of June1945, Island Command, Okinawa, was operating 35 Medical Department units,including 10 field, station, and portable surgical hospitals, and 15 Armyand Navy malaria and epidemic disease control units which were directedby a malaria and insect control headquarters in the field. The receptionof more than 1,000 sick and wounded Japanese prisoners of war had placeda heavy burden on the hospitals. Plans had been formulated for the establishmentof 14 additional station and general hospitals. A total of about 400 officersof the Medical, Dental, Veterinary, and Sanitary Corps and about the samenumber of nurses were serving in subordinate units within Okinawa IslandCommand.9
Army Air Forces, Pacific Ocean Areas
As a phase of the reorganization in the Pacific in August 1944, AAFPOA(Army Air Forces, Pacific Ocean Areas) was created, with headquarters atHickam Field, under the command of Lt. Gen. Millard F. Harmon. It consistedof Army Air Forces units in the Central and South Pacific Areas. Majorcomponents in the fall of 1944 were the Seventh Air Force (the direct descendantof the old Hawaiian Air Force), which was made a tactical air.
9 (1) Annual Report, Medical Department Activities,Tenth U.S. Army, 1944 (2) See footnote 3 (1) and (2), p. 455, (3) Reportof Operations in the Ryukyus Campaign, 26 Mar-30 June, 1945, Tenth U.S.Army, ch. 11, sec. XV: Medical. (4) Report of Surgical, Medical, and OrthopedicConsultants for Operational Reports of Okinawa Campaign, 30 June 1945.[Official record.] (5) History, Medical Section, Headquarters, Tenth U.S.Army, 1 Jan-15 Oct. 1945. (6) Quarterly Reports, Surgeon, XXIV Corps, 1stand 2d quarters, 1945. (7) See also Medical Department, United States Army.Preventive Medicine in World War II. Volume VI. Communicable Diseases:Malaria. [In press.]
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force, and XXI Bomber Command, which had begun moving into the PacificOcean Areas from the United States. Col. Walter S. Jensen, MC (fig. 106),became Surgeon, AAFPOA, while Col. Ralph Stevenson, MC (fig. 107), wasSurgeon, Seventh Air Force (based on Saipan from December 1944 to mid-1945and afterward on Okinawa), and Col. H. H. Twitchell, MC (fig. 108), wasSurgeon of XXI Bomber Command.
The XXI Bomber Command became a major element of the strategic TwentiethAir Force which carried out long-range bombing missions in both the China-Burma-Indiatheater and Pacific Ocean Areas in an airstrike against Japanese industry.Although its operations were to be aimed at a single enemy-Japan-its bombardmentwings were based in two areas under sepa-rate commands. Hence directionof the operations of elements of the far-flung Twentieth Air Force wasvested in the Joint Chiefs of Staff in Washington, where the Force wasserved directly in the staff of Army Air Forces headquarters. Under thissystem of remote control from Washington, Gen. Henry H. Arnold, CommandingGeneral, AAF, served as commander of the Twentieth Air Force, and the AirSurgeon, Maj. Gen. David N. W. -Grant, as its surgeon.
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In order to coordinate the operations of XXI Bomber Command-based inHawaii for some months after it began moving into the theater-with thoseof the Seventh Air Force, the Commanding General, AAFPOA (General Harmon),was made Deputy Commanding General, Twentieth Air Force; his surgeon, ColonelJensen, became deputy surgeon for the air force as well as Surgeon, AAFPOA.The bombardment wings of XXI Bomber Command moved into the Marianas betweenOctober 1944 and mid-1945, making the command`s first raid on Tokyo inNovember 1944. They were based at airfields on Saipan, Guam, Tinian, andIwo Jima. Other elements of the command settled on Okinawa and Ie Shimaafter June 1945. The surgeon of XXI Bomber Command and Surgeon, AAFPOA(Deputy Surgeon, Twentieth Air Force), were both located at their respectiveheadquarters on Guam after early 1945.
Besides the usual dispensaries maintained by the bombardment and airservice groups of XXI Bomber Command, 100-bed dispensaries, in realitysmall hospitals, were operated by the bombardment wings, whenever elementsof the wing were not too dispersed to make a small hospital practicable.The command found that these installations served to decrease the lossof man-days resulting from. hospitalization of air force personnel in hospitalsnot under air force control. Air force surgeons were, particularly loathto lose the flying
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time of the highly specialized men who manned the long-range B-29`s.Moreover, the wing dispensaries proved of value in relieving the regularfixed hospitals of some of their burden during periods of heavy evacuationfrom invasions. More serious cases among air force patients were sent tohospitals maintained by the Army Garrison Forces on Saipan or returnedto hospitals in the Hawaiian Islands. Medical supplies were furnished XXIBomber Command elements through the usual Army Garrison Force channelson the various islands.10
Colonel Jensen, who had recently been executive officer for the AirSurgeon in Washington, worked in close cooperation with the Air Surgeon`sOffice to build up, in accord with the latter`s policy for all overseaair forces, special medical components and practices removed from the controlof the local Army command. Besides a drive to have station and generalhospitals assigned to
10 (1) Army Air Forces Letter 20-3, 8 Apr.1944, to Chief of Air Staff, and others. (2) Narrative of Experiences ofthe Medical Section, Headquarters, XXI Bomber Command, for 1 March-31 December1944. [Official record.] (3) Quarterly Reports, Medical Section, TwentiethAir Force, 1st, 2d, and 3d quarters, 1945. (4) Memorandum, Col. WalterF. Jensen, MC, for the Air Surgeon, 10 Apr. 1944, subject: AdministrativeResponsibilities, Twentieth Air Force, Management Control.
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XXI Bomber Command, the Air Surgeon`s Office and the Surgeon, AAFPOA,made efforts throughout 1944: and early 1945 to set up a central medicalestablishment in both the Seventh Air Force and the XXI Bomber Commandlarger than the Seventh Air Force. This was the same type of unit thathad been established shortly before in the Eighth and Ninth Air Forcesin the European theater and in the Thirteenth Air Force in the South PacificArea. The Air Surgeon`s Office made strenuous efforts to get approval fora table of organization for a combined central medical establishment andconvalescent center, but by June 1945 this proposal had been definitelyturned down. However, during late 1944 and 1945 Headquarters, AAFPOA, tookover a number of rest and recreation camps and formed the Army Air ForcesPacific Ocean Areas Rest and Recreation Center. These camps had been establishedfor Seventh Air Force personnel by a committee of Honolulu civilians soonafter the beginning of the war at the request of the Seventh Air Forcesurgeon (Col. A. W. Smith). Located at Hawaiian beaches, ranches, and mountainresorts, they were used by thousands of combat crewmen of the Seventh andTwentieth Air Forces.
The Surgeon, AAFPOA, did not appear greatly interested, on the otherhand, in the efforts of the Air Surgeon`s Office to develop another unitwhich the latter office favored, the "Air Force Insect Control Unit."No particular problem had arisen in his area with respect to Army Air Forces`responsibility for airplane spraying of DDT; the work had been successfullyhandled informally. After a Navy malaria and epidemic disease control unit(attached to Naval Construction Battalions) did the initial job of spraying,the island surgeon (who might be an air, ground, or naval officer) tookcharge, and the Army Air Forces simply furnished the planes which he askedfor. Apparently, Colonel Jensen did not feel that the prestige of ArmyAir Forces would be materially enhanced by the recognition of a special"air force insect control unit."
SOUTHWEST PACIFIC AREA
From August 1944 to April 1945, the top structure of theater organizationin the Southwest Pacific Area underwent no major changes except for theestablishment of a top air force headquarters, the Far East Air Forces,to coordinate the activities of the Fifth and the newly arriving ThirteenthAir Forces. Several important subordinate commands were added as additionalArmy elements formerly in the Central Pacific and South Pacific Areas movedinto the Southwest Pacific Area. The Eighth U.S. Army built up in the theaterafter September 1944 on the eve of the Leyte invasion. With the progressof the Luzon campaign, the headquarters of practically all the major commands,including their medical sections, moved from New Guinea to Luzon.
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Allied Headquarters, U.S. Army Forces in the Far East, and Servicesof Supply Headquarters
Col. George W. Rice, MC, continued as Surgeon, General Headquarters,until September 1944. Because of his experience and extensive knowledgeof the area, he was transferred at that time to the position of Surgeon,Eighth U.S. Army, exchanging assignments with Col. John F. Bohlender, MC(fig. 109), and soon becoming elevated to the rank of brigadier general.The title, "Surgeon, GHQ," ended with the departure of GeneralRice, for Colonel Bohlender not only worked through G-4, General Headquarters,but was specifically assigned there. With the aid of one enlisted man,he continued his predecessor`s work on the medical phases of the campaignplans initiated by G-4 at General Headquarters, coordinating plans forwater evacuation with the Navy and those for air evacuation with the FarEast Air Forces and the Pacific Wing, Air Transport Command. Plans werethen worked out in greater detail by Medical Department officers at theheadquarters of U.S. Army Forces in the Far East and the Services of Supply.General Headquarters moved from Brisbane to Hollandia in August 1944, toLeyte in October, and to Manila in February 1945.11
Throughout most of 1944, the office of the Surgeon, USASOS (U.S. ArmyServices of Supply), had also been at Brisbane, but in September, whenthe northward movement of troops resulted in a shift of Services of Supplyheadquarters, this office moved by echelons to Hollandia, then in early1945 to Leyte, and finally in March and April to Manila. In March 1945,General Denit commented upon the diffusion of offices under his controlby noting that he then had medical offices for the Services of Supply inthree places-an office with the advance echelon in Manila, one at mainheadquarters on Leyte, and one with the rear echelon in Hollandia. As surgeonfor the U.S. Army Forces in the Far East, he had a few officers workingunder his direction at that command`s two headquarters in Manila and Leyte.During the shift of forces from New Guinea to the Philippines, the coordinationof medical planning by these small offices was difficult.
The total officer personnel on General Denit`s staff was even less thanit had been during the period 1942-August 1944 and totally inadequate fordiffusion among several physical locations. In February 1945, for instance,only 22 officers were under his direction, 4 working with the theater headquartersand 18 at Services of Supply headquarters. Of the latter number, exactlyhalf were on detached service only; that is, their principal assignmentswere with other commands. The Services of Supply medical office still hadno chief of preventive medicine at that date. The only assignments to preven-
11 (1) Report, Chief Surgeon, General Headquarters,U.S. Army Forces, Pacific, 9 June-Dec. 1945. (2) Quarterly Report, Surgeon,2d Port of Embarkation, 4th quarter, 1942. (3) Memorandum, Col. J. F. Bohlender,MC, to Surgeon, U.S. Army Services of Supply, 17 Sept. 1944. (4) EssentialTechnical Medical Data, U.S. Army Services of Supply, 20 Nov. 1944. (5)Letter, Surgeon, U.S. Army Services of Supply, to The Surgeon General,12 Oct. 1944.
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tive medicine functions were those of a venereal disease officer anda nutrition officer. By May, however, preventive medicine had become arecognized entity. The office then had, in addition to a deputy chief surgeon,executive officer, historian, and nutrition officer, chiefs of the followingdivisions: Administra-tive, Supply, Personnel, Hospitalization, Evacuation,Plans and Training, Preventive Medicine, Dental, Veterinary, Nurses, andConsultants.12
A small allotment for administrative positions hampered not only enlargementof General Denit`s scattered staff but the development of an adequate medicalstaff at the headquarters of base sections and bases as well. In the fallof 1944 the War Department allotment of Medical Corps officers for overhead-that is, the medical sections at headquarters of U.S. Army Forces in theFar East and of the Services of Supply and its area commands-was 134 officers.Of these, only eight could be colonels. The chiefs of divisions in GeneralDenit`s office at Services of Supply headquarters and his consultants,as well
12 (1) Annual Report, Chief Surgeon, U.S. ArmyServices of Supply, 1944. (2) 2d Lt. R. C. Folwell, MAC, Historical Division,U.S. Army Forces Western Pacific, for the record, no date, subject: InformationConcerning the Office of the Chief Surgeon, USASOS and AFWESPAC. (3) Letter,Chief Surgeon, U.S. Army Services of Supply, to The Surgeon General, 23Mar. 1945. (4) Minutes, Conference of General and Special Staff Sections,Headquarters, U.S. Army Services of Supply, 5 Sept. 1944. (5) Memorandum,Chief Surgeon, U.S. Army Services of Supply, for Chief of Staff, 16 May1945, subject: List of Key Personnel in the Medical Section, With a BriefSummary of Their Duties.
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as the surgeons of bases and of base, intermediate, and advance sections,had a claim on the rank of colonel.
The difficulty of obtaining sufficient officers of adequate rank forimportant administrative assignments in the Services of Supply setup ledthe theater surgeon to activate the headquarters of six "hospitalcenters" in late 1944 and early 1945 at bases in New Guinea and thePhilippines. The table of organization for headquarters of the hospitalcenter amounted to 8 officers (including a lieutenant of the Army NurseCorps), 1 warrant officer, and 23 enlisted men. Hospital centers were notneeded in the Southwest Pacific Area. In contrast to the situation in theEuropean theater, fixed hospitals were located in close proximity to thebase headquarters rather than at various sites within a large base section.Moreover, general hospitals did not usually remain for any length of timeat a single location in the Southwest Pacific Area (most of the bases beingof short-range value); hence the specialization in handling certain typesof cases which administration under fully developed hospital centers wouldhave fostered was never feasible at the New Guinea and Philippine bases.The table of organization for the headquarters of hospital centers served,however, to give the theater surgeon a number of additional positions,some carrying advanced rank, to which he could assign Medical Departmentofficers. For the most part, such personnel did not perform the dutiesof the positions to which they were assigned but the duties of the staffof a base surgeon`s office. Most of the officers and a good many of theenlisted men assigned to the so-called, "hospital centers" wereplaced on detached service or temporary duty with the base surgeon`s office.In a good many instances, the officers had already been serving for sometime as base surgeons or in the base surgeon`s office. They were then assignedto the centers, being promoted to the next higher rank, but placed on detachedservice in their former positions. In the case of three or four of the"hospital centers," a small portion of the assigned staff didperform a few of the duties-such as the operation of a pool of vehiclesand a postal service-for the hospitals assigned to the center, but underthe circumstances which prevailed in the Southwest Pacific Area such servicescould be more advantageously performed by the base surgeon`s office forall installations located at the base. Although it was expected that theheadquarters of hospital centers in the Philippines, transferred in somecases from New Guinea with a fairly complete roster of personnel, wouldadminister the large network of hospitals designed to take care of evacueesfrom the invasion of Japan, as matters turned out they were never calledon to do so. The headquarters of hospital centers served, therefore, theprimary purpose, important to the theater surgeon, of augmenting the staffsof base surgeons.13
13 (1) Letter, Chief Surgeon, U.S. Army Servicesof Supply, to Lt. Col. Lamar C. Bevil, MC, Office of The Surgeon General,16 Oct. 1944. (2) Deputy Chief Surgeon, to Chief Supply Officer, AdvanceEchelon, Services of Supply, 22 Dec. 1944. (3) Quarterly Reports, 25th,26th, 27th, 29th, 30th, and 31st Hospital Centers, 1945.
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The lack of an efficient medical supply system, together with acuteshortages prevailing in some areas, especially during the early days ofheavy combat on Leyte, was considered by the Voorhees mission a seriousdefect in medical administration in the Southwest Pacific Area. A basiccause, the mission found, was the prevailing practice of requisitioningon a theaterwide basis. Since command was highly decentralized and depotsin New Guinea and the Philippines were spread over a distance of 2,500miles, direct requisitioning on San Francisco by a particular base wouldhave been more efficient. Moreover, medical supplies for the Philippinesmight come in at any point in the theater. They were moved from base tobase chiefly by water, and many difficulties had to be overcome beforehospitals and dispensaries could receive medical supplies: an unchartedcoast, congested ports, inadequate facilities for overland transport, andheat and humidity which hampered movement and caused swift deteriorationof items and containers. The mission failed to establish in the SouthwestPacific Area, as well as in the Pacific Ocean Areas, any coordinated andworkable system of medical supply for future operations. Its major contributionswere certain measures which it advocated to meet the heavy demands fortroops on Leyte, and its recommendations as to individuals to fill certainmedical supply posts.14
In early 1945, The Surgeon General and his Deputy Chief of Plans andOperations, Col. Arthur B. Welsh, MC, visited the Southwest Pacific Areaand inquired into the status of medical service in Australia, at severalNew Guinea bases, and on Leyte. At that date the Surgeon, U.S. Army Forcesin the Far East and U.S. Army Services of Supply, as well as the Surgeon,Eighth U.S. Army, and the surgeon with G-4 of General Headquarters, wereon Leyte. Col. Maurice C. Pincoffs, MC, and the consultants were on Luzon.Back in Hollandia were the rear echelons of the theater command and theServices of Supply and their medical sections.
Colonel Welsh was "not particularly impressed with the theaterorganization from the medical viewpoint." He observed failure on thepart of the theater command to consult General Denit on theaterwide medicalproblems and noted conflicting claims by General Denit and the medicalofficer at G-4, USAFFE, as to responsibility for medical planning for combatoperations. Lacking knowledge of the plans of the Pacific Ocean Areas commandfor future operations, medical officers in the Southwest Pacific Area foundit difficult to arrange for the transfer of excess medical units from theSouth Pacific Base Command to the Southwest Pacific Area. Colonel Welshstressed the need for organizing Army troops in the Pacific into a singletheater. The Surgeon General reported to General Somervell that the theatersurgeon lacked sufficient officers of high grades to staff his own officeand those of the surgeons of base sections and other headquarters. Manyhospital staff officers in the Southwest Pacific Area had been removed
14 (1) See footnote 2 (3) and (4), p. 454.
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to fill administrative positions at various headquarters or had beenused in dual assignments; the morale of hospital staffs had been weakenedand hospital administration had been crippled.15
Armies and Air Forces in New Guinea and the Philippines
By September 1944, major combat forces with surgeons` offices in theSouthwest Pacific Area were the Sixth and Eighth U.S. Armies, the 14thAntiaircraft Command, and the Far East Air Forces, which included the Fifthand Thirteenth Air Forces. At this time the Sixth U.S. Army surgeon`s officewas at Hollandia, New Guinea (where most of the staff medical sectionsof top commands were congregated late in the year) ; it was occupied withplanning the medical aspects of the coming campaigns on Leyte and Luzon.As of 1 October, shortly before Sixth U.S. Army headquarters took the field,the office of its surgeon, Col. (later Brig. Gen.) William A. Hagins, MC,was composed of 22 Medical Department officers, including, in additionto dental and veterinary officers, officers assigned to inspection, supply,statistics, and operations, as well as 3 malariologists. The staff variedlittle in number during the Philippine campaigns (although there were manychanges in personnel), but a surgical consultant was added late in 1944,and a medical and an orthopedic consultant from the Services of Supplyheadquarters served for a time on temporary duty. No neuropsychiatric consultantwas assigned to the office of the Sixth U.S. Army surgeon during the campaignson Leyte and Luzon until early June 1945 when the fighting was practicallyover; hence policy in the handling of psychiatric cases was not issuedfrom the army level but remained a matter for determination by divisionalneuropsychiatric consultants.
The Sixth U.S. Army included several corps during its Philippine campaign.The corps surgeon`s office typically included two or three Medical Corpsofficers, two Medical Administrative Corps officers, and a few enlistedmen. Besides the customary duties, the corps surgeon in the Southwest PacificArea bad to make frequent trips by air to divisional staging areas on scatteredislands to determine the readiness of Medical Department units of the variousdivisions for combat. To inspect medical units preparing for the invasionof Mindanao, for example, the Surgeon, X Corps, visited, in addition tothe Leyte staging area controlled by X Corps, the staging area of the 24thInfantry Division on Mindoro, and that of the 31st Infantry Division onMorotai. After a trip to Davao in the 24th Division staging area on 1 June1945, he was missing in action. Apparently his plane had been shot downafter one of his customary low-level reconnaissance flights over the frontlinesto view the terrain preparatory to planning the advance of field medicalunits into enemy territory.
15 (1) See footnotes 4(4), p. 457; and 8(l),p. 461. (2) Interview, Dr. Maurice C. Pincoffs, 22 May 1952.
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For the Leyte and Luzon invasions the Sixth U.S. Army had attached toit an "army service command," consisting of troops from the Servicesof Supply, which was to found bases when the landing forces were firmlyestablished. These service troops included the medical sections for BaseK established on Leyte and Base M established on Luzon. After the Leytelandings in mid-October, the Sixth U.S. Army surgeon`s office worked atseveral locations on the island; with the move of Sixth U.S. Army to Luzonearly in 1945 it made similar rapid moves.16
Eighth U.S. Army headquarters arrived in New Guinea in September 1941,taking over control of combat units in Netherlands New Guinea, the AdmiraltyIslands, and Morotai from the Sixth U.S. Army. Col. George W. Rice, MC(promoted to brigadier general in June 1945), shortly became Eighth U.S.Army surgeon, replacing Colonel Bohlender, the original surgeon who hadarrived in Hollandia with the advance echelon of the headquarters. In October1941, Colonel Rice had on his staff a medical consultant, a surgical consultant,a neuropsychiatric consultant, a preventive medicine officer, a dentalofficer, and a veterinarian. Surgeons were assigned at that date to thefollowing units of the Eighth U.S. Army: I Corps, XI Corps, and eight infantrydivisions (the 6th, 31st, 33d, 38th, 40th, 41st, 43d, and 93d).
Eighth U.S. Army followed Sixth U.S. Army from New Guinea into Leyteand later carried out the amphibious operations in the southern PhilippineIslands, Mindanao, and the central Visayas (as well as two operations onLuzon), while Sixth U.S. Army went on to the main invasion of Luzon. Themedical section of Eighth U.S. Army shifted from Hollandia to Leyte inthree echelons during the period from November 1944 to January 1945, leavingan officer and two enlisted men in Hollandia to follow them later in January.During the first half of 1945, the army medical section drew up plans forcoming operations in the archipelago, inspected the training and supplyof units, and supervised the medical service in the forward areas of thearmy in the central and southern Philippines-Leyte-Samar, Cebu, Negros,Panay, Mindoro, Palawan, and Mindanao and the Zamboanga Peninsula-and inits rear areas in New Guinea. It kept in close touch with medical serviceof the Sixth U.S. Army in Luzon.17
A major ground force command in addition to the Sixth and Eighth U.S.Armies was the 14th Antiaircraft Command, which had been activated at Brisbanein November 1943. A staff surgeon`s office was set up for the command inMarch 1944. At first distributed over Australia and New Guinea, antiair-
16 (1) Quarterly Reports, Surgeon, X Corps,3d and 4th quarters, 1944, and 1st quarter, 1945. (2) Quarterly Reports,Surgeon, I Corps, 1944 and 1945. (3) Quarterly Reports, Surgeon, XIV Corps,4th quarter, 1944, and 1st quarter, 1945. (4) Report of Operations in theLuzon Campaign, 9 Jan 1945-30 June 1945, Sixth U.S. Army. (5) QuarterlyReports, Surgeon, Sixth U.S. Army, 1st and 2d quarters, 1945. (6) QuarterlyReports, Surgeon, XXIV Corps, 2d, 3d, and 4th quarters, 1944.
17 (1) Quarterly Reports, Surgeon, Eighth U.S. Army, 2d, 3d,4th quarters, 1944, 1st and 2d quarters, 1945.(2) See footnote 11 (4),p. 468.
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craft troops later spread to islands north of New Guinea and then intothe Philippines. In the middle of 1944, only about half of the approximately50,000 troops of the command were under its direct control, the rest beingunder the administrative as well as operational control of Sixth U.S. Armyand XIV Corps. In the fall of 1944, the surgeon`s office was still in Brisbane,although his malariologist maintained an office at the command`s advanceechelon in Finschhafen in order to indoctrinate units in malaria control.The scattered character of the command and -the attachment of a goodlyportion of its units to other commands created some obstacles to centralizedcontrol of its medical service. The surgeon`s office found it difficultto estimate the medical personnel needed by the antiaircraft units attachedto other commands and to obtain statistics on their disease rates as wellas to supervise the work done by the medical detachments of the scatteredunits.18
The medical section of the highest headquarters of the Army Air Forcesin the Southwest Pacific Area, the Far East Air Forces, was at Hollandia,New Guinea (Base G), in the fall of 1944. It coordinated the medical activitiesof its two major components, the Fifth and Thirteenth Air Forces; air forceelements were scattered over Australia and New Guinea and later the Philippines.In November the medical section transferred with Headquarters, Far EastAir Forces, to the Philippines and by the end of March 1945 was near Tolosaon the Gulf of Leyte. Headed by Col. Robert K. Simpson, MC, it containedonly about half a dozen medical officers. The strength of the Far EastAir Forces varied from about 135,000 to about 145,000 from the fall of1944 to the spring of 1945. An attempt was made to develop the centralmedical establishment for use in the Southwest Pacific Area. One had beenorganized at Guadalcanal in June 1944 as a unit of the Thirteenth Air Force,evolving concurrently with the central medical establishments for the Eighthand Ninth Air Forces in Europe. The establishment set up in the ThirteenthAir Force in the South Pacific Area grew out of the work of examinationand disposal of flying personnel by flight surgeons which had been originallydone in the Auckland rest area of New Zealand and later at a screeningcenter established on Guadalcanal in April 1944.
The Second Central Medical Establishment, organized originally with10 officers and 25 enlisted men, was not very active during its early monthsat Guadalcanal. In September 1944, after the transfer of the ThirteenthAir Force to the Southwest Pacific Area, this unit was assigned to theFar East Air Forces and in November to the Far East Air Forces Combat Replacementand Training Center at Nadzab, New Guinea. Plans were made for a researchsection to study factors affecting the health and safety of flying personneland
18 Quarterly Reports, Medical Department Activities,14th Antiaircraft Command, Jan. 1944-June 1945.
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the methods and equipment to aid them to survive in cases of crashesover sea and jungle areas. The establishment was also to include a screeningcenter to examine flying personnel before granting them leave, a centralmedical board to review the status of individuals whose physical or mentalfitness for flying was in doubt, an aircrew indoctrination section, anda rehabilitation section. Not all of these units ever developed, nor didsome others which were proposed. Frequent changes in location of the centralmedical establishment, the separation of some of its elements from eachother, the scattering of air force units in many locations, and the interferenceof theater organization apparently prevented its progress along the linesthat Medical Department officers in the Far East Air Forces and the Officeof the Air Surgeon would have liked. Moreover, the end of the war removedany need for it and for two more such establishments requested for theFar East Air Forces.19
The Air Surgeon (Maj. Gen. David N. W. Grant) accompanied by the Surgeon,Far East Air Forces, and the Surgeon, Army Air Forces, Pacific Ocean Areas,visited air force units on New Guinea, the Philippines, and various islandsin November 1944. General Grant attempted to enlarge the medical servicewithin the Far East Air Forces by advocating a large increase in personnel-theaddition of 61 medical officers and 80 dental officers-and other measures.He declared that doctors in the theater Services of Supply organizationdid not understand the "highstrung, sensitive mechanism" of aviators;only flight surgeons could keep aviators in flying condition. General Grantstressed the need for central medical establishments to classify and disposeof flying personnel discharged by the general hospitals. He also urgedthe desirability of direct control of general hospitals by the Far EastAir Forces, pointing out that a precedent for such control had alreadybeen established in the Mediterranean theater.
Although his recommendations were largely sustained by the Far EastAir Forces, both the theater medical staff and the Chief Surgeon, USASOS(General Denit), were unalterably opposed to control of hospitals by theair forces. The U.S. Army Services of Supply continued to control the fixed.hospitals of the Southwest Pacific Area; the air forces in the area (andin the South Pacific) were restricted to control of 25-bed portable surgicalhospitals assigned to them, and hospitals, termed dispensaries, operatedby the XXI Bomber Command. The assignment of a flight surgeon to GeneralCarroll`s office as a liaison officer from the Far East Air Forces provedhelpful in convincing medical officers of the latter headquarters thatthe staff of the Services
19 (1) See footnote 2(2), p. 454. (2) Memorandum,Commanding Officer, 2d Central Medical Establishment, Special, for ChiefSurgeon, Headquarters, U.S. Army Forces in the Western Pacific, 25 July1945, subject: Location of Medical Installations. (3) Quarterly Reports,Medical Department Activities, 2d Central Medical Establishment, Special,covering period, 5 June 1944-31 Dec. 1945. (4) Link, Mae Mills, and Coleman,Hubert A.: Medical Support of the Army Air Forces in World War II. Washington:U.S. Government Printing Office, 1955, pp. 751-756.
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of Supply medical section understood the "peculiar and highly sensitivecharacteristics of Air Corps personnel."20
Base Sections and Bases: Australia, New Guinea, and the Philippines
In the latter part of 1944, the area organization of the U.S. Army Servicesof Supply in Australia was declining, while it was still building up inNew Guinea and just getting underway in the Philippines. Base Section,USASOS, established in June 1944 with headquarters at Brisbane, administeredArmy medical service for all troops in Australia with only three area subcommands-Bases 2, 3 (later absorbed by the base section), and 7 at Townsville, Brisbane,and Sydney, respectively. In the fall of 1944 this, medical office consistedof eight officers, including a veterinary consultant, a dental consultant,and a nutrition consultant, four enlisted men, and six civilians. Sincewar had moved far away from Australia, Medical Department officers stationedthere were able to give more time and effort to acquainting themselveswith recent developments in medical and dental techniques; in 1944 a numberof interallied dental meetings and conferences took place. Liaison withlocal Australian authorities continued in connection with the program forcontrol of venereal disease, food inspection, and the maintenance of adequatenutritional standards, as well as with respect to medical service providedfor Australian civilians employed by the U.S. Army. At the end of 1944,one general and three station hospitals sufficed to care for troops remainingin Australia. After further retrenchment, including consolidation of Armyand Navy medical facilities, in the first 6 months of 1945, less than halfa dozen officers and a few enlisted men and Australian civilians comprisedthe medical section of Australian Base Section.21
In the fall of 1944 Intermediate Section, with headquarters at Oro Bay,controlled all seven New Guinea bases (including the last one, Base H,established on Biak Island). During that period the chiefs of technicalservices at the New Guinea bases were given command control of the installationsmaintained by their services. The base surgeon was thus placed in actualcommand of medical units, hospitals, and other medical installations atthe base.22 As in the case of the Central Pacific Base Command,the surgeon re-
20 (1) Letter, The Surgeon General, to ChiefSurgeon, U.S. Army Services of Supply, 28 Nov. 1944. (2) Letters, ChiefSurgeon, U.S. Army Services of Supply, to The Surgeon General, 7 and 8Dec. 1944. (3) Memorandum, the Air Surgeon for Commanding General, ArmyAir Forces, 23 Nov. 1944, subject: Reports on Special Mission. (4) Seefootnote 2(2), p. 454. (5) Quarterly Reports, Medical Department Activities,Headquarters, Far East Air Force, 3d and 4th quarters, 1944, and 1st and2d quarters, 1945. (6) Letter, Chief Surgeon, U.S. Army Services of Supply,to The Surgeon General, 18 Nov. 1944.
21 (1) Quarterly Reports, Medical Department Activities, BaseSection, U.S. Army Services of Supply, 3d and 4th quarters, 1944, 1st quarter,1945. (2) Quarterly Report, Medical Department Activities, Australian BaseSection, U.S. Army Forces in the Western Pacific, 3d quarter, 1945. (3)See footnote 11 (4), p. 468.
22 Letter, Surgeon, Intermediate Section, to Chief Surgeon,U.S. Army Services of Supply, 2 Sept. 1944.
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ceived the full control over the medical resources of the command whichstaff surgeons invariably welcomed.
By the end of 1944 several New Guinea bases, especially those at MilneBay, Port Moresby, and Lae, had declined markedly in importance. Base Gat Hollandia, on the other hand, was receiving a large share of the evacueesfrom the Philippines. The base at Biak (Base H) was also getting many casualtiesand was the point of departure for air evacuation to the United States.In February 1945, when the Services of Supply was building up its basesin the Philippines, all seven New Guinea bases were placed under the newlyestablished New Guinea Base Section (successor to Intermediate Section)with headquarters at Oro Bay. Although the New Guinea Base Section surgeonoriginally had a full complement of staff officers, before the end of Marcha number of the members of his medical section were sent forward to basesin the Philippines.23
The original bases in the Philippines were developed by the Army ServiceCommand which accompanied Sixth U.S. Army and established the Servicesof Supply bases in the wake of the army. At Hollandia in the fall of 1944it assembled the nucleus organization, including medical sections, of thetwo bases initially established in the Philippines, Base K at Tacloban,Leyte, and Base M, originally at San Fabian, Luzon (January-April 1945),and finally at San Fernando, Luzon. Army Service Command moved to Leytein the late fall of 1944 and put together at Tacloban the organizationfor two additional bases of minor importance, Base R which was to be atBatangas on Luzon and Base S to be on Cebu. Early in 1945, Army ServiceCommand moved. on to Luzon where, renamed Luzon Base Section, it revertedto the control of the Services of Supply and directed the activities ofBase M and three subbases.
The medical organization of the bases established in the Philippineswas largely a repetition of that of the New Guinea bases, although themedical section that entered a Philippine base was usually more nearlyfull fledged than the usual office which had had to tackle the initialmedical job at a Now Guinea location. The San Fernando Base (Base M), forexample, had about 25 Medical Department officers assigned to it from theoutset. Besides the base surgeon and the usual dental officer, veterinarian,and medical supply officer, the Philippine bases had in their initial setupcertain medical assign-ments which some of the New Guinea bases (or, atleast, those earliest established) had not received until they had beenin existence for some months: A malariologist, a port surgeon, an areacommand surgeon, a hospitalization officer, an evacuation officer, anda personnel officer. The assignment of one or more venereal disease controlofficers to the Philippine bases from the out-
23(1) Quarterly Reports, Medical DepartmentActivities, various New Guinea bases, 3d and 4th quarters, 1944, and 1stand 2d quarters, 1945. (2) Quarterly Report, Medical Department Activities,Intermediate Section, U.S. Army Services of Supply, 3d and 4th quarters,1944. (3) See footnote 11 (4), p. 468.
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set betokens the Medical Department`s memory of the high venereal diseaserates that had prevailed among U.S. Army troops in the Philippines beforethe war. An early attempt was made to sponsor measures, including the adoptionof special local legislation, which had been found effective in copingwith the problem in Australia.24
Several Medical Department officers present in the early days of theLeyte invasion left a graphic picture of the geographic, climatic, andadministrative obstacles which they encountered in getting the medicalservice of Base K into running order. Like the other Army logistic officers,they encountered the adverse weather and terrain which Sixth U.S. Armyengineers had prophesied would make the founding of a base in Leyte Valleya difficult undertaking. On the 13th day of the invasion, the Base K surgeon,Lt. Col. Paul 0. Wells, MC (fig. 110), reported:
Have been in this base for 8 days and have spent mostof that time on reconnaissance. I am sorry to have to report that it isthe most undesirable terrain on which to build a base that I have everseen * * *. Every service is scrambling for suitable area and it is notto be had. I would estimate that only 5-4001o of the land can be used fordumps or any other installation. The remainder is swamp and rice paddy* * *. There are some optimists who think that they can hang hospitalson these hill sides but I am convinced that they cannot do so without theuse of more earth moving equipment than the engineers can make availablefor hospital construction * * *.
The civilian population here is in good shape with 3 monthssupply of looted rice and two hospitals running with native doctors. Thecivilian situation around Dulag is bad since the town and adjacent districtwas destroyed and there are several thousand huddled on the beach withoutmuch food and no shelter or medical care. The PCAU [Philippine Civil Affairs]units were swamped and have called for help. Sent one doctor down and theyhave been given Jap medical supplies. Have no other supplies of my ownas yet so have to refer them to 6th Army. Col. Hagen [Hagins, Sixth U.S.Army Surgeon?] will give them help as the military needs will permit. WishI could do more.25
Within a few days, Colonel Wells had been able to survey much more desirablevalley terrain around Burauen but could not locate his hospitals thereas it was necessary to place them close to other base installations nearthe port of Tacloban. On 22 November he recounted additional difficulties.
Jap bombing has slacked off considerably though we havehad a number of planes crash dive on ships with heavy casualties in somecases.* * * the ship on which the 101st and 91st Station Hospitals werelocated was one of the victims. They lost a total of 4 killed, 4 missingand 6 injured at latest report.* * * I continue to have serious difficultiesIn retaining suitable sites for hospitals. Have been allocated and subsequentlylost a majority of the desirable area in the base. The latest happenedtoday when I lost the site of my convalescent hospital to an air strip(They have had to give up on one of the strips because of the mud, etc.)and the site of a 500 bed station to an ordnance dump!* * *
24 (1) Historical Record of Army Service Command,23 July 1944 to 13 February 1945. (M-1 Operation). [Official record.] (2)Quarterly Reports, Medical Department Activities, Bases K and M, 4th quarter,1944, 1st quarter, 1945. (3) Krueger, Walter: From Down Under to Nippon.Washington: Combat Forces Press, 1958, p. 353. (4) See footnote 12 (1),p. 469.
25 (1) Cannon, M. Hamlin: Leyte: The Return to the Philippines.United States Army in World War II. Washington: U.S. Government PrintingOffice, 1954, ch. XI. (2) Letter, Lt. Col. Paul O. Wells, MC, to Brig.Gen. Guy B. Denit, 1 Nov. 1944.
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The need for beds is critical with only about 150 vacantbeds in the base. Had a conference with Colonel Hogan [Hagins?] today andhe wanted to know how many beds I could provide in 48 hours. I told himnone unless he could get the hospital equipment unloaded from the shipsand some engineer effort on hospital construction. Sixth Army is stillin control here and sets all priorities on unloading and engineer effort.He stated that he was presenting the facts to the Chief of Staff this afternoonand insisting on immediate action. He was very critical of the 6th ArmyEngineer.
We have had two mild typhoons and one other alarm. Havekept my hospitals back a distance from the open beach in anticipation ofpossible big blows from the open sea. Couldn`t have gotten them on thebeach anyway in view of the number of headquarters arriving here.26
As late as 9 January 1945, a Medical Corps officer with Advance Headquarters,USASOS, corroborated Colonel Wells` account of his difficulties.
From the planning stage we have progressed to the constructionand development era. * * * To be frank with you, we love it. We alwayswork best with our feet on terra firms, and canvas overhead. * * * in factwe are very well pleased with the cooperation we have received from everyone.We are doing our damnedest to help, but we feel that it will take an actof God to correct the deficiencies present in this Base. We do not understandhow Colonel Wells has been able to remain a sane person after what he hasgone through.
26 Letter, Lt. Col. Paul O. Wells, MC, to Brig.Gen. Guy B. Denit, 22 Nov. 1944.
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He has had to deal with Sixth Army, GHQ, ASCOM, USAFFE,USASOS, ADSOS, Base "K," Leyte Engineer Command, Eighth Army,XXIV Corps, Philippine Civil Affairs Units, and other agencies too numerousto mention.
Colonel Voorhees noted extreme confusion with respect to the channelsof medical supply as well:
The red tape passed any belief. Even a radio requisitionhad to go from the medical supply officer to the Base Headquarters, fromBase Headquarters to Advance [should be "Army"] Service CommandHeadquarters (known as ASCOMI; I felt that the accent should be stronglyon the first syllable), from there to Sixth Army Headquarters, from thereto USASOS Headquarters at Hollandia, and from there to Intermediate Section1,000 miles farther away at Oro Bay.
This was, of course, an extreme situation which developed in the courseof establishing, during heavy combat, a large new base at the end of anextended supply line. But similar difficulties, though in less severe form,attended the early stages in developing medical service at other basesin the Philippines.27
Public Health in the Philippines
The Philippine Islands were the major region of the Southwest PacificArea where U.S. Army doctors had responsibility for reestablishing publichealth services for a people formerly under enemy domination.28 Effectivehealth measures in these island possessions after more than 2 years ofJapanese domination would contribute significantly to the regenerationof American prestige. The civil affairs program in the Philippines wasa wholly unilateral operation of the United States, and the U.S. Army plannedas well as administered it. Hence policy and top direction of the programstemmed from a staff section created at the top U.S. Army headquarters-Headquarters,U.S. Army in the Far East-in November 1944. The Civil Affairs Section,USAFFE, which had general responsibilities for coordinating all mattersof civil administration until responsible government could once again beestablished throughout the archipelago, had the specific responsibilityfor planning and supervising health and sanitary measures. Other taskswhich it undertook, such as the restoration of destroyed or damaged publicutilities, were, as elsewhere, closely related to the public health program.Colonel Smith, recently theater malariologist, was put in charge of thesmall medical section. As in other theaters, a similar medical sectionwas created in G-5 at lower levels of command, both area and tactical.
A Civil Affairs Detachment was formed at Headquarters, USAFFE, to developPhilippine Civil Affairs Units. The first eight such units to be created,made up largely of personnel from the First Filipino Regiment and
27 (1) Letter, Maj. U.S. Steinberg, to Col.R. O. Dart, MC, 9 Jan. 1945. (2) See footnote 2(3) and (4), p. 454. (3)Letter, Lt. Col. David A. Chambers, MC, to Brig. Gen. Guy B. Denit, 28Dec. 1944. (4) Engineers of the Southwest Pacific, 1941-1945, vol. VI;Airfield and Base Developments. Washington: U.S. Government Printing Office,1951, pp. 311-312.
28 Civil Affairs in New Guinea, New Britain, and the Admiraltieshad been handled by the Australian-New Guinea Administration Unit (ANGAU).
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the Second Filipino Battalion of the U.S. Army, were trained by thisdetachment at Oro Bay, New Guinea.29 Eventually 30 units weredeveloped, all being used during the campaign for the Philippines. Oneof the 10 officers in each unit was a medical officer and 4 or 5 of the39 enlisted men had medical duties. Many of the personnel, particularlythe officers, had received training at the civil affairs training schoolsin the United States. The civil affairs units were attached to army commands(the Sixth and Eighth U.S. Armies) at the army, corps, or division levelor to base commands. Eventually they worked in every province of the archipelago.
In the early stages of a campaign, Philippine Civil Affairs Units wereusually allocated to the division or corps. When Sixth U.S. Army went intothe Leyte campaign, for example, two Philippine Civil Affairs Units wereattached to X Corps, two to XXIV Corps, two to the Army Service Command,while two were kept in reserve under Sixth U.S. Army control. Initiallythe units were further attached by corps headquarters to the divisions.Services which their personnel could perform at the corps or division levelin the initial stages of a campaign included giving initial care to woundedand sick refugees in Army hospital units, salvaging Japanese medical suppliesfor use among Filipino civilians, hunting out civilian doctors, and establishingdispensaries and some hospitals for civilians. The successive phases ofdivisional, corps, and Army control of civil affairs units passed quickly,of course. In Tacloban, for example, responsibility for civil affairs passedfrom divisional to Sixth U.S. Army control late in October 1944, and BaseK relieved X Corps of responsibility in Leyte Valley on I January 1945.The greatest difficulty encountered by medical officers assigned to theunits was a lack of medical supplies for civilian use. Shortages were due,as were shortages of relief supplies in general, to shipping shortagesand the inadequate capacities of ports. As in other areas it was necessaryto divert to civilian use medical stores intended for troops.
The largest task of restoring normal health facilities lay in Manila,where widespread destruction in the wake of prolonged street-to-streetcombat intensified health problems. The rapid rehabilitation of Manilawas important not solely because it was the capital and the, key city foreconomic renaissance of the Philippines. At that date it was consideredvital to supply lines for an invasion of Japan, and for a few months theU.S. Army had the additional motive of self-interest in reestablishinggood health conditions and preventing epidemics in the city.
Eight Philippine Civil Affairs Units accompanied XIV Corps as it foughtits way into Manila in February 1945. One entered the burning city on 5February, 2 days after the first troops went in. Reports of widespreaddisease, starvation, and death reached the advance echelon of General Headquarters
29 The Civil Affairs Detachment, U.S. ArmyForces in the Far East, corresponded to the European Civil Affairs Division,the training entity of the European theater, while the Philippine CivilAffairs Units were similar to units which performed the fieldwork in theEuropean theater.
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located north of Manila. Colonel Pincoffs, Chief Medical Consultant,USAFFE, was sent forward with other officers to survey the city and founda complete breakdown of water, sewage, lighting, telephone, and transportationsystems. Those civilian hospitals still in operation were overcrowded withwounded citizens and lacked medical supplies, as well as food, water, andlight. Bodies were "stacked like cordwood" in the morgues; manylay in the streets. No organized medical service existed; the central officeof the Manila Department of Health had been abandoned and three Governmenthospitals were the only elements of the city health service in operation.The civil affairs units were attempting, with the aid of the Surgeon, XIVCorps, who had his own wounded to care for, to distribute food and medicalsupplies to the population.
Colonel Pincoffs recommended the establishment of a provisional Departmentof Health and Welfare under American auspices and outlined the needs inMedical Department officers and units. Near the end of February, PresidentSergio Osmena asked General MacArthur to appoint a U.S. Army officer totake charge of the task of reestablishing the Manila Department of Healthand Welfare. A provisional department was created at the beginning of Marchwhen Headquarters, USAFFE, took over direct control of civil affairs inManila from Sixth U.S. Army. Colonel Pincoffs was attached to the CivilAffairs Section, USAFFE, and made Director of Health and Welfare of GreaterManila, with responsibility for administering a citywide public healthprogram. He remained in charge of this office, located at the San LazaroContagious Disease Hospital, until May. With the aid of American Army doctors,the Philippine Civil Affairs Units, and Filipino physicians, he set aboutthe task of getting citywide reports on communicable diseases as a prelim-inarymeasure to-ward checking incipient epidemics. Cholera, smallpox, and plaguewere the three diseases most dreaded by the civilian population. Many casesof tuberculosis were discovered. Diarrhea, dysentery, and the venerealdiseases were the maladies which occurred with the greatest frequency duringthe early months.
Manila was divided into eight districts, in each of which operated acivil affairs unit, which was attached to Headquarters, USAFFE, and supervisedby the latter`s civil affairs section. The medical officer of each unitwas made the district health officer, and his office obtained and forwardedto the San Lazaro headquarters the daily reports on cases of communicablediseases at the civilian hospitals. Later an epidemiologist was assignedto each health district and a clinical consultant to the San Lazaro headquarters.The latter checked for undetected cases of disease at hospitals throughoutthe city. The development of a statistics section at the headquarters,the reestablishment of requirements for the issuance of death certificates,and the restriction of burial to cemeteries run by the provisional healthdepartment were additional steps taken to reestablish normal controls overinformation on the incidence of communicable diseases.
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The Division of Sanitation of Colonel Pincoffs` department, run by Col.Gottlieb L. Orth, MC, checked all water points for contamination duringa 3 months` period while the Japanese kept Manila on short water rationsby holding the major water reservoir in the mountains. Its chief job, however,was to clean up the city, a task carried out in each of the eight cityhealth districts by a malaria control unit, now called a "sanitarygroup." The first and worst of the unorthodox tasks which the sanitarygroups had to perform in Manila was the burial of thousands of dead. Otherjobs were the cleaning of the city block by block, the restoration of publicand private facilities for the disposal of sewage and garbage, as wellas the abattoirs, and the inspection of public eating and drinking places.Colonel Orth`s staff and the district sanitary groups also tackled thetask of insect and rodent control, maintaining flycatching stations whichchecked on the results of regular spraying of Manila with DDT by planesof the Far East Air Force.
The period of control of the Manila public health service by Headquarters,U.S. Army Forces in the Far East, and its successor, U.S. Army Forces,Pacific, ended on 1 August 1945. Preceding months witnessed a gradual,well-planned transfer of control from the Army to the civilian authoritiesof Manila. The Philippine Civil Affairs Units were withdrawn from the cityduring April and May, being replaced by similar units provided by the PhilippineGovernment. Civilian district health officers were chosen, but SanitaryCorps officers assigned to the districts continued to aid with the collectionof reports on communicable diseases, the distribution of medical supplies,and the sanitary inspections of civilian hospitals and refugee centers.On 1 August the Army turned over the Department of Health, now staffedby Filipino civilians, to the Philippine Government.30
Thus Army tactical elements and then U.S. Army Forces in the Far Eastexercised successively the major responsibility for reestablishing a publicmedical program in the Philippines. Apparently the intent of Headquarters,USAFFE, was that the tactical commander should retain responsibility forall civil administration and relief until the theater headquarters of thePhilippine Government should assume it.31 The Services of Supplyand its elements had little responsibility. However, the base surgeonswere called upon to furnish
30 (1) Pincoffs, M. C.: Health Problems inManila. Transactions, American Clinical and Climatological Association,vol. LVIII, 1947. (2) History of U.S. Army Forces in the Far East, 1943-1945.[Official record, Office of the Chief of Military History.] (3) Letter,Surgeon, U.S. Army Forces in the Far East, to The Surgeon General, 23 Mar.1945. (4) Report of Civil Affairs Operation on Leyte-Samar by Chief ofCivil Affairs, Headquarters, Sixth U.S. Army, 4 March 1945. (5) Memorandum,Col. M. C. Pincoffs, MC, for Commanding General, U.S. Army Forces in theFar East, 17 Feb. 1945, subject: Report on Civilian Health and Welfarein Manila in Relation to Disease Control and Care of Battle Casualties.(6) Interview, Col. Maurice C. Pincoffs, MC, 22 May 1952. (7) Letter, Col.Maurice C. Pincoffs, MC, to Brig. Gen. Guy B. Denit, 20 June 1945. (8)Letter, Col. Maurice C. Pincoffs, MC, to Col. John Boyd Coates, Jr., MC,USA, Director, The Historical Unit, U.S. Army Medical Service, 1 Sept.1955.
31 In some areas of the Philippines responsibility for civilaffairs passed from Army control (with more responsibility shared by thebase), directly to the Commonwealth Government, without an Interim periodof control by theater headquarters.
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medical supplies for civilian relief. In Base K, the base surgeon setaside two small station hospitals for the care of civilians. Moreover,in performing the base surgeon`s usual duties in the control of venerealdisease and the prevention of malaria and other insectborne diseases-forexample, the spraying of entire towns in the base section with DDT-thebase surgeon contributed to the protection of civilian health.32
DEVELOPMENTS AFTER APRIL 1945: THE PACIFIC THEATER
In April 1945 General MacArthur, while retaining his Allied commandunchanged, was made Commander in Chief of AFPAC (U.S. Army Forces, Pacific).For the first time U.S. Army forces in the Pacific (with the exceptionof the Twentieth Air Force and troops assigned to the North Pacific Area)were placed under a single command to constitute one Army theater of operationsfor the entire Pacific. The two major area commands under AFPAC were theU.S. Army Forces in the Far East and the U.S. Army Forces, Pacific OceanAreas. In June, the former command was absorbed by the U.S. Army Forces,Western Pacific, and the latter was superseded by the U.S. Army Forces,Middle Pacific, consisting of Hawaii and other islands.
Surgeon, U.S., Army Forces, Pacific, and Subordinate MedicalElements
U.S. Army Forces, Pacific, had no surgeon until June 1945. At that timeBrig. Gen. Guy B. Denit (who had acted in the dual assignment of ChiefSurgeon, U.S. Army Forces in the Far East, and Chief Surgeon, U.S. ArmyServices of Supply) was made Chief Surgeon, General Headquarters, U.S.Army Forces, Pacific. In his new assignment he headed an office which exercisedgeneral technical supervision over the medical service within all the followingmajor commands under the U.S. Army Forces, Pacific: U.S. Army Forces, WesternPacific (which took over the former functions of both USAFFE and USASOS)and U.S. Army Forces, Middle Pacific, which were the two main territorialcommands (map 10) ; the Far East Air Forces; the Sixth U.S. Army; and theEighth U.S. Army. At the close of June 1945, Army strength in the SouthwestPacific Area totaled 866,214 and Medical Department strength 69,665. GeneralDenit served additionally as Surgeon, U.S. Army Forces, Western Pacific,until August, when a separate surgeon was appointed for that command.
Thus after June 1945 a surgeon headed a complete medical section atan Army theater headquarters for the entire Pacific (except the North PacificArea). The office remained in Manila throughout 1945 and in the monthsjust
32 Quarterly Reports, Medical Department Activities,Bases K and M, October 1944-December 1945. (2) Annual Report, Medical DepartmentActivities, Base M, 1946. (3) Quarterly Report, Medical Department Activities,Base R, February-December 1945. (4) Quarterly Report, Medical DepartmentActivities, Base S, 4th quarter, 1945. (5) Quarterly Report, Medical DepartmentActivities, Base X, 3d quarter, 1945.
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before the Japanese surrender was occupied with making medical plansfor the expected Allied invasion of Japan. General Denit apparently intendedoriginally to keep his main office small, as had been his medical staffat his principal office at Headquarters, U.S. Army Forces in the Far East,and to restrict it to policymaking. The medical section at Headquarters,U.S. Army Forces, Western Pacific, would contain personnel to handle medicalsupply, medical records, hospitalization, and so forth. However, sincehis office supervised medical service for troops scattered throughout thePacific and since increased incidence of certain diseases- trenchfoot andvenereal disease, in particular- was anticipated with the invasion of Japan,the office underwent temporary expansion. At the end of 1945 it consistedof 40 officers and 57 enlisted men. Throughout the latter months of theyear, General Denit had consultants for a few months in the fields of medicine,surgery, neurosurgery, neuropsychiatry, and nutrition, but practicallyall of these had left by the end of the year. In October 1945 a "veterinaryconsultant," a "nursing consultant," and a "dentalconsultant" were appointed; these were relatively permanent positions.
The unification of Pacific areas into a single theater responsible forstriking directly at Japan facilitated cooperation between the medicalservice of the Army and that of the Navy in making invasion plans. It alsomade possible a concerted effort by the Surgeon General`s Office and thetheater medical organization to build up well-developed medical staffsfor high-level commands in the Pacific. Many Medical Department officershad noted that the division of the Pacific into separately controlled areas,remoteness of these areas from the United States, the complexity of thecommand structure, and the concen-tration on problems of the European theaterat the expense of the Pacific areas had led to insufficient contact betweenthe Surgeon General`s Office and medical authorities in the Pacific. TheDirector of the Control Division, the Surgeon General`s Office, commentedearly in 1945, shortly after his trip to the Pacific, upon the waste inpersonnel, as well as supplies, that had occurred on some islands and atcertain levels of command and concluded that "theater walls have beentoo often wafer-tight compartments." The lack of adequate staff, especiallyconsultants, at the headquarters of higher commands which he had observedthroughout the Pacific (as well as in the China- Burma-India theater) wasimmediately attributable to the limits placed by the area`s top Army commandsupon suballotment to the medical service. It was ultimately attributable,he emphasized, to the War Department, which had set the area`s allotmentin the first place. Central planning of oversea medical staffs by the SurgeonGeneral`s Office, furthered by direct contact between The Surgeon Generaland his staff and the War Department General or Special Staffs in drawingup these plans, was sorely needed.33
33 Memorandum, Col. Tracy S. Voorhees, JAGD,for Maj. Gen. George F. Lull, 29 Jan. 1945, and inclosure, subject: Suggestionsas to Need for Changed Methods in Utilization Overseas of Medical DepartmentUnits.
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Map 10.- U.S. Army Forces, Pacific,June 1945
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During the summer months before the sudden surrender of Japan, the SurgeonGeneral`s Office and the Pacific theater surgeon engaged in concerted planningof this type. The latter made known his needs for officers with varioustypes of training, especially those who could fill administrative positions.He asked the Surgeon General`s Office for men qualified to replace thosechiefs of surgery in his general hospitals who were being returned to theUnited States after long service in the Pacific, and for additional officerstrained in venereal disease control. The Surgeon General`s Office calculatedneeds for officers trained in some other special fields-pathologists andbacteriologists in laboratories-and selected men with such skills to sendto the Pacific. The surrender of Germany had made it possible to releasefor the Pacific officers experienced in medical administration who wereserving in the European and Mediterranean theaters.
The Director of the Control Division, the Surgeon General`s Office,promoted the development of a consultants` system comparable to that whichhad worked so profitably in Europe. Shortly before the Japanese surrender,he issued a report which compared the medical service afforded in the Pacifictheater, particularly in the Southwest Pacific Area, with that in the Europeantheater, relating difficulties encountered in medical service in the formerdirectly to organizational handicaps which had faced the medical sectionat the highest level of command in the Southwest Pacific Area: its positionat a level which restricted its power to function in forward areas andwhich limited its access to high command and its participation in planningthe medical support of forward movements. He called attention to the lowerpriority of the Pacific theater compared with that of the European andMediterranean theaters, especially for medical specialists. He recommendedmeasures designed to improve the quality of medical service in the Pacificpreparatory to the expected invasion of Japan, including the assignmentof specialists who had served in Europe and North Africa as consultants.He stressed the importance of vesting technical control over all medicalservice in the Pacific in the Surgeon, U.S. Army Forces, Pacific. The Surgeon,U.S. Army Forces, Western Pacific- that is, the surgeon of the communicationszone- should act as his deputy, he thought. Furthermore, the Pacific theatersurgeon should take an active part in planning the medical support forthe invasion of Japan. A medical staff of adequate size, including consultants,might function either in the office of the theater surgeon or in that ofthe surgeon of the communications zone, he thought, but in either caseits work should be directed by the theater surgeon.
The theater surgeon sent Col. Maurice C. Pincoffs, MC, to Washingtonto obtain additional Medical Department officers for administrative positionsin the theater, especially an officer with expert knowledge of trenchfootand one trained in venereal disease control. He requested four officerswho had had training at the Command and General Staff School at Fort Leavenworth,Kans., and at the Medical Field Service School at Carlisle Barracks, Pa.,for the positions of corps and division surgeons, a nurse with administrativeexperience to
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act as chief nurse, and a chief quarantine officer from the U.S. PublicHealth Service. Entry into Japan would greatly magnify problems of quarantine.Colonel Pincoffs discussed personnel problems with officers of the SurgeonGeneral`s Office and higher elements of the War Department. General Denithimself went to the United States for consultation on these matters soonafterward. Since no invasion of Japan took place, the more fully developedtheater surgeon`s office and the innovations in medical service advocatedby the Surgeon General`s Office and the theater surgeon were never fullytested.
In the autumn, after the Japanese capitulation, the principal Army medicaloffices supervised by the theater surgeon were practically the same asthose which he had directed since June: the medical offices of the twoterritorial commands, the U.S. Army Forces, Western Pacific, and the U.S.Army Forces, Middle Pacific; the office of the surgeon of the Far EastAir Forces (renamed Pacific Air Command in December) ; and the medicalsections of two ground commands, the Eighth U.S. Army occupying Japan andXXIV Corps occupying Korea. During the fall General MacArthur made Tokyohis headquarters for the discharge of his duties as SCAP (Supreme Commanderfor the Allied Powers). General Headquarters, SCAP, was at the top of anadditional chain of control, its functions being primarily concerned withthe Allied occupation of Japan rather than with the internal administrationof the U.S. Army. The major medical work of this command was its programfor rehabilitation of public health services in Japan.
The sudden surrender of Japan presented the U.S. Army medical servicewith the immediate problem of providing medical care for liberated prisonersof war and internees of the Allied countries in addition to that of servingthe occupation troops. An advance echelon of General Denit`s office, locatedin Tokyo and headed by Col. A. H. Schwichtenberg, MC, took care of theseduties in the latter months of 1945. Besides advising on hospitalization,evacuation, and preventive medicine for the occupation forces, this officeserved as a clearinghouse for officers and special committees sent by theWar Department or General Denit`s office to Japan during the early monthsof occupation to make technical studies; for example, for the Committeefor the Technical and Scientific Investigation of Japanese Activities inMedical Sciences which inquired into Japanese research on the preventionof tuberculosis, new dengue vaccines, antimalaria drugs, and drugs forthe treatment of leprosy. Another group of officers served on the commissionestablished by General MacArthur to investigate the effects of the atomicbomb in Japan.34
34 (1) Administrative History, Medical Section,U.S. Army Forces, Pacific. [Official record, Office of the Chief of MilitaryHistory.] (2) Annual Reports, Medical Department Activities, U.S. ArmyForces, Pacific, 1945, 1946, 1947. (3) Annual Report, Medical DepartmentActivities, Far East Command, 1947. (4) Letter, Chief Medical Consultant,Office of The Surgeon General, to Chief Surgeon, U.S. Army Services ofSupply, 25 June 1945. (5) Notes in Pacific Medical Conference, 3 Aug. 1945,by Director, Control Division, Office of The Surgeon General. (6) Memorandum,The Surgeon General, for the Chief of Staff, 10 Aug. 1945, subject: ReportWith Recommendations as to Medical, Surgical, and Neuropsychiatric Problemsin the Pacific. (7) Memorandum [letter], Brig. Gen. Guy B. Denit, to Col.Maurice C. Pincoffs, MC, 25 May 1945. (8) Letters, Col. Maurice C. Pincoffs,to Brig. Gen. Guy B. Denit, 8 June 1945; Brig. Gen. Guy B. Denit, to Col.Maurice C. Pincoffs, 20 June 1945.
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U.S. Army Forces, Middle Pacific
U.S. Army Forces, Middle Pacific, which largely superseded U.S. ArmyForces, Pacific Ocean Areas, on 1 July 1945, took over the latter`s subordinatecommands-three area commands, the Tenth U.S. Army, and AIRMIDPAC. The mostrecently created of its subordinate area commands was the Western PacificBase Command (map 9), established the preceding April. It had the samelogistic responsibility that the Central and South Pacific Base Commandshad within their respective boundaries. It included the Army garrison forceson islands of the Marianas and Western Carolines-Saipan, Guam, Tinian,Iwo Jima, Peleliu, Ulithi, and Angaur; it had headquarters on Saipan. Col.Eliot G. Colby, MC, was surgeon and cooperated closely with the surgeonsof various Navy commands in the area. On Saipan, Guam, Tinian, Angaur,and Iwo Jima a command termed "army garrison force" was the topcommand for Army troops on the island; each had the usual surgeon`s officeUntil V-J Day many general and station hospitals and a variety of surgical,veterinary, dental prosthetic, and optical repair detachments were brieflystationed on these islands. The Western Pacific Base Command gave medicalsupport to the invasion of Iwo Jima and Okinawa and made plans to furnishpersonnel, units, and supplies for the expected invasion of Japan. Afterthe Japanese surrender, medical service still had to be provided for Armygarrison forces stationed on some of the islands-Saipan, Tinian, and IwoJima-and throughout 1946 a small surgeon`s office existed at command headquarterson Saipan (moved to Guam in October of that year).35
The other two area. commands subordinate to U.S. Army Forces, MiddlePacific-the Central and South Pacific Base Commands (map 9) -were undergoingfurther decline in 1945. In October, shortly after V-J Day, the officeof the Surgeon, Middle Pacific, Brig. Gen. John M. Willis, contained 31Medical Department officers. This number represented substantial growthsince the establishment of the predecessor command (U.S. Army Forces, PacificOcean Areas) in the middle of the preceding year, but was not up to theexisting allotment of 45 officers. Although consultants were still assigned,several were soon released. The medical consultant and laboratory consultantbecame members; of the atomic bomb commission which went to Hiroshima andNagasaki for 90 days` study of the effects of the atomic bomb on thesecities and their inhabitants. In November 1945, when the Central PacificBase Command was discontinued and its elements transferred to the directcontrol of Headquarters, U.S. Army Forces, Middle Pacific, the staff ofthe base command surgeon was transferred to the office of the Surgeon,U.S. Army Forces, Middle Pacific.36
35 (1) Annual Report, Veterinary Service, Headquarters,U.S. Army Forces, Middle Pacific. (2) See footnote 3(l) and (2), p. 455.(3) Annual Reports, Medical Department Activities, Western Pacific BaseCommand, 1945, 1946.
36 (1) General Orders No. 61, Headquarters, U.S. Army Forces,Middle Pacific, 20 Oct. 1945; and No. 75, 1 Nov. 1945. (2) Annual Report,Medical Department Activities, Headquarters Detachment, Oahu Medical Service,Army Ground Forces, Pacific, 1946. (3) See footnote 3 (1), p. 455.
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In the South Pacific Base Command, the staff surgeon`s office in NewCaledonia supervised medical service for the remaining Army service troops,which by September 1945 had dwindled to about 14,600 men. Most of the 209Medical Department officers who served the command were stationed on thetwo islands of troop concentration, New Caledonia and Guadalcanal. Thechief Medical Department installations and units- including a 1,000-bedgeneral hospital and a 50-bed station hospital on New Caledonia, a 500-bedstation hospital on Guadalcanal, and a few platoons of medical supply depotcompanies- were also on these two islands. During 1945, the widespreaduse of DDT dramatically decreased the rates of incidence of malaria andfilariasis in the South Pacific Base Command, both diseases being chieflytransmitted in this region by the same mosquito vector. The abatement ofmost other Army health problems in the South Pacific islands derived mainlyfrom the absence of combat and the decline of troop strength.37
U.S. Army Forces, Western Pacific
The Manila office of the Chief Surgeon, U.S. Army Forces, Western Pacific(General Denit was surgeon during the period June-August 1945 and Brig.Gen. Joseph I. Martin from the latter date to January 1946), had essentiallythe same job as the office of the Surgeon, U.S. Army Services of Supply,Southwest Pacific Area, had had. The area which it served at its inceptionin June 1945 (map 9) included more than 10,000 islands, extending alongthe 6,000-mile route of advance from Australia to Japan. Of its subordinateterritorial commands, Australia Base Section, with headquarters at Sydney,had only a skeletal organization; the last remaining Australian bases,at Townsville -and Sydney, were discontinued in June 1945. New Guinea BaseSection and Philippine Base Section had several subordinate bases each.Army Service Command I, formed on 1 August 1945 by merging the island commandsestablished on Okinawa and Ie Shima, also came under the control of U.S.Army Forces, Western Pacific.
During the summer of 1945, while bitter local fighting was still goingon in the Philippines, the medical section of U.S. Army Forces, WesternPacific, distributed large-scale shipments of whole blood from the UnitedStates to Manila and Leyte and directed large-scale air evacuation. Theoperations of nearly every division of the surgeon`s office were beingexpanded to meet the demands of the expected invasion of Japan. Plans wereunder way for expansion of hospital beds in Manila. At the time of thesurrender Manila had one of the largest medical depot systems developedin any theater of operations during the war. A major continuing problemin the Philippines which reached its peak in mid-1945 was the control ofvenereal disease among troops. Two officers from the Surgeon General`sOffice made a special survey of the situation. Throughout the spring andsummer of 1945 the War Department and theater
37 Annual Report, Medical Department Activities,South Pacific Area, 1945.
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headquarters, (Headquarters, AFPAC) brought pressure on the WesternPacific command and all its subordinate tactical and area commands to takemeasures, including those for the repression of prostitution, to lowermounting venereal disease rates among troops in the Philippines.
After the Japanese surrender the major problems of the medical sectionat Headquarters, U.S. Army Forces, Western Pacific., were the usual onesinvolved in readjusting medical facilities, Supplies, and personnel tomeet the needs of a rapidly shifting military population. The rear basesin New Guinea were being "rolled up," and troops and units werebeing sent forward to the Philippines and Japan. Men and units in forwardareas were being returned to the United States. Hospital beds were reduced`by more than half between V-J Day and the end of 1945. Permanent buildingsoccupied by general hospitals in the Philippines were returned to civilianauthorities. Medical care for prisoners of war liberated in Japan and Chinawas a heavy responsibility in the last months of 1945. Emergency packsof medical supplies, assembled by the medical depots -of Base X in Manila,were dropped by air to thousands of Allied prisoners of war in remote,areas of China and Japan until these men could be evacuated. The surgeon`soffice, U.S. Army Forces, Western Pacific, supervised this immediate joband the longer range ones, continuing into 1946, of evacuating and hospitalizingthe recovered Allied soldiers and civilians. The disposal of surplus medicalsupplies, which continued into 1946, was largely handled by a "surplusproperty disposal officer" in the surgeon`s office. He visited theNew Guinea bases and made arrangements for the sale of nearly 5 milliondollars` worth of medical supplies and equipment, including a general hospitalat Biak, to the Netherlands Government. The Office of the Chief Surgeon,U.S. Army Forces, Western Pacific, also assisted with some phases of medicalservice in the Philippine Army, including the giving of physical examinationsto about 150,000 Philippine Army personnel being demobilized and processingtheir medical papers. In April 1946, similar work was begun for the 37,000Filipino troops to be turned over to the new republic on 1 July 1946.
The formal dismissal of the Combined Advisory Committee on TropicalMedicine, Hygiene, and Sanitation took place shortly after the Japanesesurrender. The committee had remained somewhat dormant throughout 1945while General Headquarters, under whose aegis it met, had gone forwardto Hollandia and Manila. It had continued in existence however becauseGeneral MacArthur wanted its aid if future combat operations should againcall for close coordination of preventive measures against disease betweenthe Australians and Americans. It was formally dissolved as of 1 November1945, and the Western Pacific command attended to the details of windingup its affairs.38
38 (1)Semiannual Reports, U.S. Army Forces,Western Pacific, 1 July-31 Dec. 1945, and 1 Jan.- 30 June 1946. (2) Memorandum,Col. M. C. Pincoffs, MC, for Chief Surgeon, U.S. Army Forces, Western Pacific,25 Sept. 1945, subject: Combined Advisory Committee oil Tropical Medicine,Hygiene, and Sanitation. (3) Letter, Adjutant General, U.S. Army ForcesWestern Pacific, to Chairman, Combined Advisory Committee, 14 Oct. 1945,subject: Discontinuance of the Combined Advisory Committee, etc.
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Map 11.- New Guinea Bases, U.S. ArmyForces, Western Pacific, June 1945
Territorial commands of U.S. Army Forces, Western Pacific.- Thethree major territorial commands under U.S. Army Forces, Western Pacific,in April 1945, were the Australian, New Guinea, and Philippine Base Sections(maps 11, 12). Only the last of these was of importance. Australian BaseSection, with headquarters at Sydney by late June 1945, lasted as a skeletonorganization throughout the year and the New Guinea Base Section untilAugust 1945, when it was dissolved and its four remaining bases-at Lae,Finschhafen, Hollandia, and Biak-placed directly under U.S. Army Forces,Western Pacific. These declined and by April 1946 all had closed.39
The Philippine Base Section developed during the spring of 1945 fromthe former Army Service Command and assumed charge of directing Servicesof Supply activities, first on Luzon and later throughout the Philippines.40When it was established in April, it controlled all five bases in the PhilippineIslands: The earlier established Base K on Leyte and Base M at San Fernando,Luzon, and the recently established Base R at Batangas Bay, Luzon, BaseS at Cebu City, Cebu, and Base X (merged with Philippine Base Section fromApril to July) in Manila. These various bases came under direct controlof U.S. Army Forces, Western Pacific, in October. During the period February-April1945, Medical Department officers assigned to the former Army Service Commandwere occupied in establishing medical service on Luzon, with concentrationin the area of Greater Manila. During March, they evacuated about 3,500patients from Luzon by plane and hospital ship, and located buildings inGreater Manila
39 Quarterly Reports, Medical Department Activities,New Guinea Base Section, 2d and 3d quarters, 1945.
40 A Luzon Base Section lasted from mid-February to April 1945,when the Philippine Base Section took control of all the bases in the Philippines.
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Map 12.-Philippine Bases, U.S. ArmyForces, Western Pacific, June 1945
to house several hospitals and a medical supply depot for the base sectionand put these installations into operation. In April seven dispensaries,including three dispensaries to serve the port and a dental dispensary,were functioning. Manila became the largest center of fixed hospitals inthe Southwest Pacific, Area in the expectation that a large hospital centerwould receive thousands of patients from an invaded Japan. The problemof venereal disease among troops crowding into Manila after fighting throughthe Luzon campaign was one of the most serious faced by the base section.Venereal disease control officers assigned to tactical elements (SixthU.S. Army, XIV Corps, and 37th Division) and to the base section cooperatedin efforts to prevent venereal disease, opening eight prophylactic stationsin March. The problem continued in succeeding months as soldiers spenttheir leave in the urban areas of the Philippines.
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When a single base section was set up for all the Philippines in April,its staff medical section became a full-fledged one. A major job in Manilawas work done in connection with hiring medically trained Filipino civiliansfor the U.S. Army. Although a civilian employment service did the actualhiring, personnel of the surgeon`s office (of the combined Philippine,Base Section and Base X headquarters when they were operating jointly duringthe period April-July, and of Base X alone when they were separate) establishedjob classifications and pay scales for this group, and maintained recordson them. In addition, they supervised the work of Filipino civilian employeesused by all medical units in the Philippine Base Section Area Command.41
Shortly after the Japanese surrender, two large area commands in thePhilippines began clearing up regions occupied by the Sixth and EighthU.S. Armies after the departure of troops and handling arrangements forthe surrender and disarmament of Japanese troops in the Philippines. Thesewere the Southern Islands Area Command, which included the Middleburg andHollandia areas of Netherlands New Guinea, as well as the southern islandsof the Philippines and the islands of Biak, Wakde, and Morotai, and theLuzon Area Command, including a few islands adjacent to Luzon. A few MedicalDepartment officers directed the medical work connected with the removalof the Japanese. The medical section of Luzon Area Command, for instance,drew up the plan for evacuating sick and injured Japanese prisoners ofwar from Luzon; it made detailed arrangements for assembling evacuees atchosen locales, providing temporary hospitalization for them on Luzon,and specifying methods of evacuation. In November the two area commandswere split into smaller area commands in charge of various Army divisions;these continued the cleanup.42
The tactical forces: occupation of Japan and Korea.-On 1 July 1945,the Eighth U.S. Army was given -responsibility for all tactical troopsin the entire Philippine Archipelago, taking over Luzon from the SixthU.S. Army. With the end of the Luzon campaign, the Sixth U.S. Army surgeon`soffice at San Fernando, Pampanga, Luzon, was free, to begin training andequipping medical units preparatory to the expected invasion of Japan.In July, corps and subordinate units were transferred and regrouped inanticipation of the invasion. Following the sudden Japanese capitulation,the office of the Surgeon, Sixth U.S. Army, moved in September with theheadquarters to Kyoto, Japan, where it undertook duties typical of a medicalstaff office with an army of occupation. Early in 1946, the Eighth U.S.Army took over the entire task of Japanese occupation.
The Eighth U.S. Army had originally occupied only northern Japan. InAugust 1945 its surgeon, General Rice, arranged, after conference withofficers at General Headquarters and Headquarters, Army Forces, WesternPacific, for hospital ships, as well as medical supplies and equipment,for evacuating
41 Report, Medical Department Activities, PhilippineBase Section, 25 Sept. 1945.
42 Report, Medical Department Activities, Luzon. Area Command,17 Oct. 1945.
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Allied prisoners of war and civilian internees from Japan. In late August,his office was established in the Customs House in Yokohama and began thework of caring for and evacuating these groups, while providing the usualmedical service for elements of the Eighth U.S. Army. The office of theSurgeon, XI Corps, settled in September in Tokyo, and the office of theSurgeon, XIV Corps, moved in the same month from Luzon to Sendai in northernHonshu. A medical liaison group at Base X in Manila aided with the transferof medical units and supplies from that base to the Eighth Army in Japan.For fulfilling initial medical responsibilities toward those freed fromthe Japanese camps, the Eighth U.S. Army surgeon had organized four medicalteams to go to the various camp areas. These arrived in Yokohama on 30August. Supplementing the work of the so-called "recovery teams,"they gave initial care to the sick and evacuated the prisoners of war andinternees to Tokyo. On 3 September, the 42d General Hospital, which hadarrived in Tokyo near the end of August, assumed charge of the liberated,processing medical records related to them. At Atsugi airfield, whencethey were started on their way home, via Manila, a medical clearing company,operating under the direction of the Eighth U.S. Army surgeon, served asa holding station to arrange the order of transport. Most of the liberatedprisoners and internees, amounting to about 24,000, had been evacuatedfrom Japan before the end of September.
Throughout the summer and early fall of 1945, the medical sections oftwo service commands, Army Service Commands O and C (with the Sixth andEighth U.S. Armies respectively) and their bases were built up in the Philippinesin anticipation of the Japanese occupation. Their medical sections hadobtained information on diseases endemic in the areas which they expectedto occupy, requisitioned the necessary medical supplies, and trained enlistedmen in newly assigned duties. The channels of command established for themove to Japan were similar to those that would have been followed had aninvasion been necessary, in that the base commands developed within theservice commands were temporarily assigned to corps or divisions. Aftera. month or two of development at their Japanese sites, they were placedagain under the Army service commands.
When the Eighth U.S. Army took over control from the Sixth U.S. Armyearly in 1946, Army Service Command O was absorbed by Army Service CommandC, whose medical section was given direction of the base medical sections.Medical sections were in operation at major bases at the Japanese citiesof Kobe, Kure, Nagoya, Fukuoka (on Kyushu Island), and Yokohama. The sizeof these medical sections varied considerably, usually being smaller thanthose that had existed at the larger New Guinea and Philippine bases. Atthe beginning of 1946, the Kure Base medical section had, in addition tothe surgeon, an executive officer, a veterinarian, a port surgeon and venerealdisease control officer, a chief nurse, a medical inspector, an administrativeofficer, and seven enlisted men. These officer assignments were more orless
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typical. A base venereal disease control officer was particularly necessary,for in the early days of the occupation the rise in incidence of venerealdisease among American troops in Japan presented a major problem.43
The XXIV Corps on Okinawa had been selected for the occupation of Koreashortly before the Japanese surrender. While still on Okinawa, the officeof the Surgeon, XXIV Corps, and that of the Surgeon, Army Service Command24, prepared medical plans for the allocation of medical responsibilitiesduring the occupation. The office of the corps surgeon opened in Seoul,Korea, on 11 September. It established dispensaries and began reconnaissancefor hospital sites. The medical inspector examined bars and restaurants,and the veterinary inspector, slaughterhouses and food storage plants.The venereal disease control officer inspected geisha districts and housesof prostitution and recommended sites for prophylactic stations. Late in1945 the longer range programs, such as typhus control and reimmunizationof troops, to be undertaken during the Korean occupation, were initiated.The medical office of Army Service Command 24 operated at the command`sheadquarters, known as ASCOM City, near Inchon. Various types of hospitalsand other Medical Department units served at Inchon, at ASCOM City, andat Seoul in the northern sector at Taejon in the central sector, and atKwangju and Pusan in the southern sector. Troops given medical service,totaling about 811000 in November 1945, were those of XXIV Corps (6th,7th, and 40th Divisions), the Fifth Air Force, the military government,and Army Service Command 24.44
In mid-1945 the office of the Surgeon, Far East Air Forces, was in Manila.It supervised the work of medical sections of the Clark Field headquartersof the Fifth Air Force, of the Leyte headquarters of the Thirteenth AirForce, and of the Hollandia headquarters of the Fax East Air Service Command.During this lull in combat, it made special effort to standardize the technicalmedical work among air force troops by having surveys and recommendationsmade in three fields; namely, psychiatric problems, ophthalmological problems,and dental deficiencies. An extensive survey of procedures in air evacuationwithin and from the Pacific theater was also made. An officer was sentto the European theater to acquaint medical units to be shifted from Europeto the Pacific with the medical problems which they might encounter intheir new
43 (1) Quarterly Report, Medical Section, EighthU.S. Army, 3d and 4th quarters, 1945. (2) Quarterly Report, Medical DepartmentActivities, XIV Corps, 2d quarter, 1945. (3) Quarterly Re-ports, MedicalDepartment Activities, X Corps, 1945; and fiscal report, January 1946.(4) Quarterly Reports, Medical Department Activities, XI Corps, 1945 and1st quarter, 1946. (5) See footnote 38(l), p. 492. (6) Periodic Reports,Surgeon, U.S. Army Service Command C, August-December 1945. (7) PeriodicReports, Medical Department Activities, Kobe Base, August 1945-December1946. (8) Periodic Reports, Medical Department Activities, Kure Base, July1945-Jan. 1946. (9) Quarterly Report, Medical Department Activities, OtaruBase, November-December 1945. (10) Quarterly Re-port, Medical DepartmentActivities, Nagoya Base, 4th quarter, 1945. (11) Final Report, MedicalDepartment Activities, Kyushu Base, 9 Dec. 1945-2 Apr. 1946. (12) AnnualReport, Medical Department Activities, Yokohama Base, 1946.
44 (1) Quarterly Report, Medical Department Activities, XXIVCorps, 3d and 4th quarters, 1945. (2) Quarterly Report, Medical DepartmentActivities, U.S. Army Service Command 24, 4th quarter, 1945. (3) AnnualReport, Medical Department Activities, U.S. Army Forces in Korea, 1948.
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location. Shortly after the Japanese surrender, the Far East Air Forcesdropped emergency supplies, including medical supplies, to prisoners ofwar and internees held by the Japanese, and an officer of the medical sectionhastened to Japan to supervise their evacuation from Japan by air. An officerof the Second Central Medical Establishment (by then reassigned to FarEast Air Forces headquarters) also went to Japan to interrogate Japanesespecialists in aviation medicine on equipment developed for the protectionof fliers and on their research into aviation medical problems.
Late in 1945, the Fax East Air Forces was renamed Pacific Air Command,absorbing former components of Army Air Forces, Middle Pacific. The medicalsection of Pacific Air Command, which moved in toto to Tokyo only in May1946, directed the medical service of five greatly reduced components:the Fifth Air Force, with headquarters at Nagoya, Japan; the ThirteenthAir Force, with headquarters at Fort McKinley, Luzon; the 1st Air Division(former Eighth Air Force) in the Ryukyus; the Twentieth Air Force, whichincluded the XX and XXI Bomber Commands in the Marianas; and the SeventhAir Force, with headquarters at Hickam. Field.45
Launching the Army`s Public Health Program in Japan and Korea
For several years after the close of the war, the U.S. Army undertooklong-range public health programs in both Japan and Korea.46During the months of 1945 when the Army`s plans for an invasion of Japanwere being drawn up, the G-5 system for the conduct of civil affairs employedin other theaters was developed; advance planning for the revival of publichealth facilities in Japan took advantage of the experience with publichealth programs in Europe and the Philippines. However, the sudden capitulationof Japan presented the Medical Department with larger immediate responsibilitiesover a much wider area than would have been the case had the Army undertakenan invasion. At the same time it simplified the task; the administrationdid not go through the usual steps of control by division, corps, and armybut was promptly divorced from a complex chain of command.
The organization that directed the program during the postwar yearswas set up on 2 October 1945, when a Public Health and Welfare Sectionwas established at the staff level at General Headquarters, Supreme Commanderfor the Allied Powers. Col. (later Brig. Gen.) Crawford F. Sams, MC (fig.111), formerly Surgeon, U.S. Army Forces in the Middle East, and more recentlyassigned to G-4 of the War Department General Staff, was made chief ofthe section and headed the program during most of the years of the occupation.
45 (1) Quarterly Reports, Medical DepartmentActivities, Headquarters, Far East Air Force, 1st, 2d, 3d quarters, 1945.(2) See footnotes 2 (2), p. 454 ; and 19 (4), p. 475. (3) Annual Report,Medical Department Activities, Pacific Air Command, 1946. (4) Annual Report,Medical Department Activities, Fifth Air Force, 1945.
46 The military government in the Ryukyus (Okinawa) was initiallyrun by the Navy, but the Army assumed control in July 1946, when the largetask of providing dispensary service, camp sanitation, and quarantine servicefor Okinawans repatriated from Japan was still under way.
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His office was originally responsible for the prevention of diseasesin the civil population of both Japan and Korea (later of Japan only),for the establishment of normal procedures for health control, and forpromoting public health and welfare activities and the establishment ofhealth facilities. Colonel Sams thus headed what became one of the largesthealth programs ever undertaken among the population of an occupied country.Early in 1946, his office was faced with epidemics of smallpox and typhusnear Kobe and Osaka. In addition, epidemics of smallpox, typhus, and choleraoccurred in China. As thousands of Japanese were returning to their nativecountry from China, the Public Health and Welfare Section, SCAP, undertooka quarantine program for the incoming repatriates in order to prevent transmissionof these diseases to Japan and U.S. Army troops occupying that country.
From September 1945 when American troops entered southern Korea to June1949 when they withdrew, the U.S. Army undertook a similar health programamong Korean civilians. In the last months of 1945 military governmentactivities, including the health program, were conducted as a staff responsibility.When the U.S. Military Government was established in Korea early in 1946,the military governor created a Department of Public Health and Welfarein Seoul; it had top responsibility for the program. The account
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of the Army`s protracted public health work in Japan and Korea fallsoutside the scope of this volume, as it belongs to the history of the Occupationperiod.47
SUMMARY: MEDICAL ADMINISTRATION IN THE PACIFIC
After 7 months` experience with medical administration in the SouthwestPacific Area, the Chief Surgeon, USAFFE (General Denit), wrote to the ChiefSurgical Consultant, the Surgeon General`s Office (Brig. Gen. Fred W. Rankin),as follows:
I have been able, to some degree, to put into effect someof my ideas, but you are quite correct in stating that our problems hereare entirely different from those in ETO. In fact the staff relationshipsand procedures are so complicated that I often find myself bewildered inattempting to carry out my functions.
Later, after Army troops in the Pacific areas had been organized intoa single theater of operations, he analyzed the difficulties which thegeographic features of the combat areas in the Pacific had imposed uponthe administration of Army medical service:
You are of course aware that the geographic problems peculiarto this theater have imposed decentralized operations to an extent neverbefore required. "Perimeter warfare," with the establishmentof large bases separated by thousands of miles of ocean or jungle and connectedonly by communications systems taxed to capacity in the transmission ofurgent business and further isolated by difficulties of transportation,has made it essential to delegate considerable authority to subordinatecommands. The higher headquarters, of course, have coordinated activitiesby frequent inspections. Nevertheless, a successful operation of such asystem is obviously dependent upon the assignment of highly qualified personnelto positions of authority in the subordinate commands. Unusually largenumbers of such key personnel are required and they are woefully lacking.48
This brief summary points out some of the basic obstacles encounteredin administering Army medical service in the Pacific. The scattering ofthe land masses over long stretches of water led to a complex divisionof responsibilities among Army and Navy commands and to considerable decentralizationof authority to lower commands. From the beginning of the war until April1945, most Army forces in the Pacific region were organized into threeelements, each of which constituted an orthodox Army theater organization.Not until April 1945 was Army organization in the Pacific revamped intothe structure characteristic of a single theater of operations. Duringthis period medical staffs were theoretically necessary for both a theaterand a Services of Supply headquarters in each of three "theaters"of the Pacific-the Central, South, and Southwest Pacific Areas-as wellas for numerous bases and base sections,
47 (1) See footnote 3(2), p. 455. (2) Letter,Col. Maurice C. Pincoffs, MC, to Brig. Gen. Guy B. Denit, 20 June 1945.(3) Report, Public Health and Welfare in Japan, no date, but includes 1948,by Brig. Gen. Crawford F. Sams, Chief, Public Health and Welfare Section,General Headquarters, Supreme Commander for the Allied Powers. [Officialrecord.] (4) Annual Report, Medical Department Activities, Headquarters,U.S. Military Government in Korea, 1946. (5) Historical Report, AlliedOperations in Southwest Pacific Area, vol. I, supplement: MacArthur inJapan, The Occupation, chs. I and VI. [Official record, Office of the Chiefof Military History.]
48 (1) Letter, Brig. Gen. Guy B. Denit, to Brig. Gen. Fred W.Rankin, 10 August 1944. (2) Letter, Brig. Gen. Guy B. Denit, to Chief,Personnel Service, Office of The Surgeon General, 16 June 1945.
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field armies, air forces, and subordinate commands which formed linksin the chain of evacuation by land, sea, and air. This situation led tothe demand for the unusually large number of Medical Department personnelfor administrative positions noted in the theater surgeon`s analysis.
In the Central and South Pacific Areas, where the top U.S. Army headquartersnever moved to a location in advance of the Services of Supply headquarters,medical service was so organized within the command structure, by the useof the same Medical Department personnel at both headquarters, as to minimizethe demand for officers to fill the higher administrative positions. Inthe Southwest Pacific Area, on the other hand, during part of the period1942-April 1945, considerable numbers were needed to staff the medicalsections of both U.S. Army Forces in the Far East and the Services of Supply,whose headquarters were located at some distance from each other. At thesame time the allocations of Medical Department officers to these headquarterswere too low to permit of a well-developed staff at either. Much of thedemand for key personnel in administrative positions in all these areasresulted from the necessity of assigning medical staffs to scattered bases,with relatively scant numbers of troops, which because of the geographiclayout could not be amalgamated into fewer bases.
In the Central and South Pacific Areas, medical service received directionfrom a surgeon`s office at the highest level of Army command. The use ofa single surgeon for both theater and Services of Supply headquarters preventedany uncertainty as to what medical officer was in the administrative positionof major importance. In the Southwest Pacific Area, on the other hand,considerable confusion, aggravated during the period September 1942 toAugust 1944: by the presence of a surgeon with ill-defined duties at theAllied command headquarters, prevailed with respect to this point. No singlemedical office was situated for any length of time at a headquarters whichhad authority to issue technical medical instructions to all Army troopsin the Southwest Pacific Area.
The Southwest Pacific Area, which had more Army troop strength thaneither of the other two Pacific Areas, was the least satisfactory of allthe major theaters of operations insofar as the organization of medicalservice within the command structure before June 1945 was concerned. ManyMedical Department officers who served there, as well as men who went outon special missions, emphasized the detrimental effects of its positionwithin the command structure. In the absence of a single surgeon with powerto put plans into effect on the theaterwide basis, it was difficult toshift hospitals, medical personnel, and medical supplies to localitiesor commands where they were most needed. Neither the highest U.S. Armyheadquarters nor the Allied headquarters had a group of consultants todirect a theaterwide consultants` system. Neither had a preventive medicinedivision to supervise a theaterwide system of disease prevention in anarea where environmental disease hazards made a strongly organized preventiveprogram necessary. The more centralized
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control over antimalaria efforts and other preventive programs whichdeveloped in the Southwest Pacific Area with time was achieved only thehard way after experience forced a recognition of the necessity for it.
In addition to the lack of a single medical office vested with centralizedresponsibility, the many changes in command structure and in jurisdictionof commands, together with the frequent moves of multitudinous headquarters(or parts of them) to new locations, were prejudicial to close liaisonof offices in the Southwest Pacific Area with each other. Medical Departmentofficers, particularly those who came from civilian life, were often uncertainas to how the structure above them worked and as to what their own medicalresponsibilities were.. Frequent shifts in command structure tended toconfuse their understanding of the channels of communication and to makemore difficult the coordination of medical reports. Officers who came intothe Southwest Pacific Area on special medical missions without having spentsufficient length of time there to study Army organization in the areain detail stated that they found its complex command structure an almostinsurmountable barrier to effective conclusion of their missions.
Decentralization of medical responsibility forced upon base and basesection surgeons, and surgeons of other small commands in the SouthwestPacific Area, more diverse and nonmedical duties and problems than werethe lot of most such staff surgeons in other theaters. Some, base and basesection surgeons enjoyed more control over the medical resources allottedto the command which they served than did surgeons in similar positionselsewhere, since they had command control over the medical units and installationsof the base or base section. Surgeons with this authority were better ableto see to it that the medical resources within their small areas were employedto the best advantage. However, the decentralization of command which wascapable of leading to more economic and efficient use of medical resourceswithin a small local command tended to hinder effective use of the totalmedical resources of the Southwest Pacific Area.
Another factor, not alluded to in the passage quoted but frequentlypointed out by Medical Department officers in administrative posts, wasthe lack of contact between Medical Department officers in the theaterand the Surgeon General`s Office. This derived in part from the great distancebetween the Southwest Pacific Area and the United States. In the case ofsome officers, the lack of awareness of developments at home sprang fromthe fact that they had come to their assignments from other oversea areaswhere they had been stationed during the prewar years; they had not beenin close contact with the Surgeon General`s Office during the planningperiod of 1940 and 1941. Hence they were less well informed as to the broadpreventive medicine program formulated by the office and the medical consultantssystem than were those who were sent overseas by the Surgeon General`sOffice. Officers of the Surgeon General`s Office exhibited, in their turn,a good deal of uncertainty as to what surgeon they should address whenthey wrote letters outlining
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proposals for improvement of one phase or another of medical service.Their channels of information were apparently inadequate to give them satisfactoryinformation on the medical responsibilities of commands not in accord withthe Army doctrine that they had studied; the many changes in high levelsof command in the Southwest Pacific Area compounded the uncertainty. Whileit seems that, given the geographic features of the area, a high degreeof decentralization of command would always have prevailed, smoother workingof the medical service could presumably have been achieved by the earlyestablishment and consistent maintenance of a full-fledged medical sectionat General MacArthur`s Allied headquarters.
