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Chapter XIII

Contents

CHAPTER XIII

Offensive Operations: The Solomons to the Palaus

SOUTH PACIFIC AREA

Halting the Japanese Offensive

Because of the Japanese activities at Lae, New Guinea, and Guadalcanal in early 1942, it became obvious to the Allied Command that it would be necessary to launch a counteroffensive to reverse this trend and relieve the apparent threat to Australia. The U.S. Marines opened the campaign on Guadalcanal some 8 months after Pearl Harbor on 7 August 1942, and the 16th Infantry Regiment of the Americal Division entered the scene on 13 October 1942. Other combat elements of the Americal Division, including the 101st Medical Regiment, arrived on Guadalcanal on 11-12 November 1942.

The medical supply section of the 101st Medical Regiment assumed responsibility for medical supply on Guadalcanal, including the support of certain Navy and Marine personnel. Fortunately, the Americal Division, at the time, carried a 60-day supply, and no serious shortage was caused by this added burden. The only supplies really low were glucose, plasma, and sulfaguanidine. The 101st Medical Regiment was relieved of its supply responsibility for the base on 4 January 1943 with the arrival of Section 1, Advance Depot Platoon, 21st Medical Supply Depot (map 33).

Col. Dale G. Friend, MC, Surgeon, 101st Medical Regiment, made some significant recommendations concerning medical supply on Guadalcanal. Because it was necessary to supply Navy and Marine personnel as well as the Army, the 60-day supply level proved to be inadequate. Colonel Friend recommended that equipment of medical troops assigned to combat operations be made available in small portable waterproof containers which would be capable of floating reasonable periods of time in the event that they would be used in landing operations and river crossings.

Because plasma bottles and other glass containers were being shattered by mortar and artillery fire as well as bombings, it was recommended that these items be placed in shock-absorbing containers. It was also recommended that the new Army-issue and the Navy-type litters replace the cumbersome Army-issue oak litter.

Development of Field Equipment

The combat plan to meet and destroy the enemy, wherever found, meant that units would be sent into difficult jungle country, remote from


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MAP 33.-Medical supply support on Guadalcanal.

sources of supply. This problem was solved by combining Navy, Marine, and Army field equipment. It was found that the Navy and Marine valise-type medical chest was extremely advantageous in that it could be carried by one man on the foot marches and contained sufficient equipment to provide for treatment. Another important item was the so-called combat dressing chest which was made up of two watertight tin cans containing various types of dressings. These cans together fitted in a canvas carrying case which one man could carry. Due to the shortage of this particular item, the cans were forwarded from the collecting station by litter bearer, emptied at the aid station, and then returned to the collecting station for refilling.

It is interesting to note that two types of jungle kits (fig. 109) were added to the medical supply catalog shortly after the battle for Guadalcanal.1

Supply Points and Storage Facilities, 1943

Late in 1943, there were eight medical supply points in USAFISPA (U.S. Army Forces in the South Pacific Area). These points, each operated by a particular section or detachment of a medical supply depot, were located on Espíritu Santo, Fiji, Bougainville, New Caledonia, and Guadalcanal Islands. The South Pacific General Depot at Nouméa, New Caledonia,

1(1) Daboll, Warren W.: The Medical Department: Medical Service in the Asiatic Theater. United States Army in World War II. The Technical Services. [In preparation.] (2) Annual Report, 101st Medical Regiment, South Pacific Area, 1942. (3) Whitehill, Buell B.: Administrative History of Medical Activities in the Middle Pacific. [Official record.]


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FIGURE 109.-A. Individual jungle kit used in the Pacific areas. B. Another version of the jungle kit.


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MAP 34.-Medical supply points, Bougainville and the South Pacific Area, 1943-44.

was organized in August 1943 and was operated jointly by the base platoon of the 11th Medical Depot Company and a section of the 17th Medical Depot Company. This depot held a 30-day reserve supply for the entire theater (map 34).

By December 1943, approximately 128,000 square feet of warehouse space was available in all depots of the South Pacific. There was also 26,000 square feet of storage under canvas (fig. 110). The prefabricated wooden warehouses of New Zealand were easily erected, but of the six warehouses constructed, only two had concrete floors. Only a limited amount of materials-handling equipment and only a few forklifts and trucks were available.

The lack of floors created an additional problem, the securing of dunnage. Approximately 35,000 square feet of dunnage was constructed from scrap lumber at the South Pacific General Depot. The necessary power equipment needed to convert boxes and crates to dunnage was not always available and had to be obtained in the same "informal" way in which the lumber was secured. Depots in forward areas often used coconut tree logs, crushed coral, and ships' dunnage for flooring.

Prefabricated warehouses were not used on Guadalcanal. The limited stock available was being held for shipment to more forward areas as combat


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FIGURE 110.-Storage of medical supplies under canvas, 68th Medical Depot Company, Guadalcanal.

continued to move north and west. Outside storage was, at its best, a poor substitute. Originally, supply of tarpaulins was very short, and many supplies were lost in open storage in forward areas due to lack of covering. By the end of 1943, this condition had been corrected, and all storage was under some type of covering (fig. 111).

Protection of alcohol, narcotics, and precious metals, although not completely adequate, presented no insurmountable problems. Generally, "strong rooms" in the area consisted of wire mesh enclosures. The shortage of lumber, cement, and other building materials prevented construction of more adequate protective storage areas in most depots. In the Guadalcanal Depot, it was necessary at times to place alcohol in outside storage. When this became necessary, armed guards were posted. Major loss of these supplies was never a serious problem, probably because all personnel were so actively engaged in the support of combat, coupled with the fact that no civilian market existed for its disposal.2

2This section is based on a manuscript covering medical supply in the South Pacific prepared for a preliminary draft of this volume by Col. Joseph C. Thompson MSC.


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FIGURE 111.-Native-type warehouses, constructed under the direction of the Corps of Engineers, provided more protection than did canvas.

Automatic Supply Discontinued

The discontinuance of the automatic supply of medical maintenance units was followed by direct requisitioning in January 1944. Better stock control, curtailment of overages and shortages, and a system of stock reporting followed.

Requisitioning of supplies was closely coordinated by Headquarters, USASOS (United States Army Services of Supply), South Pacific Area. The current status of a requisition could easily be determined because of the use of an information copy furnished the base concerned.

Late in 1944, it was required that stock level reports be filed at 10-day intervals. This gave the theater medical supply officer a system of central stock control. Lack of personnel in the depots and the headquarters as well somewhat handicapped this system. By May 1945, the theater reverted to a decentralized system.

Levels of Supply

With the discontinuance of the medical maintenance unit shipments, supply levels had to be reset. A 150 days' supply was to be on hand in depot stock, and 30 days of reserve stock in the form of medical maintenance units was to be held by the South Pacific General Depot. This plan gave the theater a total requisition objective of 300 days.


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Reorganization of Supply Units

Early in 1944, following recommendation of the War Department, the base platoon of the 11th Medical Supply Depot and Section 1, Advance Depot Platoon, 17th Medical Supply Depot, along with its optical repair section, were reorganized into the 67th Medical Depot Company. The depot units on Guadalcanal and the other island areas were also reorganized, leaving the base platoon of the 68th Medical Depot Company on Guadalcanal, the Storage and Issue Platoon of the 68th on Espíritu Santo, and sections of the 75th and 56th Medical Depot Companies on Bougainville and Fiji, respectively. The medical supply situation at the smaller stations on New Georgia and the Russells was handled by small detachments of one officer and four to eight enlisted men while the medical supply officers of individual base hospitals at Auckland, New Zealand, Aitutaki, and Efate handled all local supply problems (map 34).

On 15 June 1944, the islands in the Solomon group, north of the Russells, were designated as part of the Southwest Pacific Area, and on 1 August 1944, Headquarters, USAFISPA, became the South Pacific Base Command.

This reorganization did not change the logistical mission of the command. The three points of discharge, New Caledonia, Espíritu Santo, and Guadalcanal, remained the same. All requisitions for the other island bases were filled from stocks within the area, and supplies not available in the base command were extracted to the San Francisco Port of Embarkation.

By the last quarter of the year, the planning for the redeployment of the troops of the area became paramount. Reduction in strength at bases and the closing of some bases required constant coordination for the supply of these units. The area had reached its peak in the last quarter of 1943 and the first half of 1944. Diversity of climate and distance between islands were still factors to be considered in supply. Only after the withdrawal of the larger organizations, followed by some of the hospitals, and the closing of some islands in the eastern part of the area, did this situation become less complex.

Refrigeration.-Refrigeration in general was lacking in the early days of the South Pacific Area. By the end of 1943, walk-in-type refrigerators were available and utilized at all depots. The original refrigerator authorized to medical supply depots by the TOE's (tables of organization and equipment) was inadequate, but in emergencies, proved valuable for short periods of time until the walk-in type could be obtained and erected.

Rehabilitation.-Many combat divisions, when relieved from actual combat, were rehabilitated in New Zealand and other bases in the theater. In order not to affect the level of supply at these bases, modified medical maintenance units were assembled and shipped to these divisions by the medical section of the South Pacific General Depot when necessary.

From time to time, modified medical maintenance units were assembled at the various depots where they were segregated, marked, and designated for


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task forces to be mounted-out at that base. These units were turned over to the task force at the time of embarkation.

End of combat.-Early in 1944, the military situation in the South Pacific Area had well passed its climax. Guadalcanal, New Georgia, and many other islands were names indelibly written in history. Passage of time had created a complete change in the picture for the entire South Pacific Area, from a combat area to an area whose mission was that of logistical support.

NEW GUINEA CAMPAIGNS

While Marine and Army units were driving the Japanese from Guadalcanal, American and Australian forces were involved in a long hard struggle to eliminate the possible threat to Australia from New Guinea.

Depot Operations

Through most of 1943, the entire load of medical depot operations for the SWPA (Southwest Pacific Area) was carried by the 9th and the 3d Medical Supply Depots (map 29). To maintain a supporting position, by 1943, these units were spread along the eastern coast of Australia and New Guinea. Parent units split off platoons; platoons sliced off sections; and even sections divided into still smaller detachments. Personnel was augmented, organization and equipment modified, until all resemblance to a table of organization vanished. This fragmentation was necessitated by the number of locations and movements and the fact thatthe existing TOE for medical supply depots was totally unsuited for operation under the conditions existing in New Guinea and Australia.

Port Moresby Depot-To say that storage facilities in the Southwest Pacific Area were inadequate would be a gross understatement. The best understanding of conditions as they existed in Australia and New Guinea came from Lt. Col. Stephen G. Asbill, VC, 9th Medical Depot commander. "Storage facilities in Brisbane, Australia," he wrote, "were much better than in New Guinea, but still were far from ideal. By early 1944, the depot was operating from 12 widely separated storage facilities, one 60 miles from Brisbane. These varied from a basement of a church to college buildings. Very few were real warehouses able to support heavy loads; none were modern fireproof buildings. It was not possible to use materials handling equipment (even if it had been available)."

Storage facilities at Port Moresby were practically nonexistent in January 1943, and there was little improvement for the next 8 months. The medical depot occupied several small buildings on Ela Beach, the principal dock area, approximately 1 mile from the downtown headquarters. Two of these buildings were used for storage and loose-issue operations. Although there were no space, tonnage, and occupancy reports at this time, it was roughly estimated that the total gross space was no more than 4,000 square feet, with approximately 80 tons of medical supplies on hand. When the tonnage on hand exceeded the stor-


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age capacity, it was stored in the open and usually covered at night with tarpaulins. A locator system was not used because of the limited and crowded space. Stock selection under such conditions was not too efficient or systematic.

Security storage in New Guinea was improvised. A small detached building of not more than 200 square feet was used for storage of ethyl alcohol, original cases of whisky, original packages of narcotics, and other security-type items. Opened containers of these items were stored in an old Army field safe. Although security was thus minimal, little difficulty was encountered in handling these items. Refrigerated storage consisted of three or four kerosene-operated refrigerators of the regular household type.

The receiving operations were always accomplished in an open area. If the shipment was small, there was no problem. It could be quickly documented and placed in storage. Larger shipments, if delivered from dockside at a rate which would permit tally-in as received, had to be stored in the open until the same receiving crew could segregate items and remove them to more adequate storage. There were numerous occasions, after shipments began to arrive directly from the United States, where there was no control over rate of arrival of trucks from dockside. At times, it was necessary to split a handful of men into two crews so supplies could be received at night as well as in the daytime. Under such circumstances, because of the shortage of personnel and lack of adequate facilities, supplies were merely off-loaded and stacked in an effort to contain the entire shipment within available space, with no attempt at identification.

As the total tonnage increased, it was imperative that additional storage space be obtained. Through efforts of the command surgeon, three former Australian troop barracks, located approximately 3 miles from the main operation, were allocated for medical supply. Each was 20 by 100 feet with a center walkway approximately 24 inches lower than the main floor running the length of the building. Depot personnel immediately modified these structures so that the entire floor would be at one level. To provide additional relief for the storage problem, three hospital ward tents were erected in the same area and used for about 2 months.

After about 9 months of improvising in every conceivable manner, a suitable central location for the depot was selected and approved. This required site preparation by Engineer units and then the construction of prefabricated buildings. The construction was accomplished by depot personnel assisted by personnel from a nearby medical facility which was not operating at full capacity at the time.

Brisbane Depot-From 1 January to 31 October 1943, the Brisbane Depot (fig. 112) received 4,511 tons of medical supplies and shipped 3,723 tons. Although the tonnage was relatively small, it required a large number of men for handling since no equipment, such as forklifts, tractors, warehouse mules, or pallets, was available. All boxes were manhandled from the time they were unloaded at the dockside until they were loaded back on board ship, including stacking to heights of 15 to 20 feet when the ceiling would permit and the floor-


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FIGURE 112.-Interior view of the 3d Medical Supply Depot, Brisbane, Australia.

load would allow. This organization worked 24 hours a day when ships were unloading medical supplies, which was about 50 percent of the time. The officers unloaded and manhandled boxes just the same as enlisted men and were authorized just as many sets of fatigues. In addition to the standard medical supply responsibility, the Brisbane Depot organization handled laundry exchange for hospital ships that put into the port, hospital trains operating along the coast of Australia, and hospitals located in the Brisbane area. The unit also handled local purchasing of medical supplies, surgical instruments, and dental instruments, procuring approximately $15,000 per month during the first 6 months.

Deployment of Supply Units

Having spent a brief trial period at Milne Bay and Oro Bay, New Guinea, in late 1942 and early 1943 (map 29), the 3d Medical Depot Company realized the urgent need for additional personnel.

In addition to accomplishing the supply mission, the depot personnel at Oro Bay were assigned small arms security for 400 yards of the beach area adjacent to the depot. Several more men were sent from Port Moresby to Oro Bay and one or two to Milne Bay. This action, together with normal losses, reduced the Port Moresby force to a low of 23 men at one time.


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MAP 35.-Medical supply depots in Australia, 1943.

With the increase in combat activity in the spring of 1943, the volume of incoming supplies began to increase and additional units were arriving and increasing the population to be supported. The problem was presented to the base surgeon who was successful after a few weeks in getting enough men assigned to bring the strength back up to 32 men. Because of the situation which prevailed, little thought was given to TOE authorizations. The major consideration was the problem of obtaining the number of personnel and equipment required to support the assigned mission. This was the situation for 9 months, after which the Port Moresby remnant of the original platoon was replaced by another platoon from the parent unit in Australia. A few weeks later, the detachment divided between Milne Bay and Oro Bay was also relieved, and all returned to Australia for recuperation and reassignment to the parent organization.

Augmentation of supply units.-Before the departure of the 1st Storage and Issue Platoon for Port Moresby, plans were taking shape for assignment of the entire depot. The headquarters and base section remained at Brisbane, Australia; one storage and issue platoon was sent to Townsville and one to Rockhampton. Detachments were located in Toowoomba, Cairns, Charters Towers, and Darwin (map 35). With the three locations in New Guinea, a depot organized to operate in four locations was now operating in 10 widely


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scattered areas. Authorized personnel and equipment could not begin to cope with the situation. Consequently, additional personnel were assigned as required, when available, without regard to TOE authorization. On the Australian mainland, military personnel were augmented by civilians recruited under a joint agreement and administered under a system somewhat similar to Civil Service procedure, but much less complex.

This situation was particularly true at Brisbane where, at the peak period, approximately 35 Australian civilians were assisting the headquarters and base section in all sorts of jobs, such as stenographers, clerks, stock selectors, warehousemen, and ordinary laborers. Practically all of the work of posting to the stock record account and maintaining voucher files was performed by Australian girls. In the islands between Australia and the Philippines, any indigenous personnel recruited were strictly laborers. Native potential as a labor force, however, was very limited because the average native of islands like New Guinea and Biak was small of stature, undernourished, either diseased or weakened from disease, and unaccustomed to sustained periods of manual labor. Their habits and living conditions were strictly primitive.

Depot equipment.-Equipment was obtained by each separate unit or detachment on an issue or loan basis, depending on its assigned mission and justified by the type and volume of work to be done. Each platoon, detachment, or task group operated almost entirely independently from the parent unit in this respect since each was supporting different areas separated by a distance of 50 to 1,000 miles or more.

Two small powersaws were obtained in the United States. One, retained by the base section, was very valuable as it enabled assigned personnel to make full use of all salvageable lumber to construct crates, boxes, and shelving, to fabricate items for various uses in offices, and to improve living conditions in the field-type bivouac area. The other powersaw was taken to Port Moresby by the 1st Platoon of the 3d Medical Depot and was put to a similar use. It was not possible to keep the existence of such a piece of equipment a secret, and as soon as other units learned of it, there were numerous requests for a loan. Within a few months, it was worn out and there was no replacement parts.

In the later phases of the operations in Australia, when the base headquarters staff finally had time to require a review of status of equipment in units, the medical depot was authorized to retain many items of equipment not on its TOE and twice the quantity of many authorized items. This was based on a justification, and recognized by the staff, that the depot was operating 100 percent in excess of the mission as contemplated by the TOE. After equipment became available in the theater, most of the things which were necessary for the assigned mission were obtained, but there was an initial period when operations suffered for lack of this equipment, special tools, and power tools. Also, there was practically nothing authorized for operation of a maintenance shop.3

3(1) Quarterly Reports, 9th Medical Supply Depot, Southwest Pacific Area, 1943. (2) Quarterly Reports, 3d Medical Supply Depot, Southwest Pacific Area, 1943. (3) Personal recollections of Lt. Col. Stephen G. Asbill, VC, Commanding Officer, 3d Medical Depot Company.


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Obtaining Supplies From the United States

Initially, all maintenance supply (class I) from the United States was on an automatic basis by means of medical maintenance units. Classes II and IV medical supplies were obtained by requisition based on TBA (table of basic allowances) shortages for class II and 180 days' level for class IV. In addition, theater levels of certain critical items which were frozen for use only, as the name implied, were shipped on an automatic basis from the United States as the Final Medical Reserve. Automatic shipments of medical maintenance units were discontinued in late 1943 and those of Final Medical Reserve units in early 1944. Stocks of the latter were absorbed into ordinary theater stocks. It must be realized that a comprehensive central stock record system was maintained to compute theater requirements and prepare requisitions. This necessitated monthly postings based on inventory reports received from all depots, due-in records, maintenance factor cards for each item, troop strength projected at least 6 months in advance, and TBA consolidated shortages. These centralized stock control records were, of course, also useful for balancing stocks within the theater and for extracting.

This central stock control system was difficult, time consuming, and an onerous task using "hand" methods. Electric accounting machines for the Supply Division would have been welcomed.4

An extremely important facet of computation of requirements was the problem of adjusting replacement or maintenance factors. No resupply system can be any more efficient or accurate than its maintenance factors. At the beginning of the war, maintenance factors were inadequate and inaccurate for use in the SWPA. Many examples of gross inadequacies were detected. Certainly, one of the most vital functions was the continuing readjustment of maintenance factors based on actual consumption.

On the whole, the Zone of Interior did a good job in getting medical supplies to SWPA. There were a few items which plagued the theater from the beginning to the end of the war. Among the most troublesome and frustrating shortages throughout the entire war were Atabrine (quinacrine hydrochloride), foot powder, litters, penicillin, some dental items, especially burrs and handpieces, and spare parts of all types.

The "battle" to keep Atabrine levels up to theater requirements was a bitterly contested one. It was a hand-to-mouth-type existence. Shortages were always threatening, but, somehow or other, help always arrived at the last moment. This was not entirely due to failure of the United States to send Atabrine in sufficient quantities. Theater shipping, unloading, and distribution inadequacies caused some of the trouble, as did stowage in ships. It was not unusual for 50 ships to be backlogged in a New Guinea port. It was almost certain that there was Atabrine on many of these ships. Because of the backlog

4(1) Essential Technical Medical Data, U.S. Army Services of Supply, Southwest Pacific Area, for March 1944, dated 1 Apr. 1944. (2) Preliminary draft of Medical Supply History, Services of Supply, Southwest Pacific, by Col. Alfonso M. Libasci, MC.


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and because Atabrine was stowed far down in cargo hatches, it was not possible to get to it. In this situation, an emergency air shipment from the United States was necessary to prevent a serious shortage. Another paradox was that the Australians always had enough Atabrine and, on many occasions when called on, would lend us all we needed. They obtained it on lend-lease from the United States!

Foot powder, although the allowance per 1,000 men per month was steadily increased from 75 cans at the beginning of the war to 1,000 cans near the end of hostilities, was never available in the quantities needed. Shortage of this item seemed to cause more concern and more complaints than any other in the entire theater. Letters, radiograms, and reports of visitors and inspectors were replete with concern over foot powder. In the Tropics, the constant moisture caused the skin of the feet to be extremely susceptible to fungus infection. Adequate use of foot powder greatly reduced this most uncomfortable and often disabling condition.

Litters were in short supply in the later stages of the war. The losses from bases and from the theater were very high due to faulty property exchange.5

Distribution Within the Theater

As stocks gradually were built up in the theater, standard catalogs were distributed and replenishment issues of any item became available. Units were instructed to use maintenance factors and TBA's as a basis for requirements. Requisitioning was on a monthly basis. Depot stocks were balanced by intratheater movement of stocks at first, later by direct shipments from the United States to the designated port depots.

All control of depot stocks was centrally vested in the office of the Chief, Supply Division, Surgeon's Office, USASOS, where the central stock records were kept. Routine requisitions were cleared at base section level. Items in excess of TBA's or controlled items required the approval of the Chief, Supply Division.

This was a system based on standard supply practices of industry and the military. There was a minimum of wasted efforts, centralization was tight only where needed, and no undue obstacles were interposed between consumer and supplier.

During 1943, two ships had been converted in the theater for use as intratheater hospital ships. These ships, the Tasman and the Maetsuycker (fig. 113), were equipped and staffed with supplies and personnel available within the theater. Their mission was to make scheduled evacuation runs from the New Guinea ports to the Australian base ports. On their return trips, they would carry medical supplies and units or personnel from Australia. They were extremely useful because of their regular schedule. The cargo space was con-

5(1) Annual Report, Chief Surgeon, U.S. Army Services of Supply, Southwest Pacific Area, 1944. (2) Check Sheet, G-4, Headquarters, U.S. Army Services of Supply, to Chief Surgeon, 8 Mar. 1945, subject: Joint Supply Survey Board Report of Inspection. (3) Letter, Col. Charles M. Downs, MC, Surgeon, X Corps, to The Surgeon General, 12 Dec. 1944, subject: Shortage of Foot Powder.


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FIGURE 113.-Hospital ship Maetsuycker was taken over from the Dutch and used as an intratheater hospital ship.

siderable-about 1,100 ship tons for both ships-enough for over 30 days' medical maintenance for 40,000 men. During the first 3 months of its operation, the Tasman alone carried 2,500 ship tons of medical supplies to New Guinea.6

Special Methods for Automatic Supply

Medical supply officers in advance bases on New Guinea, plagued by heat, humidity, lack of equipment, enemy nuisance raids, and impossible roads, had concluded that a system had to be devised that would more efficiently supply advanced bases. Paperwork needed to be reduced, trained personnel were needed desperately, and overages and shortages had to be eliminated (fig. 114).

Automatic shipment of supplies was not the answer. Shipment on a requisitioning basis would eliminate overages and shortages, but this would put a load on personnel in the forward bases by asking them to compute requirements.

An effective, yet simple, method of automatic supply to forward areas, based on actual consumption, was developed. Under this system, the requisitioning depot entered on the "Inventory Report" form the amount on hand,

6(1) See footnotes 4, p. 443; and 5(1), p. 444. (2) Historical Report, 4th Quarter, 1943, Hospital Ship Tasman and 2d Portable Surgical Hospital.


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FIGURE 114.-A. Medical supplies at Oro Bay, New Guinea, deteriorated when stored in buildings having leaky roofs, dirt floors, and inadequate storage space. B. Uncovered medical supplies at a depot in Oro Bay, New Guinea, exposed to the elements, rotted for lack of protection.


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and the issuing depot completed the form indicating supplies known to be en route but not received, authorized and estimated requirements, and action taken.

After the computation and completion of the report, it was forwarded to the appropriate depot for filing. The system worked well as it was simple, reduced paperwork and the need for trained personnel in the forward bases, furnished supplies at a rate approximating actual consumption, thus eliminating imbalances which occurred with a strictly automatic method, and provided a periodic stock status report from forward bases.7

Planning Operation DEXTERITY

At the same time that the Japanese were being driven from the Solomons, the Sixth U.S. Army was establishing its headquarters at Cape Sudest, New Guinea. Plans were made there for Operation DEXTERITY which involved attacks on Arawe on 15 December 1943, on Cape Gloucester, New Britain, on 26 December 1943, and on Saidor on 2 January 1944. DEXTERITY was the first operation under Sixth U.S. Army control.8

While initial medical supply for these operations consisted of those supplies carried in by the units involved, resupply for the Arawe operation came from the 15th Medical Supply Platoon (Aviation) and a platoon of the 9th Medical Supply Depot while, on 30 January 1944, the 21st Medical Supply Platoon (Aviation) landed at Cape Gloucester with two medical maintenance units, each designed to provide medical support to 5,000 troops for 30 days. This was the first time that a medical supply platoon (aviation) was used in operational support, and this action proved so successful that it became a frequent procedure in later operations.

Shortly after the task force arrived in the objective area, Headquarters, Alamo Force, received an urgent request from the Arawe surgeon for sufficient supplies and equipment to reestablish an operating room. The single operating room setup on Arawe had received a direct hit, virtually destroying all material. With the aid of medical officers, the essential items were ascertained and assembled, and within 18 hours after receipt of the message from the Arawe surgeon, the supplies and equipment had been delivered.

To accomplish this swift delivery, the material was airlifted from Cape Sudest to Finschhafen, moved to Dreger Harbor by jeep, with the final lap to the beachhead at Arawe by PT boat. Thus, the pattern was set. The many medical supply emergencies that were to follow would be met in a similar unorthodox fashion by close coordination of land, sea, and air transportation.

7Quarterly Reports, Surgeon, U.S. Advanced Base, 1. Oct. 1942 to 31 Mar. 1943.
8(1) Quarterly Reports, Surgeon, Sixth U.S. Army, 20 Jan.-30 June 1943. (2) Quarterly Reports, Surgeon, Sixth U.S. Army, 1944. (3) Manuscript covering medical supply activities of the Sixth and Eighth U.S. Armies in the Southwest Pacific, prepared for a preliminary draft of this volume by Lt. Col. John M. Hunt, MSC, and Col. Albert E. Minns, Jr., MSC. (4) For further details, see footnote 1 (1), p. 432.


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Meanwhile, the 27th Medical Supply Platoon (Aviation) had moved from Milne Bay to Cape Cretin where it staged for the Saidor operation, and then had moved to Saidor on 6 January where it operated a medical supply depot until 20 March.

Medical Supply for the Hollandia-Aitape Operation

Planning for the assault on Hollandia and Aitape accelerated in April 1944. The operation, which was spearheaded by two task forces, "Reckless" and "Persecution," began on 22 April with simultaneous assaults. The 163d Regimental Combat Team struck at Aitape, 125 miles southeast of Hollandia, while the 24th and 41st Infantry Divisions landed at Hollandia and marched immediately to the airfields near Lake Sentani. Each division carried 30 days' medical supplies and was backed up by the 21st Medical Supply Platoon which had staged at Oro Bay and Finschhafen since February (map 36).9

In addition to being the first full-scale operation in the Southwest Pacific Area, the Hollandia operation also provided the first real logistical nightmare despite the fact that enemy resistance at Hollandia was much less than anticipated. To provide dispersion, two beaches were selected, one on Tanahmerah Bay and one on Humboldt Bay. Although available maps indicated that both would provide suitable areas for dumps, Tanahmerah Bay soon presented many serious problems. Offshore coral reefs prevented the LST's (landing ships, tank) from discharging as planned. The area behind the beach, moreover, was swampy, and there was no connecting road between the beach and the main supply route which led to Lake Sentani and the airfields. As a consequence, an order was issued to divert those supplies destined for this beach to the Humboldt Bay area, which by this time was stacked with supplies of all technical services. To add to the confusion, a lone Japanese bomber, on the night of D+1, bombed a former Japanese ammunition dump on White Beach. The explosion started a fire at the gasoline dump which burned for 2 days, causing extensive damage and jeopardizing the surrounding area.

Fires on the beach resolved the problem of segregating the mixture of supplies, which in itself had caused shortages of some items very early in the operation. More seriously, however, with more troops arriving continually, the fire created a situation in all types of supply from which the base was several weeks in recovering. This was the first base at which 62- and 112-foot supply vessels were utilized by the supporting base surgeon, Lt. Col. (later Col.) Everett G. King, MC. They proved to be invaluable, being utilized in the delivery of medical supplies to forward bases, such as Hollandia, and in procuring items from rear bases as well as movement of patients to and from ships. Meanwhile, supply support at Hollandia was further complicated by heavy rains and landslides that made existing roads useless and entire areas impassable to troops carrying medical supplies on litters. To compensate for the han-

9(1) See footnotes 5(1), p. 444; and 8(2), p. 447. (2) Quarterly Reports, 32d Infantry Division, 2d, 3d, and 4th quarters, 1944.


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MAP 36.-Medical supply support for the New Guinea operations, 1944.


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dicaps, approximately 50 tons of medical supplies and equipment were airlifted into the operational area. This, plus the supplies brought in by the reserve units, promoted a gradual buildup. By the latter part of June 1944, sufficient supplies were positioned to meet most demands.

The 127th Regimental Combat Team of the 32d Infantry Division, which arrived at Aitape on D+1, received its medical supplies through the chain of evacuation. The supplies forwarded overland were carried inland from the end of the ambulance trail by returning litter bearers or native carriers. Other medical supplies were airdropped with the rations, with a good percentage of recovery. On 1 August, when parachutes were supplied, the airdropping and recovery of litters and glass-contained medical supplies became perfect, the parachutes cutting the drop sufficiently to avoid all breaking, as well as furnishing a visible distinguishing marker. Critical items were foot powder and typhus vaccine.

Movement Toward the Philippines

In mid-May 1944, a reinforced regimental combat team, setting forth from Hollandia, captured Toem and nearby Wakde Island with supply support provided by the Hollandia Depot. At the end of May, the 41st Infantry Division embarked from Hollandia for an attack on Biak with medical supply support coming from a platoon of the 27th Medical Depot Company, and with resupply coming from the depot at Finschhafen being operated by the base platoon of the 29th Medical Depot Company, and from Hollandia where the Storage and Issue Platoon of the 29th had relieved the 21st Medical Supply Platoon which had begun staging for the Leyte operation (fig. 115).

By mid-September, Noemfoor Island, midway between Biak and the western end of New Guinea, bases on Vogelkop Peninsula which fell in late August, and Morotai which fell without major enemy resistance had been cleared of enemy forces, thus setting the stage for further operations in the Philippines (fig. 116).

SOUTHWEST PACIFIC AREA

Early Supply Activities of the Sixth U.S. Army in Australia

The Sixth U.S. Army, under command of Lt. Gen. (later Gen.) Walter Krueger, arrived at Camp Columbia, near Brisbane, on 17 April 1943. Intensive training for amphibious and jungle warfare followed, accompanied by a mounting incidence of malaria and a growing shortage of Atabrine.

From 17 April to June 1943, a Sixth U.S. Army medical supply subsection, which consisted of one warrant officer and two enlisted men, was engaged in planning for the support of the Kiriwina and Woodlark Islands operations (Alamo Force) which were to be mounted from Milne Bay. Concurrently with inspections and training activities, the first requisition for medical supplies was submitted to USASOS to support the operation. Shortly thereafter, the


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FIGURE 115.-Local issue office of the 29th Medical Depot Company, Base F, Finschhafen, New Guinea.

plans were changed, as were most plans, to stage and mount the task force from Townsville, and it was necessary to submit another requisition for the troops in that area.

Combat Supply Lines Begin to Stretch

From June through early September 1943, combined Australian and American forces executed a plan that was to regain that area of New Guinea situated between Buna and Finschhafen. The U.S. Army Services of Supply provided logistical support to the Army and the Navy with 30 to 90 days of stocks placed at intermediate and advance bases. In addition to the support of the Alamo Force, which was first designed to conduct operations in Woodlark, Kiriwina, and New Britain under control of General Headquarters, SWPA, and separate from forces operating in New Guinea, the Sixth U.S. Army was also responsible for the support of the 503d Parachute Infantry Regiment which operated directly under General of the Army Douglas MacArthur.


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FIGURE 116.-Conveyor system for bringing supplies ashore on Morotai Island, September 1944.

On 14 June 1943, the forward echelon of the Sixth U.S. Army, then operating as the Alamo Force, moved to Milne Bay, from which Operation CHRONICLE, involving the Kiriwina and Woodlark Islands, was launched on 30 June (map 37). Medical supply support for Kiriwina was assigned to a detachment of the 9th Medical Supply Depot while the medical supply officer of the 52d Evacuation Hospital was responsible for medical supply on Woodlark. Although both operations were unopposed, participating personnel figuratively and literally got their feet wet by way of introduction to the peculiarities and problems of actual amphibious landings and operations on the Pacific islands. Steady torrential rains made it difficult to locate, establish, and maintain operational supply points, or to preserve supplies and equipment. Also, receipt and control of shipments without the necessary documentation became more difficult as supply lines lengthened and transportation shortages were added to administrative delays. Unorthodox methods were the rule in overcoming medical supply deficiencies.

Logistical problems were constant companions as the Alamo Force went on to develop Milne and Oro Bays. During the early phases of these combat


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MAP 37.-Medical supply support for Operation CHRONICLE.

operations, some delays in acquiring supplies were rooted in the administrative procedures. As an example, supplies requisitioned by the Sixth U.S. Army with a request that they be earmarked for Army use in a specific operation were receipted for and placed in base depots. Units, for which the supplies were intended, were required to submit formal requisitions through the base surgeon for editing and approval before supply action. In view of the usual urgency circumscribing each operation, this added step was frustrating to the medical units assigned to combat forces.

On 15 August 1943, Services of Supply assumed responsibility for the buildup of Milne and Oro Bays from the Alamo Force which moved to Goodenough Island. At about this same time, the Surgeon, Sixth U.S. Army, began augmenting both echelons of his supply staff as the first requisitioned medical units began to arrive from the Zone of Interior. Warrant Officer (later Lt.) Leslie C. Scott, MAC, who had been serving as medical supply officer from the date of Sixth U.S. Army activation, was provided an assistant, Lt. (later Capt.) Irwin Lee, MAC, who was assigned as the rear echelon liaison officer. This arrangement ended abruptly on 8 December 1943 when Lieutenant Scott succumbed to a heart attack, and Lieutenant Lee was quickly detailed to the Alamo Force as his replacement. A permanent replacement for Lieutenant Lee was not forthcoming until June when Lt. (later Maj.) John M. Hunt, Jr.,


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MSC, was ordered in to assist the stepped-up planning for the invasion of the Philippines.10

Eighth U.S. Army Supply Activities

Headquarters, Eighth U.S. Army, was established at Lake Sentani in September 1944. Col. John F. Bohlender, MC, Surgeon of the Advance Party, Headquarters, Eighth U.S. Army, was succeeded by Col. (later Brig. Gen.) George W. Rice, MC, who had been in the Pacific ever since the early days of the war.

Because the Eighth U.S. Army was scheduled to operate in the wake of the Sixth U.S. Army in a mopping-up role, Colonel Rice directed his medical supply officer, Maj. (later Lt. Col.) Albert E. Minns, Jr., MAC, to make immediate contact with the Sixth U.S. Army medical supply officers to gain the advantage of their experience, become acquainted with their modus operandi and the status of medical supplies, and to assure that a cooperative spirit prevailed from the beginning. The first meeting with the medical supply personnel of Sixth U.S. Army headquarters resulted in the establishment of the very finest of working relationships which was to last throughout the war.

The Medical Supply Division, Eighth U.S. Army, consisted of two officers, one warrant officer, and three enlisted men. Normal methods of obtaining supplies, when a unit was preparing for an operation, were usually sufficient, but there were always urgent appeals for items that had been lost in shipment, destroyed by enemy action, broken in normal usage, or forgotten in the preparation to move out. Movements of this kind were followed by immediate resupply action.

Colonel Rice, before being designated Surgeon, Eighth U.S. Army, was adviser on medical matters in the G-4 section of General Headquarters. He was thus familiar with the peculiarities and problems of logistics. He had seen at firsthand how fast action could reduce or, in some instances, eliminate suffering and, in general, was acquainted with the medical supply situation. He knew that emergencies would arise and expected his supply personnel to go to almost any extreme to deal with them. This was both medical supply policy and standing operating procedure for the Eighth U.S. Army.

In practice, when a radio request for medical supplies was received by the Medical Section, Eighth U.S. Army headquarters, one of the two officers or the warrant officer would be contacted regardless of the time of day or night. The procedure from that point was to go to the nearest medical depot, pick up the requested items immediately, tuck them under the arm of one of the supply personnel, who would hitchhike by air to the nearest airstrip, then solicit rides by vehicle or small craft to the final destination, and personally deliver the items requisitioned. The courier usually would have delivered the material within a few hours and returned to home base by the means used in making the delivery.

10See footnote 8 (1), p. 447.


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Trips to supply points were often dangerous. Sometimes, the planes were not able to land either because of enemy action or because of excessive mud. On some runs, due to the exigency of the need for the item being delivered, the pilot would make a pass over the unit and the items would be dropped in the unit's front yard. Official statistics do not show the tremendous amounts moved forward in that manner.11

CHANGES IN THEATER SUPPLY PROCEDURES

Distribution Functions

In early 1944, a major change took place in supply procedure in Services of Supply whereby all distribution functions of all services were lumped together into two operating field agencies known as Distribution Division, Headquarters, USASOS, at Sydney, under command of Lt. Col. John D. Blair, MC, and the Distribution Division, Branch A, at Milne Bay, with Capt. Leonard H. Kolb, MC, in command. In each of these, a medical section was assigned under the supervision of well-qualified medical supply officers. As for the medical supply division, this change was a crippling one, resulting in near disaster. The establishment of the new system definitely hindered and played havoc with the medical supply system.

The mission of the Distribution Division was to establish schedules to assure the movement of supplies and equipment from the United States and from Australia to New Guinea in accordance with requirements, effect distribution of supplies and equipment to maintain prescribed theater levels and balanced stocks for the theater as a whole, control receipts and shipments to assure proper distribution between Australia and New Guinea and between base sections in Australia, requisition on the United States or Director of Procurement for supplies and equipment to maintain prescribed theater levels, and prepare status of supply reports required by the Commanding General, USASOS.

Distribution Branch A had a mission to establish schedules to assure movements of supplies and equipment between bases forward of the Australian mainland in accordance with requirements; to effect distribution of supplies and equipment to maintain prescribed levels and balanced stocks in bases forward of the Australian mainland; and to forward requisitions for critical and controlled items to Headquarters, USASOS, and to the Director of Distribution, for all other supplies and equipment to maintain prescribed levels, provided such requisitions were not filled from bases forward of the Australian mainland. The concern for strict uniformity in all services resulted in "hitching racehorses to mules." One of the semiannual medical requisitions was delayed over 2 months lying around or being passed from one to another and then finally returned for complete retyping to furnish extra copies for each

11(1) Quarterly Reports, Eighth U.S. Army, June-December 1944. (2) See footnote 8(3), p. 447. (3) Minns, Albert E., Jr.: Medical Supply, United States Eighth Army: New Guinea to Japan. [Official record.]


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division. This created very serious and almost disastrous shortages later in 1944.

In New Guinea, the situation was even worse. Distribution Branch A at Milne Bay was again merely another echelon, another obstacle in the headquarters maze. Requisitions from units bounced around from subbases, to bases, to Intersection headquarters, to Distribution Branch A, to the Australian mainland to the Distribution Division, and back again through the same tortuous cycle. It was a wonder the consumers ever got anything at all.

U.S. Army Services of Supply General Depot

In late 1944, still another agency was created on top of all the others, the USASOS General Depot, whose mission was to adjust maintenance factors, control theater stock levels, and prepare requisitions on the United States. All the technical services were represented in this agency. There were now two completely independent agencies involved in stock control in the theater, one for intratheater (Distribution Division) and one for control of theater levels and requisitioning from the United States (USASOS General Depot). It was intended that the latter would eventually become a true depot, responsible for the actual physical handling of supplies.

With the creation of these two agencies, the Chief of Medical Supply, USASOS, virtually ceased to have operating functions. All phases of stock control, including control over critical items, were now out of his hands. Even planning for future operations was done by one or the other of the two supply agencies.

The USASOS General Depot, an independent agency, did accomplish one useful purpose. A detailed study was initiated on maintenance factors. By the end of 1944, approximately 700 items had been studied and factors revised with very encouraging results later. Replacement factor studies were placed on a continuing basis to further modify the existing factors as applied to actual consumption in the Southwest Pacific Area.12

NEW GEORGIA CAMPAIGN

Planning the Assault

The initial medical supply plan for the New Georgia operation, scheduled to begin in June 1943, was a joint responsibility of the 43d Infantry Division and the Navy Task Force. The XIV Corps, on Guadalcanal, was charged with the responsibility for furnishing the necessary medical supplies for the operation, but had no part in the planning.

The original plan provided that complete TBA equipment would be on hand, plus such additional non-TBA equipment as was deemed necessary for the operation. Sixty days' medical maintenance supplies were to be available, 30 days' supply to be carried by units, with the remainder in division reserve

12See footnote 5(1), p. 444.


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to be forwarded as soon as practicable. It was also planned that a 60-day level of medical maintenance supplies be maintained. Certain vital supplies, such as sulfonamide drugs, dried blood plasma, intravenous saline, glucose solutions, battle dressings, morphine Syrettes, and other items which were expected to be expended at an abnormally high rate, were to be supplied in amounts 10 times the normal maintenance allowances. Individual jungle kits were to be supplied on the basis of one per officer and medical department soldier and one per four nonmedics. Antimalarial drugs were to be supplied for 60 days and maintained at that level.

The Surgeon, XIV Corps, reported that duplication of requisitions resulted from an attempt to secure medical supplies in excess of anticipated needs. Supplies came not only from Guadalcanal, but some were also sent directly to the 43d Division from the rear. This procedure resulted in last minute confusion because of the all-out effort to fill all reasonable requests for supplies. Supplies were not issued according to actual needs, but on a basis of taking all that could be made available.

Problems of Supply Distribution

Because estimates of cubage and tonnage were made on the basis of days of supplies rather than actual stocks on hand, units arrived on the beaches with more impedimenta than could be accommodated on assigned water transportation. Many supplies were left on the beaches to follow at a later date. The bulk of critically needed items did not accompany troops on their initial move. Only a 10-day medical maintenance supply actually accompanied units instead of the usual 30-day, and these were hopelessly mixed with rations, fuel, and ammunition. Radiographic requests for additional medical supplies took almost 3 days to reach Guadalcanal. Emergency shipments had to be flown to New Georgia.

The division medical supply officer, left at the Russell Islands to service the garrison there and other small garrisons at Wickham, Viru, and Segi, finally came in on his own initiative, but brought with him none of the 75 tons of supplies stored on the Russells. These were finally sent on 5 August 1943. In the meantime, a 30-day medical maintenance allowance had been sent from Guadalcanal. Despite the obvious mishandling of supplies, medical service of the 43d Division was not impaired.

It was learned in this operation that a definite supply level must be established and maintained, but without any excess that might hamper movement. Containers must be properly marked to show quantity and nature of contents and critical items must be separated and left in the hands of medical department personnel. A medical supply dump had to be established under adequate supervision with a central location for reserve supplies. Sufficient personnel to handle supplies properly was also a necessity.13

13See footnote 1(3), p. 432.


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MAP 38.-Medical supply in the New Georgia campaign, 5 September 1943.

Medical Supply Support in the Field

The 17th Field Hospital, which arrived on New Georgia on 4 September 1943, after the island was secured, found that it was short of litters and biologicals and, upon request, received a medical maintenance unit with allowances for 5,000 men for 30 days from Guadalcanal. Until the medical depot was established by an advance section of the 23d Medical Depot on 8 September, the 17th Field Hospital served as the storage and distribution point for corps medical supplies (map 38). These supplies, consisting of biologicals, litters, antimalarial drugs, and various insecticides, were then transferred to the depot and, along with the 30 days' supply brought by the depot unit, provided the source of supplies for all Army units at the base. When the 37th Infantry Division moved to the rear, they were instructed by the Surgeon, XIV Corps, to turn in all surplus medical supplies and unserviceable equipment to the 23d


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Medical Depot. This obviated the possibility that many supplies might be discarded and scattered. As the units moved out, approximately 30 tons of supplies, many critical items, were turned in.14

ALEUTIAN ISLANDS CAMPAIGN

While the Japanese offensive in the South and Southwest Pacific was being contained in New Guinea and the Solomons, the Japanese, who had moved into the Aleutians15in the summer and fall of 1942 and occupied Kiska and Attu, were posing a threat to the Alaskan mainland.

On 1 April 1943, a joint directive from Commander in Chief, Pacific, and Commanding General, Western Defense Command, ordered the elimination of the Japanese and the occupation of Attu. Directives were issued to organize a joint Army and Navy force, under overall Navy command. The nucleus of the Army component was to be the 7th Infantry Division.

Planning the Assault on Attu

Late in March 1943, Maj. (later Col.) Laurence A. Potter, MC, Commander, 7th Division Medical Battalion, was recalled from a training exercise aboard ship off San Diego, and returned to the home station of the division, Fort Ord, Calif. Upon arrival, he (in private session with the commanding general of the division) was informed that he was to become Surgeon, 7th Infantry Division; that the division would form an independent task force for the recapture of Attu from the Japanese; that he, the surgeon, would go immediately to Headquarters, Fourth U.S. Army, in San Francisco, to plan the medical support, and prepare and submit requisitions to assure that the flow of supplies and equipment to the docks would begin in less than 10 days; that he could take no one from the medical service of the division with him, nor could he discuss with any medical service person in the division the mission or any of its requirements. Neither the medical supply officer, Capt. (later Lt. Col.) Leland H. Barton, MAC, nor his assistant, Capt. Horace D. Worley, MAC, was to be informed in any way of the mission.

Colonel Potter, Surgeon, 7th Infantry Division, acting as his own medical supply officer, proceeded to Headquarters, Fourth U.S. Army, and was briefed further with other division staff officers similarly restricted. After the general briefing, he was briefed separately by the Surgeon, Fourth U.S. Army. With the able assistance of members of the Fourth U.S. Army surgeon's office and in particular of Lt. Col. Bernard N. Riordan, MAC, 175 separate requisitions were prepared and submitted to the San Francisco Medical Depot in 36

14(1) Annual Report, 17th Field Hospital, South Pacific Area, 1943. (2) See footnote 1(3). p. 432.
15This section on medical support in the Aleutian Islands Campaign and on support of the Alaskan Garrison is based on the following documents: (1) Annual Report, Medical Department Activities, 7th Infantry Division, 7 Jan. 1944. (2) McNeil, Gordon H.: History of the Medical Department in Alaska in World War II. [Official record.] (3) Annual Report, Surgeon, Alaska Defense Command, 1942. (4) Annual Reports, Surgeon, Alaska Department, 1943 and 1944. (5) Personal recollections of Lt. Col. Laurence A. Potter, MC, Surgeon, 7th Infantry Division.


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hours. A separate requisition was prepared for each stage of unloading of each ship carrying Army troops and Army cargo. Each attack transport was combat loaded for sequential discharge of a fighting force and its supporting elements, composed of battalion landing teams.

The medical supplies for the 15,000-man task force were divided into two 3-month groups. One group of supplies was carried on two cargo ships, and the other group was carried on the personnel and cargo carriers to supply units as they landed and progressed inland. They were divided into three elements for progressive discharge, 15 days carried by the units going ashore, 15 days for early unloading, and 60 days for late discharge.

The two field hospitals that provided hospitalization for the task force were non-TOE outfits, each short on equipment because there had been no time to supply all needed items before departure. Plans for the proper disposition of supplies and equipment were not discussed in detail until the task force was aboard ship and underway.

Supply Support of the Attu Landings

On 4 May 1943, the invasion force left Cold Bay, landing at two widely separated points on Attu in a dense fog on 11 May after several days' delay because of bad weather. For the entire 21-day period required to secure the island, it was necessary to provide medical supplies separately for each of these two combat elements. The central supply base was with the headquarters section of the organic medical battalion, whose supply officer served both the battalion and the division. All medical supplies received during the 7th Division's 4-month stay on Attu were in the form of medical maintenance units (fig. 117).

Supply Operations on Attu

In the initial stages of the operation on Attu, all equipment and supplies had to be hand-carried inland (map 39). Chests and rucksacks were necessarily left behind, to be brought forward by returning litter bearers as resupply. Much of the equipment, of course, would have been useless in any event, as tents drew enemy fire.

Because of the rugged terrain of Attu, rising sharply out of gluey mud, medical supply of the infantry battalions was extremely difficult and hazardous. Eventually, bulldozers were able to peel tundra down to the volcanic gravel of the island and provide a trail over which heavy trailers and sleds could be pulled for the movement of supplies (fig. 118).

Scheduled medical maintenance units arrived soon after the initial assault and were used to support the 400-bed semipermanent hospital for the garrison and preparations being made for the Kiska operation.


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FIGURE 117.-Supplies piled on the beach at Attu, Aleutian Islands, 20 May 1943.

Medical Supply for the Kiska Assault

While the Attu operation was still in progress, planning began for the invasion of the neighboring island of Kiska. In late April 1943, units of the 7th Infantry Division which had not participated in the Attu operation were joined at Adak with the 13th Canadian Infantry Brigade, the 17th Infantry Regiment, and the 53d Infantry Regiment (Composite) of the Alaska Defense Command.

One of the important features of the training program, both at Fort Ord and later at Adak, was the emphasis given to the lessons learned at Attu. Reports and other material from Attu were made available, and the advice of those who had participated in that battle was eagerly sought.

To provide support for the battalion landing groups, the medical service force of 3,000 men was decentralized and divided to make each landing group medically self-sufficient and self-sustaining. Clearing stations and field hospitals were to be set up initially in the vicinity of the beach, and the initial 3-day supply for all but field hospital units was to be backpacked ashore in rucksacks and on packboards, with additional supplies and organizational equipment combat loaded for early debarkation. Individual medical kits were expanded, with each officer carrying two pouches, in one of which was a unit of dried plasma. A 30-day maintenance supply was combat loaded on each


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MAP 39.-Medical supply support in the Attu campaign, 4 May 1943.

transport ship, and, in addition, a 60-day maintenance supply was loaded on cargo vessels. A medical supply dump was to be established on each beach to handle these supplies (map 40).

It was considered a possibility that isolated units which might not have the services of a medical officer would need emergency medical supplies. To meet such an eventuality, 58 medical parachute packs were prepared, packed in 5-gallon milk cans, and turned over to the Air Forces for delivery when necessary. Each pack contained morphine tartrate Syrettes, heat pads and refills, large and small first aid dressings, gauze bandage, muslin bandage, adhesive plaster, paregoric tablets, pentobarbital sodium capsules, sulfanilamide crystals, and a brief list of instructions.

Operational plans for the assault called for the unloading of all types of supplies for the various branches of the Air Forces as rapidly as possible, in view of the possibility that the ships might suddenly have to leave the island. Large dumps of supplies, indiscriminately mixed, soon piled up on the narrow, muddy beaches. Segregation of organizational equipment had been planned, but the system did not work. It became practically impossible to find much of the necessary equipment for the field hospitals, as all kinds of organizational supplies and equipment had been dumped on the beaches.


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FIGURE 118.-Tractor bogged down in mud at Massacre Bay, Attu, 16 May 1943.

In one instance, it took 2 days to locate certain hospital equipment, which it was then possible to move by Caterpillar tractor only as far as an intervening creek. From that point, it had to be manhandled another 450 or 500 yards and finally hauled up a 50-foot embankment by rope.

The problems of gathering and properly caring for the widely dispersed medical supplies were numerous. A large number of medical maintenance units had been landed at North Beach, Gertrude Cove, and Kiska Harbor in addition to the other beaches. The almost complete lack of transportation had complicated the problem from the beginning, and tons of heavy equipment had to be moved by hand. The establishment of medical supply dumps in the main camp and in the Gertrude Cove area was handicapped by a shortage of lumber and cover, as well as a shortage of trained personnel (map 39). The organizational equipment of the field hospitals and of the Canadian and American medical units had to be retrieved and cared for by the Air Forces medical supply officer. Poorly marked and packed equipment added further complications, along with the large amount of pilfering which occurred. Further, the medical supply dump was moved four times on orders from higher authority before it was permanently located.


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MAP 40.-Medical supply on Kiska.

ALASKAN GARRISON, 1943-44

Problems of Supply Organization

The surgeon of the Alaskan theater, who was responsible for medical supply, was handicapped in his operation because he had to comply with the policies and procedures of three levels of command in addition to his own: the War Department, The Surgeon General, and the Overseas Supply Branch, Seattle Port of Embarkation.16

The necessity to function from one end of the territory of Attu, which is 3,201 air miles from Seattle by way of Fort Richardson, to Annette Island, 702 miles from Seattle, was also a distinct handicap. Despite the central location of Fort Richardson, the distance to the more remote posts was formidable.

This isolation of posts made it sometimes impossible to maintain the required quarterly and weekly reports on medical supply. An inventory of all medical supplies and equipment on hand as of 31 December 1942 was ordered by the theater surgeon in an effort to obtain an up-to-date and accu-

16See footnote 15, p. 459.


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rate picture of the status of supplies in the command, and to provide the supply agencies in the United States with the required and pertinent information.

Supply Procedures

Initial requisitions for equipping a new station hospital were prepared and submitted by the Surgeon, Alaska Defense Command, or by a higher echelon of command which had assumed responsibility for the supply of the initial troop movement. In most instances, the Overseas Supply Branch, Seattle Port of Embarkation, acting on the recommendation of the Surgeon and available information concerning the strength of new stations and the plans for hospitalization, initiated the necessary requisitions for equipment and supplies, including medical maintenance units to provide a sufficient margin of maintenance for isolated Alaskan posts. Beginning in 1943, control over this initial planning passed into the hands of the theater surgeon, who assumed the responsibility for the medical equipment and supplies for the new stations established during that year.

In the early period, the function of the theater surgeon in the maintenance of adequate resupply was limited. By means of the medical maintenance unit, automatic shipment was made by the Seattle Port of Embarkation to each of the stations in Alaska from the summer of 1942 until November 1943. It was then discontinued on the recommendation of the theater surgeon because operating conditions made a requisition system more desirable and possible. The surgeon, however, had stated: "Without this Unit it remains doubtful whether medical supplies would have been on hand at the critical time."

Requisitions submitted for supplies in excess or not supplied by medical maintenance units received a preliminary editing in the surgeon's office and were then forwarded to the Seattle Port of Embarkation for further editing or submitted to The Surgeon General for a final decision. The theater surgeon in editing requisitions followed a policy of limiting special requisitions according to existing conditions.

Levels of Supply

On 4 August 1943, new supply levels were authorized. Group I (for easily accessible stations) was set at 30 days' operating, 60 days' reserve; group II (the majority of Alaskan stations), 30 days' operating, and 180 days' reserve; and group III (icebound), 270 days' operating and 180 days' reserve. Subsequent changes were made in these levels to reduce the prescribed figures as supply procedures became more regular. On 30 December 1944, the following levels for classes II and IV supplies were announced: Nome and Galena (icebound), 300 days; Shemya Island (inadequate harbor facilities), 210 days; and for all other stations, 105 days.


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FIGURE 119.-Arctic first aid kit.

Experimenting With Medical Supplies

The Experimental Board, Alaskan Department, which had been established during 1941 to conduct tests during maneuvers, conducted experiments to determine the appropriate items to be contained in chests and kits needed by small detachments. These kits when developed were confirmed by their use in the 1944 maneuvers (fig. 119).

To determine the effects of freezing on common medical supplies, an extensive test was conducted in February 1943. Eighty-nine items, mostly Medical Catalog classes 1 and 9, were subjected to a temperature of -20°F., and then thawed and examined for any changes. Many of the items suffered no ill effects although frozen solid. For example, 50 units of blood plasma were subjected to freezing temperatures and the distilled water was frozen solid in the bottles. Only a very few bottles were cracked and, although the rubber stoppers were raised about 1/8 inch, no seals were broken. There was no precipitation or other obvious change in the appearance of the distilled


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water. Another test with medical supply implications showed that the batteries for medical instruments froze and became useless when exposed to the extremely low temperatures.

The Deemphasis and Closing Down of the Alaskan Theater

After the elimination of the Japanese from the Aleutians, the War Department ordered a drastic reduction in the command from a peak strength of 147,000 in 1943 to approximately 50,000 by the end of 1944. Of the 34 posts activated during the period 1940-43, only 11 posts were large enough to have station hospitals. This introduced the problems peculiar to closing installations, packing and crating, and disposition of excesses in the wake of a reduced strength. At the outset, stations shipped surpluses directly to the Zone of Interior, but it was found more proficient to have the stations report their surpluses by radio to the surgeon at Fort Richardson. Thereafter, reports were screened for lateral distribution before the surgeon reported the items to the Zone of Interior as surplus.

BOUGAINVILLE CAMPAIGN

Planning the Campaign

While the Japanese were being driven from the Aleutians, thus removing the threat to the Alaskan mainland, American forces moved on Bougainville, the largest and most northerly island of the Solomons group. The invasion was launched on 1 November 1943 by the 3d Marine Division. A week later, the first elements of the 37th Infantry Division joined the battle, which became exclusively an Army affair when the Americal Division relieved the Marines in the latter part of December. Supply support for the 37th Division was carefully planned on the basis of that unit's own experience in the New Georgia campaign. Each element was supplied with 10 days' maintenance, including special items required by local conditions, so that each would be self-sustaining. Nondivisional units, although they requested many items of medical supply, received only those that did not interfere with the 37th Division supply needs.

Supply of Replacement Units

The Americal Division arrived on Bougainville in 1943 with a 90-day supply of medical items (fig. 120). A 30-day supply was carried by each infantry combat team, and a 30-day supply for the entire division was brought in with the division medical supply of the medical battalion (map 41).

Since it was generally difficult to obtain emergency medical supplies by air from Guadalcanal, certain items believed to be most valuable were added to the equipment of the clearing company. Most important were the autoclaves, anesthesia machines, aspirator, laryngoscopes, X-ray equipment, demountable fracture table, laboratory incubator, and refrigerator.


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FIGURE 120.-Surgical team that arrived via SCAT plane on Bougainville is loading its equipment on a jeep for delivery to forward area of operation.

By February 1944, the medical maintenance unit method of supply had been replaced by the requisition from the service command.

Because of last minute loading, schedule changes resulted in leaving much equipment and medical supplies at the staging areas. When these supplies were most needed at the time of landing, they were not available. Base medical supply in the combat area was not set up for 2 or 3 months after the beginning of the operation.17

CENTRAL PACIFIC AREA

Early in 1943, following a period of rebuilding and expansion, the Hawaiian Department became a huge staging area for a number of infantry divisions which would later participate in numerous assaults on strategic Pacific islands. On 14 August 1943, the Hawaiian Department, previously expanded to include Midway, Christmas, and Canton Islands, was redesignated the Central Pacific Area.

17See footnote 1(3), p. 432.


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MAP 41.-Medical supply support of the Bougainville campaign, 1943.

Supply Support of Operation GALVANIC

The Gilbert Islands, located approximately 2,400 miles west of the island of Oahu, were chosen as the target for the first assault launched in the mid-Pacific.

The 27th Infantry Division, in this joint Army, Navy, and Marine Corps operation, was given the objective of assaulting Makin Atoll on 15 November 1943. In this amphibious assault, the most essential medical supplies were removed from Medical Department chests, packed in canvas containers, and


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MAP 42.-Operations in the mid-Pacific, 1943-44.

carried on the backs of medical personnel. The battalion aid station operated for about 5 hours, using the supplies contained in these canvas bags before more supplies became available in quantity.

Supplies and equipment were also carried in jeeps equipped with litter frames, which had been priority loaded in the holds of the ships. Equipment sufficient for a 50-bed clearing station had been loaded for each clearing platoon. Extra instruments, cots, blankets, an electric portable suction apparatus powered by a small generator, and an 8-cu. ft. kerosene refrigerator, as well as supplies for 10 days based on a 20-percent casualty rate, made up the equipment.

This equipment was successfully unloaded on one of the assault beaches. It was followed by medical maintenance units, divided into 10-day and 20-day increments packed in special boxes not weighing over 100 pounds, so they could be easily handled. By D+4, supplies were collected and brought inland to a central dump at Hen Village. Resupply was in two sections, each a cross section of a medical maintenance unit. Three 10-day cross sections, one for each battalion landing team, were carried on the ships with the troops and turned over to the battalion supply officers upon landing. Two 15-day cross sections, loaded on two different ships, remained in division control upon landing (map 42).18

18(1) See footnote 1(3), p. 432. (2) Annual Report, Surgeon, 27th Infantry Division, 1944. (3) Essential Technical Medical Data, United States Army Forces in the Central Pacific Area, for February 1944, dated 5 Mar. 1944. Inclosure 1, subject: Medical Service in Amphibious Operations.


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Support of the Marshalls Campaign

After the successful invasion and capture of Makin and Tarawa in the Gilbert Islands, attention was focused in January 1944 on the Marshall Islands. Kwajalein, the largest of 80 islands and islets, was the target for a combined Army and Marine assault. The 7th Infantry Division, veteran of the Aleutian Islands Campaign, was assigned the responsibility of capturing the southern half of Kwajalein Atoll and also Majuro.

As they did in the assault on the Gilbert Islands (Operation GALVANIC), medical personnel carried most of the essential supplies on their backs. Among the successfully used carrying devices were rucksacks, waterproofed standard packboards, and BAR (battery acquisition radar) belts.

Medical sections were supplied varying amounts of plasma according to their projected needs. A total number of 1,156 units was carried by the task force. In addition, 1,000 morphine tartrate Syrettes were issued to medical personnel with each company aidman carrying 10 (map 42).

Platoons of the clearing company embarked separately, each with a battalion landing team. Each clearing platoon carried 20 litters, 2 blankets, 1 splint set, and 9 waterproofed boxes containing medical supplies, additional blankets, cots, and an electric portable suction machine. An electric refrigerator and other valuable pieces of equipment were carried by each clearing platoon to establish an effective surgical unit and, if necessary, a 200-bed hospital.

Medical maintenance for the assault forces consisted of an accompanying shipment of 30 days' supply divided into two lots, one for 10 days and one for 20 days, both loaded for the assault. These units came ashore in excellent condition because of the care taken in packing boxes and in using waterproof paper and pallets. The medical maintenance unit for the resupply of the assault forces consisted of an accompanying shipment of 30 days' supply which was divided into ten 10-day lots, each of which accompanied a battalion landing team and division artillery. The 20-day lot for medical detachments and hospital units was subdivided into two units of 10 days each for 7,500 men. All nonessential items were eliminated from these supplies, which were packed in 18- and 22- by 30-inch boxes and palletized.

Nine shore parties, assigned to the 7th Infantry Division to handle combat supplies, began functioning on the Kwajalein beaches on 1 February 1944, D+1. Resupply of aid stations was successfully accomplished by ambulances and litter bearers who brought up supplies on their return from the rear. Because of this system, medical maintenance units did not have to be used in the early stages of the operation.

The addition of blood transfusion equipment in the clearing company saved many lives. It was noted that advance medical units should carry L-splints in place of Thomas splints, one jet Coleman gas-burning stove, tarpaulins, and at least 18 litters and blankets. It was also recommended that more refined gauze compresses be used in lieu of the smaller Carlisle dressings.


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Waterproofing was found to be most essential in the preservation of supplies and equipment.

After the successful elimination of the Japanese from Kwajalein, field supplies left by tactical units were used for some time. An excess of supplies was experienced in the 31st Field Hospital and also in the 1st Station Hospital. Supplies were issued regularly every Tuesday except for emergency supplies which were issued as requested. To offset the deterioration of supplies caused by salt water spray, rain, and high winds, a program of lubrication and protection of surgical instruments was established. A medical supply subdepot was established at Provisional Station Hospital No. 2 with direct support coming from the 5th Medical Supply Depot in Hawaii.19

Medical Supply Activities on Eniwetok

The assault on Eniwetok, essentially a Marine operation, began on 17 February 1944 (map 42). Elements of the 106th Regimental Combat Team of the 27th Infantry Division supported the Marines and were instrumental in the capture of Eniwetok Island itself.

All medical units of the 106th Regimental Combat Team carried plasma, battle dressings, morphine Syrettes, and sulfanilamide powder. The provisional portable surgical hospital was equipped with instrument sets, a portable electric suction machine, a portable orthopedic table, operating lamps, a 1½-kilowatt electric power unit, and a complete set of blood transfusion apparatus. Its clearing company carried enough extra equipment to care for 400 patients.

The collecting platoons and battalion medical sections carried their essential supplies with them when they landed. Resupply of aid stations was through the regimental aid station using a battalion landing team medical maintenance unit, and by property exchange with the collecting platoons and the naval beach party in the early days of the operation, avoiding embarrassment which might have occurred because of delays in the landing of supplies.

Each battalion landing team carried a 7-day medical maintenance unit in the assault personnel carrier, and a 30-day unit, all boxed and palletized, was on the cargo vessel. As a result of this and previous operations, the medical maintenance unit was streamlined and a standard special list of equipment was developed by the Central Pacific Base Command consisting of items in excess of TOE's that would be needed to support a particular operation. These lists served to standardize authorizations for requisitioning materials and were subject to modifications as experience dictated.

Modification of the medical pouch by better waterproofing and enlarging was recommended after the Eniwetok campaign. The subsequent adoption of this modification made it unnecessary to carry the 3-day medical supply of plasma, sulfanilamide dressings, and morphine previously required.20

19(1) See footnote 1(3), p. 432. (2) Report, Surgeon, 7th Infantry Division, to the Surgeon, United States Army in the Central Pacific Area, 27 Mar. 1944, subject: Medical Report, 7th Infantry Division, Reinforced, "Flintlock" Operations. (3) Annual Report, Army Garrison Forces, Kwajalein, 1944.
20See footnote 1(3), p. 432.


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Medical Supplies for Operation FORAGER

The strategically placed Marianas Islands were selected as the next U.S. target in the mid-Pacific. An attack force consisting of the 2d and 4th Marine Divisions, backed up by the 27th Infantry Division, landed on Saipan Island on 15 June, covered by units of the U.S. Fifth Fleet. The intensity of the fighting brought the 27th into action earlier than anticipated.

Medical supplies for the assault either were carried in waterproofed bags on the backs of aid personnel, or were loaded on jeeps with litter frames. Supplies for the second echelon medical personnel were priority loaded on ¼-ton trucks, which were unloaded first, and 2½-ton trucks for the hospitalization units, or palletized in 2- by 2- by 3-foot boxes which had been loaded as broken stowage (fig. 121).

To facilitate handling, supply items were further divided into groups "A" and "B." The "A" group consisted of items needed initially by a battalion surgeon or a collecting station. This group, because it would be rapidly consumed, was given high priority in both loading and unloading. The "B" group consisted of items needed primarily by hospitalization units and would probably not be needed for at least 72 hours. This group required only normal unloading. Packing lists were given to each medical officer, and each box was numbered in the event that the pallets were unloaded on the wrong beaches.21

Special items to be used in Operation FORAGER were prepared by the Surgeon's Office, Central Pacific Area. Jungle kits for all Army assault forces and pack equipment for medical assault elements were approved for use.

All units carried a 10-day medical supply, and the field hospital carried an additional 20 days' maintenance. Supplies for the 27th Infantry Division were so packed that 10 days' supply would land with the assault forces and 20 days' supply would be delivered later to service echelons of the divisions for issue to units in the field. Each first and second echelon medical unit carried organically a 1-day reserve of certain rapidly expendable items, such as plasma, morphine Syrettes, and first aid dressings. The clearing company carried a 3-day reserve so that resupply would not be necessary immediately when the division would be operating from dumps along the shore.

Equipment other than the initial combat equipment, which generally proved to be adequate, was landed between 48 and 72 hours after the hospitalization platoons. Combat-loaded 2½-ton and ¼-ton trucks, landed a few hours after the combat troops, in some instances lost 5 to 10 percent of the major items of equipment either in transit or on the beaches. The late landing and slow procurement of organizational equipment and supplies created a heavy initial demand on division maintenance supplies and so depleted the stock of certain items that they had to be drawn from the garrison forces.

Resupply to the Marianas was placed in action by 20 June and was accomplished by automatic block shipments consisting of 3,000-men, 30-day

21See footnote 1(3), p. 432.


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FIGURE 121.-Medical supply dump on Saipan.

maintenance units, modified from time to time according to the requests of the island surgeon for Saipan. Emergency resupply was on air shipment by emergency requisition.

Medical resupply in first and second echelon units was effected by request through channels from battalion aid stations to the collecting stations, to the clearing stations, to the division medical supply dump, or, in some instances, to the field hospitals. The supplies were then brought forward by ambulances returning from the rear. Because the activities of the regimental aid stations were limited, they were able to replenish supplies of battalion aid stations. The portable surgical hospitals were resupplied by the organization to which they were attached.

Only once when property exchange between the hospitals ashore and the hospital ships faltered did this method of resupply break down. Litters and blankets often remained too long with the dead at the cemetery, and when a heavy volume of casualties drained the supply of litters and blankets, these became the most critical items of supply. Patients had to be evacuated in makeshift litters. The shortage was corrected several days later when the volume of casualties decreased and the litters from cemeteries were reissued.

Shortages of intravenous sets, whole blood, X-ray machines, generators,


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and washing machines were notable. Salt water and high humidity rendered generators and X-ray machines useless.

The organizational equipment of a 400-bed field hospital was not sufficient when it had to be expanded to 900 beds. On the other hand, the clearing company found itself overburdened with supplies and understaffed with personnel in many instances. Because of this situation, most of its equipment and supplies had to be left at a beach dump.

The medical supply officer of the Army Garrison Force, Saipan, arrived on D+10 and set forth with his medical supply sergeant, who had arrived earlier, to comb the beaches for scattered supplies. By 27 June, supplies had been accumulated at the temporary dump and were issued to troops.

To alleviate the shortage of personnel, eight men from various detachments were assigned to the Army Garrison Force Depot. Troops of a medical sanitary company were used as stevedores.

Early in July, the supply dump was moved to its permanent location at Magicienne Bay where supplies were stacked on dunnage and covered by a tarpaulin. Some time later, a frame building was constructed for use as a narcotic vault.

Supply activities of the Army Garrison Force Depot included the salvaging and issue to civilians of captured Japanese medical supplies, the rehabilitation of the 27th Division before departure from Saipan, aiding the 77th Division before departure from Guam, and processing requisitions from Guam, Tinian, and later Angaur, Peleliu Island, and Ulithi.

After Saipan, the next target was Guam, where the assault units, the 3d Marine Division and the 1st Provisional Marine Brigade, were supported by the 77th Infantry Division. In the Guam landings, quantities of medical equipment and supplies, including a large number of cots, were lost. As a result, the sick and wounded had to be placed on the ground. Much equipment was water-soaked and broken in the initial assault which occurred on 21 July 1944, less than 1 week after Saipan. Because of the barrier reef and deep water, difficulty in landing and unloading supplies was experienced. Despite initial problems, the type and amount of medical supplies on hand for the operation was adequate.

The capture of Tinian, the sister island of Saipan, was the third phase of Operation FORAGER. The Northern Attack Force, composed of the 2d and 4th Marine Divisions and elements of the 27th Infantry Division, launched the attack on 24 July.

As Tinian was close to Saipan, casualties were shipped directly to Saipan with LST's serving as hospital ships. Approximately 2,400 beds were made available on Saipan for the Tinian campaign. The only Army units that actually landed on Tinian were one battery from the 106th Field Artillery Battalion of the 27th Division Artillery and an engineer battalion. Because of the limited Army participation in the Tinian campaign, no drastic supply problems were encountered.


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Support for the Palau Campaign

Capture of the Palau Island Group by American forces was essential to provide a Western Pacific airstrip for operations against the retreating Japanese. Again, as in previous operations, supplies were priority loaded with the basic load, a 3-day medical supply, being carried in by medical personnel or loaded on jeeps. A floating reserve consisted of a 10-day medical supply per each battalion landing team and a 20-day supply loaded aboard ship as broken stowage.

During the assault on Angaur Island by the 81st Infantry Division on 17 September, the "weasel" proved impractical as it threw its tracks on the rough terrain. Jeeps were used successfully in movement of patients and supplies. The beachmaster directed the unloading of the palletized supplies, which were brought ashore in LVT's (tracked landing vehicles), DUKW's (amphibious trucks, 2½-ton cargo), and other landing vehicles. Supplies were unloaded by hand until cranes were brought ashore sometime later (fig. 122). Medical battalion personnel collected all medical supplies in a central area and moved them as rapidly as possible to a medical supply dump. Many containers were discovered broken open and certain items, such as cots, litters, and alcohol, were pilfered. A satisfactory property exchange with the naval beach section made needed dressings, plasma, blankets, and litters available.

Division medical resupply was established on a 30-day basis, palletized, and located according to size of unit and the length of time the supplies were to last. One pallet weighing a ton supplied 2,000 men for 10 days. Two additional pallets of this size were set up for division special troops and reserve. A 20-day resupply for 7,500 men was set up on four pallets. An extra six pallets of medical supplies and one pallet of food were carried by each clearing platoon. Resupply of litters and blankets worked satisfactorily as did the resupply all down the line.

In this operation, it was evident that there was a need for an additional 2½-ton, 6X6 truck with a 1-ton trailer, one ¾-ton truck with water trailer, and one ¼-ton truck. There also was evidence that salt tablets needed to be kept dry in a waterproof container.

In the Peleliu operation, the 321st Regimental Combat Team took only a small amount of supplies with them on the initial assault. Difficulty in unloading cargo from the ships forced the unit to borrow supplies from the Marines. Absence of proper laundering and sterilizing equipment handicapped operation in the clearing station until a field sterilizer was sent from the 17th Field Hospital.

Owing to the absence of enemy troops on Ulithi Atoll, which was seized on 21-22 September, no problems of medical supply were encountered.22

22See footnote 1(3), p. 432.


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FIGURE 122.-Docks at Red Beach, Angaur, showing unloading of supplies, September 1944.

Improvements in Medical Supply

As a result of the experience gained in combat operations during 1944, waterproofing and packaging techniques improved, timely computations of the total TOE requirements were more thoroughly checked against depot stocks, and shortages were submitted as a bill of materials to the War Department for approval. The dispatching of separate requisitions which reflected the date, place, and time that the approved items would be needed expedited delivery of the materials to the using units before their deployment. Recognizing that the standard medical maintenance unit was not exactly suited for garrison needs, the Central Pacific Base Command in October 1944 compiled a modified equipment list, "Annex H Medical Maintenance Unit, Ten Thousand Men, 30 days," which was submitted to the San Francisco Port of Embarkation for subsequent delivery to advance bases as determined by the command. In addition, a medical maintenance unit was developed by the command to fill the demand for a streamlined block of medical supplies to accompany small groups of personnel moving to forward bases. By utilizing these new medical mainte-


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nance units, medical supplies were dispersed more nearly on a per capita basis.23

Transition to Requisitioning in the Mid-Pacific

Experience resulting from the Marianas and the Palau operations in mid-1944 revealed that garrison forces were incapable of predicting and preparing the necessary requisitions for supply requirements immediately subsequent to the termination of automatic supply. This stemmed from the fact that resupply requirements had to be initiated at such an early date after the islands had been secured that the stock records in force were not accurate for requisitioning purposes, nor was the medical supply staff often sufficiently informed of current conditions to enable it to compile requisitions at such an early date. To circumvent this condition, a plan was exercised whereby the supply section of the Surgeon's Office, Central Pacific Base Command, in consultation with the task force surgeon, prepared initial requisitions and a phasing schedule before the departure of the garrison force. The items and quantities were based upon past consumption tables prepared in the medical supply section of the Central Pacific Base Command as well as the considerations of the task force surgeon.24

VOORHEES MISSION TO THE PACIFIC

Organization of the Survey Team

In the fall of 1944, a survey team headed by Col. Tracy S. Voorhees, JAGD, was sent by the Surgeon General's Office to the Pacific to make a survey of medical supply similar to the one performed in the European theater during February 1944.25

Colonel Voorhees was accompanied by Mr. Charles W. Harris, Deputy Chief of Supply for Storage, Surgeon General's Office, Lt. Col. Louis F. Williams, MSC, and Maj. Gordon S. Kjolsrud, MAC, of the Medical Branch, Overseas Supply Division of the San Francisco Port of Embarkation.

Survey of the Supply Situation in Hawaii

Arriving in Hawaii in early October 1944, the Voorhees team inspected depots on the islands of Hawaii, Kauai, and Maui and concluded, because of the excellent steamer service from Oahu, the site of the 5th Medical Supply Depot, that depots and warehouses were not needed on those outer islands. Great excesses and much old stock were stored in these depots following the old principle of dispersion invoked after Pearl Harbor.

23(1) See footnote 1(3), p. 432. (2) Manuscript, covering medical supply in the Hawaiian Department, the Central Pacific, and Pacific Ocean Areas, prepared for a preliminary draft of this volume by Maj. Gen. Paul H. Streit, USA (Ret.), and Lt. Col. Allan W. Phelps, MSC.
24See footnote 23(2), above.
25This section is based on Voorhees, Tracy S.: Story of Pacific Trip, Oct-Dec. 1944. In Colonel Voorhees' personal file.


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To consolidate stocks in the Hawaiian Depot, the Voorhees team recommended that branch depots on the islands of Hawaii, Kauai, and Maui be closed and all supplies for the hospitals be requisitioned from the main depot on Oahu.

Two hundred people were engaged in preparing medical supplies for expeditions and assembling medical maintenance units which could be done on the mainland. By closing down this activity, it was hoped that some of these people could be used on Saipan, where there was a serious shortage of trained supply personnel.

The consolidation of the office of the medical supply officer of the Central Pacific Base Command surgeon with the depot was recommended as it would save much time and personnel involved in preparing the monthly stock report which would be unnecessary. It was suggested that one officer be made medical supply officer and commander of the 5th Medical Depot Company.

Supply Problems of the South Pacific

Upon arrival at New Caledonia on 25 October, a survey team discovered a great excess of medical supplies stored in two depots that were manned by an entire medical depot company. Although some excesses had been reported to the War Department, the depot was using the Surgeon General's Office consumption rates and had failed to develop any of their own.

It appeared that no one from command headquarters had inspected the depots on Guadalcanal and Espíritu Santo in the past 4 to 6 months and that excesses similar to those in New Caledonia also existed there.

As a result of the Voorhees survey, it was recommended that surpluses discovered in the inventory of stocks be reported to the Surgeon General's Office and nonusable stocks be shipped to the United States. This would reduce the depot workload.

Survey of New Guinea and the Philippines

In the survey of New Guinea which commenced on 7 November with the landing at Nadzab, New Guinea, the team found that the harbor at Hollandia was crowded with ships, many of which were waiting to be unloaded. Delays in requisitioning, caused by red tape, had created a serious shortage of certain items. All requisitions from the United States were processed through the Distribution Division, then located at Oro Bay, near Buna.

Shortages which existed at the depot at Hollandia were caused by the fact that the depot was not allowed to requisition directly. The requisitions had to clear through the Distribution Division and G-4 at Brisbane before reaching the depot at San Francisco. The basic weakness spotted in the supply system of the Southwest Pacific Area was that requisitioning was still being conducted on a theaterwide basis although depots were spread over 2,500 miles. No dependable transportation existed between bases, thus handicapping the transfer of supplies. While the three members of the survey team went on to Saipan,


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Colonel Voorhees went to Leyte where the supply situation was "worse than critical" because of poor planning, excessive red tape in the requisitioning process, and the absence of suitable sites for depots and hospitals.

Because of the discrepancies found in consumption rates in the Southwest Pacific Area and the South Pacific Base Command, it appeared of prime importance that the Pacific theaters develop their own specific rates after careful study of actual rates for the more active items based upon issue experience for 1944. This was expected to result in great dividends in conservation of warehousing space, man-hours, and stocks.

Medical Supply Problems on Saipan

The supply team discovered that, because of failure to order supplemental items not in the medical maintenance unit in advance, stocks of certain items were seriously low on Saipan.

It was also noted that only one medical supply team of 2 officers and 20 men was handling the supply situation. At least one medical depot company was needed. The available personnel, although doing an exceptional job, lacked training in requisitioning.

To relieve this personnel problem on Saipan, it was recommended that a medical depot company be sent there to speed up supply functions and implement the necessary consolidation of supplies.

Recommendations for Improved Supply Operations

To avoid the shortage of supplies such as the one which occurred on Saipan, the Voorhees mission recommended that the necessary items not included in the medical maintenance units always be requisitioned well in advance of D-day of any operation. The approving office was encouraged to return a copy of the approved requisition to the ordering unit so that they might know what to expect before it arrived. The practice of back ordering was to be dropped to avoid duplicate requisitions and the keeping of a large number of unnecessary records.

It was further recommended that no island depot separate from the base depot was necessary. Consolidation of depots such as recommended for Hawaii and the South Pacific Area would save space as well as personnel and also would eliminate the intermediary step in distribution of supplies.

The survey team reported that the chief of the Supply Service, Central Pacific Base Command, should have clear-cut supervisory responsibility over medical depot operations, and the depot commander should report directly to him rather than to the surgeon.

To help with stock control and storage methods, it was recommended that an experienced depot officer be brought to the theater for 60 days.


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Major Changes

Close scrutiny of the total Voorhees mission report reveals fundamentally that the absence of a closely knit medical supply organization had magnified some of the problems. The 3,700 miles that separated Hawaii, the supply base, from the Marianas did not permit a close-knit supply system.

Picking up the concern of many and the necessity for change, the Voorhees mission attempted to unscramble the situation and make a more proficient operation possible. Virtually all of the mission's recommendations were accepted and inaugurated, although gradually, as in the development of better storage facilities on Saipan and the arrival of additional supply personnel.

To offset the lack of a medical supply officer in the Pacific Ocean Areas, Maj. (later Lt. Col.) Donald E. Remund, MAC, an expert on warehousing, was assigned to the Surgeon's Office, Pacific Ocean Areas, as medical supply officer, but his influences on supply operations were less than expected. Because his responsibilities were not fully defined, his dealings with base commands were largely informal.

With the replacement of Brig. Gen. Edgar King by Brig. Gen. John M. Willis, as Surgeon, Headquarters, Pacific Ocean Areas, it appeared that the responsibility of the medical supply officer would increase. General Willis requested that Colonel Williams, a member of the Voorhees mission, be assigned as medical supply officer.

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