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Chapter XV

Contents

CHAPTER XV

The China-Burma-India Theater

BEGINNINGS OF MEDICAL SUPPLY ACTIVITIES IN 1942

Theater Background

The CBI (China-Burma-India) theater,1 which evolved from the American Military Mission to China established in October 1941, did not become fully organized as a theater until 22 June 1942, when the War Department ordered Lt. Gen. (later Gen.) Joseph W. Stilwell to issue orders relieving all units under his command from assignment to Army Group, Washington, D.C., and reassigning them to the American Army Forces, China, Burma, and India. By 6 July, General Stilwell had set up the command structure for his theater. From a small task force organized to support China and encourage larger participation and effort on the part of the Chinese Army, this mission of the CBI theater developed to include the operation of airbases for actions against Japan and the organization of various types of American units to wage guerrilla warfare against the Japanese.

Organization of Services of Supply and the Supply System

In the spring of 1942, efforts had been made by the Theater Surgeon, Col. (later Brig. Gen.) Robert P. Williams, MC (fig. 132), to organize the Chinese Medical Service, to deploy the small Seagrave medical unit, and to relieve the inadequacy which existed. Supplies had been stored in depots at Mandalay and Lashio, Burma; Calcutta and Karāchi, India; and in China.

Having reached the theater in late March 1942, Lt. Col. (later Col.) John M. Tamraz, MC (fig. 133), was designated Surgeon, SOS (Services of Supply), and his headquarters was established at Karāchi. The primary responsibility for organizing a medical supply program fell on Colonel Tamraz, and on 1 April 1942, he asked for the establishment of a medical supply depot at Karāchi with 2 officers and 10 enlisted men.

Effort was made by Colonel Tamraz to locate a source of supplies which could be substituted for unavailable shipments from the United States. The British Army's medical supply depot at Karāchi had sufficient stores of many items to supply the American troops in India through Reverse Lend-Lease. The surgeon was also allocated $3 million to purchase medical supplies on the

1(1) Stone, James S.: Organization and Development of Medical Supply in India and Burma, 1942-46. [Official record.] (2) Romanus, Charles F., and Sunderland, Riley: Stilwell's Mission to China. United States Army in World War II. The China-Burma-India Theater. Washington: U.S. Government Printing Office, 1953.


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FIGURE 132.-Brig. Gen. Robert P. Williams.

local market; yet, during 1942, various supply problems plagued the Medical Department. The 500 tons of medical supplies reportedly on the way to the theater were slow in arriving. Six hospital units arrived in May and June without any equipment and placed a heavy demand on the medical supply system. Supplies allocated to the U.S. Public Health Service and designated for the treatment of personnel involved in the construction of the Yunnan-Burma Railway, Chinese Defense supplies, and American Red Cross supplies all had to be used by Services of Supply.

Much material designated for China could not be used in India or Burma to the regret of Colonel Tamraz who stated that these supplies would often stay on the Calcutta docks and would gradually deteriorate.

When medical supplies began to arrive in late May 1942, warehouse space was hard to find, and when found, it had to be cleaned and reconditioned.2

The American Medical Supply System, during 1942 and 1943, was based on the automatic issue of the 10,000-man, 30-day MMU's (medical maintenance units). In July 1942, Charleston, S.C., was designated as the port of embarkation for the China-Burma-India Theater, and a theater supply level was established at 180 days.

2Diary, Col. John M. Tamraz, MC, Chief Surgeon, Services of Supply, China-Burma-India Theater. [Official record.]


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FIGURE 133.-Col. John M. Tamraz, MC, SOS Surgeon.

The previously requested medical supply detachment reached the theater by July, and a Medical Supply Section was established in the general depot at Karāchi (map 49).

Despite the arrival of several shipments of medical supplies, a shortage of sulfaguanidine, Atabrine (quinacrine hydrochloride), Plasmochin (pamaquine naphthoate), and nicotinic acid was revealed when a request for these items from a training center at Rāmgarh, India, was by necessity turned down.

A major problem in the CBI theater during the first year of operation was lack of the medical supply personnel required to plan for and carry out the distribution of supplies.

Because Chinese medical treatment facilities were relatively limited in scope, it was initially decided that the medical maintenance units furnished to the forces in Yunnan (Y-Force) should be modified by eliminating laboratory, dental, X-ray, and elaborate hospital equipment, and special supplementary drugs and chemicals. This modification of the standard unit established two noninterchangeable MMU's within the system.

The biggest problem of 1942 seemed to be the lack of a supply program with uniform policies and systems. This problem plagued the theater for the next year and a half.

GROWTH OF MEDICAL SUPPLY

Early in 1943, Maj. Walter J. Newton, DC, was placed in charge of the Medical Supply Section, Surgeon's Office, SOS. During January and February 1943, the movement of material into the Ledo area in preparation for


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MAP 49.-Medical supply depots, CBI theater, 1943-43.


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the beginning of road construction in March was the principal medical supply project. Special MMU's were lined up to supply the Seagrave unit which had been active in Burma during the first Burma Campaign of 1942 and had been providing medical care for the Chinese at Rāmgarh. The Karāchi medical depot and its subdepot at Chābua, India, had been ordered to assemble medical maintenance units designed by Lt. Col. Gordon S. Seagrave, MC, and ship them to Ledo. Supplies were funneled into Ledo, which was to serve as a receiving area for 30,000 troops being sent from the United States to launch the construction program. A request for equipment and supply units for hospitals of 250 beds, 100 beds, and 50 beds was approved, but consolidation of hospital beds was impossible, making it necessary to place small hospital units at widely scattered points.

The SOS Surgeon, while on an inspection tour during April and May 1943, discovered that most depots were below supply levels. The worst situation was at K'un-ming, China, because of the difficulties in getting supplies over the Hump by air.

Although the supply depot at Ledo was scattered in several warehouses, it seemed to be accomplishing its purpose. The depot at Chābua (map 49), in contrast, was quite low on surgical supplies, sulfonamides, and dental equipment.

Support of Chinese Forces

According to surveys of Chinese troops in the CBI theater, the Y-Force had sufficient supplies and equipment on hand for 6 months of combat. Only a shortage of vehicles for the transportation of equipment and supplies handicapped their supply operations (fig. 134). Action was taken by the Chief Surgeon, SOS, to provide for automatic replacement of depleted medical supplies. For the eastern group, the Zebra or Z-Force, the necessary requisition to provide 30 Chinese defense supply medical maintenance units per month was being prepared. A shift of responsibility for Chinese defense supplies to rear-echelon headquarters at this time relieved the theater surgeon of an onerous task.

Supply of Antimalarial Drugs

With the approach of summer and the malaria season, shortages of malaria control supplies and equipment appeared. Delays in requisitioning, loss of supplies due to sinkings of cargo vessels, and the rapid growth of troop areas, caused an emergency situation. As late as July 1943, no antimalarial supplies of U.S. origin had reached Assam. Only British and Indian equipment, generally considered by Americans to be inferior, was available, but this was also being depleted rapidly.

The large number of Chinese soldiers and Indian coolies employed in construction and maintenance enlarged the antimalarial supply problem since they had to be provided for as well. Approval for additional supplies was received too late to produce the supplies in time for the malaria season. To


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FIGURE 134.-Typical pack train fording a river near Nasin, Burma.

alleviate this situation, all equipment and supplies in the antimalarial category were concentrated in the Medical Supply Section of the Base General Depot at Calcutta under the supervision of a malaria control supply officer. Assistant theater malariologists, in cooperation with depot officers, approved distribution of these supplies. This system of depot control permitted the most economical supply distribution.

Plans for Increased Support for Chinese Troops

During July 1943, plans were formulated for supplying Chinese troops in both India and China. Full delivery of table of basic allowances equipment for medical units of the Y-Force was guaranteed by 30 medical maintenance units per month beginning in March 1944.

Shipment of Medical Maintenance Units to the CBI Theater

The CBI theater's supply program was set back in midsummer 1943 by the arrival of broken or partially complete assemblies, which the subdepots had to reconstitute as MMU's before requisitions could be filled. This problem


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was aggravated by lack of personnel qualified to handle these incomplete units. When ships were sunk en route to the theater, MMU components were lost, thus delaying the schedule several months. Theater stocks remained unbalanced until repeat shipments could be made.

Army Air Forces Medical Supply

In August 1943, the Army Air Forces proposed a supply system of its own, which would interpose Air Service Command medical supply points as "wholesalers" between Services of Supply depots and the using units. The Air Forces proposed to stock these depots with a 90-day level of common-use medical supplies and to handle all special items of equipment peculiar to the Air Forces. Services of Supply would thus act only as a feeder to the Air Service Command depots and cease issuing directly to AAF (Army Air Forces) units.

With the Air Forces taking over responsibility for supply to its units, Services of Supply would be relieved of an extra burden, but Colonel Tamraz and his medical supply officers agreed that the AAF proposal would establish a duplicate system of medical supply distribution and further deplete the already short stocks. By September, a compromise had been worked out whereby a 30-day supply was to be stocked by air depot groups, a 30-day supply by Air Service Centers, and a 10-day additional supply by tactical organizations.

The Medical Depot System in 1943

During the final quarter of 1943, many problems of the medical supply system were in the process of being solved. There was a mixture of optimism and misgiving by medical supply authorities. The medical supply officer, SOS, recorded a 117-day level of supplies in September which was somewhat below the authorized 180-day level. The antimalarial supply level was reduced from 60 to 90 days to 30 days because considerably more supplies were en route to the theater.

By November 1943, general depots with medical sections were located at Karāchi and Calcutta. An intermediate general depot was located at New Delhi, with the 100th Station Hospital serving as a subdepot for troops in the vicinity of the theater headquarters.

Advance general depots were located at Gayā, India; Chābua, the transshipment depot for supplies going by air to China; K'un-ming, the China depot; and Kuei-lin, China, which served the advance bases of the Fourteenth Air Force. Seven additional depots were operated by the Army Air Forces in eastern India to serve the Air Transport Command and the Tenth Air Force bases. Special depots for Chinese defense supplies were located at Karāchi, Sukkur, Calcutta, Chābua, and K'un-ming. A railhead depot served the Ledo area with a 45-day stockpile in the Advance General Depot at Chābua (map 49).


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Early Supply Procedures

Late in 1943, the Surgeon's Office, SOS, was developing a system of stock control and inventory for medical supplies in the theater. SOS headquarters was the final authority for processing all requisitions before they were sent to a depot. They also controlled hospital equipment assemblies and replacement items and were the responsible agents for procurement of priority items.

Emphasis on Experienced Personnel

Despite the optimistic outlook of the SOS Surgeon concerning the availability of supplies, general concern was felt over the nonavailability of trained supply personnel.

At the close of 1943, only two small medical supply units were in operation in the CBI theater. Sections of Medical Supply Detachment No. 2 staffed the depots at Karāchi, Calcutta, and Chābua, with the help of local personnel. The Ledo supply point was manned by a section of the Advance Depot Platoon, 7th Medical Supply Depot. A personnel shortage was expected to remain until sometime in 1944 despite the fact that two depot companies were on requisition.

Elimination of the Medical Maintenance Units

In October 1943, the War Department announced that automatic shipment of medical maintenance and medical reserve units would be discontinued by 1 January 1944. Estimates made by the Los Angeles Port of Embarkation showed that a 160-day supply of MMU's was either in the theater or en route, and a 178-day supply was on order. It was estimated that a 66-day supply of medical reserve units was either in the theater or en route, with a 77-day reserve on order.

Beginning in 1944, requisitions were to be submitted for maintenance to provide an 80-day supply in the theater as well as a 210-day supply to cover timelags. The Los Angeles Sub-Port, which became a port of embarkation for this theater in May 1943, recommended that requisitions be submitted once a month for a 30-day supply that would be required 210 days later, meaning that supplies requisitioned in November 1943 would not arrive until June 1944.

Following this change in procedure, the medical supply officer, SOS, planned to consolidate all theater requisitions each quarter and to submit special requisitions as necessary. His records were to show the status of all items stocked in the theater, and his procurement policy would be directed by a three-phase estimate system which calculated the stocks on hand for the current quarter, stocks due from the port of embarkation for the following quarter, and stocks to be requisitioned at the beginning of the first quarter for use during the third and fourth quarters. It was contemplated that MMU's would continue to be issued for 2 of the 3 months in each quarter,


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with the quarterly item-by-item requisitioning being used to balance theater stocks. The first requisition was scheduled for dispatch on 1 January 1944. The emphasis of the new system on proper accounting procedures resulted in timidity on the part of SOS medical officers. The medical supply officer, Major Newton, was relieved of his supply duties in October so that he might devote full time to dental service. His replacement, Maj. (later Lt. Col.) Claud D. La Fors, PhC, was experienced in medical supply, but his arrival was delayed. In the interval, no advance requisition was placed sufficient to maintain adequate stock levels between the close of automatic supplies and the date at which requisitioned supplies would be received.

Failure of British Supply

At the end of 1943, one of the major flaws still existing in the CBI supply system was the failure of Chinese forces in India, the X-Force, to be supported by the British and by the Government of India. Only approximately 25 percent of requested medical support requirements were received, and these were not up to established standards or familiar to U.S. medical personnel. To take up the slack, it was necessary to divert MMU's from other forces for the use of the Chinese Army in India.

MEDICAL SUPPLY DURING 1944

Inspection of the Supply System

When the new theater medical supply officer finally arrived, an inspection trip of supply facilities was arranged to familiarize him with the existing situation. Almost complete collapse was discovered at K'un-ming, where only the bare necessities were available. No reserve existed and many items were completely out of stock. The medical supply officer had files of requisitions which had been disapproved by the SOS Surgeon. Bad flying weather also hindered delivery of requested items over the Hump.

After inspection at one end of the supply line, Major La Fors and the AAF medical supply officer inspected the depot at Chābua, the final base for medical supply points in China and a key link in the chain of supply leading to Ledo and Burma. There, expendable supplies were nearly depleted and non-expendable supplies were scarce. Only Chinese defense supplies, not available for U.S. use, were in quantity, and these were scattered in poorly constructed, poorly managed warehouses.

At Ledo, special efforts were made to push medical supplies forward into combat areas. Supplies for American medical units were adequate, but supplies for Chinese combat troops were at a low level. Consumption was 100 percent over estimated requirements because of losses connected with airdropping of supplies as well as wasteful habits of the Chinese. As a result, supplies were


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being depleted rapidly while the replacement system still functioned at the old standard.

At General Depot No. 2, in Calcutta, the medical supply officer found a large but unbalanced stockpile of supplies in the Medical Section. It was estimated that if these supplies had been properly distributed to the field, the theater supply situation would have been nearly adequate. It was ascertained, however, that the flow of supplies from the Zone of Interior was interrupted by failure to requisition supplies as soon as automatic shipment of medical maintenance units was discontinued.

The biggest defect in the theater supply system was maldistribution. The general depot in Karāchi had only a 48-day supply on hand for 25 percent of the theater personnel; the general depot in Calcutta, which supplied 75 percent of the theater strength, had only a 70-day supply in stock. At the Chābua depot, all that was available was 63 days of a 90-day supply for Chinese troops and a 45-day supply for troops in Burma.

Corrective Action

Faced with the task of reconstructing the medical supply system, the Medical Supply Section personnel requisitioned needed supplies for immediate shipment to the theater, requesting at the same time that MMU's sufficient to maintain supply levels be sent for use until the requisition was received.

The theater medical supply officer directed discontinuance of all unauthorized methods of procuring or issuing supplies and also strict adherence to theater policies. This policy was designed to eliminate leapfrogging requisitions to the SOS Surgeon or even directly to the port of embarkation in the Zone of Interior. Supplies were to be procured only from the SOS depot in the immediate vicinity. Army Air Forces supply officers were directed to put requisitions through the air depot and Air Service Command, as authorized by SOS Memorandum No. 187 of 1 November 1943.

To fix responsibility in the field, medical supply officers of the general depots were designated as area supply officers and directed to establish and maintain authorized levels of supply at all supply points within their respective areas. Stocks on hand were to be surveyed and suitable requisitions sent to adjust discrepancies. They were also directed to edit and fill requisitions for units in their areas.

As a result of frequent inspection, these area supply officers were ordered to eliminate hoarding of supplies and to make certain that excess and unauthorized equipment was returned to depot stocks. The Stock Record Card System was adopted, and the standard revised requisition form was put to use. Despite the unfamiliarity of medical supply officers with the new procedures, they began at once to institute the new system.

To further invoke the provisions of new theater directives on supply procedures, it was necessary to improve the personnel involved in the program's


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operation. The medical supply officer outlined the staff he wanted to develop in the Surgeon's Office, SOS, to maintain control of the supply system. It was recommended that three officers deal with procurement, malaria supply control, and other theater supply matters. It was also recommended that an attached officer from Air Service Command establish liaison between Services of Supply and Air Service Command on medical supply matters.

None of these recommendations was adopted. Instead, the medical supply officer had three commissioned assistants, two of whom, being very inexperienced, were poorly qualified for a responsible role. An AAF liaison supply officer was borrowed from Army Air Forces headquarters.

With the arrival of new medical supply officers from the States, a new officer was assigned as assistant to the chief of the section, and he and the chief handled most of the supply matters. This system lasted until late 1944 when the two officers were replaced by one Medical Administrative Corps officer. The Air Forces liaison officer remained until midsummer.

Medical Depot Companies Organized

Personnel problems evident at the command level were also existing in the field. Of the two medical depot companies requisitioned in 1943, only one had reached India by December 1943. After almost a year of basic and unit training, the 14th Medical Depot Company arrived in India and was assigned to General Depot No. 2, Calcutta, to relieve the provisional detachment (fig. 135). Plans were made at that time to send advance detachments to K'un-ming, Ledo, and Chābua. No separate medical supply units had been functioning in that area before detachments of the 14th arrived. At Ledo, the 14th detachment, of one officer and six enlisted men, augmented Section 1, Advance Depot Platoon, 7th Medical Supply Depot, which had been there since the depot was established in November 1943 (map 50).

Valuable time was lost at the general depot when, because of disagreement over who was in authority, the depot company was not able to deploy its full strength and time on the distribution of medical supplies.

Supply Shortages in the Field

To avert serious shortages at Chābua, 10 medical maintenance units were planned to be shipped there immediately. Chābua was the key point for the supply of the Ledo and K'un-ming depots, and this shipment helped to relieve a serious shortage. By 10 January, the level of supplies had dropped to 1.5 MMU's. Emergency arrangements provided for the transportation of critical items to balance the stock level until March.

As the depot at K'un-ming was nearly out of supplies by January, two MMU's were prepared for air shipment to the depot (fig. 136).

The uncertainty of transportation between Calcutta and Chābua was a real handicap, and little could be done about it at that time.


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MAP 50.-Medical supply depots, CBI theater, 1944.


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FIGURE 135.-Native laborers carry and stack medical supplies at the Medical Depot, Calcutta, India.

The medical supply officer at Ledo had not been able to build up his supplies to the authorized 45-day level. Actually, he could not even count on a 10-day level, particularly in class I items. Combat troops were consuming medical supplies at an unexpectedly rapid rate. Besides losing supplies in the airdrop procedure, requisitions submitted by Chinese forces or by the Seagrave unit were not properly screened (fig. 137).

The hospitals in the field had serious supply problems. Shortages of equipment, lack of replacement parts, and scarcity of many drugs and laboratory


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FIGURE 136.-C-47 transports lined up on the airstrip at Myitkyina, Burma.

supplies occurred. General dissatisfaction with the medical maintenance unit was common because of its failure to include many drugs used locally in the treatment of disease.

Supply Support for Chinese Troops in India

To add to the already mounting problems in early 1944, British support of the Chinese troops in India was dwindling rapidly. Because of the inability of the British to meet the overwhelming demands for certain critical drugs and chemicals, these items were diverted from Chinese defense supplies and already critically short U.S. Army stocks.

The Chinese defense supplies were not complete, and British Army supplies did not coincide with U.S. standards. The procedure under which field medical units with Chinese troops received Chinese-type medical supplies exclusively, while fixed American hospitals received Chinese-type supplies in proportion to the number of Chinese who would be occupying hospital beds, was criticized by American medical officers who found it difficult to use British medical items, which were of poor quality and scarce in quantity of critical items.


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FIGURE 137.-Men in a C-47 shove out supplies to fellow soldiers in the field in Burma, 1944.

A firm recommendation was made by the theater surgeon in March 1944 to abandon the existing system and pool all medical supplies for the Chinese obtained through normal U.S. channels with American stocks in the theater, and issue as required.

Lack of Supplies in Depots

Medical supplies at Chābua were stored in a poor "basha" construction without cement floors; therefore, much deterioration occurred as a result of the climatic conditions. Because supplies were shipped to China in bulk rather than on an items-needed basis, stocks were enormously unbalanced.

At Ledo, lack of personnel and inadequate and widely dispersed warehouses hampered operations. To support the Chinese Army in India, this depot, commanded by Capt. Warren R. Lee, MAC, relied on air supply. After holding conferences with the base surgeon, the base medical supply officer, and the base commander, a new area was secured, with 50 percent more warehouse space and an adequate refrigeration vault for biologicals. Thus, the Ledo depot was changed and refurbished for more systematic operation.


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IMPACT OF THE VOORHEES MISSION

Background

With the numerous problems of medical supply mushrooming into crises and no immediate solution available, strong voices of concern emanated from all quarters. At a most opportune time, July 1944, a group of medical supply specialists, under the direction of Col. Tracy S. Voorhees, JAGD, was dispatched from the Surgeon General's Office to the China-Burma-India theater to make a comprehensive survey of the entire supply program.3 This trip was prompted by specific complaints made by the Air Forces regarding medical supply.

To satisfy the Air Forces, a compilation of its reported needs was included in a special requisition prepared in July to balance incoming stocks. Fortunately, 50 tons of air cargo space to be used for medical supplies from the United States was made available at that time. Heavier items were to come by water, but were given a high priority.

Specific Failures in Medical Supply

Following that action, the Voorhees team conducted a thorough survey of the depots in all base and advance sections of the theater. Four principal causes of the breakdown in supply were identified.

Before 1 January 1944, medical supplies had been received in the theater in the form of medical maintenance units, which consisted of 700 barely minimum items. There was no systematic way to supplement these items and, as a result, theater stocks were generally unbalanced, with some items badly depleted.

Failure to take action to avoid shortages after the automatic system of supply terminated also hurt. The SOS Surgeon and his chief medical supply officer had failed for 90 days to place any substantial requisitions to continue the flow of supplies.

Because of the inadequacy of automatic supply and the failure to file supplementary requisitions by the spring of 1944, there was a general shortage of medical supplies in the theater. No adequate stocks of nonexpendable items existed.

General Depot No. 2, over a long period of time, failed to sort, place in stock, and make available for issue a large quantity of medical supplies which were stored in bulk in a 28,000-sq.-ft. warehouse in the Hoboken section of the depot. Even after the arrival of the 14th Medical Depot Company in early January 1944, the stock was not moved until March. Failure to properly utilize the services of the 14th Medical Depot Company caused this problem.

The mishandling of 80 MMU's in Base Section No. 2 (Calcutta) and Advance Section No. 2 (Chābua) was the fourth identified reason for the

3Voorhees, Tracy S.: Visit to the China-Burma-India Theater to Survey Medical Supply, 11 Sept. 1944, together with attachments and inclosures thereto. [Official record.]


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supply difficulties of the theater. These units, intended for the Y-Force, were to be moved forward to Chābua at the rate of 20 units per month. The entire 80 units were sent in one shipment without advance notice and with no warehouse space available. As a result, the goods were dumped in a field and were not sorted for 2 months. No proper selection of the items to go forward to the Y-Force could be made and misshipments ensued. Not until June, when a new liaison officer for the Y-Force came to Chābua, was the pile of supplies sorted out and proper shipments made. This whole problem stemmed from lack of coordination between the action of the Y-Force authorities in seeking the shipment and their arrangements for its trip over the Hump. A more clearly defined authority in the Surgeon's Office, SOS, seemed necessary to prohibit the recurrence of this condition.

After authorities visited most of the larger station and general hospitals and studied their needs for extra equipment, requisitions to meet such needs were placed, specifying the most rapid form of shipment available.

Recommendations of the Voorhees Survey

As a result of the Voorhees survey, constructive steps were taken to alleviate the serious problems that existed. Recommendations were made to change the organizational setup in Services of Supply to clarify authority and divide responsibility between the SOS Surgeon's Medical Supply Section and the base sections or advance sections.

By the end of August, 40 tons of medical supplies had reached Calcutta by air, and the flow of supplies to the interior had become continuous as a result of emergency requisitions sent to The Surgeon General by the survey team. It was anticipated that stock would be balanced by October with the assistance of the Voorhees mission. The solving of personnel problems also began. The 14th Medical Depot Company was assigned a more experienced depot commander, and Maj. Arthur Gallagher, MAC, an officer experienced in medical supply stock control, was brought in to establish a centralized system of stock control and requisitioning.

To strengthen the weak depot system, a second medical depot company, the 25th, under the command of Lt. Col. Robert E. Selwyn, MAC, arrived on 27 August 1944 and was assigned to take over the supply operations for all American and Chinese troops in Upper Assam and Burma.

On 1 August 1944, upon recommendation of the medical supply officer, SOS, and the Voorhees mission, the Medical Section of General Depot No. 1 was closed, thus releasing personnel for redistribution. The responsibility for medical supply in the Karāchi-Bombay area was assumed by the 181st General Hospital in Karāchi, which served as a subdepot.

Realinement of Depots

As a result of personnel consolidations, the 69th Medical Depot Company was organized and stationed at Chābua, and the detachments of the 14th Medi-


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cal Depot Company at Chābua and K'un-ming were reconsolidated at Calcutta to take on an ever-increasing load of supplies. The 14th, under command of Major Gallagher, was outstanding in its handling of supplies which poured in at a tremendous rate. The limited personnel available often worked around the clock to keep supplies moving during a most critical period. As a consequence, essential supplies were distributed and an adequate medical supply service was made possible sooner than expected (fig. 138; map 50).

IMPROVEMENT OF THE SUPPLY SYSTEM AND ITS PROCEDURES

Personnel Shifts and Changes

During the last half of 1944, it was necessary, as recommended by the Voorhees mission, to obtain better qualified personnel to handle large-scale depot operations and to establish and maintain a sound inventory and stock control system. Medical depot companies had obtained better qualified commanders. Excess officers were absorbed into other medical supply installations, such as those in the larger hospitals. Within the SOS Surgeon's Medical Supply Section, experienced officers were drawn out to serve in field installations, and a smoothly running team of well-qualified officers was brought in to replace them.

Inventory and Stock Record Changes

Stock records at the time of the Voorhees mission were kept in General Depot No. 2 and in SOS Headquarters. As a followup of the survey, the 14th Medical Depot Company was instructed to develop a system of distribution to forward depots based on consumption rates. These data were to be translated into the necessary statistics by the Medical Supply Section in the Surgeon's Office. Before 1944, none of these records had been kept and only limited progress had been made to show the gross needs of the theater and set up a full-fledged inventory control system.

A new system, based on those being used successfully in the United States and in the European theater, was recommended by the Voorhees mission. The first step would eliminate the duplicate set of records in the Surgeon's Office, and assign all requisitioning to an inventory control officer located in a Calcutta branch office. This officer would be solely responsible for the satisfactory operation of the new stock control plan. A stock level was to be set for each item carried in theater stocks. Reorder points were to be calculated on the basis of stock level plus the amount to be issued during a 6-month period. An accurate due-in record would show the current stock status of each item at all times. Monthly review of records would follow for adjustment of stock levels on the basis of actual experience and the picking up of all items which had fallen below the reorder point. Requisitions would be submitted as necessary when indicated by stock records and by due-in record cards.


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FIGURE 138.-Distribution of medical supplies. A. Men of the 14th Medical Supply Depot operate a conveyor belt and check supplies as they are made ready for shipment. B. Native laborers unload medical supplies at a subdepot of the 25th Medical Depot in northern Burma.


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Together with members of the Voorhees group, the SOS medical supply officer set up initial stock levels for all items needed in the theater, to be reviewed by the inventory control officer, and integrated with depot stock records at Calcutta. A comprehensive requisition was prepared by the inventory control officer for submission in September. Chinese, as well as American, supplies were brought under the system.

As the medical supply situation began to improve, the inventory control officer reviewed stock levels of forward depots in the light of theater levels. The plan was gradually put into effect throughout the medical supply system, and all requisitioning was coordinated and unified.

Changes in the Chinese Supply Program

The Voorhees mission in June had backed up the earlier theater recommendation that supplies for the Chinese Army in India no longer be procured from the British. Unification of procurement and distribution of Chinese supplies through SOS channels was a basic necessity. This action was approved by the War Department in August 1944. With the standardization of procedures, Services of Supply received authority to take over all supplies for all forces in China, except AAF technical equipment and supplies.

Supplies, formerly designated as Y- and Z-Force material, were brought into the stock and inventory control plan at Calcutta and Chābua. By October 1944, Chinese procurement was included in the American medical supply program, thus consolidating theater medical supply requisitions. This meant that there was a single method of procurement, intratheater receiving, storage and issue, stock control, and accounting under Services of Supply.

The reorganization proved to be even more timely and valuable when, on 24 October 1944, the China sector of the CBI theater was constituted as a separate theater with Col. (later Maj. Gen.) George E. Armstrong, MC, as its surgeon (fig. 139). The India-Burma theater became the supply and administrative base for the new China theater.

MAJOR ACCOMPLISHMENTS OF 1944

Improved Organization

At the end of 1944, the whole supply program of the China and India-Burma theaters was working smoothly and efficiently. Critical shortages had been eliminated, both in the depots and in the field. A compact and better functioning supply organization which capably handled requirements for Chinese and American troops in China, Burma, and India had been established. Stock and inventory control procedure had been instituted at all levels of medical supply, thus eliminating many serious imbalances of stock. Automatic supply had been replaced by a process of continuous requisitioning which maintained proper supply levels. Personnel problems were almost entirely eliminated despite the split into two theaters. Transportation, particularly air transport, improved greatly, enabling a much more efficient distribution of supplies.


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FIGURE 139.-Col. George E. Armstrong, MC, Surgeon, China theater.

PROGRESS IN 1945

Support for Two Theaters

The year 1945 was placid in the field of medical supply compared to the previous year. Despite the planning for peak operations in anticipation of continued combat in Burma and a combat and logistical program in China climaxing in the final assault on Japan, seizure of the Burma Road early in 1945 and the sudden surrender of Japan in August reduced the medical supply operation progressively and hastened its end.

In carrying out the basic program of providing medical supplies for Chinese and American forces, the first phase of operations was the supply program for the China theater. Emphasis was shifted to an area which heretofore had been only a sector of an entire theater. However, no new burden was imposed on the supply program since the supply of troops in China had already been a part of the overall responsibility of the entire theater. Included in the program had been the supply of the Chinese Y- and Z-Forces, and the Fourteenth Air Force and its subordinate units, as well as a small number of American troops in support of Chinese training and operations. Supplying the Chinese sector had been simplified in late 1944, and every effort was made to


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extend to China the same principles of supply management which had been instituted in India and Burma. The fact that the principal consumers were the Chinese Y- and Z-Forces made it impossible to carry out the refinements of the system. Despite efforts to advise and develop in the Chinese military organization the same operational methods which were standardized for American troops, it was impossible to achieve complete uniformity of policy and procedure.

Planning Precedes Changes

To work out details of the China theater supply program, the Surgeon of the China theater, Colonel Armstrong, conferred with the staff of the Surgeon, India-Burma theater, in November 1944. During those conferences, a plan was adopted continuing the system which had developed during the previous months. Maintaining a 90-day level of medical supplies for American and American-sponsored Chinese forces, Services of Supply was to procure, store, and issue all commonly used medical supplies and equipment using the intermediate General Depot, Chābua, as its base. Army Air Forces items, however, were to be obtained by the Air Service Command through the AAF supply depots in India.

By 1 January 1945, initial organizational equipment for the Chinese troops was authorized by the International Aid Division, ASF, in Washington, and stocks for the China theater were divided between Calcutta (90 days), Chābua (45 days), and K'un-ming (45 days). By February, in accordance with the War Department's reduction in supply levels, the level was reduced to 45 days at Calcutta and 30 days at Chābua. The 45-day level was retained at K'un-ming.

Development of the Chinese Supply System

In January 1945, Maj. (later Lt. Col.) James S. Morgan, MAC, was assigned as Medical Supply Officer, China theater. Having two medical supply officers in the China and India-Burma theaters helped to coordinate medical supply activities.

Many of the old procedures were carried over as still being suitable. In the China theater, Services of Supply began to take over all supply organizations which provided service to the Chinese components of the Y- and Z-Forces. Services of Supply became responsible for all the operations necessary to procure material from India for Americans and Chinese in China. During the first few months of 1945, a system of base depots was organized at the entrance to China and at key points in the China theater. The maintenance levels of the India-Burma theater were initially accepted and later revised as experience indicated.

The inability to set levels and stabilize the rate of stockage, issue, and requisitioning prevented an even requisition of supplies from the India-Burma base. Periodically, larger than usual demands for medical supplies in the India-Burma theater necessitated air priority shipment from the United


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States. Humps in the flow of medical supplies from the India-Burma theater to China were caused by unexpected changes in operational situations in China, the need to stock adequately newly established depots, and the modification of usage tables based on actual experience. Improvement in the supply program resulted from the mutual exchange of correspondence, roundtable discussions at the Second Medical Supply Conference in May, and the loan of the India-Burma theater inventory control officer to the China theater for a brief period.

End-of-the-War Curtailment

As the end of the war approached, it became necessary to curtail the supply program for the China theater. The India-Burma supply line could be shut off when China's ports were opened for more direct supply to the theater. The supply level for the China theater was reduced to 60 days with medical supplies distributed equally between the Calcutta, Chābua, and China depots. The discontinuance of lend-lease brought no change in the policy of providing maintenance, supplies, and equipment for U.S.-approved Chinese forces. Tonnage allocations for shipment of medical supplies from Chābua to China were canceled for October 1945, and only emergency shipments by air were made thereafter as the bulk of the supplies went over the Stilwell Road or by water from Calcutta. On 31 December 1945, the supply responsibility for China was transferred from the India-Burma theater to the Pacific Area Command.

Disposal of Medical Supplies

With the end of the war, immediate steps were taken to set aside sufficient medical supplies to support the terminal theater activities and to declare excesses and surpluses. Agreements were reached with the Government of India for the disposition of a number of hospitals, and certain other equipment was sold to foreign governments.

By 31 December 1945, great progress had been made in the disposal of supplies:

Tonnage determined excess

long tons

11,887.00

Tonnage shipped to date

long tons

3,074.51

Tonnage declared surplus to F.L.C. (Foreign Liquidation Commission)

long tons

5,209.00

Value of surplus tonnage

dollars

$7,319,093.35

Tonnage disposed of by F.L.C.

long tons

843.00

Value of tonnage disposed of by F.L.C.

dollars

$1,010,897.45


Because of the considerable labor entailed in disposal activities, both the 25th and the 14th Medical Depot Companies remained in the theater until January 1946.

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