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Chapter 7

A Decade of Progress - Contents

Medical Supply

In its proper sense, therefore, the art of war is the art of making use of the given means in combat.-CLAUSEWITZ.

THE MEDICAL SUPPLY FUNCTION

During the past 10 years, the medical supply system has changed extensively. These changes resulted in greater flexibility and a corresponding increase in the ability to meet changing tactical and strategic requirements. This greater flexibility was not achieved easily-the degree of flexibility of a medical supply system is dependent in large measure on its administrative control, and such control shifted many times in the period from 1959 to 1968. When in 1968 administrative responsibilities for medical supply activities were returned to the Army Medical Department, medical support flexibility was enhanced.

In 1959, the Military Medical Supply Agency, a single managership under the Secretary of the Navy, was assigned the responsibility for procurement and distribution of standard items of medical materiel within the Department of Defense. This agency had been established to consolidate the military supply systems and to preclude duplication of functions, with a subsequent reduction in the expenditure of Government funds. The Surgeon General retained the responsibility for determining the items that he needed for treatment and for prophylaxis requirements.

Under the Military Medical Supply Agency, the Army Medical Department in 1959 was responsible for the


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operation of two of three major distribution points: the Louisville Medical Depot, Louisville, Ky., which serviced the central United States, and the Medical Supply Section, Sharpe General Depot, Lathrop, Calif., which supplied the western area of the country. Additionally, in the northeast, the Medical Supply Section, Schenectady General Depot, Schenectady, N.Y., provided a limited primary stock to that portion of the country, while in the southeast, the Medical Supply Section, Atlanta General Depot, Atlanta, Ga., provided that same mission. Also included in the Army's medical depot system was the Memphis General Depot, Memphis, Tenn., which operated a carrying stock point for medical materiel. All five of these depots functioned as reserve stock points in the wholesale depot system.

As part of the Department of Defense program to consolidate materiel managerial efforts, these depots were transferred from the command jurisdiction of The Surgeon General to that of the Supply and Maintenance Command by 1 August 1962. The Supply and Maintenance Command was established in the course of the reorganization of the Department of the Army in 1962 to control supply functions within the Army.

Further indication of the effort of the Department of Defense to centralize the managerial control of supply procurement and distribution was the establishment in August 1961 of the Defense Supply Agency-an agency accorded an authoritative position in the Department of Defense organizational structure on the same level as the secretaries of the armed services. The effect of this structural reorganization of the Department of Defense was a redesignation of the Military Medical Supply Agency as the Defense Medical Supply Center on 1 January 1962, and a shift of medical materiel control and management from the Department of the Navy to the Defense Supply Agency.

In further consonance with the Defense Department policy of centralizing managerial control and authority, the Defense Medical Supply Center was "disestablished"


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in July 1965, and its function, together with other materiel and supply activities, for example, clothing, equipage, and subsistence was transferred to the newly established Defense Personnel Support Center in Philadelphia, Pa. The Directorate of Medical Materiel within the structure of the Defense Personnel Support Center, was the medical materiel manager responsible to the Defense Supply Agency for the operation of a National Inventory Control Point in Philadelphia.

The consolidation of materiel and supply effort at the top of the Department of Defense organizational structure was followed by a similar centralization of supply activities within the Army structure. Although advantageous in many respects (namely, control, simplification, and funding), consolidation of materiel commodities precluded the personalized attention and flexibility required in the handling of medical items. To this "lumping" of materiel, The Surgeon General and command surgeons throughout the Army objected strenuously.

The disadvantages in treating medical materiel as just another category of supply items were not fully realized when medical materiel support in Europe declined precipitously. The situation became so serious that the Commander, U.S. Army, Europe, returned the control to medical personnel for necessary remedial actions. A similar situation arose during the Southeast Asia buildup in 1965. In November of that year, the Vice Chief of Staff requested that The Surgeon General investigate and recommend appropriate measures to resolve the medical supply difficulties and shortages occurring in Vietnam and other subordinate commands within the U.S. Army, Pacific. A representative of The Surgeon General investigated the situation and discovered that the U.S. Army, Pacific, Inventory Control Point-which had the responsibility for the control of all requisitioning of supplies within the theater and for the centralized maintenance of records on the status of supplies within each of the subordinate commands-could not provide


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pertinent data regarding the medical supply situation within U.S. Army, Pacific. Consequently, requisitioning objectives were being computed without the full knowledge of subordinate command conditions, environment, or professional requirements. In fact, to ensure adequacy of objectives, subordinate commands were obliged to review their records constantly and thus employ an undesirable duplication of effort. The investigation revealed that the U.S. Army, Pacific, Inventory Control Point did not contribute any assistance to the subordinate commands nor to the surgeons who were responsible for the health of troops in those subordinate commands.

While the inadequacies and malfunctioning of the supply system were being investigated, a concept study advocating a bold, new approach to the problem of the administrative support of a theater Army entitled "TASTA-70 (The Administrative Support-Theater Army 1965-70)" was under study in the Office of the Chief of Staff. Commenting on the study, The Surgeon General recommended that the Army Medical Department be given control over medical depots and medical inventory control activities. Approved by the Chief of Staff, The Surgeon General's recommendation was incorporated in the TASTA-70 concept and provided the basis for the realinement of medical supply activities under the command surgeons in overseas commands which began in the summer of 1966 and was completed on 1 October 1968.

Completion of the transfer marked the return of managerial control over medical materiel to the Army Medical Department. More important, it marked the return of the flexibility necessary to satisfy directly the medical needs of overseas commands.

REORGANIZATION WITHIN THE SURGEON
GENERAL'S JURISDICTION

When General Heaton became chief of the Army Medi-


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cal Department in June 1959, the supply and distribution of medical materiel within the U.S. Army was managed by the Army Medical Supply Support Activity, a class II activity under The Surgeon General, which coordinated its efforts with the Defense Medical Supply Center. Both activities were located in Brooklyn, N.Y. In early March 1965 and in consonance with the proposed movement of the Defense Department's medical materiel function, the Army Medical Supply Support Activity moved to Phoenixville, Pa., relatively near the National Inventory Control Point at Philadelphia, where it was satellited on an existing medical facility, Valley Forge General Hospital. On 5 April 1965, the activity resumed operations and, shortly thereafter (15 April 1965), was redesignated the U.S. Army Medical Materiel Agency. Agency functions and responsibilities did not change with the redesignation but remained as follows: (1) The computation of the Army medical supplies and equipment quantitative gross requirements for peacetime (new items only), for general mobilization, and for specific mobilization reserves; (2) the administration of military and civilian foreign aid programs; (3) the redistribution of retail level excess medical supplies and equipment; (4) the operation of a finance and accounting office; and (5) the performance of a liaison service in supply and stock control activities between The Surgeon General and the Directorate of Medical Materiel, Defense Personnel Support Center.

During the summer of 1966, and as part of the four-phase transition in managerial control of medical materiel, the medical supply system supporting military activities in Southeast Asia was realined by shifting the responsibility for determining requisition objectives for stocked medical items and for ordering replenishment supplies from the Inventory Control Point, U.S. Army, Pacific, to the U.S. Army Medical Depot in the Ryukyu Islands. This depot, in turn, ordered replenishment supplies directly from the Defense Personnel Support Center through the U.S. Army Medical Materiel


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Agency. This same shift of medical materiel responsibility and realinement followed for the remainder of Army medical units worldwide and was completed before the end of calendar year 1968. The effect of this realinement was the routing of all requisitions for medical materiel from subordinate commands within the U.S. Army, Pacific, to the U.S. Army Medical Materiel Agency where the order was recorded and reviewed before it was transmitted to the Defense Personnel Support Center. Thus, the U.S. Army Medical Materiel Agency was able to maintain control and "followup" on each requisition to ensure that the requesting agency was kept fully informed regarding the status of its order and, when necessary, to expedite the delivery of urgently needed items.

Within the Office of The Surgeon General, the Supply Division, which provided staff assistance in medical materiel, was reorganized several times to meet the changing requirements of the Department of Defense medical materiel system. In fiscal year 1960, for example, the Supply Division was reorganized by combining similar or related functions and by clarifying the various fields of responsibility in order to assure greater efficiency in supply operations under the single-manager system. Again, on 1 June 1962, to achieve these same objectives, the division was reorganized and reduced from an authorized personnel strength of 77 (16 military and 61 civilian) to 63 (12 military and 51 civilian). Since that time, and with the buildup of military forces in Southeast Asia, the authorized civilian strength has been increased to 57, while the authorized military strength has not been altered.

MOBILIZATION RESERVE, PRESTOCKAGE, AND MEDICAL ASSEMBLAGE AND REPLACEMENT PROGRAMS

The advent of centralized management of medical materiel failed to provide for any allocation of general


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mobilization reserve stocks held by the controlling agency. Under the single-manager system, from 1957 until 1 July 1959, no provision had been made for the allocation of reserves on any specific basis to the three medical services. The Surgeon General contended that such an allocation was necessary for the effective management of mobilization reserve stocks. Following a detailed analysis of the policy in effect, stimulated in part by The Surgeon General's position, the Department of Defense published a directive on 8 July 1959 which established a new policy for the management of these stocks. The directive stated that mobilization reserve stocks were to be divided into two categories: Prepositioned War Reserve Stocks and General Mobilization Reserve Stocks. It provided that stocks previously identified for specific reserve purposes were to be positioned, before hostilities, at or near the point of planned use or issue to the user, to ensure timely support of a specific project or designated force during the initial phase of war. Noteworthy as reflecting the position which had been advocated by The Surgeon General was the fact that these stocks, to be designated Prepositioned War Reserve Stocks, were to be under the control of the respective services. In contrast, the directive provided that gross mobilization requirements were to be allocated administratively to the military medical departments on the basis of priorities established by the Joint Chiefs of Staff. Although the policy that Prepositioned War Reserve Stocks were to be under the control of the respective services was adopted in July 1959, it was not implemented until November 1963. At that time, a Department of Defense directive was issued stating that reserve Defense Supply Agency stocks which met the criteria for Prepositioned War Reserve Requirements were to be transferred to the ownership of the military services. It was not until September 1966, however, that an agreement for the decapitalization and recapitalization of Prepositioned War Reserve Stocks was negotiated


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between the Defense Supply Agency and the military services.

As a result of this recapitalization of prepositioned war reserve medical stocks by The Surgeon General, medical stocks were returned to the ownership of the Army, and the maintenance of inventory and financial records became a responsibility of The Surgeon General. The custody and accountability of the materiel, however, remained the responsibility of the Defense Supply Agency depot system. The management functions (that is, the maintenance of records, and so forth) were assigned to the U.S. Army Medical Materiel Agency, and a subsequent increase in that agency's staff was approved.

In addition to reserve and prestockage programs, two other programs were given special impetus during the past decade. The first of these was a program started during fiscal year 1958 and designed to reconstitute major medical assemblages. Its primary purpose was to reduce the weight and size of assemblages through the employment of the latest packaging concepts and techniques and to replace wornout and obsolete equipment currently packaged. Although the program was fundamentally complete by the close of fiscal year 1961, the same assemblage techniques were carried over into assembly programs which in fiscal year 1962 were necessary to meet the requirements of activated U.S. Army Reserve and National Guard units, and the requirements for overseas commands and the Military Assistance Program.

The second program, which is discussed in greater detail elsewhere, was the Hospital Equipment Program. This program, which was established by The Surgeon General in 1959 to assist commanders in acquiring modern equipment to keep pace with an expanding medical technology, had been enlarged over the years to encompass not just major capital equipment, as had been the early intent, but all medical equipment. Its objectives resulted in the Army Medical Department Equipment Replacement and Modernization Program and a Medical


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Equipment Programming and Reporting System. Its effect has been far-reaching in the replacement and modernization of medical equipment and the purchase of additional equipment throughout the U.S. Army.

In addition to the resumption of the control of Army medical materiel, the supply and materiel function of the Army Medical Department expanded greatly during this period. Owing to the many advances in the military practice of medicine, many new items were type-classified as standard for entry into the military medical supply system, while other items (not as great in number) were deleted from the system as outmoded, obsolete, or nonessential. Growth and advancement in the procurement and distribution of medical materiel was the theme of the 1959-69 period.

SPECTACLE FABRICATION

By 1959, Army optical laboratories located at the U.S. Army Medical Optical Maintenance Activity, St. Louis, Mo., and the Medical Supply Section, Sharpe General Depot, had increased their workload of spectacle fabrication by furnishing spectacles for Navy personnel in the western United States, in addition to an already growing list of Army and Air Force fabrications.

With the exception of a temporary "breather" in fiscal year 1963, attributable to a drop in strength of the Armed Forces and the release of National Guard and Reserve units from active duty following the Berlin Crisis, this workload expansion in spectacle fabrication continued during General Heaton's entire tenure in office. In fiscal year 1960, the Optical Section, 32d Army Medical Depot, Brooke Army Medical Center, Fort Sam Houston, Tex., was given an optical training mission for the fabrication of spectacles for two stations. By the summer of 1963, planning for the decentralization of optical fabrication activities (single-vision laboratories) had begun, and by December 1964, six laboratories (four of which were of the single-vision type) and two table


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of organization and equipment optical detachments were provided spectable fabrication services for Army and Air Force stations throughout the continental United States.

During the period 1963-64, the base optical laboratories at St. Louis, Mo., and Lathrop, Calif., underwent changes in their operations or location. The U.S. Army Medical Optical and Maintenance Activity, St. Louis, was moved in October 1963 to Fitzsimons General Hospital, Denver, Colo., and then deactivated; its optical laboratory functions were assumed by the hospital. The control of the optical laboratory at Sharpe Army Depot, Lathrop, Calif., was transferred from the U.S. Army Supply and Maintenance Command and was activated, effective on 1 July 1964, as the U.S. Army Optical Activity, Sharpe Army Depot, a class II activity under the jurisdiction of The Surgeon General. (On 4 February 1969, the U.S. Army Optical Activity, Sharpe Army Depot, was redesignated the U.S. Army Medical Optical Laboratory and its address changed to Tracy, California.)

By fiscal year 1965, spectacle fabrication was being accomplished in overseas commands at five optical laboratories; the three in Alaska, Europe, and Korea were equipped and staffed to perform surfacing functions, while the laboratories in Hawaii and the Ryukyu Islands (Okinawa) fabricated single-vision spectacles only and forwarded multi-vision spectacle prescriptions to the continental United States for fabrication. The European laboratory had in fiscal year 1965 increased its fabrication workload by preparing special-order spectacles for dependents of U.S. civilian and military personnel on a reimbursement basis. The purpose of this provision was to reduce expenditures on the local economy and thereby assist in alleviating the balance of payments (gold flow) problem.

By the end of fiscal year 1966, two new optical laboratories, one at the U.S. Army Medical Depot in Okinawa and one at the 32d Medical Depot in South Vietnam


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(formerly at Fort Sam Houston, Tex.), had begun operation.

The fabrication of spectacles had so expanded that, with the close of fiscal year 1968, a total of 1,596,638 pairs of spectacles and other eyewear, an increase of almost 9 percent more than the fiscal year 1967 total, had been fabricated. What is startling, however, is the increase in fabrications between fiscal year 1965, the last year before the Army's Vietnam buildup, and fiscal year 1968. During fiscal year 1965, 952,631 pairs of spectacles were fabricated; this amount, when compared with the 1968 fiscal year total, relates an expansion of more than 60 percent over a 3-year period.

NBC (NUCLEAR, BIOLOGICAL, CHEMICAL)
MEDICAL MATERIEL PROGRAMS

In 1959, the medical materiel program for nuclear casualties had finally progressed to the packaging and distribution to the continental United States of emergency care, medical supply sets. By the end of fiscal year 1962, after funding had been made available, distribution was completed to all continental United States and overseas stations.

The medical materiel program, initiated in 1956, provided two emergency Medical Treatment Units (phase I and phase II) which contained the medical supplies required to furnish emergency medical care for nuclear casualties. The program had been initially devised to treat dependents in overseas commands as well as military casualties resulting from a nuclear attack. The phase I sets were positioned with troops (one for each 100 personnel) whereas the phase II sets were positioned with medical facilities with one set capable of providing supplies for 1,000 casualties.

In the summer of 1963, the Medical Materiel Program for Defense Against Biological and Chemical Agents was established as another preparedness measure against the threat of nuclear, biological, or chemical warfare.


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This program which prepositioned medical supplies in two phases was established to increase the capability of the Armed Forces to defend against chemical and biological agents. As monitor for the program within the Department of the Army, The Surgeon General took the necessary action to assure that the required supplies were procured and shipped to complete prepositioning with individuals at treatment facilities and in depot reserves.

The phase I portion of the program, which included broad-spectrum antibiotics for the prophylaxis and treatment of infectious disease, naturally or artificially induced, and atropine Syrettes and automatic atropine injectors for treatment of casualties resulting from posure to nerve gases, was completed by the close of fiscal year 1964, while phase II, which consisted of the preoverpositioning of pralidoxime chloride, an oxim to be used as an adjunct to atropine in the treatment of nerve-gas poisoning, was completed before the end of fiscal year 1965.

PROCUREMENT ACTIVITIES

Although, as related earlier, the wholesale stocks of standard items of medical materiel in continental United States depots were purchased by other Department of Defense agencies, there were certain purchasing and contracting functions for which the Office of The Surgeon General was responsible. Among these expenditures were those for research and development activities, the purchase of nonstandard items, and the procurement of supplies and services required by class II installations for hospital and other local mission operations. During General Heaton's tenure, these purchasing and contracting functions were performed with economy in mind and in keeping with Department of Defense policy regarding small business contracts. (Department of Defense policy prescribed that a certain percentage of all


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Government contracts, at least 25 percent of total dollar amount, be granted to small business.)

FUNDING AND ACCOUNTING

Medical materiel inventories were an important part of the medical supply function. In 1959, the Medical-Dental Division, Army Stock Fund, managed the funding of bulk inventories of medical materiel at 22 class I and seven class II installations and activities in the continental United States and at six overseas commands. It performed this function with a home office managed by the Supply Division, Office of The Surgeon General, 22 branch offices in the continental United States (25 by fiscal year 1965), and an office in each of the six overseas commands. The Army Medical Department procured the greater portion of its supplies and equipment from the wholesale medical supply stocks (capitalized under the Navy Stock Fund) of the Military Medical Supply Agency, the operating activity of the single manager for medical materiel (Navy).

On 1 July 1959, the six branch offices (nine by fiscal year 1962) in the Third U.S. Army area were decapitalized and recapitalized in the Zone of Interior Installations Division, Army Stock Fund, on a test basis to evaluate the concept of horizontal stock funding; that is, stock funding at command, rather than at technical service, levels.

While command-level stock funding was being tested, other projects and programs were either being expanded or added to the existing stock funding system. Such an addition was the funding procedures for the Military Assistance Program, which before 1961 had been designated the Army Mutual Security Program. Effective during fiscal year 1962, the Military Assistance Program requisitions extracted by The Surgeon General from the Defense Medical Supply Center were financed by the Medical-Dental Division, Army Stock Fund, with subsequent sales to, and reimbursement from, Military As-


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sistance Program funds, effected upon delivery in accordance with new central reimbursement procedures. Previously, Military Assistance Program requisitions placed with the Defense Medical Supply Center were financed with Military Assistance Program funds held by The Surgeon General. With the change, Military Assistance Program funds became centrally controlled by the U.S. Army Military Assistance Program Logistics Agency. Therefore, to facilitate the processing of requisitions and to expedite reimbursement to the Defense Medical Supply Center, it became necessary to finance Military Assistance Program orders through the Army Stock Fund.

During the early period, 1960-62, funding requirements for mobilization reserves continued to increase while the funding of operating stocks achieved a leveling-off of expenditures.

In concurrence with the Department of Defense centralization policy of materiel management, on 1 July 1964, the Medical-Dental Division, Army Stock Fund, ceased operations as an active stock fund entity but continued disbursement actions and reports until all outstanding obligations could be liquidated. The overseas commands, the U.S. Military Academy, West Point, N.Y., and Aberdeen Proving Ground, Md., were decapitalized to their respective command channel stock funds, while the installations and activities under the command jurisdiction of The Surgeon General (seven class II hospitals and medical centers and the Sharpe Optical Activity) were capitalized into The Surgeon General's Subhome Office of the U.S. Army Materiel Command Installations Division for peacetime operating and mobilization reserve requirements. Later, during that same fiscal year, the U.S. Army Medical Materiel Agency, Phoenixville, Pa., was also designated a branch office in the Office of The Surgeon General for the purpose of centrally procuring Prepositioned War Reserve Stocks-Medical Facilities materiel. Incidentally, this command channel stock fund was devised to manage nine other


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materiel categories in addition to medical-dental. The Military Assistance Program was capitalized into the U.S. Army Materiel Command Division of the Army Stock Fund, with the Army Medical Supply Support Activity as a branch office; during fiscal year 1966, this division was assigned the additional responsibility for procurement and direct shipment of high priority medical items required in Southeast Asia. Consequently, what occurred in the Office of The Surgeon General during fiscal year 1965 was a "phaseout" of the Medical-Dental Division, which continued to exist until the close of fiscal year 1968, and the addition of two new command channel segments of the Army Stock Fund, the U.S. Army Materiel Command Installations Division and the U.S. Army Materiel Command Division.

The management of these new Army Stock Fund segments entailed programming, budgeting, accounting, reporting, and supply management, and was the entire responsibility of The Surgeon General. An interesting aspect of these two fund entities was a decrease in the sales and obligations of the U.S. Army Materiel Command Division, Army Stock Fund, and an increase in those same areas in the U.S. Army Materiel Command Installations Division, Army Stock Fund. The reason for the former was a shift in certain funding obligations (namely, Southeast Asia requisitions for Vietnamese forces and some U.S. Army requirements) from this stock fund to a U.S. Army, Pacific, stock fund. The reason for the latter-the increase in U.S. Army Materiel Command Installations Division, Army Stock Fund requirements-can be attributed to the necessity for supporting units for deployment to Southeast Asia and for the expansion of patient load in Army Medical Department class II facilities.

When discussing stock funding and stock funding procedures, particularly as they pertain to bulk inventories, the subject of stock accounting quickly comes to mind. Again, in consonance with a consolidation and economy of managerial effort, an economic inventory procedure


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system was implemented by The Surgeon General at all Army Medical Department class II installations and activities during the last quarter of fiscal year 1962. Also, before Army-wide implementation of the Military Standard Requisitioning and Issue Procedure system on 1 July 1962, a representative from the Supply Division of the Office of The Surgeon General assisted class II installations and activities in training supply personnel in the procedures. The Surgeon General, in concurrence with Army and Department of Defense policy, emphasized a continuing program of improvements in stock accounting and inventory procedures.

THE MILITARY ASSISTANCE PROGRAM

The Military Assistance Program was of special interest to The Surgeon General in that he had staff responsibility for technical evaluation, coordination, and direction of medical materiel programs related to it. The program consisted of two main elements: Grant aid, which provided direct assistance financed by U.S. funds; and military assistance sales, which provided U.S. defense materiel to friendly nations on a direct-sale basis, financed through the recipient nation's treasury. The Surgeon General's Military Assistance Program activities were quite extensive; they included planning and forecasting requirements and deliveries, assistance to Military Assistance Advisory Groups and customer nations in the development of specification and technical descriptive materiel, and computation of quantitative requirements for such items as repair parts. The medical materiel supplied through grant aid and sales included all items in the Defense Medical Supply Catalogs, and also nonstandard materiel.

MEDICAL SUPPLY SUPPORT OF EMERGENCY
OPERATIONS

During the 10 years of General Heaton's service as


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The Surgeon General, the Army Medical Department responded quickly and skillfully to the medical materiel requirements of the U.S. Army. The Berlin, Cuban, and Dominican Republic Crises of 1961, 1962, and 1965, respectively, were ably supported with necessary medical materiel. In the Berlin Crisis, provisions were made to prepare medical assemblages for newly activated Reserve and National Guard units. In all three crises, plans were formulated and distribution points alerted for the automatic resupply of units designated to provide medical support. Also, in addition to the medical resupply of military forces, provisions were made for the medical materiel support of civil affairs operations in the areas of operation.

During the initial stages of the Dominican Republic Crisis, April 1965, requirements for automatic supply and resupply for troop support and civil affairs were processed through the Office of The Surgeon General. Effective on 4 June 1965, however, normal requisitioning was established for support of U.S. Army troops in the Dominican Republic, and only nonstandard medical materiel requirements continued to be processed through the Office of The Surgeon General.

Early in fiscal year 1966, Army medical materiel support units were faced with another expanded support mission-the buildup of U.S. Army troops in Vietnam. One of the most significant supply problems at the onset of the buildup was a lack of adequate medical supply personnel in the theater. The 8th Field Hospital at Nha Trang was assigned the responsibility for medical supply distribution to the medical units in South Vietnam. This unit was augmented by a small staff which was not adequate to provide the necessary control over the tremendous requirements being generated practically overnight. This situation was compounded by the protracted delay in deployment of the 32d (Field Army) Medical Depot which, although "ready" in July of 1965, was not deployed until late October. One supply detachment had been deployed in July and another


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shortly thereafter, but these detachments did not have a sufficient depth to manage supply activities in a theater of operations the size of Vietnam. With the escalation of United States efforts in Vietnam, greater dependence was placed upon the Ryukyu Islands as the offshore base to support units in Vietnam. A supply detachment was deployed to Okinawa in August, and in November 1965, the 70th Medical Depot was deployed to augment and expand the operation of the medical depot in Okinawa.

The Surgeon General, handicapped by an insufficiency in strength and capability of medical supply and other types of supply organizations, coordinated with the Commander in Chief, U.S. Army, Pacific, to establish a system of automatic shipments of medical materiel for the support of U.S. Army troops in Vietnam. These shipments, initiated in July 1965, were based upon schedules developed to support forces which were deployed from the continental United States to Southeast Asia. The materiel shipped consisted primarily of medical resupply sets and later, after their development, included optical resupply sets. The automatic supply support system continued for a period of approximately 10 months, with peakloads of resupply occurring during November 1965 through January 1966. This system, although only a temporary measure, did not meet with the success that was anticipated. Delays in shipment from continental United States ports and in off-loading procedures at South Vietnam facilities and the splitting of the medical resupply sets into various shipments on board vessels were the major problems experienced.

The lack of qualified medical logistics personnel in South Vietnam, the shortcomings of the medical resupply system related above, and the inability of a centralized supply management activity in Hawaii to meet the medical materiel demands occasioned the request by the Vice Chief of Staff for an investigation and subsequent recommendations for a resolution of the medical materiel problems. The ultimate result was The Surgeon


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General's plan for the realinement of the managerial control of medical materiel under the Army Medical Department.

The Surgeon General's plan, as it pertained to Southeast Asia, was to assign the management of medical materiel to the U.S. Army Medical Depot in Okinawa; this assignment, which was put into effect on 1 July 1966, included the computation of replenishment needs and the requisitioning of such materiel needs directly from the Defense Personnel Support Center through the U.S. Army Medical Materiel Agency.

The result of this assignment of medical materiel management to the Okinawa depot was the expansion of that depot in size and responsibilities. These responsibilities increased to such a degree that the depot ultimately supported U.S. Army units in South Vietnam and Thailand; the Armed Forces of South Vietnam, Thailand, and Laos; and activities of the Agency for International Development in Southeast Asia, while also supplying military customers on the Ryukyu Islands. The amount of depot sales to customers during fiscal year 1968 ($64 million) more than doubled the sales figure for fiscal year 1967 ($28.5 million).

In South Vietnam, the 32d Medical Depot, which had been deployed in October 1965 and which received its medical materiel support from the Okinawa depot, provided medical materiel for units of the United States Army and the Armed Forces of Korea, the Philippines, Australia, and New Zealand, operating in South Vietnam. Its functions included the fabrication of single-vision spectacles and the maintenance and repair of medical equipment of supported units throughout South Vietnam. The depot operated through five locations (four advance depots and a base depot at Cam Rahn Bay). Two of these advance depots and the base depot utilized a National Cash Register Company 500 computer system for stock control and inventory management. During fiscal year 1968, the 32d Medical Depot issued about $30 million of medical materiel in South Vietnam.


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During the past decade, the medical supply system was marked by extensive change and improvement. These changes ranged from the revision of supply catalogs, bulletins, and regulations to the development and issue of new resupply sets, from the modernization of storage techniques to the automation of the supply system, and from the establishment of effective equipment maintenance to the renovation of the ambulance fleet. By these and other means, General Heaton's objective of flexibility and responsiveness in the supply system was achieved.