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Chapter 10

Contents

CHAPTER X

The Balkans and Hungary

Richard T. Shackelford, M.D.

The Balkan States comprise most of the former territory of the Ottoman Empire in Southeast Europe, generally considered to be Romania, Bulgaria, Yugoslavia, Albania, Greece, and European Turkey. Hungary has been added to this chapter because of its geographic position and similar World War II situation (map 10). The location of the Balkan Peninsula has made it subject to invasion throughout its history, and the intense nationalism of its inhabitants has resulted in almost continuous internal discord.1

Conflicts in the Balkans.-In this century, the Balkan nations have been involved in three major conflicts-the Balkan Wars (1912-13), World War I, and World War II. There was a sharp split among them in World War II; Yugoslovia, Albania, and Greece were attacked and occupied by the Axis powers while Bulgaria, Hungary, and Romania allied themselves with Germany and provided more than 1.4 million troops to her cause. Turkey remained neutral until February 1945, when she finally declared war on Germany and Japan but took no active part in the fighting.

As the Axis Armies were forced to withdraw from Yugoslavia, Albania, and Greece, these were designated "liberated" countries, and their legitimate governments were restored. Since no armies of occupation or control commissions had to be established for them, and no armistice agreements or peace treaties had to be written, these liberated countries will not be discussed in this chapter. Bulgaria, Hungary, and Romania, classified as "enemy" countries, had to be dealt with by the Allies when hostilities ceased.

It became obvious to Bulgaria, Hungary, and Romania in the summer of 1944 that their defeat was inevitable, and, as Russian troops advanced further into their territory, these countries sought to make peace with the Allies. Romania was the first to do so, signing an armistice in Moscow on 12 September 1944, followed by Bulgaria on 28 October. Hungary was the last to come to terms, doing so only after the Red Army had occupied a large part of her territory. This armistice was signed on 20 January 1945.2

Postwar agreements.-Anglo-American troops were only slightly involved in the fighting in the Balkans; Russia had done the greater part of the fighting and had suffered most of the casualties there. The British were willing to concede that Russia should predominate in postwar arrangements

1Wolff, Robert Lee: The Balkans in Our Time. Cambridge, Mass.: Harvard University Press, 1956, pp. 10-24, 92-95.
2Werth, Alexander: Russia at War, 1941-1945. New York: E. P. Dutton & Co., Inc., 1964, pp. 816-826, 868.


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MAP 10.-Hungary, Romania, and Bulgaria.

there, just as Great Britain and the United States predominated in Italy where Russian troops had not been involved.

Winston Churchill accepted this in his meeting with Joseph Stalin in Moscow on 9 October 1944. They arrived at a so-called "percentages agreement" in which Russia would have 90 percent predominance in Romania, as compared with 10 percent for the other Allies. Russia would predominate 75 percent to 25 percent in Bulgaria, with a 50-50 split in Hungary. The United States did not have a representative at this meeting. President Franklin D. Roosevelt wired Stalin before the meeting, declaring that in his view the Churchill-Stalin talks were merely preliminaries to a three-power conference.3

When this conference was held at Yalta in February 1945, the United States sponsored a "Declaration on Liberated Europe" in which she expressed her firm belief that no major power should establish a sphere of influence in Europe and that all liberated and former enemy nations should be allowed to "create democratic institutions of their own choice." After

3See pages 259-262 of footnote 1, p. 343.


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some argument, the Soviets agreed to this outwardly, and the Declaration was made part of the official Yalta communiqué issued on 11 February 1945. Russia, however, demonstrated from the beginning that she intended to disregard the spirit of this declaration and, instead, use the percentages agreement as justification for her arbitrary actions in Eastern Europe.4

Allied Control Commissions.-Allied Control Commissions were established by the terms of the armistice agreements signed by each of Germany's former allies. For example, in the agreement between the United States of America, the Union of Soviet Socialist Republics, the United Kingdom, and the Government of Romania of 12 September 1944, paragraph 18 stated: "An Allied Control Commission will be established which will undertake until the conclusion of peace the regulation of and control over the execution of the present terms under the general direction and orders of the Allied (Soviet) High Command, acting on behalf of the Allied Powers." Similar agreements were signed with the Bulgarian and Hungarian Governments. These three-power commissions were to oversee the activities of the governments of the former enemy nations until formal peace treaties were drawn, and to assure that provisions of the armistice were carried out.

Since Russian troops had occupied Romania, Bulgaria, and Hungary and were present there in large numbers, the Americans and British consented to having Soviet officers serve as chairmen of the Allied Control Commissions in these three countries. Neither of the Western Allies initially took exception to the Russian view that the actual operation and administration of the Commissions should be in the hands of the Red Army, just as the Americans and British, whose troops had seized and occupied Italy, operated the Control Commission there. This was considered to be expedient as long as hostilities with Germany continued, but the United States hoped to have the Allied Control Commissions become tripartite after the defeat of Germany, with all three Allies having equal representation.5

After the surrender of Germany on 8 May 1945, Russia showed no inclination to curtail her dominance over the Control Commissions in Bulgaria, Hungary, and Romania. Despite Allied protests, she continued to make arbitrary decisions without consulting the British or Americans and often without even informing them of the decisions after they had been made. Russian authorities and, to a lesser degree, provisional governments in the occupied countries engaged in harassing American and British personnel by restricting travel, refusing entrance visas, intimidating natives who demonstrated pro-Western sympathies, and by other more subtle annoyances.6 Since these countries were occupied by the Red Army, the

4See pages 265-266 of footnote 1, p. 343.
5Foreign Relations of the United States. Diplomatic Papers, 1945. Volume V: Europe. Washington: U.S. Government Printing Office, 1967, pp. 238-240, 245, 512-515.
6(1) History of Allied Control Commission, Bulgaria, United States Delegation (to 31 March 1946), pp. 2, 19-34, 83, 86, and 87. (2) Final Report of the United States Military Representation on the Allied Control Commission for Romania, 15 Oct. 1947, pp. 7-8, 19-23, 27, 33-36. (3) Commanding General's Narrative Report of Operations, United States Military Representation on the Allied Control Commission for Hungary, 4 Sept. 1946, pp. 1, 4, 24, 48, 79, and annexes 124 and 130.


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Americans and British could do little to dissuade the Russians, particularly during the immediate postwar period when demobilization dominated American policy.

During 1945-47, Russia was successful in bringing Romania, Bulgaria, and Hungary into her sphere of influence by establishing Communist-dominated governments. The devices of manipulated elections, false arrests and other police-state tactics, highly developed propaganda methods, and economic pressure were used to achieve these objectives.7

Formal peace treaties with Germany's allies were drafted at a meeting of the Big Four Foreign Ministers in New York and were signed in Paris on 10 February 1947. The Allied Control Commissions were disbanded under the provisions of these treaties, which were proclaimed on 15 September 1947. American and British personnel departed from the three countries well within the 90-day limit specified in the peace treaties, thereby ending their formal military participation in the Balkans and Hungary.8

FUNCTIONS OF U.S. ARMY MEDICAL OFFICERS 
ON ALLIED CONTROL COMMISSIONS

The U.S. military representation on each of the three ACC's (Allied Control Commissions) in the Balkans included one or more U.S. Army medical officers (usually only one was assigned, but there were exceptional periods when two were simultaneously present for a short time). These officers were usually lieutenant colonels or colonels. Professional qualifications for the position apparently were not considered. One was a trained public health physician; the others had had experience in general medical practice or in a surgical or internal medicine specialty before their assignment. They received no briefing or special training on the historical background of the country, armistice terms, or political problems, either before or during their tour of duty.

Duties.-The designated duties of these officers were (1) to organize a dispensary and to provide or arrange for medical, surgical, dental, and preventive medical care for the members of the U.S. Representation on the Allied Control Commission and of the U.S. diplomatic mission in each country; (2) to make the routine periodic reports on personnel health required by the U.S. Army Medical Department; and (3) to requisition, store, and dispense the medical and surgical supplies required for performing these duties.

In all three countries, medical care for the personnel of the U.S. military and diplomatic missions required very little of the medical officers' time as the units were small, the incidence of disease was unusually low, and the ailments were minor. The medical officers treated those illnesses which they were equipped to handle, and referred the others, on a contract basis, to

7See ch. 9 of footnote 1, p. 343.
8See footnote 6, p. 345.


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local physicians, surgeons, and dentists whose ability had been investigated and found to be satisfactory. In only two or three instances in all three countries were patients transferred for medical reasons to U.S. medical installations abroad or sent home. Required medical reports and requisitioning supplies took up more time.

Other activities.-Since in the Balkan countries there was no section for health, welfare, or education in the organization of the Allied Control Commissions, nor any official relationship with the health agencies, the medical officers had little designated contact with the Russian, British, or local officials. Because the medical officers had much free time on their hands, some of them, on their own initiative, gathered information on the health and welfare problems of the occupied country. They then reported significant information to the chiefs of the U.S. Representations on the Allied Control Commissions, who often used these reports to make appropriate recommendations at the ACC meetings. These reports were also useful in informing the War Department in Washington of significant health and welfare developments in the occupied country or those which might affect either the health of neighboring countries or the entire European Continent.

The gathering of accurate information for reports about the health and welfare of the occupied countries was time consuming and interesting. The Russian-controlled Allied Control Commissions and, in some instances, the local Communist-dominated government appeared purposely to block the release of this information from official sources. In all three countries, the officially reported statistics often were inaccurately compiled, deceptively presented, made inaccessible to the U.S. medical officer, or not compiled at all.

To obtain this information, the medical officers often had to rely upon unofficial sources. Frequently they contacted local physicians who were not in the government, but who were recognized authorities in their particular fields, and learned from them all they could about local conditions. Then, when permitted by the Allied Control Commission, they visited the area reported to have a significant health or welfare problem so that they could personally observe and evaluate the accuracy of what they had been told. Often such a trip or visit was prohibited, and the information could be checked only by conversations with other local residents, any or all of whom might give a prejudiced and even completely different opinion. This sequence of events inevitably led to broad contacts with the medical profession and institutions in the country, important official and nonofficial persons (both medical and nonmedical), members of the Russian and British Military Missions, and a cross section of the native population. These persons were variously friendly or hostile, procommunist or anticommunist, honest or dishonest, reliable or unreliable, seeking personal gains or trying to be unselfishly helpful. Evaluating their reports accurately was difficult and required experience.


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As a result of these contacts, and because of their Western medical education, the American medical officers were in great demand for professional consultations on patients or members of military or diplomatic missions of other nations affected with puzzling or critical medical conditions, particularly if there was any possibility that the condition might be amenable to treatment by the new "wonder drug," penicillin. Antibiotics were completely unknown in the Balkans until they were introduced by the American and British medical officers. American medical officers also lectured to the local medical societies and schools which had been isolated from international medical literature since before the war. This work was valuable in giving the local physicians an insight into recent Western medical advances.

The activities mentioned differed in their scope in the three enemy countries. The most work was done in Hungary; less was accomplished in Romania, and least of all in Bulgaria, for reasons which will be described.

BULGARIA

Medical and health conditions in Bulgaria9 by 1944 had regressed from merely inadequate to deplorable. There were severe shortages of virtually every ingredient of even a minimally successful program of medical care, including physicians, nurses and related personnel, drugs and supplies, and hospital facilities.10

The first contingent of American troops to staff the American Section of the Allied Control Commission, four officers and seven enlisted men, arrived in Bulgaria on 14 November 1944, followed by the commanding officer of the delegation, Maj. Gen. John A. Crane, who assumed his command in Sofia on 26 November. The medical officer, Maj. (later Lt. Col.) William H. Gronemeyer, MC, was flown in on 29 December. Major Gronemeyer served until 16 November 1945, when he was replaced by Capt. John A. Love, MC, who served as commission medical officer until the commission was dissolved in September 1947.

Mission of the Medical Section.-The primary mission of the Medical Section was the care of American personnel assigned to the mission, which numbered between 40 and 50 men during most of the 1944-47 period. According to reports by Captain Love, their health was excellent; only two cases of serious illness required base hospitalization during a typical 6-month period ending 31 March 1946. There were no serious epidemics of any kind except the usual colds and sore throats in the winter months. The incidence rate of venereal disease was also very low; only one case was reported during the same 6 months. The Medical Section also provided treatment for Bulgarians employed by the American Section of the Allied

9Unless otherwise cited, the information in this section is derived from footnote 6 (1), p. 345.
10War Department Technical Bulletin (TB MED) 58, 28 June 1944, subject: Medical and Sanitary Data on Bulgaria.


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Control Commission; about 10 Bulgarians were seen and treated daily. In addition, Capt. Blagio Angelov, a Bulgarian medical officer on liaison duty with the commission, helped to arrange for Captain Love to see a number of civilians not connected with the delegation, in consultation with their own physicians. Possibly as a result of this, Captain Angelov was eventually arrested by Bulgarian authorities and relieved of his duties.

Food and water supplies.-The usual Army sanitary precautions were applied to the water and food supply. The water was drawn from two sources, the city of Sofia and the enlisted men's billets at American College, an institution located about 6 miles southeast of Sofia, which had been operated by American educators before the war. Water obtained from the city system had to be filtered and chlorinated, but the American College water was derived from a mountain spring and underwent a natural filtration process. Daily tests were conducted in a laboratory in Sofia and, as an extra precaution, a monthly test was done at the 300th General Hospital in Naples.

Most of the food for the troops was obtained from local sources. Government slaughterhouses provided meat which was carefully inspected by local veterinarians. Farms in the Sofia area were called upon to supply butter, milk, and fresh vegetables. Pasteurized butter was available for table use, and unpasteurized butter was deemed adequate for cooking purposes. Since no sufficient facilities for milk pasteurization were available, milk was boiled before use to kill bacteria. Vegetables were thoroughly washed in hot water to remove impurities.

U.S. medical assistance.-American medical officers had little opportunity to assist the Bulgarians in matters of public health or preventive medicine. This can be attributed mainly to two factors:

First, travel by American personnel was severely restricted by the Russians and the Bulgarian Government. Americans were permitted to venture out of rigidly defined areas only if they were accompanied by Soviet escort officers. In July 1945, after repeated American complaints, this policy was eased somewhat to allow officers to travel without being accompanied by Russians if they submitted their proposed itineraries to Soviet Headquarters and were issued "propusks," or passes. However, the passes often were not granted, not delivered until the last minute, or not honored by Russian commanders in the field.

Second, the Soviets and Bulgarian Communists intimidated those citizens who associated with Americans by refusing them clothing or food permits, bringing them in for questioning, and generally making life miserable for them. This naturally inhibited professional contacts between U.S. medical personnel and their Bulgarian counterparts, and caused Bulgarians to be somewhat reluctant to ask for or to accept medical assistance from the Americans.

These restrictions notwithstanding, the Bulgarian Government, hospitals, and private individuals did call upon the American delegation for


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medicine and medical supplies. Even before the war, Bulgaria's public health program and medical facilities were highly inadequate, and the care of almost 30,000 military battle casualties, in addition to civilian casualties, added an even greater burden to her already overtaxed medical capacity.

Shortages of drugs and medical supplies.-Bulgaria had always imported most of its drugs and pharmaceuticals but, because of the war, was cut off from many suppliers. Although Bulgaria was still able to receive shipments from Germany and Hungary, these countries had severe wartime needs of their own. A black market in drugs, bandages, cotton, and medical instruments flourished both during and after the war.11

In view of this situation, the American delegation was sympathetic to requests for medicine. Most solicitations were for penicillin, sulfadiazine, and DDT, although there were many requests for other types of drugs. At the request of the Bulgarian Ministry of War, about 200 bottles of penicillin were furnished to individuals and 42,000 sulfadiazine tablets were distributed. The American delegation cooperated with the Ministry of Health in lending 1,000 bottles of penicillin to the Bulgarian Government, which eventually repaid the loan in full. As another American-Bulgarian cooperative project, 100 pounds of DDT compound were contributed to aid in combating a typhus epidemic, and later, another 500 pounds of DDT compound and 5,000 immunizations of typhus vaccine were given.

In summary, it can be said that U.S. medical personnel gave as much medical help to the Bulgarian people as the circumstances permitted. In the other former enemy countries, Hungary and Romania, where travel was not so restricted and freer association with Americans was permitted, American doctors could be, and were, more active in public health and preventive medicine.

ROMANIA

As in Bulgaria, the assigned duties of the U.S. Army medical officers in Romania12were relatively easy and took little time. In all, five medical officers served in Romania at different times. They were only required to run a dispensary which provided treatment for American military and diplomatic personnel, make routine reports on the health of these personnel, and dispense the medical supplies which were sent in from higher headquarters.

During the early period of occupation, the medical section supervised the removal of U.S. airmen who had been shot down over Romania and had been liberated later by the Russians, or who had been forced down behind the Russian lines. Until 1 April 1945, these evacuees were brought

11Report of U.S. Section, Allied Control Commission for Bulgaria, 13 Apr. 1945, subject: Medical Supply Situation, Bulgaria, p. 1.
12Unless otherwise cited, the information in this section is derived from (1) the personal observations and records of the author, who served as medical officer for the U.S. Representation on the Allied Control Commission for Romania from 16 October 1945 to 1 March 1946, and (2) footnote 6 (2), p. 345.


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to Bucharest, usually by a Russian liaison officer, and were given food, clothing, lodging, and medical care until they were flown to Italy. The commanding officer of the Russian military hospital in Bucharest offered his facilities, but the American authorities preferred to house the evacuees elsewhere because of language differences and because the Russian facilities were considered substandard. However, those airmen who were sent directly to the Russian hospital did receive the utmost in consideration and courtesy from the hospital staff.

Beginning in April 1945, these evacuees were routed by train to Ploesti and Odessa, and then by boat to Italy because of a clause in the Yalta Agreement of 4 February 1945 which stipulated that all personnel being evacuated from Russian to American territory should go through Odessa. The Russian authorities insisted upon a literal interpretation of this clause until the end of the war despite its impracticality and despite American protests.

There were no epidemics or serious diseases among United States personnel. The venereal disease rate was extremely low; there were no cases from 1 June 1946 to 1 March 1947. Medical and dental cases which could not be handled at the dispensary were referred on a contract basis to Romanian dentists and physicians whose qualifications had been investigated by the medical officers. Therefore, they had time to engage in other medical activities beyond their assigned duties.

Health problems.-The American medical officers often aided and advised Romanian physicians who requested their help and, less frequently, Russian medical officers. Lt. Col. Richard T. Shackelford, MC, who served as medical officer for the U.S. Representation on the Allied Control Commission for Romania from 16 October 1945 to 1 March 1946, reported that medicine and surgery in Romania were of poor quality even though there were talented individual Romanian physicians and surgeons. He observed that their hospitals used outmoded methods and equipment, mainly because they had been isolated from Western medical advances since 1939.13

After the Communists gained power, the public health situation worsened. Key health positions were filled by Communists, many of whom were unqualified. The public health department received very few funds with which to operate. There were no drugs or institutions to treat syphilis or tuberculosis, and victims of these contagious diseases were allowed to wander freely and spread their diseases widely.

Colonel Shackelford, who was a surgeon, was horrified at the hundreds of patients he saw who could have been cured by modern surgical methods. Blood transfusions were used sparingly, and two patients were seen who had not been transfused and who later died of hypovolemic shock in the early postoperative period.14

13Shackelford, Richard T.: Red Regime Coming to Romania: Observations of a U.S. Surgeon of the Allied Control Commission During the Critical Years of 1945-47. Mil. Med. 117: 530-537, December 1955.
14See footnote 13.


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Penicillin.-As in the other Axis countries, antibiotics were unknown in 1945; sulfonamides were used for everything. American medical officers introduced penicillin to Romania. The drug was extremely successful in the first few cases in which it was used, curing a seemingly fatal case of meningitis in a Romanian child. This caused Romanian physicians to exaggerate the usefulness of antibiotics, and brought many more requests for antibiotics than the medical officers could handle with their small supply.

Penicillin was authorized for non-American use only in instances of diplomatic requests or extreme emergencies. For example, Colonel Shackelford was called personally by the Prime Minister, Dr. Petru Groza, late one night to examine one of his cabinet ministers who was suffering from lobar pneumonia. The medical officer agreed to treat the official with penicillin, and he recovered. He also treated the Minister of Trade of the Communist Government of Poland for an infected foot.

Other medical aid.-The case of a Romanian girl paralyzed from neck to feet by poliomyelitis came to the attention of the medical officer, who, in turn, notified Brig. Gen. Cortland V. R. Schuyler, Chief of the U.S. Representation on the Allied Control Commission, of the need for an iron lung. An improvised respirator was obtained from Italy, and this was used to keep the girl alive until the American Red Cross in New York shipped a standard respirator. The girl lived in this for more than 2 years before she died of pneumonia. The iron lung and poliomyelitis were both unknown in Romania at the time. This case aroused considerable interest and much favorable publicity for the Americans and helped to establish friendly relations with leading Romanian private physicians and medical authorities.

Colonel Shackelford was called upon several times to prescribe for the Royal Family of Romania. He also lectured on Western advances in medicine and surgery to the local medical society and hospital staffs, receiving favorable publicity in the Bucharest newspapers before they became controlled by the Communist Government. These efforts created much good will among the local population.

American and British medical officers maintained close and friendly relations, but relations with Soviet medical officers varied from rather friendly, easygoing social functions to several cold and formal meetings in Soviet military hospitals. Colonel Shackelford treated several Russian patients, including a general and a prominent politician, at the request of Soviet medical officers. He used penicillin in both cases, and left instructions for its use along with a small supply. But he was never allowed to see either patient again, and was closely guarded during his stay inside the Soviet hospital.

American medical officers made frequent authorized trips about the country to gain information on health conditions as well as political, military, and economic conditions. These trips were limited until the summer of 1945, when the Russians agreed at the Potsdam Conference to allow freer travel by American and British representatives. After that time, medical


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officers always checked in with the provincial representatives of the Russian Army, most of whom proved to be courteous and cooperative. However, the medical officers were watched carefully, if not conspicuously.

Typhus.-One of the more serious disease problems in Romania was typhus. The American medical officer made several field trips in early 1945 to study the Romanian health situation. He reported that a serious typhus epidemic was raging in the northern and eastern provinces and recommended immediate preventive measures. General Schuyler immediately urged the ACC Deputy Chairman, Lieutenant General Vinogradov, to have the ACC invite Brig. Gen. Leon A. Fox, MC, Field Director of the United States of America Typhus Commission, into the country to safeguard the health of both Romanian citizens and Russian soldiers. General Schuyler asked that General Fox be allowed to travel freely about the country with his assistants and with the necessary medical supplies to control the epidemic. The Deputy Chairman took no action. Twelve Russian women physicians and 48 sanitary agents did come to Romania; they had little equipment, and their help seemed to have little effect in stemming the epidemic, which finally died out in early summer, after killing at least 5,000 Romanians and an unknown number of Russians troops. In all, approximately 80,000 cases were reported.

A second typhus epidemic struck during the winter of 1945-46. This time, the UNRRA (United Nations Relief and Rehabilitation Administration) offered aid if the Romanian Government would request it and would agree to UNRRA administration of the program. Romanian health authorities were urged to accept this help because they did not have the resources to fight the epidemic. Finally, in April 1946, the Romanian Government asked just for supplies from UNRRA, without general UNRRA assistance. The U.S. Representation of the Allied Control Commission recommended the disapproval of this request because it was then too late to help fight the epidemic and the supplies would be used only for political purposes by the Romanian Government; also, UNRRA would have no part in administering the assistance. Therefore, neither the Typhus Commission nor UNRRA was ever given the chance by the Allied Control Commission or the Romanian Government to fight typhus in Romania.

Famine.-A severe famine hit Romania during the winter of 1946-47; it was caused by the severe summer drought and also by the Soviet policy of collecting all available surpluses for the use of their own troops. As the situation became desperate, General Schuyler, through the ACC, demanded that an accurate report of the situation be given by Romanian Government officials. Despite numerous promises, these reports were never furnished. After a detailed survey by U.S. Representation field teams in February 1947, General Schuyler asked the War Department to provide immediate relief on a humanitarian basis. President Harry S. Truman took immediate action through the American Red Cross, and a relief program was started. Even though Romanian citizens were dying of starvation throughout this


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critical period, the Romanian Government continued to supply the Soviet forces with large quantities of food.

U.S. enlisted men and civilian clerks ate in a hotel dining room throughout the existence of the Allied Control Commission. All officers and diplomatic personnel had their own billets and dining facilities. Rations were provided by the Romanian Government, supplemented by U.S. rations from U.S. headquarters in Europe. Much work was needed at first to get the kitchen up to United States standards. However, no diseases or illnesses resulting from bad food or messing facilities ever occurred among U.S. personnel in Romania.

U.S. Army medical personnel in Romania did as much as they could to improve health conditions during the existence of the Allied Control Commission. Despite some obstruction from the Soviet Representation, positive steps were taken, including the introduction of antibiotics and the respirator, the education of Romanian physicians in recent Western medical advances, and the treatment of Romanian citizens without payment and without regard to social standing or political affiliation. These accomplishments helped to earn the appreciation and good will of the Romanian people.

HUNGARY

When the United States Representation on the Allied Control Commission for Hungary15 arrived in the country in February 1945, they found medical conditions in general to be "catastrophic." Sanitary conditions were poor, and diseases of many different types were widespread because of the movement throughout the country of large segments of the population of both Hungary and neighboring countries. Units of the German Army, the Hungarian Army, and the Red Army had also moved rapidly around the country, both in combat and in returning to their homes. Food, medical supplies, and installations were virtually nonexistent, and trained medical personnel were scarce. The competing armies had stripped the farms, many crops were ruined or unplanted, and the little food that was produced could not be moved for lack of transportation. The hospitals had so little equipment and so few supplies that only emergency operations were performed, and these under local anesthesia. Iodine was the only antiseptic available, and newspapers were used for surgical dressings.16 Serious epidemics threatened to erupt at any time. This was the situation confronting the medical section of the U.S. Representation when it arrived in Hungary.

15Unless otherwise cited, the information in this section is derived from (1) the personal observations and records of the author, who served as medical officer for the U.S. Representation on the Allied Control Commission for Hungary in August and September 1945, and as medical adviser to UNRRA from March 1946 to January 1947; and (2) footnote 6 (3), p. 345.
16Shackelford, Richard T.: Draping the Iron Curtain Over Hungary: Observations of a U.S. Surgeon of the Allied Control Commission During the Critical Years of 1945-47. Mil. Med. 117: 140-150, August 1955.


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Lt. Col. Harry C. McClain, MC, served as the medical officer for the U.S. Representation in Hungary for the entire existence of the Allied Control Commission from early 1945 to September 1947, except for August and September 1945 when he was on temporary duty in the United States and Colonel Shackelford replaced him. Later, from March 1946 to January 1947, Colonel Shackelford returned to Hungary from Romania as medical adviser to UNRRA. The only other members of the medical section were one enlisted man and several Hungarian civilians.

Upon its arrival in Hungary, the medical section, along with the other sections of the U.S. Representation, established headquarters in Debrecen. Colonel McClain worked with the Division for Public Health of the Ministry of Public Welfare of the Provisional Hungarian Government to gain information on health and sanitation conditions.

Aid to airmen.-One of the first duties of the medical section was to examine and give medical aid to American airmen who had parachuted from their disabled planes and subsequently were hospitalized in Soviet military or civilian hospitals in Hungary, Yugoslavia, and Czechoslovakia. After being examined, these airmen were flown to U.S. installations in Italy.

Cooperation with Hungarian officials.-In March 1945, the U.S. Representation moved to permanent headquarters in the Bauxite Building in Budapest. The medical section set up a dispensary and inspected sanitary conditions in the areas of Budapest where quarters, messes, and offices were being established. Colonel McClain found the officials of Budapest University to be very cooperative; they made available facilities for hospitalization of any personnel who might require it.

Aid to Hungarians.-The health of American personnel was generally excellent, and the efforts of the medical section were devoted mainly to bringing relief to the Hungarian people. Upon arrival in Budapest, Colonel McClain immediately made plans to cooperate with the Hungarian medical profession to fight the threat of widespread epidemics. The severe food shortage received intensive study as evidence of far-reaching malnutrition became apparent. Typhus, a disease which was rarely encountered by Hungarian physicians, became a threat, but was quickly controlled with the help of preventive measures which had proved successful previously for the American medical service in Africa and Italy. One typhus epidemic did occur in the Szeged prisoner-of-war camp where the Red Army prevented U. S. help. At a time when epidemics were probable in Budapest, no great outbreaks occurred because of the steps taken by the American medical section and the Hungarian physicians and health authorities. Waterborne diseases were easily controlled because, fortunately, the water supply of the city remained potable.

It was obvious, however, during the spring and summer of 1945 that a medical crisis existed in Hungary. Hospitals, which were formerly among the best equipped in Europe, were trying to function with the most primitive equipment. Biologic laboratories, which had produced vaccines and anti-


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toxic sera, were closed because they lacked the necessary equipment and stock animals. The new Hungarian Government was virtually powerless to handle the situation or to provide the needed medical supplies. Colonel McClain reported that changes in political personnel in the Hungarian Department of Public Welfare had reduced the information which could be obtained on sanitary conditions, and some obstacles were thrown in the path of U.S. efforts to aid deserving individuals and institutions.

Relief to Hungary.-The catastrophic medical conditions forced the Hungarian Government to cooperate more closely with the U.S. Representation. Dr. Vikar, who proved to be more friendly and knowledgeable than his predecessor, was appointed Health Minister. The victory of Allied Armies in Europe also made the introduction of relief supplies an easier task. During the summer of 1945, a group of American citizens of Hungarian origin formed the American Hungarian Relief, Inc., to raise money and buy relief supplies for Hungary which they asked the U.S. Representation to distribute. Maj. Gen. William S. Key, Chief of the U.S. Representation, assigned the job of receiving and distributing these supplies, including food, clothing, and medicines, to Colonel McClain and the Chief of the Hungarian Liaison Section of the U.S. Representation. General Key instructed that this distribution would be handled only until the Hungarian Relief group could establish its own headquarters in Hungary; he could promise distribution of only such quantities as his limited staff could administer effectively.

The first shipment, consisting of $10,000 worth of medicines purchased from the International Red Cross, was presented by General Key to the Hungarian Red Cross in a ceremony on 27 July 1945. While Colonel McClain was in the United States during August and September, he informed the American Hungarian Relief, Inc., of the specific needs. They immediately authorized an additional $40,000 for medicines, and thanked General Key for giving the support of the U.S. Representation to the relief program.

An almost complete lack of insulin made the treatment of diabetics a serious problem. In September, the Hungarian Relief Headquarters sent 2,000 vials, which were turned over to the Hungarian Ministry of Industry after the U.S. Representation had carefully inspected that agency's means of distribution and found it to be well managed. American Hungarian Relief, Inc., continued to supply insulin, and until April 1946, this supply, received and delivered for distribution by the U.S. Representation, was the only source of insulin for Hungary.

In October 1945, General Key agreed to receive and distribute 600 gift packages of food and clothing donated by American civilians. This supply arrived in time for Christmas, and General Key and his officers used the food and clothing as the basis for a massive Christmas party throughout Budapest. The officers contributed to the purchase of large quantities of fruit and candy, and set up Christmas trees in several sections of the city.


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Gift packages of food and clothing were distributed to sick, orphaned, and needy children. The American officers received many expressions of gratitude from the people of Budapest and plaudits in the local press, which was normally hostile to every American action.

In early 1946, the Hungarian Government rescinded the reception and distribution of relief supplies from outside Hungary. When a Swedish "Save the Children" organization arrived in February with large quantities of badly needed powdered milk, cod liver oil, and drugs, and the International Red Cross airmailed 23 additional boxes of mixed drugs, Colonel McClain went to see the Minister of Public Supply and the Minister of Public Welfare. They agreed to ignore the recent decree and to allow distribution. The supplies were allocated to hospitals through Hungarian agencies, which were carefully checked by Colonel McClain. He was satisfied that the supplies were distributed fairly and reported that the contribution was extremely beneficial to the health of the children in hospitals. Again, Hungarian authorities lavished praise on all responsible for the supply and distribution of this valuable aid.

In May 1946, Mr. Martin Himmler, who was associated with American Hungarian Relief, Inc., arrived in Budapest. General Key informed him that the quantities of relief supplies arriving in Hungary were so large that they were an excessive burden on his small staff. Mr. Himmler then formed a committee of Hungarians, comprised of representatives of the Government, churches, trade unions, Red Cross, and relief organizations, to receive and distribute the supplies. On 27 May, this committee relieved the U.S. Representation of these activities which had, in the words of General Key, "greatly enhanced the prestige of the United States Representation and of the United States among all Hungarians."

UNRRA.-Another source of relief aid was the United Nations Relief and Rehabilitation Administration. In August 1945, Colonel Shackelford wrote a detailed report on the serious health conditions in Hungary. General Key and Mr. H. F. Arthur Schoenfeld, the American Minister in Budapest, used this report to ask for UNRRA aid even though Hungary was technically ineligible because it was an "enemy" country. In December, General Key reported to the Allied Control Commission that UNRRA aid would be given if the Hungarian Government requested it. Acting on the ACC's recommendation, the Hungarian Government requested aid, and UNRRA allocated $4 million in relief supplies for Hungary. The knowledge of Hungary's medical problems, acquired by Colonel Shackelford while compiling his report, prompted the U.S. Army to assign him to UNRRA as the medical adviser on Hungary.

Mr. Stanley Sommers, an American, led a staff of American and British UNRRA representatives into Budapest in the spring of 1946 to survey the needs and order supplies. UNRRA quickly provided fats, sugar, milk, canned meats, some medical supplies, and trucks to transport the supplies. After the Hungarian Government officials argued about the distri-


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bution of the supplies, Colonel Shackelford and Brig. Gen. George H. Weems, who had replaced General Key as chief of the U.S. Representation, arranged to borrow a nutrition team from the U.S. Army in Germany. This team instructed the Hungarians how to make nutrition surveys so that supplies brought in would be in scientifically gaged proportions, that food distribution would be on an impartial and scientific basis, and that political favoritism for certain districts or groups of people would be avoided. The nutrition team proved successful in improving the distribution system, and the supplies were generally allocated fairly. UNRRA did a commendable job in Hungary. More than 60 percent of the UNRRA funds came from the United States.17

Penicillin.-From the beginning of his service in Hungary, Colonel McClain realized that Hungarian physicians, who included some of the best in the world, were poorly informed about the medical and surgical advances which had been made since the beginning of the war, when a scientific barrier was thrown up between Hungary and the West. They were especially interested in penicillin, expressing surprise that the drug really did exist and had been proved worthwhile. Colonel McClain held frequent discussions with Hungarian physicians and medical officers in the Red Army to inform them of Western medical advances.

While the war was still in progress, it was impossible to use penicillin for anyone but Allied military personnel. However, on 31 May 1945, the Acting Secretary of State informed the U.S. mission in Hungary, which in turn informed the U.S. Representation, that controls on the distribution of penicillin were being relaxed. In August, Colonel Shackelford noted that the health of U.S. personnel was excellent, and penicillin stocks were accumulating. He asked General Key and U.S. Minister Schoenfeld for authorization to use penicillin on critically ill Hungarian civilians. This request was forwarded to Washington. On 14 September 1945, the Department of State authorized General Key to use his own discretion in distributing penicillin to Hungarian civilians and to Russian and Hungarian wounded in Hungarian hospitals.

Limited amounts of penicillin from U.S. Army stocks were used from September 1945 to January 1946 to help treat Hungarian soldiers and civilians and Russian soldiers. The American medical officers personally examined each case and closely watched the distribution system to prevent seepage of the drug onto the black market. Each case was followed up to completion.

Meanwhile, Colonel McClain conferred in the United States with officials of American Hungarian Relief, Inc., who agreed to send a continuous supply of penicillin and insulin when these drugs could be purchased and exported. When the war against Japan ended, the ban against private

17See footnote 16, p. 354.


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export of these drugs was lifted, and American Hungarian Relief began sending shipments.

Penicillin became an overnight sensation in Hungary. During the initial period from September 1945 to January 1946, approximately 100 cases, all emergency patients, were treated personally by the American medical officers. Hungarian physicians were amazed at the results, and the drug received extensive publicity in the press. Penicillin acquired the reputation of a "miracle drug," and people with a wide variety of illnesses inundated the U.S. Representation with requests for consultation and treatment. The American medical officers decided that interviews would be given only to physicians who gave detailed case histories of their patients. Requests, averaging from 75 to 100 a day, came not only from Hungarian civilians, but also from the U.S. Legation and American civilians, the British Military Representation and British Legation, the Soviet ACC Representation and the Red Army, the missions of Czechoslovakia, Yugoslavia, Sweden, and France, and all the departments of the Hungarian Government.

The small staff of the U S medical section was burdened with an almost impossible workload. They visited hospitals to insure the proper use of the drug and to instruct Hungarian physicians. Colonel McClain estimated that, from October 1945 to May 1946, 2,000 patients were treated, 500 of whom were seen personally by the American medical officers. Many more persons were examined and were refused penicillin treatment. About 1.4 billion units of penicillin were issued for the use of the 2,000 patients being treated in the hospitals.

The U.S. Representation hired private detectives to keep penicillin off the black market. These investigators reported that all the penicillin confiscated from the black market came from other countries in central Europe and not from U.S. supplies. The Hungarian Government dealt severely with two physicians who were found guilty of misapplication of the drug, and the U.S. Representation did not intervene or offer advice in these cases.

In late January 1946, a special penicillin ward was set up in facilities offered by the University of Budapest. The clinic had a three-room ward, with 18 beds, complete laboratory facilities, and an exceptionally competent staff. Patients were chosen carefully, with no discrimination as to race, religion, or political affiliation, and detailed records were kept of every case. About 300 patients were treated at the clinic, which was designated the clinic for receipt of direct aid from American Hungarian Relief, Inc. Its staff was able to use the detailed reports and publish papers which were valuable in instructing the medical profession of Hungary in the use of penicillin.

Honors received.-The American medical officers, Colonels Shackelford and McClain, also aided the education process by delivering frequent lectures at medical schools throughout Hungary and to the Hungarian Medical Society. Both officers were awarded honorary membership in this society.


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In addition, Colonel McClain was awarded medals from the Universities of Budapest and Pécs in appreciation of the humanitarian work and the furthering of medical science accomplished by the American medical officers.

These medals were only a few of the testimonials received. The Hungarian Government, the press, American Hungarian Relief, Inc., UNRRA, and the State Department all praised the work of the U.S. Representation in the highest terms. In addition, hundreds of letters of appreciation from Hungarian citizens were received by the American Mission. There is no doubt that the medical and relief activities of the U.S. Representation on the Allied Control Commission for Hungary greatly improved the prestige of the United States in the eyes of the Hungarian people at a time of great suffering.

SUMMARY

The many and varied activities carried out by U.S. Army medical officers in Bulgaria, Romania, and Hungary, beyond their assigned duties, proved to be very valuable and worthwhile in several ways. First, and most importantly, the medical officers were able to bring great relief and medical aid to the people of these countries at a time when they desperately needed this help. By studying the health needs of these countries, by ordering and distributing medicines and relief supplies to meet these needs, by introducing antibiotics which were unknown in these countries, and by instructing the local medical professions in the latest advances in Western medicine, the American medical officers were able to make a significant contribution to the public health of the area.

These activities and reports were also of considerable value to the economic and other sections of the U.S. military and diplomatic missions in these countries; and, with time, the medical officers who made the efforts attained increasing stature in the deliberations of the U.S. Representation. It was a most satisfying assignment for the medical officers of the U.S. Army who served in Bulgaria, Romania, and Hungary.

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