CHAPTER VIII
Procurement of Civilian Personnel
ZONE OF INTERIOR
Overall Employment
A considerable number of civilians worked in headquartersoffices, most of them in the Surgeon General`s Office where their numbers in theearly stages of mobilization grew slowly enough to permit an effectiveclassification of skills. Many who entered the Office at this time developedtheir own potentials to a point where, before the war was over, they wereperforming a large portion of the duties normally assigned to officer personnel.It was thus possible to keep down the requirements for officers, and even torelease some officers for oversea service. It was these civilian employees whofurnished the continuity so necessary to the smooth running of an office, at atime when both law and War Department policy put severe limitations upon thelength of time Regular Army officers might remain in nontroop duty assignments.The tabulation which follows shows both the rise in the number of civiliansemployed in the Surgeon General`s Office, especially during the year ending on30 June 1941, and the growing proportion they bore to the officer and nursepersonnel assigned to the Office.1
|
30 June 1939: |
Number |
|
Officers |
31 |
|
Civilians |
161 |
|
Nurses |
3 |
|
195 |
|
30 June 1940: | |
|
Officers |
40 |
|
Civilians |
201 |
|
Nurses |
3 |
|
244 |
|
30 June 1941: | |
|
Officers |
98 |
|
Civilians |
717 |
|
Nurses |
4 |
|
819 |
1Annual Reports of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1939 to 1941, inclusive.
248
The great expansion of the hospital system after the calling up of theNational Guard and the introduction of selective service in 1940 was largelyresponsible for an increase in civilian employment to supplement the supply ofenlisted men assigned to hospitals-an increase bringing the proportion ofcivilians on hospital staffs considerably above the 20 percent which The SurgeonGeneral had considered the maximum desirable.
More than 3,000 civilian employees of the Medical Department at large werepaid from various special funds during the fiscal year 1939. Of these, 595 werepaid from the Medical and Hospital Department, Army, appropriation; 600 fromVeterans` Administration funds; and 1,985 were paid by the Civilian ConservationCorps. These numbers grew rapidly during 1940 and 1941 (table 18).
As the figures demonstrate, the most important of these funds as a source ofcivilian employment during 1939-41 came to be the Medical and HospitalDepartment Fund, which was appropriated by Congress to finance strictly MedicalDepartment activities, exclusive of the pay of military personnel. In addition,the Veterans` Administration, lacking adequate hospital beds of its own, and theCivilian Conservation Corps, wholly dependent for long-term hospitalization onthe Medical Department, each year paid the latter to care for certain of theirpatients in the Department`s hospitals; the money could be used for all expensesincident to patient care, including the pay of civilians.
In addition to the above, a number of civilians in hospitals were employedunder the Construction and Repair of Hospitals Fund, another separateappropriation of Congress. Exact figures on civilians paid from this fund arelacking. Appropriations for the year ending on 30 June 1940, however, weresufficient to cover 52 "positions." Budget estimates for the followingyear covered 724 positions, but as further appropriations raised the totalamount of the fund from $2,892,886 to $4,489,886, the number of civiliansemployed may have been considerably higher.2The fund was used particularly for hospital maintenance and was disbursed by theMedical Department. During this period, however, it was legally a Quartermasterfund.3
Until 1940, the Office of The Surgeon General acted as the employing agentfor civilians in all installations of the Medical Department and kept records onthem. In September 1940, however, when it became evident that the numbersemployed would increase greatly, the authority to employ civilians in stationhospitals was delegated to the corps area surgeons, The Surgeon Gen-
2The Budget of the United State Government. Washington: U.S. Government Printing Office, Fiscal Years Ending 1942 and 1943.
3The U.S. Office of Education also appropriated money to be used by State authorities in conducting vocational courses for servicemen on or off military posts. Some civilian instructors were employed at the medical replacement training centers; information is lacking, however, as to whether any or all of them were paid from this fund. (Letter, The Adjutant General, to Chief of Staff, General Headquarters, and Commanders of Arms and Services, February 1941, subject: Assistance From Civilian Educational Institutions.)
249
Table 18.-Civilians employed by theMedical Department from various funds, March 1940-December 1941
|
Fund |
1940 |
1941 | ||||||
|
March |
June |
September |
December |
March |
June |
September |
December | |
|
Medical and Hospital Department: | ||||||||
|
District of Columbia |
150 |
146 |
157 |
239 |
534 |
813 |
954 |
925 |
|
Elsewhere |
724 |
913 |
1,143 |
3,572 |
8,730 |
18,396 |
22,297 |
26,425 |
|
874 |
1,059 |
1,300 |
3,811 |
9,264 |
19,209 |
23,251 |
27,350 |
|
Civilian Conservation Corps: | ||||||||
|
District of Columbia |
138 |
148 |
138 |
122 |
34 |
41 |
17 |
14 |
|
Elsewhere |
1,628 |
1,587 |
1,376 |
989 |
774 |
751 |
565 |
486 |
|
1,766 |
1,735 |
1,514 |
1,111 |
808 |
792 |
582 |
500 |
|
Veterans` Administration: | ||||||||
|
District of Columbia |
84 |
85 |
98 |
102 |
106 |
116 |
6 |
6 |
|
Elsewhere |
495 |
544 |
488 |
409 |
495 |
491 |
513 |
359 |
|
579 |
629 |
586 |
511 |
601 |
607 |
519 |
365 |
|
Total Medical Department: | ||||||||
|
District of Columbia |
372 |
379 |
393 |
463 |
674 |
970 |
977 |
945 |
|
Elsewhere |
2,847 |
3,044 |
3,007 |
4,970 |
9,999 |
19,638 |
23,375 |
27,270 |
|
3,219 |
3,423 |
3,400 |
5,433 |
10,673 |
20,608 |
24,352 |
28,215 |
Source: Civilian Personnel Division, Office of The Surgeon General, U.S. Army.
250
eral retaining the right in connection with generalhospitals.4 Under this arrangement, The SurgeonGeneral continued to control all the funds but allotted certain amounts to thecorps area surgeons; whereas, previously, he had allotted funds to theindividual stations. The Surgeon General`s Office constructed tables showing jobtitles, numbers, and grades to guide those actually engaged in staffinginstallations.
At the end of July 1945, the Department had in its employmore than 70,000 civilians in the United States, most of whom were under thejurisdiction of the service commands.5 On 30June 1945, about 8,100 civilians were employed in activities under the directcommand of The Surgeon General. The majority of these worked in medical depots;others were assigned to the Army Medical Center, the Army Medical Library, andthe Army Medical Museum, all located in Washington, D.C. The Surgeon General`sOffice itself employed 1,402, about 200 of this number being in his PersonnelService, which at that time included both the Military and Civilian PersonnelDivisions.6
Contract Surgeons
Among civilian employees were a few contract surgeons7and specialists, the latter engaged temporarily for particular cases. Early in1941, civilian physicians began to be used for other purposes when the Secretaryof War, acting on the recommendation of The Surgeon General, created the Boardfor the Investigation and Control of Influenza and Other Epidemic Diseases inthe Army. The board was composed of outstanding civilian doctors and MedicalCorps officers, the former acting as consultants to the Secretary of War toadvise The Surgeon General on problems of infectious diseases in the Army.8Civilian members were to be paid a per diem of $20 plus transportation expenses.Eventually, this board comprised about 200 members, divided into variouscommissions. Civilian consultants had been used during the First World War; thecreation of the new board meant the revival of an important practice whichcontinued throughout World War II.
Nursing Personnel
To help perform nursing duties for the Army in the United States, sizablenumbers of civilians were obtained. The number of civilian graduate nurses so
4(1)Letter, Office of The Surgeon General (Lt. Col. F. C. Tyng), to Surgeons, Corps Areas and Departments, 12 Sept. 1940, subject: Use of Civilian Personnel in Army Hospitals. (2) Letter, The Adjutant General, to Commanders of Arms and Services, Commanding Generals, all Corps Areas, and Commanding Officers of Exempted Stations, 21 Oct. 1940, subject: Provision for Civilian Employees in Hospitals of Exempted Stations.
5Monthly Progress Report, Army Service Forces, War Department, 31 Aug. 1945, Section 5: Personnel and Training.
6War Department Civilian Personnel Statistics Bulletin, vol. 3(12), June 1945, p. 5.
7On 30 June 1939, 31; on 30 June 1940, 28; and on 30 June 1941, 36.
8Letter, The Surgeon General, to The Adjutant General, 27 Dec. 1940, subject: Establishment of Board for Investigation of Influenza and Other Epidemic Diseases in the Army, and 1st endorsement thereto, 11 Jan. 1941, reprinted in Bull. U.S. Army M. Dept. No. 64, 1942.
251
employed amounted to somewhat more than 1,000 in April 1945,9a figure that was probably close to the peak, since, with the return of nursesfrom overseas, civilian nurses were released from Army hospitals.
The influx of civilian nurses` aides into Army hospitals wasconsiderably larger. The Office of Civilian Defense and the American Red Crosscooperated in training such personnel and, by March 1942, had some 12,000 to15,000 in training. In January 1945, The Surgeon General informed the Red Crossthat the quota for paid nurses` aides was set at an additional 5,000, and herequested the latter to train and recruit that number; later, however, on WarDepartment orders, he withdrew the request. An agreement was thereupon madewhereby further recruiting would cease and only those already in training wouldbe hired.10 The peak strength of nurses` aides-paidand unpaid-serving in Army hospitals reached about 2,000 (in June 1945);11it seems likely that more than half of that number were in the paid category.
The cadet nurse program also furnished a large quota. During the period from15 June 1944, when the first cadet nurses were placed in Army hospitals, to 1October 1945, The Surgeon General received from the Civil Service Commission atotal of 9,891 cadet nurse applications for service in Army hospitals. Of thisnumber, 5,688 cadets were accepted and assigned to hospitals; 3,953 of thesecompleted the course, and 1,674 were on duty on 1 October 1945. A total of 61were dismissed or resigned during the whole period. There is no record of thetotal number who accepted Army Nurse Corps commissions upon completing thecourse, although it is known that 93 who had had senior cadet nursing experiencein Army hospitals had been commissioned up to 1 January 1945.12Some, either not physically qualified for or not desiring a commission, servedin civilian status after graduation.
Occupational Therapists
At the time the United States entered the war, only 12graduate occupational therapists were working in Army hospitals. Their numbersincreased only slowly before late 1943. In August of that year, The SurgeonGeneral, pointing out that their work was of professional character and formedan important part of the treatment given to patients especially in orthopedicand neuropsychiatric cases, stated that of the 71 then employed in Armyhospitals in
9Civilian Nurses in Army Hospitals. Am. J. Nursing 45: 263, April 1945.
10(1) Letter, Surgeon General Kirk, to Mrs. Walter Lippmann, National Director, Volunteer Nurses` Aid Corps, American Red Cross, 1 Jan. 1945. (2) Letter, Surgeon General Kirk, to Basil O`Connor, Chairman, American Red Cross, 6 Jan. 1945. (3) Memorandum, Deputy Assistant Chief of Staff, G-1, for Deputy Chief of Staff, 13 Jan. 1945, subject: The Surgeon General`s Campaign for Red Cross Nurses` Aides.
11Information furnished by Resources Analysis Division, Office of The Surgeon General.
12(1) Memorandum for Record, Capt. J. D. Boole, MAC, 2 Oct. 1945. (2) Annual Report, Valley Forge General Hospital, 1945. (3) Memorandum, Brig. Gen. R. W. Bliss, Assistant Surgeon General, for Director, Bureau of Public Relations, War Department, 27 Jan. 1945, subject: WAC Technician Program.
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the United States, about 25 were probably not qualified. He succeeded at thattime in getting the authority to pass upon qualifications of therapists procuredin the service commands by compiling lists of qualified individuals from whichthe appointments were to be made. He also obtained the right to pass on theprofessional qualifications of those whose names the service commands submittedto him. However, responsibility and authority for the employment of occupationaltherapists remained with the service commanders. Procurement increased rapidlyafter this date, and in August 1945, the Army was employing a peak strength of447 graduate occupational therapists and 452 apprentices in more than 70 of itshospitals.13 None served overseas during thewar.
Dietitians and Physiotherapy Aides
Women dietitians and physiotherapy aides served in civilian status until1942. Their number increased during the emergency until, by May 1941, dietitianson duty in Army hospitals numbered 103, and physiotherapy aides, 47. At thattime, there were 350 vacancies for dietitians and 125 for physiotherapy aides.
Nonprofessional Personnel
In addition to the professional and trained personnel, the Medical Departmentemployed large numbers of civilians in clinical and administrative positions andas laborers and skilled workmen. The turnover in these jobs was more rapid thanin the professional categories and also required on-the-job training for many ofthe people recruited.
Red Cross Workers
The number of Red Cross workers in Army hospitals in the United Stateslikewise increased. Although statistics are not complete, the American NationalRed Cross reported that on 30 November 1942 a total of 244 paid staff workerswere serving in 22 general hospitals and 787 in 122 station hospitals in theZone of Interior. As regards the volunteer staff, the Red Cross reported that itwould be "fairly accurate to say" that 1,300 were serving in Armyhospitals in November 1942 and 7,500 in December 1944, the last month in the warperiod for which figures are available. Shortly after the war, there were 1,213paid workers in 203 station hospitals. Numbers in general hospitals at that timeare not available.
13(1) Letter, The Surgeon General, to Commanding General, Army Service Forces, 13 July 1943, subject: Occupational Therapy Personnel, with 2d endorsement thereto, 7 Aug. 1943. (2) Letter, The Adjutant General, to The Surgeon General and Service Commands, 12 Aug. 1943, subject: Occupational Therapy Personnel in Zone of Interior General Hospitals. (3) The Surgeon General`s Letter No. 149, 12 Aug. 1943.
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Red Cross workers assigned to hospitals overseas were ofcourse not military personnel, but they occasionally performed work in the wardsin addition to preparing patients for the operating room.14
OVERSEA THEATERS
Under regulations in existence even before the establishmentof any theater of operations, theater commanders were authorized to facilitatethe use of local civilians within their commands to the extent needed to preventdiminution of the efficiency of their troops.15However, while the Surgeon General`s Office was aware that local labor would beused-as is shown by a reference to it in TOE 8-500, published on 23 April 1944and revised on 18 January 1945-no general policies were established whichspecifically promoted the use of such manpower sources outside the continentalUnited States.16
The Medical Department`s use of civilian employees in overseaareas developed in accordance with policies and conditions in these areas. Thetheater commander established policies applicable to the entire theater and notsolely for the benefit of the Medical Department. By virtue of their location,relative stability, and type of function, installations in the communicationszone or base sections were able to utilize such personnel on a greater scalethan those troops in combat areas.17 The actualprocurement, administration, and payment of extra-Army personnel usually waseffected through nonmedical channels, such as base section headquarters.
Types of Personnel Utilized
Civilian labor used by the Medical Department overseas may bedivided into four general classes: (1) Professional (including certain "subprofessional"personnel such as laboratory technicians and nurses` aides); (2) clerical(including messengers and interpreters); (3) skilled; and (4) unskilled.
The professional category of civilian employees was relativelyunimportant, because highly trained civilians were rarely available overseas.However, in certain emergency situations, they were temporarily helpful.
14In field hospitals, Red Cross workers "assisted in removing bloody or torn clothing, removing excess blood from the patient, removing his shoes and washing his face and hands under the guidance of medical authorities." Occasionally, where there were not enough psychiatrists on the staff of a convalescent hospital, a Red Cross social worker was asked to conduct the interviews in which patients "ventilated" their personal anxieties. (Letter, C. H. Whelden, Jr., Chief Statistician, American National Red Cross, to Max Levin, Office of The Surgeon General, 6 June 1952, with enclosure thereto.)
15War Department Field Manual 100-10, Field Service Regulations, 9 Dec. 1940, p. 121; and 15 Nov. 1943, p. 151.
16The oversea portion of this chapter is very largely a condensation of a manuscript, "Medical Department Utilization of Civilian and POW Labor Overseas in World War II," prepared by Cpl. Alan M. White in the Historical Unit, U.S. Army Medical Service, under supervision of the authors of this volume. The major sources for Corporal White`s work are the periodic reports of medical units and headquarters, too numerous to list here.
17(1) Letter, Lt. Col. Irvine H. Marshall, to Col. C. H. Goddard, Office of The Surgeon General, 1 Aug. 1952. (2) Letter, Col. I. A. Wiles, to Col. C. H. Goddard, Office of The Surgeon General, 14 Aug. 1952.
254
Civilian surgical teams contributed much to the care ofcasualties at the time of Pearl Harbor, and in the invasion of Luzon, volunteerPhilippine doctors and nurses worked with Medical Department personnel incertain Army hospitals which were flooded with casualties. Immediately after thefall of Rome, 12 young Italian-American graduates of the University of RomeMedical School, who had been interned in Vatican City during the Germanoccupation, together with Italian doctors and medical students recruited bythem, served as prophylactic station attendants in the Italian capital.18 InAustralia, the services of a few physical therapy aides were obtained, and invarious theaters, small numbers of Catholic nuns, missionary or native, wereutilized as nurses. Civilian nurses` aides worked in some Army hospitals inFrance, the Philippines, and China, and sometimes there were as many as 50 in asingle hospital. Laboratory assistants and other technically trained individualswere used when available.
Civilian clerical workers were used in various types of Medical Departmentunits, but particularly in fixed installations. Typists, stenographers, andclerks were employed in all theaters, but, of course, in such areas as NewGuinea, Burma, parts of Africa, and some of the Pacific islands, the educationallevel of the population was not high enough to make many available for servicein hospitals.
The skilled workers probably were the most valuable of the MedicalDepartment`s civilian employees. Especially in the North African theater andSouthwest Pacific Area, the Medical Department had to do a great deal of its ownconstruction because of the shortage of Engineer personnel. Carpenters,plumbers, masons, electricians, and painters were hired in these areas andelsewhere to supplement the meager strength of the hospitals` utilitiesdepartments both in construction and in maintenance work.19 Theservices of other skilled civilians, such as barbers, tailors, and cooks, wereless essential but were often used by Medical Department units. Skilled workerswere more plentiful in the North African-Mediterranean and European theatersthan elsewhere and, hence, were used more extensively there, but the 95thStation Hospital at K`un-ming, China, reported having hired "carpenters,masons, plumbers, tinsmiths, etc." in 1944, and the 49th General Hospitalin Leyte, the Philippines, in 1945, listed 49 skilled workers (includingcarpenters, plumbers, electricians, and mechanics) among its 353 civilianemployees.
Unskilled workers were by far the most important category ofcivilian employees numerically, not only because the Medical Department needed agreat deal of heavy labor but also because this was the category most available;indeed, in most areas, there was a very large supply of unskilled labor.Employees of this class performed such diverse duties as ditching, draining,spraying, and oiling required in malaria control projects; clearing undergrowth
18Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944.
19Letter, Col. I. A. Wiles, to Col. C. H. Goddard,Office of The Surgeon General, 17 Sept. 1952. (Although the construction ofhospitals in North Africa and Europe usually was accomplished by the Engineers,a great deal of minor construction was left for the unit personnel, and this wasoften more than the hospital utilities sections could handle.)
255
from hospital sites; aiding in construction work; cleaningdirt and rubble from buildings and grounds; landscaping and gardening; wastedisposal and sanitation ; "kitchen police" and mess help; cleaning ofhospital wards; movement of supplies and equipment and litter bearing.
Resultant Savings of Military Personnel
The use of civilians, prisoners of war, and similar locallabor made it possible to release Medical Department enlisted men for service ascombat troops, to relieve such men from unskilled and routine work for moretechnical duties within the Medical Department itself, and in certain instancesto effect considerable reductions in the table-of-organization strength ofunits. By this means, the 814th Hospital Center, in the European theater, inJanuary 1945, was able to order its attached general hospitals to reduce theirenlisted complements to 400, instead of the 450 allotted by the relevant tablesof organization. It further directed its attached station hospitals and smallerunits to reduce their enlisted strength 20 percent. This resulted in a totalsaving of nearly 800 Medical Department enlisted men. The 815th Hospital Center,located in the Seine Base Section (Paris), European theater, was able by theemployment of local labor, in 1945, to reduce the aggregate military strength ofits general hospitals by 557 men (table 19).
TABLE 19.-Economies in enlisted personnel through utilization of local labor, 815th Hospital Center,
European theater, 1945
|
General hospital |
T/O capacity (number of beds) |
Authorized T/O enlisted strength |
Reduced enlisted strength |
Percent saving |
|
1st |
1,500 |
562 |
450 |
19. 9 |
|
191st |
1,500 |
562 |
450 |
19. 9 |
|
194th |
1,000 |
450 |
375 |
16. 7 |
|
198th |
1,000 |
450 |
375 |
16. 7 |
|
203d |
2,000 |
641 |
550 |
14. 2 |
|
217th |
1,500 |
562 |
450 |
19. 9 |
Source: Annual Report, 815th Hospital Center, European Theater of Operations, U.S. Army, 1945.
The Situation in the Various Theaters
The number of civilians hired by a particular MedicalDepartment unit depended not only on that unit`s needs in a particularsituation, but also on the availability of local labor. In the European theater,an attempt was made to develop a plan for civilian employment in Army hospitalsbased on the patient census, but this proved impossible because it was foundthat a unit`s personnel needs were more dependent on the type of buildings inwhich it operated than on the number of patients in its care. The numbers ofcivilian employees in Army hospitals overseas thus varied widely from theater totheater
256
and, within a theater, from hospital to hospital. Even within a particularhospital, there were substantial fluctuations over relatively brief periods.20
Southwest Pacific theater
The variety of situations within a given major area isillustrated by the Southwest Pacific. Civilians were used in headquarters and inhospitals in Australia, but the manpower shortage there did not permit theiremployment in great quantity on that continent. In New Guinea, native litterbearers were used to carry casualties over the rugged Owen Stanley Mountains andto bring casualties to collecting points on the beaches during amphibiousoperations (fig. 36). Few natives, however, were employed by the hospitals,although in 1944 the 2d Station Hospital, west of Lae, had from 15 to 20 nativeworkers who were used for common labor outside the hospital (fig. 37). At MilneBay, approximately 100 natives per month were used by malaria control units inthe summer of 1944.21
20This is perhaps one reason for lack of comprehensive statisticalinformation concerning employment by the Medical Department of civilians inoversea areas.
21See footnote 17(2), p. 253.
257
In the islands north of Australia, the average number ofnatives employed per day in 1943 for purposes of malaria control exceeded1,000 and reached 2,000 in 1944.22 The picture in regard to hospitalemployment was very different in the Philippines. The 49th General Hospital had60 workers on 1 January 1945, 353 on 31 March, 448 on 30 June, and a peak of 465on 30 September 1945. The 125th Station Hospital averaged 180 Philippineemployees daily in the first quarter of 1945, and 150 in the second.
A recent rough estimate based on recollection alone indicates that, at thepeak of activity at Base K in Leyte (that is, about the end of 1944 and theearly part of 1945), 2,500 civilians were employed by the Medical Departmentwithin the area covered by that command.23 This was equal to about 4percent of the military medical personnel of the entire theater.
South and Central Pacific theaters
In the South and Central Pacific Areas, there were relatively few civilianemployees outside the Hawaiian Islands. This may have been because many of thenatives in the Japanese mandated islands were hostile to the American forces,because shortages of military labor were infrequent, or because Navy
22Letter, G. L. Orth, to Col. C. H. Goddard, Office of TheSurgeon General, 17 Sept. 1952.
23See footnote 17(2), p. 253.
258
FIGURE 38.-Indian laundry workers, 371st Station Hospital, Ramgarh, India, 28 February 1945.
construction personnel and corpsmen were sometimes used to build and work inArmy hospitals.24
In the Central Pacific, the number of civilians employed bythe Medical Department remained relatively constant throughout the war, totaling526 in December 1941 and 464 in August 1945. The peak of employment was reachedwith 656 in June 1942. Apparently, a large proportion of civilian MedicalDepartment personnel in this area was located at old Tripler General Hospital orthe 218th General Hospital as it was later known. This, the largest hospital inthe Hawaiian Islands, was authorized to employ as many as 168 civilian employees(including several with strictly medical duties) in 1942.
China-Burma-India theater
The China-Burma-India theater was probably the region with the most acuteshortage of medical personnel, a shortage caused in part by its responsibilityfor the care of Chinese Army personnel, and it seems likely that most MedicalDepartment units in that theater used natives for common labor (fig. 38).
The 20th General Hospital in 1944 (at Margherita, Assam, India) employed 120natives in the mess department and 100 more for general mainte-
24Two exceptions may be noted: Some native labor was usedin construction of the 222d Station Hospital on Banika Island in the Russells,and native labor was used to clear ground preparatory to the actual constructionwork on the 48th Station Hospital at Guadalcanal.
259
nance. When the 18th General Hospital shifted from Assamto Burma in 1945, it took 165 civilians with it. Only 125 of these were actually employed bythe hospital, however, since 40 were used as "aiyahs" and"personal bearers." In 1943, the 95th Station Hospital atCh`ung-ch`ing, China, employed 15 Chinese nurses in lieu of its Americannurse contingent, Army nurses having been excluded from China on GeneralStilwell`s orders. In its first year of operation (1942), the 159th StationHospital at Karachi, India, hired 100 native laborers. From 100 to 500 laborerswere engaged in various malaria control projects in the Calcutta area inearly 1943. In Burma, native litter bearers were used. During 1944, the numberof civilian personnel used by the Medical Department in the China-Burma-Indiaarea was, at the lowest, equal to 10 percent of the strength of the militaryelements of the Department in that area.
Africa-Middle East theater
In the Africa-Middle East theater, native employees, usedprimarily in malaria control and waste disposal and other sanitary activities,were hired in considerable numbers. In 1943, there were over 100 employed at the67th Station Hospital in Accra, and at Roberts Field, Liberia, the employmentof over 1,800 natives at all times during 1944-a number considerably greaterthan the entire Medical Department military personnel in the Africa-Middle Eastarea-was estimated to have saved the labor of 800 to 1,000 troops. Natives wereused in malaria control operations in the Persian Gulf Command. Civilians werealso employed there in hospital work, and the number in relation to that ofmilitary medical personnel in the Command was considerable (table 20).
TABLE 20.-Ratio of civilian hospital workers to militarymedical personnel, Persian Gulf Command, 30
April 1943-31 July 1945
|
Date |
Civilian hospital workers1 |
Military medical personnel2 |
Ratio of hospital workers to military medical personnel (percent) |
|
1943 | |||
|
30 April |
197 |
1,812 |
10.9 |
|
31 December |
419 |
3,067 |
13.7 |
|
1944 |
|
|
|
|
31 August |
703 |
2,017 |
34.9 |
|
31 December |
421 |
1,980 |
21.3 |
|
1945 |
|
|
|
|
31 July |
64 |
496 |
12.9 |
1From table 13, "Distribution of U.S. Army civilianemployees in the Persian Corridor, 1943-45," in Motter, T. H. Vail: ThePersian Corridor and Aid to Russia. United States Army in World War II. TheMiddle East Theater, Washington: U.S. Government Printing Office, 1952, p. 500.
2From unadjusted data in table 31 for dates shown therein and from pertinentissues of "Strength of the Army" for other dates.
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North African-Mediterranean theater
In the North African-Mediterranean and the European theaters,possibly because operating conditions were more uniform than in other areas,various hospitals of like type tended to engage more equal numbers of civilianemployees than did similar hospitals elsewhere. Even so, variations innumbers of civilian personnel utilized by like medical units in both theatersexisted. The number of French and Arab civilians utilized by Army hospitals inNorth Africa and the number of Italian civilians used by such hospitals in Italydepended very largely on the availability of Italian service troops, since thelatter, after the organization of Italian service units in late 1943, werealmost universally preferred to the civilians. For a general hospital not usingItalian troops, the average number of civilians employed in the North Africantheater was probably from 150 to 200, although as many as 275 were used onoccasion. The normal civilian complement for an evacuation hospital in similarcircumstances was about 50, but at times well over 100 civilian workers wereemployed.
Available statistics do not justify generalizations about thenumber of civilians normally employed in station and convalescent hospitals andin malaria control and other Medical Department units.25 However, if theaverage number of personnel, not including U.S. troops, that were used inMedical Department installations at the end of the war be taken as a criterionof the strength of civilian employment prior to the use of Italian servicepersonnel, it is likely that as many as 4,000 civilians were employed in theMedical Department in the North African theater about the time of the invasionof Italy (table 21). This was equal to 7 percent of the strength of the MedicalDepartment elements in the theater on 31 October 1943.
European theater
The high educational level of the civilian population inEurope, as compared with that of peoples in other parts of the world, meant thatit was possible to utilize European indigenous labor in a wider variety ofoccupations than elsewhere and to place greater reliance upon their ability toperform relatively unskilled tasks. This partly explains why the number ofcivilians employed by the Medical Department was greater in the European theaterthan in any other oversea area. Shortly after V-E Day, the number of civiliansso employed in medical installations of the communications zone alone exceeded20,000 (table 22). However, the fact that the Army overseas had its greateststrength in that theater, helped to produce the same result. Indeed, the numberof civilians employed in the communications zone Medical Depart-
25Station and convalescent hospitals and malaria controlunits in the North African theater employed civilians, but statistics of thenumber used are available only in isolated instances. The 7th Station Hospitalat Oran at one time employed 80 French civilians, and an unspecified number ofcivilians were used in malaria control work.
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TABLE 21.-Utilization of civilian workersand Italian prisoners of war, by Medical Department service-type units,Mediterranean theater, 1 May 1945
|
Type of unit1 |
Number in theater |
Civilian workers |
Italian prisoners of war | ||
|
Number |
Average per unit |
Number |
Average per unit | ||
|
General hospital: | |||||
|
2,000-bed |
2 |
--- |
0 |
204 |
102 |
|
1,500-bed |
9 |
119 |
13.2 |
815 |
90.5 |
|
Station hospital: | |||||
|
750-bed |
1 |
--- |
0 |
33 |
33 |
|
500-bed |
17 |
219 |
12.8 |
1,423 |
83.7 |
|
250-bed |
2 |
--- |
0 |
223 |
111.5 |
|
150-bed |
1 |
--- |
0 |
35 |
35 |
|
Malaria survey detachment |
1 |
--- |
0 |
170 |
170 |
|
Malaria control detachment |
10 |
25 |
2.5 |
1,707 |
170.7 |
|
Medical base depot company |
4 |
20 |
5 |
224 |
56 |
|
Medical general dispensary |
2 |
16 |
8 |
--- |
0 |
|
Medical general laboratory |
1 |
--- |
0 |
65 |
65 |
|
Medical service battalion |
1 |
10 |
10 |
112 |
112 |
1One medical laboratory, 6 prophylactic platoons, 13 veterinary food inspection detachments, 2 veterinary evacuation detachments, and 1 hospital train used no local labor.
Source: "Digest of Principal Type Service Units Utilized inMTO," compiled by G-4 Section, Mediterranean Theater ofOperations, U.S. Army; revised November 1945, pp. 8-12.
ment activities around V-E Day was equivalent to about 5percent of the number of troops utilized in the entire medical service of thetheater, and while civilians also were used in the combat zone, they probablydid not raise this percentage by a very great amount.26 Thus, itappears that in relation to the military strength of the Medical Department inthe European theater the number of civilians employed by that branch of the Armywas less than it was in many other places.
Since labor was scarce in Great Britain and strictly rationedby the British authorities, an Army hospital there usually employed no more thanfrom 20 to 30 civilians. On the Continent, an entirely different situation prevailed. General hospitals in France at times had from 600 to 700 civilians intheir employ, although the average may have been somewhat lower. In April 1945,the 11 general and 3 station hospitals of the Seine Section had a total of 7,513civilian employees, an average of 609.9 per general and 268.0 per stationhospital; and in May 1945, the 203d General Hospital established what wasprobably an oversea record with 1,248 civilian employees. When they were notusing German prisoners of war instead, most evacuation hospitals in the Europeantheater employed from 60 to 80 civilians, although as many as 120
26Letter, Brig. Gen. Alvin L. Gorby, to Col. C. H. Goddard,Office of The Surgeon General, 30 July 1952.
262-263
TABLE 22.-Medical Department civilianlabor, Communications Zone, European theater (exclusive of headquarters),June-December 1945
|
Type |
15 June 1945 |
15 July 1945 |
15 August 1945 |
15 September 1945 |
15 October 1945 |
15 November 1945 |
15 December 1945 |
|
General (all branches of Army): | |||||||
|
Number |
171,477 |
156,025 |
154,787 |
131,818 |
101,452 |
89,151 |
81,729 |
|
Mobile:1 | |||||||
|
Number |
38,908 |
31,587 |
24,281 |
21,887 |
14,677 |
11,330 |
12,212 |
|
Percentage of general |
22.7 |
20.2 |
15.7 |
16.6 |
14.5 |
12.7 |
14.9 |
|
Static:2 | |||||||
|
Number |
132,569 |
124,438 |
130,506 |
109,931 |
86,775 |
77,821 |
69,517 |
|
Percentage of general |
77.3 |
79.8 |
84.3 |
83.4 |
85.5 |
87.3 |
85.1 |
|
Clerical:3 | |||||||
|
Number |
15,009 |
15,323 |
15,882 |
15,463 |
13,545 |
13,180 |
12,750 |
|
Percentage of general |
8.8 |
9.8 |
10.3 |
11.7 |
13.4 |
14.8 |
15.6 |
|
Male: | |||||||
|
Number |
6,419 |
6,816 |
7,503 |
7,581 |
6,548 |
6,379 |
6,236 |
|
Percentage of clerical |
42.8 |
44.5 |
47.2 |
49.0 |
48.3 |
48.4 |
48.9 |
|
Female: | |||||||
|
Number |
8,592 |
8,507 |
8,379 |
7,882 |
6,997 |
6,801 |
6,514 |
|
Nonclerical: | |||||||
|
Number |
117,558 |
109,115 |
114,624 |
94,468 |
73,230 |
64,641 |
56,767 |
|
Percentage of general |
68.6 |
69.9 |
74.1 |
71.7 |
72.2 |
72.5 |
69.5 |
|
Medical Department: | |||||||
|
Number |
20,099 |
15,418 |
12,133 |
10,220 |
7,223 |
5,083 |
3,650 |
|
Percentage of general |
11.7 |
9.9 |
7.8 |
7.8 |
7.1 |
5.7 |
4.5 |
|
Mobile:1 | |||||||
|
Number |
3,086 |
2,170 |
2,356 |
2,947 |
1,051 |
707 |
559 |
|
Percentage of Medical Department civilian labor |
15.4 |
14.1 |
19.4 |
28.8 |
14.6 |
13.9 |
15.3 |
|
Percentage of general mobile |
7.9 |
6.9 |
9.7 |
13.5 |
7.2 |
6.2 |
4.6 |
|
Static:2 | |||||||
|
Number |
17,013 |
13,248 |
9,777 |
7,273 |
6,172 |
4,376 |
3,091 |
|
Percentage of Medical Department civilian labor |
84.6 |
85.9 |
80.6 |
71.2 |
85.4 |
86.1 |
84.7 |
|
Percentage of general static |
12.8 |
10.6 |
7.5 |
6.6 |
7.1 |
5.6 |
4.4 |
|
Clerical:3 | |||||||
|
Number |
963 |
757 |
573 |
519 |
412 |
344 |
341 |
|
Percentage of Medical Department civilian static |
4.8 |
4.9 |
4.7 |
5.1 |
5.7 |
6.8 |
9.3 |
|
Percentage of general static clerical |
6.4 |
4.9 |
3.6 |
3.4 |
3.0 |
2.6 |
2.7 |
|
Male: | |||||||
|
Number |
329 |
231 |
199 |
171 |
139 |
91 |
93 |
|
Percentage of Medical Department clerical |
34.2 |
30.5 |
34.7 |
32.9 |
33.7 |
26.5 |
27.3 |
|
Percentage of general static male clerical |
5.1 |
3.4 |
2.7 |
2.3 |
2.1 |
1.4 |
1.5 |
|
Female: | |||||||
|
Number |
634 |
526 |
374 |
348 |
273 |
253 |
248 |
|
Percentage of general static female clerical |
7.4 |
6.2 |
4.5 |
4.4 |
3.9 |
3.7 |
3.8 |
|
Nonclerical: | |||||||
|
Number |
16,050 |
12,491 |
9,204 |
6,754 |
5,760 |
4,032 |
2,750 |
|
Percentage of Medical Department civilian labor |
79.9 |
81.0 |
75.9 |
66.1 |
79.7 |
79.3 |
75.3 |
|
Percentage of general static nonclerical |
13.7 |
11.4 |
8.0 |
7.1 |
7.9 |
6.2 |
4.8 |
1Employees working from day to day in whateverlocality their services were required. Includes all civilians, other than Germannationals, employed in Germany.
2Employees residing in the locality of their employment.
3Office workers, including clerical and administrative personnel suchas clerks, typists, stenographers, and accountants. These are not necessarilythe total of such workers since there also may have been office workers amongthe mobile employees.
Source: (1) Progress Report, Communications Zone, U.S. ArmyForces, European Theater, for months shown. (2) Circular No. 72, Headquarters,Communications Zone, European Theater of Operations, U.S. Army, 22 May 1945.
264-266
were "profitably" employed in one instance. In the medical units ofthe Continental Advance Section, European theater, in February 1945, civilianlabor reached a peak of 1,770 workers against an enlisted strength of 7,871, or1 civilian for every 4.4 enlisted men.
As late as June 1945, the United Kingdom employed 8.9 percent of the totalcommunications zone Medical Department civilian employees while it had only 5.3percent of communications zone employees in general. Indeed, while the tworatios tended to approach each other, this situation was in existence even atthe end of August 1945 (table 23).
TABLE 23.-Geographic distribution ofmedical personnel, European Theater of Operations, Communications Zone,1April 1945 to October 1945, inclusive2
|
Group |
1945 | |||||
|
April3 |
May3 |
June |
July |
August |
October | |
|
Total manpower: | ||||||
|
General (all branches of the Army): | ||||||
|
Total |
1,076,445 |
1,185,957 |
1,130,948 |
1,134,845 |
1,142,590 |
947,520 |
|
United Kingdom: | ||||||
|
Number |
114,729 |
105,644 |
103,414 |
88,542 |
80,226 |
49,281 |
|
Percent of general manpower |
--- |
--- |
9.1 |
7.8 |
7.0 |
5.2 |
|
Medical Department: | ||||||
|
Total |
183,632 |
196,426 |
191,762 |
142,892 |
116,732 |
89,887 |
|
United Kingdom: | ||||||
|
Number |
60,550 |
59,247 |
50,595 |
35,019 |
28,173 |
12,135 |
|
Percent of Medical Department manpower |
--- |
--- |
26.4 |
24.5 |
24.1 |
13.5 |
|
Total troops: | ||||||
|
General (all branches of the Army): | ||||||
|
Total |
569,635 |
571,284 |
522,211 |
497,162 |
491,437 |
458,581 |
|
Percent of total general manpower |
--- |
--- |
46.1 |
43.8 |
43.0 |
48.3 |
|
United Kingdom: | ||||||
|
Number |
93,479 |
80,989 |
70,657 |
57,925 |
51,349 |
30,778 |
|
Percent of total troops |
16.4 |
14.2 |
13.5 |
11.7 |
10.4 |
6.7 |
|
Medical Department: | ||||||
|
Total |
125,868 |
123,338 |
114,228 |
86,393 |
68,379 |
58,621 |
|
Percent of total Medical Department manpower |
--- |
--- |
59.5 |
60.4 |
58.5 |
65.2 |
|
United Kingdom: | ||||||
|
Number |
54,674 |
50,846 |
41,292 |
29,898 |
23,371 |
10,305 |
|
Percent of Medical Department troops |
43.4 |
41.2 |
36.1 |
34.6 |
34.2 |
17.6 |
|
Total prisoners of war working: | ||||||
|
General (all branches of the Army): | ||||||
|
Total |
263,318 |
351,968 |
400,518 |
454,625 |
463,577 |
387,487 |
|
Percent of total general manpower |
--- |
--- |
35.4 |
40.0 |
40.5 |
40.8 |
|
United Kingdom: | ||||||
|
Number |
20,755 |
24,905 |
25,222 |
23,501 |
23,390 |
15,666 |
|
Percent of total prisoners of war working |
7.8 |
7.1 |
6.3 |
5.2 |
5.0 |
4.0 |
|
Medical Department: | ||||||
|
Total |
39,064 |
54,782 |
53,882 |
39,325 |
33,966 |
24,043 |
|
Percent of total Medical Department manpower |
--- |
--- |
28.0 |
27.5 |
29.0 |
26.7 |
|
United Kingdom: | ||||||
|
Number |
5,876 |
8,401 |
7,518 |
3,857 |
4,140 |
1,549 |
|
Percent of total Medical Department prisoners of war working |
15.0 |
15.3 |
14.0 |
9.8 |
12.2 |
6.4 |
|
Total Italian service unit personnel: | ||||||
|
General (all branches of the Army): | ||||||
|
Total |
37,776 |
38,712 |
39,976 |
34,291 |
32,789 |
0 |
|
Percent of total general manpower |
--- |
--- |
3.5 |
3.0 |
2.8 |
0 |
|
United Kingdom: | ||||||
|
Number |
0 |
0 |
0 |
0 |
0 |
0 |
|
Percent of total Italian service unit personnel |
0 |
0 |
0 |
0 |
0 |
0 |
|
Medical Department: | ||||||
|
Total |
3,436 |
2,919 |
3,559 |
2,095 |
2,254 |
0 |
|
Percent of total Medical Department manpower |
--- |
--- |
1.8 |
1.4 |
1.9 |
0 |
|
United Kingdom: | ||||||
|
Number |
0 |
0 |
0 |
0 |
0 |
0 |
|
Percent of total Medical Department Italian service unit personnel |
0 |
0 |
0 |
0 |
0 |
0 |
|
Total civilian workers:4 | ||||||
|
General (all branches of the Army): | ||||||
|
Total |
20,516 |
223,993 |
168,243 |
148,767 |
154,787 |
101,452 |
|
Percent of total general manpower |
--- |
--- |
14.8 |
13.1 |
13.5 |
10.7 |
|
United Kingdom: | ||||||
|
Number |
--- |
--- |
7,535 |
7,116 |
5,487 |
2,846 |
|
Percent of total civilian workers |
--- |
--- |
4.5 |
4.8 |
3.5 |
2.8 |
|
Medical Department: | ||||||
|
Total |
15,264 |
15,387 |
20,093 |
15,079 |
12,133 |
7,223 |
|
Percent of total Medical Department manpower |
--- |
--- |
10.4 |
10.5 |
10.3 |
8.0 |
|
United Kingdom: | ||||||
|
Number |
--- |
--- |
1,785 |
1,264 |
662 |
281 |
|
Percent of Medical Department civilian workers |
--- |
--- |
8.9 |
8.4 |
5.5 |
3.9 |
1All strengths from Progress Report, Communications Zone, European Theaterof Operations, U.S. Army, for corresponding months. General and MedicalDepartment data exclude headquarters personnel.
2September has been omitted as a result of numerous errors in the corresponding issue of the Progress Report.
3All data exclusive of civilian workers in the United Kingdom.
4Does not include U.S. civilians or British civilians employed on the Continent.
In 1944 in the South Atlantic, the Medical Department had adaily average of 150 employees, used mostly in malaria control work, which wasgreater than one-fourth of the average military strength (534) of the Departmentin the theater for the year. In the Caribbean Defense Command, the peakcivilian-employment totals in 1943 and 1944 included 10 civilians in the Officeof the Surgeon, Antilles Department, and approximately 270 workers engaged inmalaria control duties in the Panama Canal Department. These alone, withoutconsidering hospital workers and sanitation workers in areas outside the PanamaCanal Department, were equal to about 6 percent of the mean Medical Departmentmilitary strength in the Caribbean during 1944 (4,425).27
27Mean strengths are the average of the adjusted strength on 31January, 30 April, 31 July, and 31 October 1944, and 31 January 1945 as shown intable 31.
