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ACCESS TO CARE
The whole question of the history of military hospitals in the United States has been considered, in the previous pages of this volume, in a manner regardless of hospitals especially provided aviation stations. These hospitals at aviation stations were managed in a way somewhat similar to that which obtained at post hospitals in peace times; being small and detached from other training camps, and being provided essentially for the care of local sick and injured, they were not organized as were the large base and general hospitals, but were managed as were post hospitals.
The general problem of providing hospitals for the Aviation Service was entirely distinct from that connected with the provision of hospitals for the Army as a whole. The two activities paralleled one another, aviation hospitals, however, being on a very much reduced scale. The separate provision of aviation hospitals was provided for by an act of Congress approved July 24, 1917, which appropriated special funds for the construction, maintenance, and repair of hospitals at aviation stations, and making the responsibility for the provision of these hospitals that of the Chief of the Aviation Service.1
TYPES OF AVIATION HOSPITALS
In July, 1917, the Chief of the Signal Corps, who was at that time at the head of the Aviation Section, Signal Corps, sent the officer in charge of construction at aviation camps to Camp Borden, Canada.2 At that time Camp Borden was the foremost flying field on this continent, and the object of the visit of the construction officer was to obtain data which would be of value in the construction of buildings at the aviation camps in the United States. During that period the hospital facilities at Camp Borden comprised merely a small dispensary;2 and desiring a more adequate provision for the hospitals of the flying fields of the United States, this officer enlisted the services of a leading architect of Detroit to design suitable plans for a cantonment hospital. This was accomplished, and six hospitals so designed were constructed forthwith at Selfridge Field, Mount Clemens, Mich.; Chanute Field, Rantoul, Ill.; Hazelhurst Field, Minneola, Long Island; Scott Field, Belleville, Ill.; and two at Wilbur Wright Field, Fairfield, Ohio.2 In this original type of hospital three wards were provided to accommodate 24, 12, and 4 patients each, or 40 in all.3
The original program called for unit aviation fields with a normal capacity of 450 each, and only in an emergency was it contemplated that there would be double that number. A hospital was accordingly planned for 40 beds, which would be sufficiently large for 5 per cent of a garrison of 800 men, or for the sick of a continuous force of 450 men, with an occasional addition of an equal number. It so eventuated, however, that as soon as the fields planned for 450 men started to operate there were never less than 700 to 900 men assigned to them, and subsequently this number was increased to 1,200 to 2,000 men per unit field.
After the original hospitals had been constructed it was found that the floor space provided for the patients was considerably less than the minimum established at about that time by the Surgeon General, and that instead of 40 patients
only 24 could be accommodated in them.4 This necessitated an enlargement of each hospital, which was effected by extending each of the three wings sufficiently rearward to give the required capacity.5 This enlarged type of hospital was subsequently built at Kelly Field No. 2, and at Dallas Repair Depot, Tex.6 Hospitals of the original type and practically the same bed capacity were then erected at each of the following fields: Call, Wichita Falls, Tex.; Rich, Waco,
Tex.; Park, Wellington, Tex.; Love, Dallas, Tex.; Barron, Fort Worth, Tex.; Carruthers, Fort Worth, Tex.; Taliaferro, Hicks, Tex.2
It was not until January, 1918, that a division was organized in the office of the chief surgeon, Aviation Service, for the specific purpose of administering and constructing hospitals.2 Considerable study was then devoted to the problem of enlarging the original type of hospital to 50 beds. The plan was
finally adopted of adding to the original design an isolation wing of 10 beds and an additional ward of 17-bed capacity.7
Early in February, 1918, the construction division of the Signal Corps made up plans for a 50-bed hospital which were adopted for use at the new single-unit aviation fields.7 This type, called the 50-bed standard, was erected at each of the following nine fields: Souther, Americus, Ga.; Brooks, San Antonio, Tex.; Payne, West Point, Miss.; Carlstrom, Arcadia, Fla.; Dorr,
Arcadia, Fla.; Eberts, Lonoke, Ark.; March, Riverside, Calif.; Mather, Sacramento, Calif.; Taylor, Montgomery, Ala.6 This standard type of hospital was of the gridiron pattern, consisting of a corridor with perpendicular wings on each side.
Subsequently, a 100-bed standard hospital, similar in plan to the 50-bed standard, was designed and built at Post Field, Fort Sill, Okla.3 At the Army
Balloon School, Arcadia, Calif.,9 it was used for the construction of a hospital, minus one 20-bed ward. A modification of this type of hospital was also built at Chapman Field, Miami, Fla., which was sufficient in capacity to accommodate 28 patients and a detachment of 14 enlisted men of the Medical Department. This was done with a view to a later extension if such were found to be necessary.
The hospital erected at Kelly Field No. 1 was a standard 60-bed hospital; and the hospitals provided the Garden City Air Service Depot and the station
at Morrison, Va., were of the corridor and wing type with an original accommodation of 163 beds, subsequently expanded by the addition of wings of 250 beds each.
A 40-bed permanent two-story hospital of Spanish type of architecture was completed about November 18, 1918, at Rockwell Field, Calif. The second
story of this hospital was intended solely for the accomodation of the detachment, Medical Department.10
An isolation hospital was built at the Mechanics Training School, St. Paul Minn., from plans drawn by the officer in charge of construction in the chief surgeon's office, in collaboration with the surgeon at the training school. This hospital was of the pavilion type and had accommodations for 120 patients.11
Two types of infirmaries were designed: One 8-bed type with a squad room for enlisted men, built at Indianapolis Repair Depot, and McCook Field, Dayton, Ohio; and a 6-bed type with a squad room for enlisted men at Lee Hall, Va., Montgomery Repair Depot, Montgomery, Ala., and Buffalo Acceptance Park, Buffalo, N. Y.2
The standard plans for nurses' quarters for 6, 12, and 30 nurses were prepared with the intention of erecting a building for 6 nurses at each singleunit field, one for 12 nurses at each double-unit field, and a building for 30 nurses at the larger fields.6 The buildings for 6 and 12 nurses were planned to furnish each nurse with a separate bedroom, with sufficient floor space to
permit doubling the number of occupants in emergency. The 30-nurse building contained but 15 rooms. The quarters for these nurses were never authorized by the Secretary of War,6 and the nurses at all single-unit fields had to be quartered in hospital wards, of which there was always a scarcity. At Eberts Field a dormitory for nurses was constructed with funds temporarily supplied by the American Red Cross.12 Dormitories with a capacity of 12 nurses were constructed at Post Field, Fort Sill, Okla.; Wilbur Wright Field, Fairfield, Ohio; Army Balloon School, Arcadia, Calif.; Gerstner Field, Lake Charles, La.; and Ellington Field, Fort Omaha, Nebr.6 Buildings for 30 nurses were constructed at the Air Service Depot, Garden City, Long Island, N. Y., and at Camp Morrison, Va.6 At the Middletown Supply Depot, Middletown, Pa., the nurses were accomodated in a small wing of the hospital.13
ENLISTED MEN'S BARRACKS
In the early months of the war all aviation hospitals were designed to accommodate the enlisted personnel of the Medical Department in the same building.3 Later, when it was necessary to increase the capacity of these hospitals, separate barracks were erected for the men; and these were designed to accommodate 30, 60, and 200 men each.6 The type of 30-men capacity was built at Brooks Field, San Antonio, Tex.; Carlstrom and Dorr Fields, Arcadia, Calif.; Eberts Field, Lonoke, Ark.; March Field, Riverside, Calif.; Mather Field, Sacramento, Calif.; Payne Field, West Point, Miss.; Souther Field, Americus, Ga.; Taylor Field, Montgomery, Ala.; Barron Field, Fort Worth, Tex.; Call Field, Wichita Falls, Tex.; Carruthers Field, Fort Worth, Tex.; Love Field, Dallas, Tex.; Park Field, Millington, Tenn.; Rich Field, Waco, Tex.; Taliaferro Field, Fort Worth, Tex.; Chanute Field, Rantoul, Ill.; Scot
Field, Belleville, Ill.; Selfridge Field, Mount Clemens, Mich.; Hazelhurst Field, Mineola, Long Island, N. Y.; and Camp John Wise, San Antonio, Tex.6
The type of 60-men capacity was erected at Fort Omaha, Nebr.; Post Field, Fort Sill, Okla.; and Wilbur Wright Field, Fairfield, Ohio.6
The 200-men type was erected at the Air Service depot, Garden City, Long Island, N. Y., and at Camp Morrison, Va.6 At each place a separate building was provided as mess hall and kitchen. At Langley Field, Va., a special barracks for 50 men was constructed, to be used in addition as a detention barracks for new arrivals.14 At Gerstner Field, Lake Charles, La., a barracks plan was used, which represented half the regulation Department of Military Aeronautics squadron barracks. This accommodated 75 enlisted men of the Medical Department.15 At Ellington Field, Houston, Tex., the enlisted men's barracks was incorporated in the plan for enlarging the hospital.16 A special small wing for enlisted men was built at the supply depot, Middleton, Pa., and connected by corridor with the hospital.17 At Hazelhurst Field, Mineola,
Long Island, a wing was likewise provided to accommodate the enlisted personnel of the Medical Research Laboratory at that place.18
Separate buildings used as mortuaries were erected at the following aviation fields:2 Barron, Brooks, Call, Carlstrom, Carruthers, Chanute, Chapman, Dorr, Eberts, Ellington, Gerstner, Camp John Wise, Love, March, Mather, Park, Payne, Post, Rich, Scott, Selfridge, Souther, Taliaferro, Taylor, and Wilbur Wright.
MEDICAL RESEARCH LABORATORIES
Special buildings to be used as medical research laboratories were constructed at the following fields: Barron, Call, Carlstrom, Eberts, Ellington,
Gerstner, Kelly No. 1, Love, March, Park, Payne, Post, Rich, Rockwell, and Selfridge.19
STYLE OF CONSTRUCTION
All hospital buildings, except the permanent two-story hospital at Rockwell Field, were of one-story type, 2 feet off the ground, built on wooden posts without masonry. They were constructed of wood throughout. The exterior walls were covered with sheathing and siding; interior walls were lined with wood wainscoting with wall board above and on ceilings, and the roofs were covered with two-ply prepared roofing. Ventilators were of metal, and windows and porches were well screened. The operating room was painted with white enamel, and the remainder of the building, both inside and out, was painted white. They were heated by steam, with a separate heating plant for each building. Hot-water plants were provided, and all buildings were lighted by electricity.2
From the earlier experience of the Allies, and that of the Medical Department of our Army during the fall and winter of 1917-18, it became evident that aviation personnel required not only special medical supervision to prevent their flying when physically or temporarily unfit, but, in addition, places other than ordinary hospitals to which they could be sent for recuperation. At first this problem was solved by giving convalescing officers and others short leaves, designating the localities in which they were to be spent. Many patriotic citizens living near aviation fields opened their homes to the men for weekend parties, and in many instances for longer periods of time. Flight surgeons were thus able to see that men who had become stale or who had worries rendering them temporarily unable to fly were given short periods of rest at these places. This plan, however, was open to the objection that while the aviators were away from the post they were not under the supervision of anyone in authority; and while in the main the results of this policy were good, there were instances when flyers took advantage of this freedom from military supervision, did not take proper care of themselves, and returned to the flying schools without the anticipated improvement. This led to the assignment of special hospitals for the care of such cases.20
The Mary Imogen Bassett Hospital, then nearing completion at Cooperstown, N. Y., was offered the Government for the use of the Air Service.21 The offer was accepted and the hospital was opened for patients in November, 1918. Not many fliers from the United States flying fields were sent to this hospital, but it was used extensively for patients returned from overseas. No cases of acute illness were transferred there. It was only during the period of convalescence in base and general hospitals, when it was found that patients belonging to the Aviation Service did not require confinement to bed, that they were sent to the hospital at Cooperstown .
Another station in the nature of a rest camp was established at Warners, Hot Springs, Calif. This was a substation of Rockwell Field, San Diego, as well as March Field, Riverside, Calif. Both of these fields sent their convalescent patients, without transfer, to this hospital, the patients being merely placed on sick report. A comfortable tent camp was built at the springs, adjacent
to a large adobe house in which were located the mess hall and kitchen. The camp was about 80 miles east of San Diego at an elevation of 4,000 feet in the mountains. Near by was a fine landing field, and most of the transportation of the patients from San Diego and Riverside was by airplane.10
A standard 50-bed equipment was adopted for use in the aviation hospitals23 and the method of securing it was so simplified that early in 1918 it became the rule to rush hospital buildings to completion ahead of other groups at flying fields, and to have medical personnel and equipment on the field and ready for the arrival of the first troops. Since flying activities began almost immediately thereafter, it was obvious that the Medical Department strove to be ready for all emergency and ordinary needs.
A standard 40-bed equipment was at first furnished the smaller hospitals;24 and when the single-unit hospitals were enlarged to 50 beds each this equipment was increased accordingly. It thus became a simple matter to set in motion the machinery needed to put a new hospital in order for its first patients. When delays occurred they were due to rail congestion, which was overcome in time, and it is not believed that any actual suffering resulted from the few delays experienced.
As the flying of those in training proceeded and accidents occurred, it became apparent that there was destined to be a heavy drain on the ambulance service of a flying field, for crashes occurred at some distance from the field as frequently as they did on the landing field itself. It was found expedient, therefore, to add wire cutters, axes, and fire extinguishers to the box of surgical dressings usually carried in the ambulances.25
Flying fields became so active that auxiliary landing fields were provided at each airdrome, by which means specialized and group flying were accomplished without having needlessly to congest the landing facilities on the single field originally laid out. This led to a demand for additional medical personnel and ambulances so that each auxiliary field, often many miles distant, could have its own medical officer and motor ambulance on duty while flying was in progress.
It was but a step to the improvement of this emergency service by devising an airplane ambulance so designed as to carry a recumbent patient securely strapped in his litter from the scene of accident to the hospital.