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Chapter 2

Contents

CHAPTER II

Selection and Training of Civil Public Health Personnel

Thomas B. Turner, M.D.

The entire civil affairs program was carried out with a minimum of military personnel. This was particularly true of the medical and other public health aspects of the program because of the overall shortage of specialized personnel in the United States and in Great Britain. Both countries needed medical personnel to meet civilian needs at home, including public health and hospital services, as well as the needs of the military services. Thus, provision for the health program of liberated and occupied areas had to be severely limited. Such a situation is likely to recur in any major conflict. The total number of persons who were engaged officially in the work of civil affairs and military government during World War II will never be known. One estimate places the number of officers as close to 7,000. Writing about the situation existing in England and in Europe in late 1945, the chief of the Public Health Branch of the Civil Affairs Division at SHAEF (Supreme Headquarters, Allied Expeditionary Force) stated: "Into Civil Affairs were recruited some six thousand officers and enlisted personnel carefully selected on the basis of their knowledge or aptitude in the various fields of civil administration-administrators, financial experts, legal advisors, economists, supply officers, security and police authorities, public welfare officers, public relations officials, and others."1

Against this background must be judged the manner in which the civil health program was planned and carried out. For the same reasons, it follows that relatively few individuals must play a disproportionately important role, and they should therefore be carefully selected on an individual basis for these assignments. On the whole, the selection and assignment of personnel were well done in World War II. The few instances in which performance was poor can be attributed to individual shortcomings rather than to a breakdown in the system of selection.

The following is quoted from "Crusade in Europe," by Gen. Dwight D. Eisenhower:2

From the beginning of the conquest of Sicily we had been engaged in a new type of task, that of providing government for a conquered population. Specially trained "civil affairs officers," some American, some British, accompanied the assault forces and con-

1Draper, W. F.: Public Health Experiences in the European Theatre of Operations. Proc. Am. Philos. Soc. 90: 289-294, 13 Sept. 1946.
2Eisenhower, Dwight D.: Crusade in Europe. Garden City, N.Y.: Doubleday & Company, Inc., 1948 pp. 191-192, 434.


28

tinuously pushed forward to take over from combat troops the essential task of controlling the civil population.

The American contingent had been trained in the school established at Charlottesville, Virginia. Later, groups of both British and American military government officers received further training in North Africa. They operated under the general supervision of a special section of my headquarters.

Public health, conduct, sanitation, agriculture, industry, transport, and a hundred other activities, all normal to community life, were supervised and directed by these officers. Their task was difficult but vastly important, not merely from an humanitarian viewpoint, but to the success of our armies. Every command needs peace and order in its rear; otherwise it must detach units to preserve signal and road communications, protect dumps and convoys, and suppress underground activity.

The job was new to us but in spite of natural mistakes it was splendidly done. We gained experience and learned lessons for similar and greater tasks lying ahead of us in Italy and Germany.

* * * * * * *

The life of a military government officer was never dull. * * *

While features relating to medical affairs require continuing study, it is noteworthy that, as combat units undergo reorganization and tactical doctrine is brought into balance, the general staff is expanded to provide a civil affairs military government officer on the general staff level.3

As the war progressed, the need for more specialization among civil public health personnel became apparent; requirements were established for such specialities as communicable disease control, nutrition, venereal disease control, sanitary engineering, veterinary service, nursing, narcotic drug control, and medical supply.

Despite the need to conserve medical manpower and the importance of using each individual to the limit of his capabilities, civil affairs health officers were frequently placed in positions where, for lack of adequate transport, they were immobilized. This situation was particularly evident in the Italian campaign; it improved considerably in Northwest Europe and, by the time Germany was reached, adequate transport was usually available.

Another major development during the war was the increasing use of Medical Department enlisted personnel to supplement the activities of the specialized officers, always in short supply. In the Italian campaign, no enlisted personnel of the Medical Department were included; in the campaigns under Supreme Headquarters, Allied Expeditionary Force, enlisted men were used in limited numbers to great advantage; and in the plans for the invasion of Japan, they were included in larger numbers to assist Medical Department officers.

Early in the formulation of plans for personnel, the need for skilled medical supply officers, public health nurses, veterinarians (especially for laboratory and food services), nutritionists, and narcotic drug control

3(1) Department of the Army Field Manual 101-5, Staff Officers Field Manual. Staff Organization and Procedure, 18 Nov. 1954. Par. 21, p. 18, et seq., outlines the duties and responsibilities of the Civil Affairs/Military Government Officer, Assistant Chief of Staff, G-5. (2) Mrazek, J. E.: The Fifth Staff Officer. Military Review, U.S. Army Command and General Staff College, Fort Leavenworth, Kans. 36: 47-51, March 1957.


29

consultants, among others, was anticipated. Special policies and measures were instituted to make such officers available.

SPECIAL TRAINING

In the spring of 1942, a program of training civil affairs officers was developed under the general direction of The Provost Marshal General, Maj. Gen. Allen W. Gullion, USA. Later, in January of 1943, Lt. Col. (later Col.) Ira V. Hiscock, SnC, a public health trained officer and a graduate of the second class of the School of Military Government, Charlottesville, Va., was assigned to serve in a liaison and advisory capacity to the Provost Marshal General's Office. The Surgeon General's Office was requested to assist in recruiting Medical Department personnel and to provide lecturers and medical intelligence data.

In view of the character of the projected civil affairs activities, it seemed appropriate to employ in the program U.S. Public Health Service officers whose training and experience had been primarily in the field of civilian health. Accordingly, as a result of a request to Dr. Thomas Parran, The Surgeon General, U.S. Public Health Service, a number of officers were assigned for duty with the U.S. Army. These officers held corresponding rank to those in the Army and were, for all intents and purposes, on the same status as other commissioned personnel of the Medical Department.

For specialized training in civil affairs, the School of Military Government was organized at the University of Virginia (fig. 3), in March 1942, under the specific direction of Brig. Gen. Cornelius W. Wickersham, with the first class entering on 11 May 1942. Courses of 3 months were arranged for the first three classes, but in December 1943, they were reduced to 2 months. Table 1 shows course attendance of Medical Department and U.S. Public Health Service officers enrolled in six of the seven classes during 1942-43.

The curriculum was devoted largely to a study of foreign languages and of the history, culture, and social and governmental organization of the countries to which the program was oriented. No attempt was made to include public health and medical matters in the curriculum except on an

TABLE 1.-Enrollment in the School of Military Government, Charlottesville, Va., 1942-43


Class


Total

Officers enrolled

MC

SnC

VC

MAC

USPHS

1st

4

2

1

 

1

 

2d

7

4

3

 

 

 

3d

11

3

4

0

0

4

4th

9

3

2

0

0

4

5th

18

6

3

1

0

8

6th

9

6

0

0

0

3

 


30

FIGURE 3.-Students gather between classes at the School of Military Government, Charlottesville, Va., August 1943.

elementary basis directed to the nonmedical members of the class. The school maintained medical intelligence reports, public health manuals, medical bulletins, and medical and sanitary supply lists. At least one public health lecture was given to each of the early classes, supplemented by roundtable conferences with the health officers.

An increase in the public health content of the curriculum and the establishment of a committee for special functional studies were recommended, but they were not favorably considered by school authorities because of an already crowded schedule. In the light of experience, however, it seems clear that officers who were to carry the principal administrative responsibilities of civil affairs activities in the field were not sufficiently aware of the extent to which health problems would constitute one of their major responsibilities and, in general, were not prepared for the staff work necessary to cope with these problems.

The general consensus among Medical Department students was that much of the time spent in studying such problems as finance and education, even for orientation purposes, could have been used to better advantage in


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developing seminar discussions around public health problems of interest to the professionally trained student.

Twenty-two civil affairs public health officers, trained at the School of Military Government, were sent to the North African (later Mediterranean) Theater of Operations, U.S. Army, during 1942-43; these included one colonel, four lieutenant colonels, eight majors, and nine captains, most of whom subsequently played an active role in the Italian campaign, in the Balkans, or in Western Europe.

CIVIL AFFAIRS TRAINING SCHOOLS

With the increasing requirements for civil affairs personnel, the Charlottesville training facilities were supplemented by the establishment, on 1 July 1943, of a series of civil affairs training schools located at the following 11 other universities: Boston, Chicago, Harvard, Michigan, Northwestern, Pittsburgh, Princeton, Stanford, Western Reserve, Wisconsin, and Yale.

Officers selected for civil affairs training were usually sent first to a school of military government at Fort Custer, Mich., for a 6-week orientation course, then to one of the various universities for foreign language training and area studies for a 10-week period. A total of 49 Medical Corps, 38 Sanitary Corps, and two Veterinary Corps officers were trained in this program, besides two Army Nurse Corps officers who were also graduates of the Charlottesville School.

Additionally, the Provost Marshal General's Office selected a number of Medical Administrative Corps and Sanitary Corps officers and one Dental Corps officer to train for civil affairs duties other than public health.

The curriculums of the civil affairs schools again provided for a few lectures on public health, but these were too elementary to be of more than refresher and orientation value to the professionally trained individual. Because of continuing concern on the part of Medical Department personnel in the program, an effort was made in November 1943 to develop a more extensive public health curriculum at the Yale University Civil Affairs School, New Haven, Conn., under the direction of Dr. C. E. A. Winslow, professor and chairman of the Department of Public Health. Limitations of time continued to be a problem which was recognized by all concerned. Nevertheless, military observers returning from operations in Africa and Italy brought back their experiences to the schools, and the curriculums at Yale and Michigan, during the latter part of 1943, were amended to include a considerable increase in specific public health instruction relating to Germany.

PRECOMBAT TRAINING IN THEATERS OF OPERATIONS

When armies operate far from their home base, the logistic situation often requires long waiting periods in overseas theaters for certain kinds


32 

of units and personnel. This is particularly true of medical groups, whose principal activities occur at the time of actual fighting, and of civil affairs/military government personnel, who must await the conquest of a territory to have a job to do. The resulting morale-shattering boredom, especially among Medical Department personnel during World War II, was only aggravated by inadequate or misdirected provision for "made work" during this waiting period.

In preparation for the invasion of Italy, the Military Government Holding Center was established at Chréa and later was moved to Tizi Ouzou, about 60 miles from Allied Force Headquarters, in Algiers. Initially, the civil affairs group at this center consisted of a small nucleus of British and American planning officers, including medical officers, who arrived in May 1943. The group was augmented steadily by the arrival of other contingents from the Charlottesville School and from the various civil affairs training schools. As a rule, Medical Department officers were assigned to teams organized for projected civil affairs operations in Italy. While this arrangement was helpful for planning purposes, it led to a loss of flexibility in the use of scarce personnel since organized teams were reluctant to release their public health officers for more immediate health care use elsewhere.

One of the lowest points in the morale of the civil affairs public health group occurred at the Civil Affairs Center at Shrivenham, England (fig. 4), during the months preceding the invasion of continental Europe. Some civil affairs public health personnel were held there for 4 or 5 months with virtually nothing to do. What training there was had little bearing on professional activities, and it was difficult for these officers to be philosophical about what they considered to be an unnecessary waste of time. While this situation was a relatively minor problem, it probably had an adverse effect on recruitment for these assignments and could have been largely avoided by better provision for the intellectual needs of this professional group.

PERSONNEL SHORTAGES IN THE EUROPEAN THEATER

From D-day, 6 June 1944, until the surrender of Germany on 8 May 1945, the personnel situation in regard to Medical Department officers available for civil affairs and military government activities became increasingly stringent. The British were able to provide only a small fraction of the medical personnel whom they had hoped to assign to civil affairs activities. The problems faced were tremendous, especially in the care of displaced persons and refugees. Several approaches to the problem were:

1. Arrangements were made with UNRRA (United Nations Relief and Rehabilitation Administration)4 whereby UNRRA medical personnel were loaned to the Army until needed by UNRRA.

4UNRRA was an outgrowth of the U.S. Office of Foreign Relief and Rehabilitation Operations, organized in 1942 under the direction of Gov. (later Sen.) Herbert H. Lehman with a committee on public health under the chairmanship of Dr. Thomas Parran.


33

FIGURE 4.-American School Center, Shrivenham, England, 1944. Top: Civil Affairs Center. Bottom: Officers' Mess.


34

2. In many instances, the armies furnished Medical Department personnel from their own organizational strength.

3. Requests were made to the British for personnel, but only a few additional officers were provided.

4. Requests were made to the War Department for additional personnel. Personnel could not be supplied from the Zone of Interior to meet the majority of these requests. However, from time to time, a few Medical Corps officers and some Sanitary Corps and administrative officers were made available to the European theater. The War Department took the view that sufficient qualified public health officers were already in the theater to meet the civil affairs requirements. Hence, at the request of SHAEF, a list of 25 Medical Corps officers qualified in public health and already in the theater was forwarded with the recommendation that these officers be used.

Public Health Personnel From Other Agencies

In addition to the employment of members of the U.S. Public Health Service, the civil affairs program was able to use effectively personnel from the Rockefeller Foundation, the United Nations Relief and Rehabilitation Administration, and, to a limited extent, the American National Red Cross.

Early in the occupation of Italy, the Rockefeller Foundation sent certain members of its International Health Division to that country to work on various health problems. These men, although they had no official connection with the Army, rendered valuable service in several instances, notably in the control of typhus during the Naples epidemic and in malaria control measures.

In February 1944, the director and several members of the Public Health Subcommission of the Allied Control Commission expressed the desire that the Rockefeller Foundation personnel continue working with them on typhus control and, later, on malaria control. However, they desired that their connection with the Army be formalized. Although, in practice, the Rockefeller staff members had been given messing facilities, furnished transportation, and accorded certain Army privileges, they had no official standing with the Army.

During April 1944, the Rockefeller Foundation approved collaboration with the Allied Control Commission for typhus and malaria control and placed Dr. Fred L. Soper in charge of the International Health Division activities in Southern Europe and in Italy.

A memorandum of 6 April 1944 to the Chief, Preventive Medicine Service, Surgeon General's Office, suggested that these men be appointed as consultants to The Surgeon General and called to active duty when needed by the theater surgeon. Since their salaries were paid by the Rockefeller Foundation, it was thought they might be appointed as "dollar-a-year-men," with the Army paying their expenses while they were on active duty.


35

On 25 April, a memorandum was sent to the Director, Civil Affairs Division, War Department Special Staff, incorporating this suggestion and asking for approval. A first endorsement, dated 27 April, approved the recommendation. A cablegram sent on 8 May to Headquarters, North African theater, stated that, although the War Department did not approve blanket recognition of the Rockefeller Foundation as a collaborating organization, it did approve using selected Rockefeller staff members as civilian consultants to The Surgeon General at $1 per year, with assignment upon request of that theater.

In a memorandum on 12 May 1944, the appointment of five physicians under this agreement was requested. The Office of the Secretary of War objected to their appointment as "dollar-a-year-men" as contrary to War Department policy. The physicians were finally appointed, on 6 June 1944, as consultants without compensation but with payment of travel and $10 per diem in lieu of subsistence.

Six staff members of the Rockefeller Foundation were appointed for service in the Mediterranean Theater of Operations, U.S. Army, under this management: Dr. Austin Kerr, Mr. F. W. Knipe, Dr. Floyd S. Markham, Dr. Louis A. Riehl, Dr. Stuart S. Stevenson, and Dr. Bruce Wilson. Two were already in Italy, and the others arrived under War Department orders requested by The Surgeon General. The arrangement worked satisfactorily; the group was attached to the Public Health Subcommission of the Allied Control Commission (later Allied Commission) and rendered valuable service, especially in the control of malaria and typhus.

United Nations Relief and Rehabilitation Administration

The relationship of the Civil Public Health Division, Preventive Medicine Service, to the United Nations Relief and Rehabilitation Administration was maintained by close informal liaison. This arrangement was advisable because it was evident that, in at least some of the countries in which the Army was engaged in public health activities, UNRRA would be called upon to continue these activities when military control ended.

In a meeting on 25 March 1944, Dr. Thomas Parran of the U.S. Public Health Service; Dr. James Crabtree and Dr. E. R. Reckie of UNRRA; Brig. Gen. James S. Simmons and Col. Thomas B. Turner, MC, of the Surgeon General's Office; and Colonel Hiscock of the Civil Affairs Division, Special Staff, agreed that close collaboration between civil affairs and UNRRA in public health matters was desirable. This conclusion was communicated to the appropriate Army and UNRRA officials in Europe.

Cooperation in public health matters was implemented further by a mutually beneficial plan between SHAEF and UNRRA under which UNRRA medical personnel were to be detailed to the Army for civil affairs duty, thereby gaining valuable experience working in areas in which they


36 

might later serve as UNRRA representatives. Meanwhile, the Army would acquire the services of additional public health personnel.

An agreement was signed in London, on 28 July 1944, by Maj. Gen. Warren F. Draper, Chief, Public Health Branch, Civil Affairs Division, SHAEF; Lt. Gen. Sir Arthur E. Grasett, Assistant Chief of Staff, G-5 SHAEF; Dr. Wilbur A. Sawyer, Director of Health, UNRRA; and Sir Frederick Leith-Ross, Deputy Director General, UNRRA. It provided that UNRRA medical officers would be attached to the Army until needed by their own organization and released by G-5 SHAEF. While so attached, the officers would communicate officially with UNRRA only through appropriate military channels. A radiogram from SHAEF, dated 9 August, modified the original agreement to provide that these medical officers should "be ordered to UNRRA-London for attachment to Public Health Branch, G-5, SHAEF." This agreement was approved by UNRRA on 21 August and by the U.S. Public Health Service on 24 August.

In November 1944, a further agreement signed by General Eisenhower and Herbert H. Lehman, Director General of UNRRA, established close liaison and cooperation between SHAEF and UNRRA.

SELECTION AND ASSIGNMENT OF PERSONNEL FOR MILITARY
GOVERNMENT IN GERMANY

With the surrender of Germany on 8 May 1945, plans were completed rapidly for assignment of medical personnel to the USGCC (U.S. Group Control Council), which, together with the British, French, and Russians, was to take over the government of Germany. The intention to use principally officers who had been in the civil affairs program under SHAEF was carried out wherever the rotation policy made it possible.

When hostilities ceased, the U.S. Public Health Service requested the return of General Draper and other officers at the earliest practicable date. Upon the dissolution of SHAEF on 16 July 1945, General Draper returned to the United States.

Public Health and Welfare was organized as a major division of the U.S. Group Control Council, and because of its policymaking functions, the selection of a director was regarded as of prime importance. Therefore, The Surgeon General, upon the advice of General Simmons and Colonel Turner, recommended to Maj. Gen. John H. Hilldring that Maj. Gen. Morrison C. Stayer, then chief surgeon of the Mediterranean theater, be selected as the director of the Public Health and Welfare Division, USGCC. This recommendation was accepted and General Stayer assumed his duties in May 1945, when the Group Control Council was still in the planning phases at Hoechst, a few miles from Frankfurt, Germany.

Lt. Col. Joseph A. Bell and Maj. Edgar B. Johnwick, two U.S. Public Health Service officers on assignment to the Army, who composed the original USGCC medical planning group, returned to the United States


37

shortly thereafter. For his deputy, General Stayer selected Col. William L. Wilson, MC, who had served in a similar capacity in the Public Health Branch of G-5 SHAEF; he also selected Lt. Col. (later Col.) William A. Brumfield, Jr., MC, also from G-5 SHAEF, as the consultant in venereal disease control.

General Stayer desired other consultants, and the Surgeon General's Office arranged to procure the services of several civilian specialists to go to Germany for periods of 3 to 6 months. The following civilians proceeded to Germany in August 1945 to act as special advisers to General Stayer:

Judge Fred L. Reese (legal matters); Dr. Wilburt C. Davison, Dean, Duke University School of Medicine (rehabilitation of German medical schools); Dr. John J. Phair, School of Hygiene and Public Health, The Johns Hopkins University (public health laboratories); Dr. William A. Hagan, Cornell University (veterinary matters); and Mr. Samuel H. Breidenbach, Bureau of Narcotics Control, U.S. Treasury Department (narcotics control).

PERSONNEL FOR THE FAR EAST

On 5 April 1944, a conference was held in the Surgeon General's Office to discuss the personnel requirements for the Far East civil affairs program. Representatives of the Surgeon General's Office, the Civil Affairs Division of the Special Staff, and the Provost Marshal General's Office were present. A requirement for some 1,500 civil affairs officers for Japan alone was anticipated, the estimate for the medical officers being 5 percent. Of approximately 75 Medical Department officers, 32 were to be assigned from the Medical Corps.

On 25 September 1944, besides this original allotment of 75 officers, The Surgeon General, at the request of the Provost Marshal General's Office, allotted an additional 18 officers, nine of whom were in the Medical Corps. After a brief training period at the U.S. Navy Far Eastern Civil Affairs Training School at Princeton University, Princeton, N.J., these officers were transferred to the Pacific where they were assigned to the Tenth U.S. Army and later served on Okinawa.

At the request of the Commanding General, Southwest Pacific Area, another group of 20 officers was assigned and sent immediately to the Philippines. As of 20 January 1945, The Surgeon General had agreed to assign 113 Medical Department officers for civil affairs in the Far East.

University of Chicago School-The first Medical Department officers sent to the Far East were trained in the first class of the Civil Affairs Training School established at the University of Chicago, Chicago, Ill., on 24 August 1943. This class included four members of the Medical Corps and three members of the Sanitary Corps. The course was essentially one of language and area study and not until the last months was attention directed to public health matters. Maj. James G. Telfer, a U.S. Public Health Service officer assigned to this class, developed a program in


38 

coordination with the Provost Marshal General's Office and with the cooperation of the City Health Department of Chicago. Medical Department members in the class made weekly visits to municipal public health and sanitary installations in Chicago. These field trips were supplemented by an occasional lecture by a member of the City Health Department to the entire Civil Affairs Training School class. In April 1944, Major Telfer submitted to the Civil Public Health Division, Preventive Medicine Service, an "Outline of Public Health Functions for District Civil Affairs Officers in Japan," the preparation of which represented the combined efforts of the Medical Department officers. Medical Department officers were not trained at the University of Chicago following this first class, which ended in February 1944.

Princeton University School-The U.S. Navy conducted a Far Eastern Civil Affairs Training School at Princeton University in 1944-45. Particular emphasis for Medical Department officers at this school was placed on public health problems on Taiwan. The courses were of 3 months' duration, and the first class reported on 1 October 1944. A number of U.S. Army Medical Department officers were enrolled in this school, and others were included on the faculty. The first medical officers enrolled in the second class which started on 1 November 1944. A total of three lieutenant colonels, three majors, and nine captains were trained at Princeton.

Yale University School-The Provost Marshal General's Office, in coordination with the Surgeon General's Office and the Civil Affairs Division, Special Staff, developed a plan by which all Medical Department officers who were to receive public health instruction in civil affairs would be enrolled at Yale University. A proposed curriculum for public health officers at this Far East civil affairs training school was approved by the Surgeon General's Office on 3 June 1944.

The Civil Affairs Training School at Yale was under the direction of Prof. A. Whitney Griswold of the Yale University faculty, and Col. Calvin B. Garwood, Cav, was named associate director. Instructors were Lt. Col. Roland Murphy, Maj. Fred Hackett, Maj. Joel Ernest, and Maj. James B. Gillespie, MC. This last officer was assigned from the Civil Public Health Division, Preventive Medicine Service, as liaison officer for the Medical Department groups.5 The responsibility for supervision of the public health program was assumed by the School of Public Health under the supervision of Prof. C. E. A. Winslow.

After completing the 6-week indoctrination course at the School of Military Government, the first group of officers who were scheduled to attend the course at Yale was assigned for 1-day temporary duty in the Surgeon General's Office, where the functions of the various divisions in the Preventive Medicine Service were explained. Also, a series of conferences was held at which comments and expressions on the work at Charlottesville

5War Department Special Orders No. 207, 29 Aug. 1944, par. 10.


39

were invited from various student officers. In general, student officers lacked information concerning the role of public health in civil affairs because there was no medical officer on the School of Military Government faculty and because of the limited time devoted to this function. Little or no time was given to the public health aspects of military government in the field.

The curriculum at Yale consisted of intensive training in Japanese language and area studies; in addition, Medical Department officers attended special seminars on diseases, epidemiology, sanitation, and public health subjects of importance in Japan. The seminar program was devoted to such problems as control of epidemic and communicable diseases of the Far East, including animal diseases, organization of local hospital and medical care, problems of feeding and nutrition, narcotics control, and restoration of facilities for sanitation of the environment including water supply, waste disposal, and housing and food hygiene.

During each course, one week was devoted to field visits and inspections of city and State hospitals, special clinics, health departments, and local water supply and sewage disposal installations. The veterinary and supply officers of the first class at Yale spent one day at Lederle Laboratories, Pearl River, N.Y. Special attention was given on this trip to production, storage, and packaging of biologicals.

Medical and public health topics and lecturers for the civil affairs seminars at Yale were selected by Colonel Hiscock, Civil Affairs Division, Special Staff, and Colonel Turner, Director, Civil Public Health Division, Preventive Medicine Service, in coordination with the Civil Affairs Training Branch, Provost Marshal General's Office, The specialists who lectured and conducted seminars were faculty members of the Yale School of Medicine or were procured through the Surgeon General's Office, the Navy's Bureau of Medicine and Surgery, the U.S. Public Health Service, and other agencies. Unfortunately, with few Medical Department officers available who had field experience in the Far East, there was little firsthand information of existing conditions in that area.

All facilities of the Yale Medical Library were placed at the disposal of the Medical Department officers. All recent publications on medical and public health subjects from the Medical Intelligence Division, Preventive Medicine Service, Surgeon General's Office, the Provost Marshal General's Office, and other sources were made available for reference work. Films and pictures showing public health activities in the Marshall Islands, Saipan, Okinawa, and other Pacific areas were available and proved useful. Personal copies of two publications, ASF (Army Service Forces) Manual M 354-13, "Japan Public Health and Sanitation," and War Department Pamphlet 31-2, "Civil Affairs Handbook, Public Health in the Japanese Empire," were provided for each Medical Department officer. In May 1945, ASF Manual. M 354-13 was superseded by TB MED (War Department Technical Bulletin (Medical)) 160, "Medical and Sanitary Data on Japan," a publication prepared in the Medical Intelligence Division. A display of civil affairs medical


40

supply items from the basic medical and dispensary units was set up in the medical library to familiarize officers with supplies.

The training of Medical Department officers at Yale was discontinued after August 1944. In a memorandum dated 7 April 1945, from the director of the Civil Affairs Division, Special Staff, to The Surgeon General, the Deputy Chief of Staff authorized The Provost Marshal General to train 1,000 additional civil officers for the Far East. This group was to include 100 Medical Corps, 20 Medical Administrative Corps, 50 Sanitary Corps, and two Veterinary Corps officers. However, Medical Department officers procured for civil affairs assignments after 14 August 1945 did not attend the School of Military Government and were assigned directly to the Civil Affairs Holding and Staging Area, Presidio of Monterey, Calif.

After completing their work at Yale, Medical Department officers were permitted 10 to 14 days for special assignments on temporary duty before reporting to the Civil Affairs Holding and Staging Area. These assignments varied and followed a 5-day period at the Medical Field Service School, Carlisle Barracks, Pa. A number of medical officers from the first Yale class were assigned to temporary duty in the Preventive Medicine Service; some of the sanitary engineers from this class were assigned to the same office while others requested assignment to Fort Belvoir, Va. Supply officers had temporary assignments to various medical supply depots. In the first and second classes, a number of the medical officers had short assignments in tropical and military medicine at the Army Medical School, Washington, D.C. Veterinarians in the first and second classes, following short periods at the Veterinary Laboratory of the Army Medical School, spent several days at the Army Medical Nutrition Laboratory in Chicago. In several instances, by special arrangement, officers were assigned to temporary duty at civilian institutions selected because of particular facilities important in public health.

CIVIL AFFAIRS HOLDING AND STAGING AREA

The Civil Affairs Holding and Staging Area was established at Fort Ord, Calif., on 27 June 1944. On 10 February 1945, it was moved to the Presidio of Monterey. Col. Wilson C. Williams, MC, was assigned to the Civil Affairs Holding and Staging Area in August 1944,6 and was designated surgeon. The first commanding officer of the Civil Affairs Holding and Staging Area was Col. Hardy C. Dillard, MC. On 24 January 1945, Colonel Williams reported at the Surgeon General's Office for a short period of temporary duty during which conferences on medical supplies were arranged for him with representatives of both the U.S. Navy and the International Division, ASF. In addition, conferences were held on civil affairs personnel, immunization of civil affairs personnel, and training programs. A visit to the Medical Field Service School enabled Colonel

6War Department Special Orders No. 208, 30 Aug. 1944, par. 10.


41

Williams to observe field equipment improvised for mess sanitation, water purification, excreta and garbage disposal units, delousing equipment, and other demonstrations. Following this visit, he suggested that all medical and sanitation officers in civil affairs training schools be sent to the Medical Field Service School for a few days.

On 26 February 1945, Colonel Turner and Colonel Hiscock reported for temporary duty at the Civil Affairs Holding and Staging Area. During the period of their visit, conferences were held with Colonel Dillard, the Commanding Officer; Capt. W. S. Voeder, USN, Deputy Commanding Officer; and officers in charge of major staff divisions. Numerous conferences were held with Colonel Williams, the Chief Public Health Officer, and with the public health and medical staff. Various aspects of the training program were observed, including panel discussions, field demonstrations, unit exercises, physical training, language training, and staff conferences. Particular attention was given to health organization and public health training. As a result of this visit to the Civil Affairs Holding and Staging Area, certain problems requiring clarification were noted, including:

1. Integration of training in public health in the various civil affairs training schools and at the Civil Affairs Holding and Staging Area to insure continuity and to avoid duplication.

2. Early determination of responsibility between Army and Navy for procurement, storage, and issue of medical supplies for a projected operation for which civil affairs officers were being staged at the Civil Affairs Holding and Staging Area.

3. Early determination of the degree of Civil Affairs Holding and Staging Area responsibility for indoctrination and unit training of personnel in G-6 Naval Hospital Units7 scheduled for military government activities in the Far East.

In May 1945, a training program for public health officers at the Civil Affairs Holding and Staging Area was submitted to the Director, Civil Affairs Division, Special Staff. This document, containing course outlines, was concurred in by the Civil Affairs Division and the Surgeon General's Office. The program covered basic instruction in personal hygiene, water sanitation, first aid, excreta disposal, messing and mess sanitation, insect and rodent control, field sanitation, and medical supply. A special study was made of communicable diseases occurring epidemically and endemically in the Far East. The training schedule included both a basic and a functional section. The basic instruction schedule was the same for all trainees regardless of the individual's service, branch, or type of team or detachment to which he was assigned. The functional training schedule was designed for medical officers, sanitary technicians, and related specialists only.

All instruction periods proposed were for 2 hours or multiples thereof. Each instructor prepared a syllabus covering material and demonstrations

7The G-6 Naval Hospital Unit was a 100-bed advance base type hospital, an item in the Navy's Functional Component System.


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for which he was responsible. Teaching aids, such as films, equipment, and supplies, were listed at the end of each syllabus. The basic instruction was given during the first 4 weeks of training, with some additional time being devoted to field demonstrations during the fifth and sixth weeks of training in the field. After the 4-week period of basic instruction, the Surgeon, Ninth Service Command, and the director of health of California, arranged for the assignment of Medical Department officers to certain Army, State, and municipal medical and sanitary installations which provided additional training in line with the particular specialty and interest of the various officers. These temporary-duty assignments were in such facilities as the Ninth Service Command Laboratory, Fort Ord; the Los Angeles and San Joaquin County Health Departments; and the Los Angeles City Health Department. In the early fall of 1945, several officers attended the Navy School of Tropical Medicine at Treasure Island, San Francisco, Calif.

At the Civil Affairs Holding and Staging Area, eight military government headquarters groups were formed. The table of organization for each included one Medical Corps officer. In addition, 56 military government companies were organized, each with a table of organization which included one Medical Corps and one Sanitary Corps officer.

In the early fall of 1945, these units were transferred to the Pacific theater. Since Medical Department officers with Far Eastern training from the School of Military Government and civil affairs training schools were insufficient to fully staff these units, 35 Medical Corps officers and 42 sanitary engineering officers without special training were procured from various commands in the Zone of Interior to make up this deficit.

Colonel Williams departed from the Civil Affairs Holding and Staging Area in May 19458and was replaced as chief public health officer by Col. Charles K. Holmes, MC.

SUMMARY

The civil affairs/military government public health training program was organized and put into operation hastily and under great pressure. Consequently, many aspects of the program as it related to Medical Department officers can be criticized as less than the best. And yet, on the whole, the training activities were probably as well conceived and as well carried out as could be expected in the circumstances.

Two difficult problems were inherent in the program and probably will be encountered in any future ventures of this kind. The first is the problem of achieving a balance between professional and nonprofessional types of training; and the second is the extent to which it is possible to train for service in a particular area.

The School of Military Government at Charlottesville, which initially

8As in other operations, lists of medical, nursing, and sanitary personnel from liberated and occupied territories, who had received training in public health in the United States in earlier years, were supplied to appropriate officers before invasion operations, and such a procedure proved helpful in numerous instances, including Japan.


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concentrated on problems anticipated in the combat phases of civil affairs, provided virtually no training of a professional nature for Medical Department officers. From the standpoint of the latter group, however, there were real advantages in studying and training as part of a civil affairs group, where some understanding of problems other than medical was acquired and where cooperative planning was featured.

At the Yale School, the amount of instruction in public health was greatly increased under the direction of nationally known teachers; at the same time, the content was integrated with the area studies being pursued by the entire class. Since this plan was the latest in the evolution of the training program, it is perhaps natural to regard it as the most successful from the standpoint of Medical Department officers.

In a rapidly changing world war, it is difficult to train men far in advance for service in a particular country, or even a particular area of the world. For example, in 1942, recent graduates of a British Skiing School in Lebanon were rushed to take part in the defense of Java and, in 1943, the main unit selected for the recapture of Attu was the 7th Infantry Division, fresh from training in the Mojave Desert. So also, men who had become fluent in Italian and familiar with the details of Italian life and culture frequently found themselves deeply engaged in civil affairs problems in Germany or in the Far East, while others trained in the Japanese language saw service in the Philippines.

Perhaps in the future, much of the basic training in the concepts and principles of civil affairs and military government operations and, to a certain extent, in area studies can be given more leisurely on a reserve training status so that, if a wartime problem is eventually confronted, this basic type of training can be limited to a relatively short orientation and refresher course.

Unit training and intensive area study can probably best be carried out at places closer to the area of operation.

In the final analysis, however, civil affairs is an activity in which the results reflect to a unique extent the quality of the relatively few individuals assigned to these duties. This point of view was expressed in the words of Maj. (later Lt. Col.) Henry T. Rowell, MC, as submitted in a report of a review of military government operations in Sicily in August 1943:

An organization in the last analysis is only as good as the men in it. This is particularly true of a new organization that has to function without the cohesive force of experience and tradition. Each man, to a certain extent, must feel his own way and make his contribution to the whole structure on the basis of what he has learned himself.

In this AMGOT [Allied Military Government of Occupied Territory] was most fortunate. The great majority of its officers proved by achievement that they possessed the intelligence, flexibility, and character which were needed for the job. They not only made a good plan into a living reality but improved it in the process. It is not a contradiction to say that they were hardheaded and humane at the same time. These are highly desirable qualities in military government. In conjunction with good will and a capacity for work, they produced a notable example of Allied cooperation and the kind of military government which does credit to the armies and men of both Allies.

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