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Chapter X

Contents

CHAPTER X

The Southwest Pacific Area

The Army medical service which took shape in Australia under Gen. Douglas MacArthur in the spring of 1942 succeeded that which had existed in the Philippine Department in the prewar period. While the Army was losing out in the Philippines it was building, up in Australia. Before the close of 1942, a thoroughgoing medical service characteristic of a theater of operations had been founded in the Southwest Pacific Area.

DECLINE OF MEDICAL SERVICE IN THE PHILIPPINES

The life of Army medical service in the Philippines after the United States entered the war was brief but dramatic. When the Japanese bombed Clark Field on the day after their attack oil Pearl Harbor, the department surgeon, Col. Wibb E. Cooper, MC (fig. 89), and his staff had to switch rapidly from the normal medical activities of an Army oversea department to those of a theater of operations. From that date on, the story was one of medical service rendered under extreme difficulty. Although the withdrawal to Bataan and Corregidor accorded with long-established plans, the administration of medical service in this time of retreat conformed to the exigencies of rapidly shifting circumstances rather than to any repeatable pattern.

When the move out of Manila began in the latter part of December 1941, Colonel Cooper's office moved to Corregidor with Headquarters, U.S. Army Forces in the Far East, and was ultimately established in the Malinta Tunnel (fig. 90). An advance echelon of the surgeon's office was simultaneously set up on Bataan initially sited with General Hospital No. 1 at Limay and later with Services of Supply headquarters. Colonel Cooper served in the dual capacity of Philippine Department Surgeon and Acting Surgeon, U.S. Army Forces in the Far East, until 21 March 1942 when the latter command was superseded by U.S. Forces in the Philippines. Colonel Cooper was named surgeon of the new command by Lt. Gen. Jonathan M. Wainwright.1

In December 1941, Lt. Col. (later Col.) William J. Kennard, MC (fig. 91), the senior flight surgeon in the Philippines, who was wounded by bomb fragments during the attack on Clark Field, was surgeon of the Far East Air Force and of its service command. The departmental medical service furnished medical supplies and hospitalization to the air troops. Excellent relations, due in some measure to the proximity of Army and Air Forces in-

    1 (1) Cooper, Col. Wibb E. : Medical Department Activities in the Philippines from 1941 to 6 May 1942, and Including Medical Activities in Japanese Prisoner of War Camps. [Official record.] (2) See also Medical Department, United States Army. Medical Service in the Asiatic-Pacific Theater in World War II, ch. 1. [In preparation.]


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stallations, existed between the department surgeon and Colonel Kennard. Medical Department officers were stationed at Clark and Nichols Fields to serve the air force squadrons which had arrived in 1940 and 1941, while just before the attack a few medical officers had moved out of Luzon with air force units to other islands as part of a dispersion program. After the move to Bataan a number of the air force squadrons were transformed into two regiments with regimental surgeons, The latter and the various group and squadron surgeons were scattered over Bataan and Mindanao. From about Christmas Day of 1941 to early April 1942, Colonel Kennard traveled several thousand miles from camp to camp, making sanitary inspections and aiding in hospitalization and evacuation.2

At the outbreak of war, Sternberg General Hospital in Manila and five station hospitals were the total assets of the Philippines in fixed Army hospitals. The commander of the station hospital at Fort Mills, Corregidor, was also the Surgeon, Harbor Defenses, and had jurisdiction over all Medical Department officers stationed at the fortified islands, including Corregidor,

    2 Kennard, Lt. Col. William J.: Report on Philippine and Australian Activities, 1942. [Official record.]


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which protected Manila Bay. On 8 December, in accordance with a previous plan, the Manila Hospital Center was established by adding several annexes, some in college and university buildings, to Sternberg General Hospital. The care of the incoming wounded lasted only a month, as the move to Bataan began in the latter part of December. On Bataan were set up General Hospital No. 1 at Camp Limay (later at Little Baguio), General Hospital No. 2 near Cabcaben Airfield, and the Philippine Army General Hospital near the Philippine Army headquarters in the rear of Bataan.

The Philippine Medical Depot in Manila, which housed the equipment for a number of tactical hospitals at the outbreak of war, furnished medical supplies by trucks and barges to both ground forces and air forces. Late in December 1941, it was transferred to a location near General Hospital No. 2 on Bataan. In April shellfire destroyed it.

In the first bombing of Corregidor in late December 1941, the Fort Mills Station Hospital sustained several direct hits and was immediately moved to Malinta Tunnel. By 9 April, as the evacuation from Bataan to Corregidor took place, fixed medical service in the Philippines- care of the many cases of malaria, malnutrition, and dysentery- was concentrated in the tunnel, with Colonel Cooper in charge. Colonel Cooper remained in Malinta Tunnel with his hospital staff and patients after the surrender of Corregidor on 6 May until 25 June, when the Japanese allowed them to move to the renovated Fort Mills Hospital. In early July all were transferred to Manila, the nurses


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finally to Santo Tomas University, converted to a prison, and Colonel Cooper and the patients to separate quarters in Bilibid Prison. Any semblance of medical organization of the U.S. Forces in the Philippines may be said to have ended at that date. Colonel Cooper was shortly transferred to Tarlac, where he rejoined General Wainwright and his group and learned of the Death March. In August, with other to ranking officers, he was sent to a prison camp on Formosa. 3

THE EARLY MONTHS IN AUSTRALIA

While medical officers in the Philippines were retreating with the Army to Bataan and Corregidor, medical service in the Southwest Pacific was taking shape in Australia. Its birth may be dated from the hasty formation of a headquarters staff, including a surgeon, for the provisional Task Force, South Pacific, under command of Brig. Gen. Julian F. Barnes. En route from Hawaii to the Philippines, the force was diverted to Australia and arrived at Brisbane on 22 December. Medical Department personnel aboard were those

    3 (1) See footnote 1 (1), p. 407. (2) Noell, Maj. Livingston P., MC: Report of Personal Experiences in the Japanese Prison Camps of the Philippine Islands, 8 April 1942-15 February 1945. [Official record.] (3) Interview, Marie Adams, Field Director, American Red Cross, 7 June 1945, subject: Conditions at Santo Tomas.


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attached to a few tactical units, plus about a dozen casual medical officers. Most of the convoy's troops, including most of the casual medical officers, went northward with the convoy toward the Philippines. Since they were unable to put in at any port in the archipelago, they landed at Darwin, in northern Australia, with the exception of a field artillery battalion, which went on to Java.

The U.S. Army Forces in Australia,4 under command of Maj. Gen. (later Lt. Gen.) George H. Brett, had its headquarters in Melbourne. The theater organization began to take shape in January 1942. Four base sections were set up extending inland from the northern and eastern coasts of Australia, with headquarters respectively at Darwin, Townsville, Brisbane, and Melbourne (Map 8).5 No permanent surgeon was assigned to U.S. Army Forces in Australia until February, when The Surgeon General sent Lt. Col. (later Brig. Gen.) George W. Rice, MC (fig. 92), to be theater surgeon. Col. (later Brig. Gen.) Percy J. Carroll, MC (fig. 93), had meanwhile arrived in Australia on the hospital ship Mactan carrying patients out of the Philippines. Since Colonel Carroll was Colonel Rice's senior, the post went to him on 7 February.6 During the spring and summer of 1942, Colonel Carroll requested additional medical personnel from the War Department. About 230 nurses arrived in February, as well as the staff of the first complete hospital, the 4th General. He also urged the War Department to send hospitals, airplane ambulances, dental laboratories, and various medical supplies, particularly dental. He had to meet urgent requests for anesthetics, blood plasma, quinine, and other medical items for General MacArthur's hard-pressed forces in the Philippines. Some further drainage of his supplies, and personnel as well, occurred when the task force for New Caledonia in the South Pacific Area. sailed from Melbourne, in March; nearly half the nurses accompanied the task force to New Caledonia.7

During the early months of 1942, the medical organization of the four base sections initially established, of two additional ones to the south and south- west-Base Section 5 with headquarters at Adelaide and Base Section 6 with headquarters at Perth-and finally Base Section 7, established in April with headquarters at Sydney, was taking shape (map 8). The early tasks of staff surgeons sent to organize the medical service for the base sections were to set

    4 For 2 weeks, from 22 December 1941 to 5 January 1942, the designation was simply USFIA (U.S. Forces in Australia).
    5 The operational base section established in the Netherlands East Indies, with headquarters at Soerabaja, Java, had some medical officers assigned, but with the collapse of the short-lived American- British-Dutch-Australian command under Field Marshal Sir Archibald Wavell in Java, Army medical service there underwent no further developments.
    6 (1) Dairy, Col. Percy J. Carroll, December 1941-30 June 1942. (2) Annual Report, Chief Surgeon, Southwest Pacific Area, 1942. (3) Barnes, Maj. Gen. Julian F.: Report of Organization and Activities of U.S. Army Forces in Australia, 7 December 1941-30 June 1942 (6 Nov. 1942). [Official record.] (4) Military History of U.S. Army Services of Supply in the Southwest Pacific Area. [Official record.] (5) General Order No. 1, U.S. Army Forces in Australia, 5 Jan. 1942. (6) Letter, Lt. Col. George W. Rice to Col. John Rogers, 20 Apr. 1942.
    7 See footnote 6(2).


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Map 8.- Services of Supply in the Southwest Pacific Area, January 1944

up the surgeon's office in some building furnished by the Australians, to establish and operate a dispensary, and to plan for hospital construction and a permanent system of U.S. Army hospitals. Meanwhile, they obtained medical supplies from the Australians and arranged for hospitalization of U.S. Army personnel in Australian hospitals. The number of U.S. Army patients in these hospitals reached a peak of approximately 16,500 in May and June of 1942. Eventually the duties of the Australian base section surgeons were to become the standard ones, but circumstances conspired to make their tasks rather unorthodox in the early months of 1942. They had to get acquainted with the Commonwealth and State medical agencies in Australia, as well as with the Australian military medical organization, and local sources of medical


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supplies and facilities. The base section surgeon in Australia needed talent for diplomacy in borrowing, for improvisation when supplies and facilities were not to be had, and for adjustment to existing shortages- skills not mentioned in Army field manuals.

Moreover, the circumstances under which base section medical service developed varied markedly from one region to another. During the severe Japanese air raid on Darwin, where the headquarters of Base Section 1 was located, on 19 February 1942 several U.S. Army hospitals, as well as an Australian hospital ship, were fired upon. U.S. Army troops evacuated Darwin and went southward. For some months all medical supplies and hospitalization were furnished by the Australians, and the base section surgeon's office became a leaky tent in the bush. U.S. Army troop areas in Base Section 1 were well within the Tropics, and roads and railroads were scarce.

At the large southeastern ports of Brisbane and Melbourne, on the other hand, it was possible to get off to an earlier start. The Australian population was concentrated in the southeastern cities, and communications and facilities there were superior to those in the north. In Brisbane, medical supplies brought in by the convoy which had arrived in December were available, and a medical supply depot was set up. The 153d Station Hospital arrived, was


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assigned headquarters at Queensland Agricultural College, and opened in March. In Melbourne, the surgeon of Base Section No. 4 soon had enough personnel to make such orthodox assignments as dental officer and medical supply officer, and was able to set up a dispensary, an X-ray service, and an ambulance service for troops in the area. In addition to the base section surgeon's office, the offices of the Surgeon, U.S. Army Forces in Australia, and the surgeon of the U.S. Air Forces in Australia, as well as the 4th General Hospital, were in Melbourne. For some months, Army medical service was concentrated in that area. Base Section 2 in Queensland and Base Section 6 in western Australia each had a station hospital in operation by the end of March.8

In April, when the Allies had lost the Netherlands East Indies and were bottled up in the Philippines, U.S. Army elements in the Southwest Pacific were reorganized. On the 18th, General MacArthur, who had arrived from the Philippines, assumed command of all forces of the United States, the United Kingdom, Australia, and the Netherlands in the Southwest Pacific

    8 (1) See footnote 6(3), p. 411. (2) Periodic Reports for 1942 of Base Sections 1-7, variously dated. (3) General Order No. 38, U.S. Army Forces in Australia, 15 Apr. 1942. (4) Memorandum, Col. Percy J. Carroll, MC, for Civil Control Level of Information, Office of The Surgeon General, 15 Dec. 1942, subject: Medical Service in Australia.


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Area. Colonel Carroll continued as Surgeon of the U.S. Army Forces in Australia, the highest U.S. Army command in the Southwest Pacific Area. With the creation of General MacArthur's Allied command, the U.S. Army Forces in Australia became primarily a service command and was superseded by the U.S. Army Services of Supply in July.

With the arrival of a group of medical officers and enlisted men from the States for duty in the surgeon's office in Melbourne in early April, Colonel Carroll was able to construct a medical staff in general accordance with the table of organization prescribed for the medical section of a communications zone (T/O 8-500-1, 1 Nov. 1940). Besides his deputy, he had a colonel of the Dental Corps, a lieutenant colonel of the Veterinary Corps, and a captain of the Army Nurse Corps to put in charge of the Dental, Veterinary, and Nursing Sections. The remaining sections of the office, each headed by a major of the Medical Corps, were: Hospitalization, Supply and Fiscal, Per-sonnel, Evacuation, and Sanitation and Vital Statistics. Most members of Colonel Carroll's staff were reserve officers. At this early period his office was more completely staffed than that of Maj. Gen. Paul R. Hawley in the United Kingdom. On 24 April 1942 it included 27 officers. This situation resulted in part from the fact that some personnel already in the area- escapees from the Philippines- were available to fill certain positions in the surgeon's office.9

By May, the roster of surgeons for the seven base sections was complete. A dental consultant was assigned to the staff of each, and base section dental laboratories were set up to fabricate prosthetic appliances for all units within the base section. In June, a Venereal Disease Control Section was added to the office of the Surgeon, U.S. Army Forces in Australia, at Melbourne, and shortly afterward a venereal disease control officer was appointed for each base section headquarters. Thus, by mid-1942 the base sections were developing fairly full fledged medical offices at headquarters.10

Medical service within the air forces in Australia was also taking shape in the early months of 1942. Air force troops who had left Java and the Philippines were reorganized in Australia with headquarters at Melbourne. A medical office was placed under the newly created Army Air Services in April. The major territorial elements established by the air forces in Australia, corresponding to base sections f or the ground troops, were the Northeastern Area and the Northwestern Area; each had a surgeon. In September, when air troops in Australia and New Guinea were amalgamated into the Fifth Air Force, medical service for air troops began shaping up accordingly.11

    9 (1) See footnotes 6(2), 6(3), and 6(4), p. 411. (2) General Order No. 1, General Headquarters, Southwest Pacific Area, 18 Apr. 1942. (3) General Order No. 43, U.S. Army Forces in Australia, 20 Apr. 1942. (4) Office Order No. 5, U.S. Army Forces in Australia, 24 Apr. 1942.
    10 See footnote 8(2), p. 414.
    11 (1) Annual Report, Surgeon, Fifth Air Force, 1942. (2) Memorandum, Maj. W. C. Shamblin, Acting Assistant Adjutant General, Headquarters, U.S. Army Air Services, for Commanding General, Army Air Force, 7 July 1942, subject: Record of U.S. Army Air Services.


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The first 6 months' experience of Army medical officers in Australia brought to light a problem which was to plague the Medical Department and higher officers of the War Department, including the Chief of Staff, throughout the war, particularly in the last half of 1942 and the first 6 months of 1943 a high incidence of malaria in the early stages of the Southwest Pacific Area campaigns. Malaria was rare in Australia itself, even in the northern tropical regions where dengue fever was endemic, but by June 1942 about 50 percent of the Australian forces around Port Moresby, New Guinea, had been infected with malaria. Australian medical authorities were perturbed over the loss of the Netherlands East Indies as a source of quinine and their failure to get a quantity out of Java. At meetings, attended by U.S. Army medical officers, which Australian medical authorities held in Melbourne in mid-1942, several aspects of the problem were discussed: the menace posed by the entry of Allied troops infected with malaria into Australia, measures taken to conserve quinine, and the threat of mosquitoborne diseases in general to Australia.12

MEDICAL OFFICES AT HEADQUARTERS OF THE THREE MAJOR COMMANDS

Theater organization in the Southwest Pacific Area underwent rapid changes in command structure. It is perhaps impossible to pick any period after Advance Base was established in New Guinea in August 1942 during which the Army's many commands in the Southwest Pacific Area remained static in name, location, and principal mission longer than a month. Many Medical Department officers in the area noted the lack of a stable and centralized control of medical service as contemplated in Army manuals and pointed to its detrimental effect upon efficient operations. The nature of the conflict- amphibious operations against small islands, and hacking out of small bases in jungles, with enemy troops still at bases in the rear- together with the extended nature of the combat and communications zones in the area, militated against any concentration of medical administration. Responsibility was thrown upon local commands.

The presence of a staff surgeon at General MacArthur's Allied headquarters, with undefined duties, caused considerable confusion in 1942 and 1943. Two further developments, uncommon in other theaters of operations, hampered centralized control of medical service. One was the lack of any U.S. Army command with theaterwide responsibilities, and hence the absence of a true "theater surgeon" from July 1942, when the Services of Supply was estab-

    12 (1) Letter, Gen. George C. Marshall, Chief of Staff, to Lt. Gen. Dwight D. Eisenhower, Allied Force Headquarters, Algiers, 13 July 1943. (2) Bass, Maj. James W. : Report of Meeting Held at Royal College of Surgeons, 7 May 1942. [Official record.] (3) Fairley, N. H. : Malaria in South-West Pacific, With Special Reference to its Chemotherapeutic Control. M.J. Australia 2: 145-162, 3 Aug 1946.


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lished, to February 1943. The other was the absence of a surgeon at the headquarters of the command with theaterwide responsibilities (the reestablished U.S. Army Forces in the Far East) from September 1943 to January 1944, as the result of a shift of all the theater chiefs of services to Services of Supply headquarters. In other theaters a chief surgeon was consistently assigned to the headquarters of the theater command.

One feature that gave some continuity to administration was the fact that from February 1942 to December 1943, Colonel Carroll headed the medical office which may be termed the theater medical office, since it was consistently located at the highest level of U.S. Army command in the area. However, the shift of this office from Headquarters, U.S. Army Forces in Australia, to the Services of Supply headquarters in July 1942, then to Headquarters, USAFFE (U.S. Army Forces in the Far East), when it was reestablished in February 1943, and once more to Services of Supply headquarters in September 1943, led to uncertainty as to the responsibilities and authority of Colonel Carroll and his staff. These shifts in medical organization contrast with the situation in other theaters where the top command structure remained relatively stable for long periods and the same surgeon continued as head of the medical service for a top U.S. Army command headquarters long enough to acquire status.

Army doctors in this area encountered two essential difficulties in the face of the periodic absence of any surgeon and medical section at a headquarters with theaterwide authority. One was in the allocation of medical personnel, supplies, and facilities- in a region which demanded quantities out of proportion to troop strength- to the areas and commands where they were most needed. The other was the problem of effecting measures to prevent environmental disease throughout all the U.S. Army commands in the theater.

An official history produced under General MacArthur's auspices accurately sums up the environmental threats to the health of troops in New Guinea:

The penetrating, energy-sapping heat was accompanied by intense humidity and frequent torrential rains that defy description. Health conditions were among the worst in the world. The incidence of malaria could only be reduced by the most rigid and irksome discipline and even then the dreadful disease took a heavy toll. Dengue fever was common while the deadly blackwater fever, though not so prevalent, was no less an adversary. Bacillary and amoebic dysentery were both forbidding possibilities, and tropical ulcers, easily formed from the slightest scratch, were difficult to cure. Scrub typhus, ringworm, hookworm, and yaws all awaited the careless soldier. Millions of insects abounded everywhere. * * * Disease was an unrelenting foe.13

The climate and terrain of New Guinea called for strict application of preventive measures on a theaterwide scale to prevent high incidence of disease among troops. The effort to prevent tropical disease, the greatest single menace

    13 Historical Report, Allied Operations in Southwest Pacific Area. Vol. I (Supplement), MacArthur in Japan, The Occupation. [Official record, Office of the Chief of Military History.]


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to maintaining an effective fighting force in the Southwest Pacific, almost constitutes a unifying theme for the entire history of Army medical service in that region during World War II. Surgeons at many levels of command laid heavy emphasis on the urgent need for control of insectborne diseases; they frequently commented upon the lack of centralized direction of efforts at control during 1942 and 1943.

A chronological account of developments will throw light on the effect of the changing command structure upon medical administration. From December 1941 to July 1942, U.S. Forces in Australia and its successor, U.S. Army Forces in Australia, acted as a combined theater and Services of Supply command. In July 1942, when USASOS (U.S. Army Services of Supply) was established on the eve of the Papuan Campaign, Colonel Carroll was transferred to the Melbourne headquarters of the new command, along with the rest of the staff of the now defunct Headquarters, U.S. Army Forces in Australia. From July 1942 to February 1943, no U.S. Army headquarters with administrative authority over all U.S. Army elements in the area- ground, air, and service- existed. The functions normally assigned to a theater command were split between General MacArthur's Allied command- General Headquarters, Southwest Pacific Area- and USASOS. Since General Headquarters at Brisbane at first had no surgeon assigned to it, Colonel Carroll was the surgeon of highest position in the theater, but USASOS headquarters could not issue medical directives to the Army's tactical ground and air force elements, since tactical operations were the responsibilities of GHQ, Southwest Pacific Area (exercised through Allied Land Forces, Allied Air Forces, and Allied Naval Forces). Its directives went only to its area commands- the Australian Base Sections and the developing New Guinea bases.

In September, Colonel Rice was made Surgeon, General Headquarters, possibly in recognition of the distance of General Headquarters from Services of Supply headquarters (GHQ had moved to Brisbane, while USASOS remained behind in Melbourne) and continued in that position until the fall of 1944. He accompanied a forward echelon of General Headquarters which moved to Port Moresby for the New Guinea campaign and to sites further forward as the offensive progressed. As surgeon for the Allied command, his duties seem to have been primarily those of coordinating the medical activities of the American Army with those of the Australian Army and other elements of the Allied forces and of drawing up medical plans for forward moves of Allied task forces, which the medical sections of USAFFE and USASOS refined and elaborated. Apparently GHQ never issued any written delineation of his duties or authority. In accordance with General MacArthur's insistence that his general and special staff sections remain small in order to keep his headquarters mobile, Colonel Rice never had any


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staff of medical officers, but only one or two enlisted men as assistants. He operated largely through G-4.14

In February 1943, shortly after the New Guinea campaign had got under way, USAFFE was established in Australia. General MacArthur was in command of it as well as of the Allied command, General Headquarters, Southwest Pacific Area, to which it was subordinate; the headquarters of both commands were in Brisbane (fig. 94). While General Headquarters continued to direct the operations of combat forces, USAFFE served as the higher administrative headquarters above USASOS, the Sixth U.S. Army, and the Fifth Air Force. It supervised the administrative organization of troops, the training conducted in the theater, the provision and adoption of equipment, and the movement of troops in other than the combat zone. Thus the responsibilities normally assigned to a theater command were divided between GHQ and USASOS. The U.S. Army Services of Supply, with headquarters at Sydney since September 1942, became the typical Services of Supply in a theater of operations, with its responsibility for administration of medical service limited to that within its own area commands. As the chiefs of technical services hitherto assigned to the Services of Supply were at this date transferred to the Brisbane headquarters of the new command, Colonel Carroll

    14 (1) Rice, Maj. Gen. George W. : Account of Activities in the Southwest Pacific Area, attached to 1st indorsement, 9 Mar. 1950, to letter, Editor, Historical Division, Office of The Surgeon General, to General Rice, 2 Feb. 1950. (2) General Order No. 36, General Headquarters, Southwest Pacific Area, 26 Sept. 1942. (3) Memorandum, Col. W. L. Wilson, for The Surgeon General, 20 Oct. 1943, subject: Visit to Southwest Pacific Area. (4), Letter, Col. John F. Bohlender, MC, to the Editor, Historical Division, Office of The Surgeon General, 26 Feb. 1951. (5) Interview, Col. Gottlieb Orth, MC, 5 Mar. 1952. (6) Letter, Maj. Gen. George W. Rice, to the Editor, Historical Division, Office of The Surgeon General, 19 June 1951. (7) Personal notebook, Col. Maurice C. Pincoffs, MC. (8) Compare appendix B, p. 562.


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became Chief Surgeon, USAFFE, and a few of his staff were shifted with him. Col. Frederick J. Petters, MC, became Surgeon, Services of Supply, at this date. Most officers of the former Services of Supply medical section remained at USASOS headquarters under the new chief.

General Headquarters continued to exercise control over strategic and tactical operations of elements of the Allied armies, which still included United States, Australian, British, and Dutch units. This command made the requests to the U.S. War Department (and to the Allied Governments) for major combat and service units necessary for Allied operations, established priorities for supplies for strategic and tactical operations, and formulated policies governing the command's relations with the various Allied forces and Allied governmental agencies. Colonel Rice continued as the medical representative at General Headquarters. 15

During the period from February to September 1943, the presence of a Surgeon and a medical section at U.S. Army Forces in the Far East, which could issue medical directives to the Sixth U.S. Army and Fifth Air Force, resulted in more thoroughgoing centralized control of medical service than had prevailed since July of the previous year. Nevertheless, some difficulty resulted from the continued assignment to the Services of Supply of certain functions, which needed to be exercised on a theaterwide basis. For a few months after the theater command and its medical section were set up, the statistical section in the office of the Surgeon, USASOS (Colonel Petters), experienced difficulty in obtaining statistics from the Sixth U.S. Army and Fifth Air Force, and later from the 14th Antiaircraft Command. In order to establish the authority of the Surgeon, USASOS, to obtain statistical reports from all Army elements in the Southwest Pacific Area, General MacArthur had to issue a special directive to the Commanding General, USASOS, establishing it as the Central Medical Records Office. With this special authorization, the Central Medical Records Office, USASOS, was able thereafter to obtain and consolidate medical reports from all Army elements in the Southwest Pacific Area. 16

During the period from February to September 1943, the Chief Surgeon, USAFFE, had a small medical office, including a chief of professional services, Col. Maurice C. Pincoffs, MC (fig. 95), formerly commanding officer of the

    15 Staff Memorandum No. 3, General Headquarters, U.S. Army Forces in the Far East, 19 Feb. 1943, subject: Allocation of Administrative Functions in USAFFE. (2) USAFFE Letter, 26 Feb. 1943, subject: Allocation of Administrative Functions within USAFFE. (3) Memorandum, the Adjutant General, Headquarters, U.S. Army Forces in the Far East, for Commanding Generals, Sixth U.S. Army, Fifth Air Force, and U.S. Army Services of Supply, 26 Feb. 1943. (4) See footnotes 6(4), p. 411; and 14(3), p. 419. (5) Order of Battle, U.S. Army in World War II, The War Against Japan, Command, Administration, and Supply Organization. [Official record, Office of the Chief of Military History.] (6) Letter, Chief Surgeon, U.S. Army Forces in The Far East, to The Surgeon General, 11 Mar. 1943. (7) General Order No. 1, U.S. Army Forces in the Far East, 26 Feb. 1943. (8) General Order No. 11, U.S. Army Services of Supply, 23 Feb. 1943.
    16 Memorandum, Preventive Medicine Division, U.S. Army Services of Supply, to Historian, U.S. Army Services of Supply, 10 Jan. 1944, subject: Relationships Between the Preventive Medicine Division, Surgeon's Office, USASOS, Sections, SOS, and Other Commands in the Southwest Pacific Area.


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42d General Hospital; the theater malariologist; a lieutenant colonel of the Veterinary Corps; a Medical Corps major in charge of hospitalization and evacuation; and a captain of the Medical Administrative Corps in charge of administrative matters. The rest of the members of the usual staff medical section, including the chief consultants in surgery, neuropsychiatry, and orthopedic surgery, were in the medical section of the Services of Supply in Sydney. Various observers emphasized the lack of a preventive medicine division, and of a consultants division, at the higher headquarters as serious defects in medical organization. Even in the medical section of the Services of Supply, where several officers were assigned to various functions in the field of preventive medicine (for example, venereal disease control), these functions were not coordinated under a single chief of preventive medicine until late in 1943. This internal organizational defect was responsible, according to Lt. Col. G. L. Orth, MC (fig. 96), assistant theater malariologist, for the deficiencies in unit equipment for the chlorination of water supply. No group with a comprehensive program for enlisting the cooperation of the Engineers in ordering the proper equipment existed in the office of the USASOS surgeon.

The Chief Surgeon, USAFFE, noted problems posed by the position of consultants in the theater setup. A consultants section developed in Colonel Carroll's office after July 1942, when a specialist in surgery and one in neuropsychiatry were sent to the area by the Surgeon General's Office. Most full-


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time consultants (that is, those who were not assigned to hospitals with additional duties as consultants) were consistently assigned to USASOS headquarters; hence they lacked authority to inspect hospitals of the Sixth U.S. Army and the Fifth Air Force. Efforts which Colonel Carroll made to transfer the consultants to Headquarters, USAFFE, apparently met with a refusal to increase the number of Medical Department officers assigned to the higher headquarters. A duplicate assignment of consultants to both USAFFE and USASOS was considered undesirable, since it would have wasted scarce, highly specialized personnel. The Chief Surgeon, USAFFE, therefore advocated that consultants be placed on temporary duty with Headquarters, USAFFE, whenever it was desired that they inspect elements of the Sixth U.S. Army and the Fifth Air Force. On the other hand, he sometimes placed consultants assigned to Headquarters, USAFFE, on temporary duty with Headquarters, USASOS; the latter operated most of the large fixed hospitals needing consultants' advice, and consultants found that they could work more effectively when they were in close proximity. 17

    17 (1) Check Sheet, Monthly Report, Chief Surgeon, U.S. Army Forces in the Far East, March 1943. (2) Memorandum, Chief Surgeon, USAFFE, for Deputy Chief of Staff, 31 May 1943. (3) See footnote 14(7), p. 419. (4) Interview, Lt. Col. G. L. Orth, MC, 12 June 1947. (5) Annual Report, Chief Surgeon, Southwest Pacific Area, 1942, and supplement (1 Jan.-28 Feb. 1943).


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In the Southwest Pacific Area divergent views were voiced as to the, true functions of consultants: for example, whether or not they should be used farther forward and whether or not they should make inspections or restrict themselves to a consultative function. References by Colonel Carroll to "my veterinary consultant," to the chief of the Dental Division, USASOS, as "chief dental consultant," and to officers in similar positions at the bases as "base dental consultants" show a loose use of the term "consultant" in the Southwest Pacific Area in 1943 and 1944 that apparently resulted from lack of contact with the Surgeon General's Office.

In addition to the uncertainty as to the real purpose of the consultant system, several other factors militated against the establishment of a full-fledged consultant system comparable to that in the European theater, where as early as the end of 1942, 10 consultants representing a number of subspecialities were on full-time duty in the theater surgeon's office. Lack of a sufficient officer allotment in the office of the Surgeon, Services of Supply, Southwest Pacific Area, limited its roster to consultants in the three major specialities of surgery, neuropsychiatry, and medicine (assigned in late 1943), and a consultant in orthopedic surgery. Only the chief surgical, medical, and neuropsychiatric consultants were sent to the Southwest Pacific Area by the Surgeon General's Office. A number of officers on duty with the general hospitals at the New Guinea bases were "attached" to the office of the Surgeon, SOS, as consultants but remained on duty at hospitals in the bases. Although senior consultants of the office of the Surgeon, USASOS, spent weeks at a stretch visiting hospital after hospital in the field, the distances of the New Guinea bases from the office (located at Sydney throughout 1943), together with the difficulties of travel, precluded complete coverage of units scattered widely throughout Australia and New Guinea. Some observers considered line commanders in the South-west Pacific insufficiently receptive to the services of consultants, while others found the chief surgeons of USASOS and USAFFE not fully informed as to their most effective use. Inadequacy in numbers, assignment at the Services of Supply level, lack of a clear concept as to their most effective employment, and the difficulties of travel over great distances, all combined to limit the effective use of consultants in the Southwest Pacific Area. 18

In September 1943 the special staff sections, including the medical section of the U.S. Army Forces in the Far East, were returned to the Services of

    18 (1) Hillman, Brig. Gen. C. C.: Report of Observations of Medical Service in the Southwest Pacific Area and the South Pacific Area, 12 July 1943. (2) Morgan, Brig. Gen. Hugh J.: Comments and Recommendations, Medical Departments, U.S. Army Forces in the Far East, 12 Aug. 1943. (3) Letter, Surgeon, General Headquarters, Southwest Pacific Area, to Col. Maurice C. Pincoffs, MC, 16 Sept. 1943. (4) Memorandum, Brig. Gen. Fred W. Rankin, for The Surgeon General, 2 Nov. 1943. subject: Remarks on Recent Trip Accompanying Senatorial Party. (5) See footnote 14(3), p. 419. (6) Memorandum, Col. W. L. Wilson, MC, for Executive Officer, Office of The Surgeon General, 1 Nov. 1943, subject: Visit to the Southwest Pacific Area. (7) Memorandum, Lt. Col. G. S. Littell, MC, for Col. Arthur B. Welsh, MC, 31 Dec. 1943, subject: Report on Medical Department Activities in the Southwest Pacific Area. (8) Memorandum, Surgeon, Services of Supply, for Chief Surgeon, U.S. Army Forces in the Far East, 10 Sept. 1943. (9) Annual Report, Chief Surgeon, U.S. Army Services of Supply, 1943.


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Supply. Colonel Carroll, once more Chief Surgeon, USASOS, headed what was still the top medical office in the Southwest Pacific Area, although it was under the Services of Supply. Thus from September 1943 to the end of the year, there was no surgeon or medical office at Headquarters, USAFFE, although a lieutenant colonel of the Medical Corps was assigned to G-4, USAFFE, for liaison with the Services of Supply. Colonel Carroll was again at the headquarters which could not issue medical directives to the Sixth U.S. Army and Fifth Air Force. 19

During 1942 and 1943, confusion arose as to the responsibilities of General Headquarters versus those of the U.S. Army Forces in the Far East with respect to Medical Department tactical units. Requisitions for units from the United States could originate with the Surgeon, GHQ, SWPA, or the surgeon at theater headquarters. If they originated with the latter, they had to go through G-4, USAFFE, to G-4, GHQ, and thence through the surgeon at General Headquarters before they were forwarded to the War Department. The existence of a surgeon at the higher headquarters, General Headquarters, above the level of the medical office which had the major responsibility for planning, led to some confusion in case of disagreement as to the types or num-bers of units needed. In this area, a good many changes were made in the composition of the standard Medical Department units to fit the needs of task forces created for taking small coastal areas and islands. The character of combat in the Southwest Pacific Area- amphibious landing operations and jungle fighting with limited objectives rather than the open land warfare stressed in the Army schools in the prewar period- called for specially designed task forces. It led likewise to changes in the composition of some Medical Department units and to the use of units at different echelons in the chain of evacuation than those for which they had been designed. Before the close of 1942, Colonel Carroll had developed 27 small portable hospitals for use by the combat forces along the New Guinea trails during the initial stages of invasion. Their personnel were taken from the staffs of general, station, evacuation, and other hospital units. Colonel Carroll not only developed some new mobile units, including laboratory and pharmacy units, but broke up some standard units and directed some to uses other than those for which they were designed. Mobile hospitals were commonly substituted for fixed installations.

The exercise of authority over the movements of Medical Department units, as well as their composition, by General Headquarters put special difficulty in the way of centralized control of medical service in 1943. At intervals, General Headquarters issued orders to theater or Services of Supply headquarters to assign specific medical units to task forces. In the fall of 1943, for instance, it ordered, without consultation with the theater malariologist, the assignment of certain malaria control and survey units to the Alamo Force, in addition to ones already allotted by the malariologist. Colonel

    19 (1) Staff Memorandum No. 74, U.S. Army Forces in the Middle East, 27 Sept. 1943. (2) Staff Memorandum No. 155, U.S. Army Services of Supply, 27 Sept. 1943.


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Carroll pointed out that decision as to the proper assignment of units to areas where they were most needed should be made only by the theater malariologist, who maintained a file of information on the current location of the units and on rates of malaria incidence in the various regions and islands. About the same date, the Surgeon, USASOS (Colonel Petters), noted cases of arbitrary diversion by General Headquarters of hospital units to various task forces in New Guinea without reference to the Services of Supply. All hospital units, mobile as well as fixed, in the theater were under the aegis of the Services of Supply while they were being trained and equipped. Colonel Petters noted that other factors besides the immediate needs of the task force should be taken into consideration whenever units were assigned in order to have an effective distribution of hospitals in accord with needs: the percentage of bed capacity available to the Services of Supply, the areas of greater patient load, and similar factors. 20

During 1942 and 1943, reports on difficulties with medical administration in the Southwest Pacific Area. reached the Surgeon General's Office from, a number of sources, both officers serving in the area and those sent there on special missions. They emphasized several theaterwide administrative problems: insufficient number of consultants, nutritionists, and malaria control and survey units; inadequate training in malaria control of troops sent from the United States; insufficient beds in fixed hospitals in proportion to troop strength; and the poor quality and small number of Medical Department personnel trained in sanitation and tropical disease who were qualified for administrative posts- for example, base section surgeons. Colonel Carroll noted the lack of men qualified to fill key positions. The chief target of criticism was the organizational scheme. The multiplicity of commands had resulted in delay on decisions, in increase in the number of nonmedical officers through whose hands proposed directives must pass, and some medical directives at variance with those of Colonel Carroll based on divergent views of surgeons of many commands. Some observers thought that the posts of Surgeon, GHQ, and Surgeon, USAFFE, should be held by the same man. Critics agreed that no unified control over medical service existed and that a single highly placed Medical Department officer in full control was of vital importance. 21

In January 1944, Brig. Gen. (later Maj. Gen.) Guy B. Denit, MC (fig. 97), formerly surgeon of the Atlantic Base Section in North Africa, became simultaneously Chief Surgeon, U.S. Army Forces in the Far East, and Chief Sur-

    20 (1) Letters, Col. George W. Rice, MC, to Col. Percy J. Carroll, MC, 13 Nov. 1942, 6 Jan. 1943, 12 Jan. 1943. (2) Letter, Col. George W. Rice, MC, to Col. John A. Rogers, MC, Office of The Surgeon General, 31 Jan. 1943. (3) Letter, Col. George W. Rice, MC, to Col. Maurice C. Pincoffs, MC, 16 Sept. 1943. (4) Letter, Col. George W. Rice, MC, to The Surgeon General, 14 July 1943. (5) Memorandum, Chief Surgeon, U.S. Army Services of Supply, for Deputy Chief of Staff, 22 Sept. 1943. (6) Memorandum, Surgeon, U.S. Army Services of Supply, for G-3, 24 Sept. 1943. (7) Interview, Brig. Gen. George W. Rice, 13 July 1951.
    21 (1) Letters, The Surgeon General, to the Chief Surgeon, U.S. Army Services of Supply, 22 Jan. and 12 Feb. 1944, and replies, 16 and 26 Feb. 1944. (2) Letter, Chief Surgeon, U.S. Army Forces in the Far East, to The Surgeon General, 11 Mar. 1943. (3) For reflections of confusion in medical administration, see documents cited in footnote 14, p. 419.


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geon, U.S. Army Services of Supply. From then on, control over medical service was somewhat more centralized, although continuation of the theater's policy of placing most of General Denit's staff (as well as the staffs of other chiefs of technical services) at Services of Supply headquarters hampered centralized control to some extent. The role of the Surgeon, GHQ, continued to be a somewhat ambiguous one. 22

General Denit and The Surgeon General (General Kirk) made a concerted effort in 1944 and 1945 to build up a stronger medical section for administering the medical affairs of the Southwest Pacific Area, an effort that resulted in exercise of somewhat more influence by the Surgeon General's Office in the selection of General Denit's staff. Efforts to raise rank and increase numbers, on the other hand, ran into a good deal of opposition. When General Kirk attempted to elevate the rank of General Denit's staff dental officer (as well as that of his counterpart in each of the major theaters) to brigadier general, General Denit found himself unable to have the dental officer assigned to theater headquarters. He noted that any recommendation for promoting the dental Surgeon at USASOS headquarters to brigadier general would arouse resent-

    22 (1) General Order No. 4, U.S. Army Forces in the Far East, 17 Jan. 1944. (2) General Order No. 18, U.S. Army Services of Supply, 30 Jan. 1944.


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ment among some of the chiefs of technical services who were only colonels, as well as among the surgeons (also only colonels) of such commands as the Sixth U.S. Army and Fifth Air Force. When General Kirk wanted to assign his chief consultant in medicine, a brigadier general, who had requested oversea duty, to General Denit's office, the latter objected on the ground that the senior officer at each headquarters in the Southwest Pacific Area automatically became the chief of his technical service; that is, he would have supplanted General Denit. General Denit stated that he could not "sell" the command on another general officer for any of the headquarters there. 23

Throughout the period under discussion (mid-1942 to August 1944), the number of Medical Department officers in the medical sections of Services of Supply and of theater headquarters did not vary greatly in spite of a steady increase in troop strength, with concomitant increases in Medical Department strength, and in combat activity. The total (including officers of the Army Nurse Corps) in the Services of Supply medical section, the larger of the two, apparently never amounted to more than 35. The size of this medical section, plus that of the medical section at Headquarters, USAFFE (during the time when such a section existed), may justifiably be compared with the office of "theater surgeon" in other theaters. Apparently no more than 9 or 10 Medical Department officers were ever assigned to Headquarters, USAFFE. Thus de- spite an increase in troop strength (from 105,295 in September 1942 to 664,508 at the end of July 1944), the top medical office in the Southwest Pacific Area never underwent the steady growth in officer personnel that the theater medical section of the North African and European theaters experienced. The rank of officers heading major organizational elements in the Services of Supply medical section also remained low compared with that of some other theaters. In July 1944, for instance, only five colonels were assigned to that office, most branches of the medical section being headed by lower ranking officers. 24

SERVICES OF SUPPLY IN AUSTRALIA AND NEW GUINEA

In September 1942, Headquarters, U.S. Army Services of Supply, moved from Melbourne to Sydney, following General MacArthur's move of General Headquarters from Melbourne northward to Brisbane. From its Sydney head quarters, where it remained for a year, the Services of Supply operated the base sections in Australia and bases newly established with the advance of troops westward through New Guinea. Some additional Medical Department units arrived in the theater during that year; hospital trains were obtained from the

    23 (1) Letter, The Surgeon General, to Surgeon, U.S. Army Forces in the Far East, 1 Apr. 1944, and reply, 17 Apr. 1944. (2) Letter, The Surgeon General, to Surgeon, United States Army Forces in the Far East, 26 Apr. 1944, and reply, 25 May 1944.
    24 (1) Lists of personnel in the Office of the Chief Surgeon, U.S. Army Services of Supply, 14 Nov. 1942 and 6 Oct. 1943. (2) Office Memorandum No. 3, Chief Surgeon, Headquarters, U.S. Army Services of Supply, 5 Mar. 1943. (3) Office Memorandum No. 1, Chief Surgeon, Headquarters, U.S. Army Services of Supply, 3 Mar. 1944. (4) See footnote 17(l), p. 422. (5) Letter, The Surgeon General, to Surgeon, General Headquarters, Southwest Pacific Area, 2 Nov. 1943. (6) Memorandum, Assistant Chief, Personnel Section, for Surgeon, United States Army Services of Supply, 8 Oct. 1943.


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Australians to take care of evacuation among the base sections in Australia, and ships were prepared to receive patients to be transferred from one New Guinea base to another.

By the end of July 1943, USASOS still had only four general hospitals (two of 1,000 beds and two of 500 beds), all in Australia, but 26 station hospitals (ranging from 50 to 500 beds each) were serving in the Australian base sections and at the New Guinea bases. The platoons of two medical supply depots were also distributed among the base sections and bases, while detachments of two medical laboratories served in several. 25

The medical section at Services of Supply headquarters faced the difficulty of maintaining control over medical installations and units dispersed along a single line- from southeastern Australia along the northern coast of New Guinea and later to the Philippines- rather than a true zone of communications. It had to modify the standard composition and equipment of units to fit jungle, mountain, and amphibious warfare. Far removed from the San Francisco Port of Embarkation (about twice as far as its counterparts in the European and Mediterranean theaters were from New York), it was beset with difficulties of communication and transport. Because of shortages of manpower and materials, USASOS made but slow progress in 1943 in constructing buildings for hospitals.

Shortly before the transfer of the Surgeon, USAFFE, to the Services of Supply in September 1943, USASOS headquarters was moved again, this time from Sydney to Brisbane, where Headquarters, USAFFE, was already located (map 8). A rear echelon of USASOS, including a medical office, remained behind in Sydney for about a month to handle local procurement of equipment and supplies in Australia and Tasmania. Headquarters, USASOS, stayed at Brisbane until near the close of the New Guinea campaign (31 December 1944). Its advance headquarters kept in close proximity to the advance echelons of General Headquarters; of Headquarters, USAFFE; and of the Sixth U.S. Army, Fifth Air Force, and 14th Antiaircraft Command. In November 1944 it shifted from Brisbane to Hollandia (Base G), New Guinea; in February 1945 to Tacloban, Leyte (Base K); and in April 1945 to Manila. Its frequent moves and concomitant splits into an advance and a rear echelon led to segmentation of its headquarters medical office. The Chief Surgeon, USASOS (who after January 1944 was also Chief Surgeon, USAFFE), seems usually to have headed the small group of Medical Department officers familiar with problems of hospitalization, evacuation, and medical supply who went forward with the advance echelon. As the advance echelon had charge of the so called "ADSOS Fleet," consisting of ships operating interport service at the forward bases, medical personnel assigned to the advance echelon, as well as those at the forward bases in New Guinea, had a good deal of work to do in inspecting vessels to assure that sanitary conditions were satisfactory and that

    25 Civil Control Level of Information Report for 16-31 July 1943, Headquarters, U.S. Army Services of Supply.


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their safety equipment was in good order. The Deputy Chief Surgeon, USASOS, was in charge of the medical section at the main, or rear, headquarters of the Services of Supply during the periods when the advance echelon was split off from it. The frequent moves created a special problem in the administration of medical records. The large Central Medical Records Office at Services of Supply headquarters relied heavily upon civilian employees as a means of releasing soldiers for duty on the New Guinea front. With each move, numbers of civilian personnel had to be replaced and new employees trained. 26

Australian Base Sections

Until late in 1943, the principal areas of U.S. Army medical work in Australia continued to be Base Sections 1, 2, 3, 4, and 7 (map 8). The original Base Sections 5 and 6, in southwestern Australia, were disbanded about the end of 1942, because few U.S. Army troops had ever been stationed in that area. In September 1943, however, the northward movement of troops towards New Guinea and the concentration of medical units and installations around Cairns, led to the establishment of a new Base Section 5, by dividing Base Section 2. By August 1944, the decline in Australian base sections had set in, and Base Sections 1 and 4 had been disbanded.

The headquarters of the Australian base sections contained at the peak of their development in 1943 about 10 or 12 Medical Department officers each, including a dental officer, a veterinary officer, a venereal disease control officer, and a chief nurse. Officers assigned to other functions (medical supply, hospitalization, evacuation, and so forth) were often formally assigned to Medical Department installations in the vicinity- most commonly general hospitals. About mid-1943, Base Sections 2, 3, and 7 were each assigned a newly arrived food and nutrition officer. These men investigated the conditions under which food supply was procured in the base section, as well as the methods of handling it and issuing it to troops, analyzed menus, and inspected messes. Both the veterinary and venereal disease control officers worked in close cooperation with the appropriate Australian civil and military authorities. Dental clinics and laboratories and medical supply depots were established for each base section. Very few base or base section surgeons appear to have appointed a preventive medicine officer to coordinate the several activities in this field (sanitation, venereal disease control, medical inspection, malaria control, and so forth) under a single head, officers being assigned to these functions individually. One observer attributed the lack of coordination of preventive medicine.

    26 (1) Interview, 2nd Lt. C. W. Wilson, MAC, 5 Dec. 1945. (2) Letter, Headquarters, U.S. Army Services of Supply, to Commanding General, Advance Echelon, Services of Supply; Commanders of Sections, Bases, and so forth, 5 Feb. 1944, subject: Water Transportation, Control, and Responsi-bilities. (3) Annual Report, Chief Surgeon, U.S. Army Services of Supply, 1943. (4) Memorandum, Surgeon, U.S. Army Services of Supply, for Deputy Chief of Staff, 31 May 1943, subject: Movement of Medical Records Section.


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functions of the surgeons' offices of subordinate commands of the Services of Supply to a similar lack in the office, of the Surgeon, USASOS. 27

After October 1943, some of the Australian base sections (as well as later-established bases in New Guinea and the Philippines) were organized in accordance with a scheme advocated by Headquarters, Services of Supply, SWPA. Three commands were established at a base section or base: A service command, a port command, and an area command. Theoretically, a surgeon was assigned to each, but in a number of instances one man held two of these assignments. In some cases, the commanding officer of a hospital acted as port surgeon or area surgeon in addition to his hospital duties; or one officer might act as port surgeon and at the same time have charge of the work in sanitation and vital statistics for the base section. These dual assignments were frequently assigned to lack of personnel, but presumably the duties of a surgeon in such a restricted command were often insufficient to warrant an officer's full-time duty.

The surgeon of the base service command (which had under it the base chemical service, ordnance service, and so forth, as well as the base medical service), had the usual base surgeon's duties with respect to medical supply, hospitalization, and evacuation, and the usual base medical personnel were assigned to his office. The port surgeon inspected Army-controlled vessels for sanitary conditions and operated a port dispensary. At the port of Brisbane, for instance, where many ships moved in and out during 1943, 60 ships carrying troops to the advanced base in New Guinea were inspected by the port surgeon's office in the last 3 months of the year. The area command controlled all personnel not assigned to the service command or to the port command. These were chiefly personnel temporarily assigned to the base while staging or in transit. The area command surgeon worked out an areawide system of garbage removal, inspected kitchens and drainage, and cooperated with unit commanders of ground and air forces in the common effort. 28

Some common features and problems, as well as some significant variations in medical administration, in the Australian base sections may be noted. Malaria was indigenous only in the tropical regions of northern Australia (Base Sections 1, 2, and 5), but in late 1942 and early 1943, medical officers in Base Sections 3 and 4 were confronted with the problem of preventing the introduction of malaria into the southeast. During that period the malaria-ridden troops of the 1st U.S. Marine Division arrived from Guadalcanal and those of the 32d Division from New Guinea for hospitalization and convalescence, presenting the possibility of spread of the disease to nonmalarious areas. Malaria control at Brisbane and Melbourne was, like the control of venereal disease,

    27 (1) Memorandum, Col. Percy J. Carroll, MC, for The Surgeon General, 29 Aug. 1942, subject: Medical Services in Australia. (2) Annual Report, Chief Surgeon, Southwest Pacific Area, 1942. (3) Regulation No. 1-10, U.S. Army Services of Supply, 13 Nov. 1942, subject: The Mission, Organization, and Methods of Operation of Base Sections. (4) See footnotes 15(4), p. 420; 16, p. 420; and 17 (4), p. 422.
    28 See quarterly reports of the various Southwest Pacific Area base sections for 1943.


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a problem common to the large ports; it called for close liaison between U.S. Army doctors and Australian authorities, as well as close cooperation of base section medical officers with surgeons of the divisional units. In April 1943, a malaria control school was organized in Brisbane for medical officers of the 32d Division. The course, given to line officers as well as medical officers, consisted of lectures at the 42d General Hospital, work at the 3d Medical Laboratory, and practical field exercises in malaria survey and control work at an Army camp. Nearly a thousand officers, and many nurses and enlisted men, received training at the school before it was discontinued in July 1944.

Melbourne, Sydney, and Brisbane were the sites of the four general hospitals (two were in the Brisbane area) which served evacuees from New Guinea during 1943. The large eastern ports of Australia had responsibility for the initial reception of many Medical Department units, including dispensaries, various types of hospitals, medical supply depots, and medical lab oratories arriving from the United States. Throughout 1943, the port of Brisbane (Base Section 3) received the bulk of medical supplies and was the chief distribution point for all parts of the Southwest Pacific Area. The base section surgeon had a relatively large office of 35 officers, 35 enlisted men, and 25 civilians. Its work included supervision of an industrial health program for Australians employed by the U.S. Army in the base section. Closely resembling similar work in service commands in the United States, this program covered about 10,000 employees by the end of 1943. Medical examinations were given to prospective employees, industrial health inspections were made of plants operated by the U.S. Army, and Australian employees were treated in Army dispensaries and hospitals.

The medical situation in the tropical, undeveloped Northern Territory (Base Section 1) differed greatly from that in eastern Australia. Here the base section surgeon was located under tentage in "the bush" south of Darwin after the Japanese bombed Darwin early in 1942 until April 1943. He supervised the medical service at five troop locations scattered along the thousand mile stretch between Darwin in the north and Alice Springs in the south. 29

The New Guinea Bases

The establishment of U.S. Advance Base at Port Moresby, New Guinea, in August 1942 was the first move in the extension of the Services of Supply organization to New Guinea; during the succeeding 2 years, seven bases, preceded by a number of subbases, were developed. By June of 1943, four so-

    29 (1) Quarterly Reports, all Australian Base Sections, through 3d Quarter, 1944. (2) See footnotes 14(6), p. 419; and 16, p. 420. (3) Memorandum, Surgeon, Base Section 3, for The Surgeon General, 7 July 1944, subject: History of Base Section 3 Malaria Control School. (4) Letter, Col. C. R. Mitchell, to Dr. Maurice Pincoffs, 9 Dec. 1946. (5) Memorandum, Commanding General, U.S. Army Services of Supply, for Chiefs of General and Special Staff Sections, no date, subject: Plan for Organization of Base Section, USASOS and Reduction of Headquarters, USASOS. (6) Minutes, Conference of General and Special Staff Sections, Headquarters, U.S. Army Services of Supply, 2 May 1944. (7) Monthly Historical Summary, Medical Section, Base Section, U.S. Army Services of Supply, June 1944.(8) Medical History, 32d Infantry Division, 1 Jan.-30 June 1943.


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Called "advance subbases," three of which were forerunners of three New Guinea bases, Bases A, B, and D 30 (map 8), had been established under the control of U.S. Advance Base. Col. J. M. Blank, MC (fig. 98), with three other Medical Corps officers, one Medical Administrative Corps officer, and eight enlisted men undertook the task of setting up the office of the Surgeon, Advance Base, at Port Moresby in September 1942. Small U.S. Army tactical hospitals were already serving troops close to the front, but Colonel Blank's office was the first element of the Services of Supply medical organization to be established there. As a result of Japanese bombing around Port Moresby, buildings were ramshackled, and the office used furniture improvised from empty ammunition cases and packing crates. The surgeon's staff faced many difficult tasks during the early months: inspection of canned food in ration dumps, investigation of water supply, arranging storage for medical supplies shipped from Brisbane and Townsville, and delivery of medical supplies and hospital units and their equipment to forward areas by ship, plane, and parachute during the Owen Stanley-Buna campaign. Medical Department officers of Advance Base, surgeons of the 32d Division and Fifth Air Force, and medical

    30 Advance Subbase C on Goodenough Island lasted only from April to July 1943 and never developed into a base.


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officers of the Australian forces cooperated in planning measures to prevent insectborne diseases and dysentery and in adopting uniform standards of sanitation for Australian and American troops. In February, a malaria control committee of representatives of the American and Australian forces was organized, and in the following month the Australian Army medical service started a school in malaria control for men from each force in the U.S. Advance Base. The Advance Base Surgeon alluded to the usual complexity of coordinating efforts at sanitary control among air forces, ground forces, and troops of different nationalities when he stated that he was fighting simultaneously the American Air Force, the Royal Australian Air Force, the Australian Imperial Force, and the Japanese. 31

The establishment of the first three bases in New Guinea, Bases A, B, and D, 32 at Milne Bay, Oro Bay, and Port Moresby, respectively, largely set the pattern for all the New Guinea bases, the last of which was established on Biak Island as Base H in August 1944. Medical officers accompanied the task forces to some bases, while in other cases the nucleus of the surgeon's office went to the new base from an Australian base section, from. U.S. Advance Base at Port Moresby, or from an already established base in New Guinea. A number of Medical Department officers who were consistently assigned to the New Guinea bases, and later to the Philippine bases, were frequently shifted, often remaining only a month or so at one place.

Initial tasks of the medical group at a New Guinea base were to establish the base surgeon's office, a headquarters dispensary, and a medical supply depot, all usually under tentage, and to select sites for hospitals. In the New Guinea bases, malaria was a serious problem from the outset. At Milne Bay the rates were terrific in late 1942, at times amounting to 4,000 cases per 1,000 men per year. Some control work was undertaken in the early months. An Australian antimalaria control unit, for example, arrived at Oro Bay in January 1943 and began work with the aid of native labor, but the U.S. Army Medical Department's formal campaign against the disease began only in March with the arrival of control and survey units sent by the Surgeon General's Office.

Base organization in New Guinea was continually shifting in 1943 and 1944. As the Allies moved northwestward through New Guinea, forward bases were in various stages of building up, those to the southeast were in full operation, perhaps at their peak, while rear bases were in the process of

    31 (1) Memorandum, Acting Surgeon, U.S. Advance Base, for The Surgeon General, 11 Apr. 1943. (2) Letter, Surgeon, U.S. Advance Base, to Col. Percy J. Carroll, MC, 19 Sept. 1942. (3) Memorandum, Surgeon, Advance Base, for the Commanding General, Advance Base, 15 Oct. 1942, subject: Conference on Sanitation and Hygiene. (4) Letter, Surgeon, Advance Base, to Surgeon, U.S. Army Services of Supply, 20 Oct. 1942. (5) Day by Day Account of Inspection Trip to Advance Base, New Guinea, and Base Sections 2 and 3, 6 November-25 November 1942, no signature.
    32 There were various changes of designation from the date of the first establishment at Milne Bay in November 1942 to November 1943, when the terminology became "Base A," "Base B," and so forth. Down to August 1943, they were consistently referred to as "subbases." The final designation "base" is used throughout the text.


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"rolling up," as the Army's popular usage puts it. Changes in functions assigned and units and installations controlled were rapid. In August 1943, Advance Section, USASOS (replacing Advance Base, which was disbanded), wits set up, with headquarters first at Milne Bay (Base A) and shortly afterward at Port Moresby (Base D), to exercise direct control over the three New Guinea bases in existence (Bases A, B, and D). In November, Intermediate Section, with headquarters briefly at Port Moresby and then at Oro Bay (Base B), exercised control over the same bases. A new Advance Section established in November had headquarters at Lae (by January 1944 at Finschhafen) and controlled two newly established forward bases, Base E at Lae and Base F at Finschhafen (map 8). The job of the offices of the surgeons of both Advance and Intermediate Sections was largely that of supervising and coordinating the medical activities of the bases under the control of their respective sections. 33 By March 1944, both Base E and Base F had passed to the control of Intermediate Section, and Advance Section was disbanded. Bases A, B, and D continued active throughout the war. A full story of the medical work at Base A would include an account of its struggle to reduce malaria rates, handling of casualties from the Milne Bay air raids in 1943, and the great expansion of hospital beds there in 1943 and 1944. It was the site of the Second Medical Concentration Center, a pool for Medical Department units held in reserve, which by early 1944 was being expanded to a troop capacity of 5,000.

Bases E and F at Lae and Finschhafen were both established in November 1943 after these towns had been taken from the Japanese in September and October, respectively. The medical section of Binocular Force, which established a base at Lae for supplying the Fifth Air Force base at Nadzab, landed at Lae on 18 September. As a result of previous experience at the New Guinea bases, strict measures for the control of insectborne diseases, including the burning of kunai grass which harbors the mite- vectors of scrub typhus, were instituted from the start. Medical units began arriving by 1 October. By the end of March 1944, personnel handling base medical duties included, in addition to the base surgeon, a medical inspector, a. dental officer, a veterinary officer, an evacuation officer, a plans and operations officer, and a chief nurse. In early April, a nutrition officer and a venereal disease and statistics officer were assigned.

Medical personnel went from Base E to the future location of Base F in late October to make sanitary surveys and choose hospital sites. A surgeon's office was set up in early November and began operating a dispensary. Hospitals began arriving at Finschhafen at about the same time. By the end of

    33 (1) General Order No. 75, U.S. Army Services of Supply, 15 Nov. 1943. (2) General Order No. 73, U.S. Army Services of Supply, 14 Nov. 1943. The Advance and Intermediate Sections in New Guinea differed in concept from commands of the same name in other theaters. They did not include a geographic area but were merely headquarters established to supervise and coordinate the activities of two or more bases. Each was usually located at the same town as one of the bases which it controlled, and part of the personnel staffing the base also staffed the section. Decentralization of responsibility to the individual bases was the guiding principle in the administration of Services of Supply in New Guinea.


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April 1944, medical installations at Base F included a general hospital, four station hospitals, two field hospitals, seven dispensaries, a medical laboratory, and medical supply depots. Eight malaria survey and control units and a sanitary company were functioning. 34

Base G was established at Hollandia, Dutch New Guinea, in June 1944, to operate as an advance base directly under the control of Headquarters, USASOS, but in about 2 weeks it became an intermediate base under the control of Intermediate Section. In the Hollandia area the major headquarters- General Headquarters of the Southwest Pacific, Area, and the headquarters of U.S. Army Forces in the Far East, Allied Land Forces, Allied Air Forces, Fifth Air Force, and the Sixth and Eighth U.S. Armies, as well as of the U.S. Seventh Fleet- settled down during the months before the launching of the campaign for the Philippines. The last established of the New Guinea. bases, Base H on Biak Island, was developed in August 1944 after the hard summer campaign for the island.

Most medical problems encountered at the New Guinea bases, especially those which called for early solution on an area basis, were intensified in New Guinea by conditions of climate and terrain and the fact that combat preceded the establishment of the base. The undeveloped character of the country made it difficult to select satisfactory hospital sites and locate good water sources. Surgeons' offices, as well as medical installations, were usually under canvas or housed in temporary construction. Hospital personnel frequently had to clear hospital sites of trees and brush, make roads, and build their own hospitals, all the while caring for the sick and the wounded. The larger hospitals proved of less value at the New Guinea bases; to the end of 1943, no general hospitals served there, and patients needing general hospital treatment were evacuated to the large eastern ports of Australia where the general hospitals were located. As for insectborne diseases- malaria, dengue, and scrub typhus and other tropical maladies, these were much more prevalent in New Guinea than in the tropical regions of Australia; their control was rendered difficult by the fact that some cases occurred during combat before the base section organization could put areawide environmental control measures into effect.

Assignments and duties of officers in the medical sections of New Guinea bases differed little from their counterparts in the Australian base sections except for the employment of more venereal disease control officers in the Australian base sections; less emphasis on control of venereal disease was necessary in New Guinea. where troops had relatively little contact with native women. The surgeons' offices of New Guinea bases seem to have suffered a more rapid turnover of personnel than those of Australian base sections,

    34 (1) Quarterly Reports, Surgeons, Bases A-H, 4th quarter 1942 through 3d quarter 1944. (2) Quarterly Reports, Surgeons, Advance and Intermediate Sections, U.S. Army Services of Supply, 4th quarter 1943 through 3d quarter 1944. (3) History of USASOS and AFWESPAC Base at Lae Until March 1944. [Official record, Office of the Chief of Military History.] (4) History of USASOS and AFWESPAC, Finschhafen, New Guinea, Since Activation 1943 Until April 1944. [Official record, Office of the Chief of Military History.]


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building up to a greater strength and declining rapidly as troops and units were moved forward or the lines of evacuation shifted, bypassing the hospitals of the base.

THE TACTICAL FORCES

For some months, the highest tactical command of the U.S. Army ground forces in the Southwest Pacific Area was I Corps. Its staff medical section and that of the 32d and 41st Divisions in Australia and New Guinea were the principal offices supervising medical service for the U.S. Army ground forces in the area. Not until early in 1943 did a field army- the Sixth U.S. Army- build up in the Southwest Pacific Area.

Air force units were originally stationed in northern Australia around Darwin and Townsville, but as early as May 1942 some moved up to New Guinea. The Fifth Air Force was established to comprise these units in September 1942.

Air Forces

The Fifth Air Force was constituted on 3 September 1942 with headquarters at Brisbane. By the end of the year it had been organized into the three major commands typical of a numbered air force- a service, a bomber, and a fighter command- each with a staff surgeon. Col. Bascom L. Wilson, MC, was made Surgeon, Fifth Air Force. In order to conserve medical officers (venereal disease control officers and dental officers especially were needed in tactical units), the office of the air force surgeon and of the air service command surgeon, which had the larger staff, were combined. When the advance echelon of the Fifth Air Force was established in New Guinea, Maj. Dan B. Searcy, MC, became its surgeon; after his death on a bomber mission in January 1943, Lt. Col. Alonzo Beavers, MC, took his place. From the fall of 1942 to February 1944, the advance echelon was at Port Moresby; then it moved to the Nadzab Air Base (near Lae, headquarters of Base E) and remained there until June 1944, when it went to Owi Island in the Schouten group off northwestern New Guinea.

In March 1943, both the Fifth Air Force surgeon and the advance echelon surgeon had small staffs of two Medical Corps officers, a veterinarian, and a few enlisted men and civilian clerks. In succeeding months the three main task forces of the Fifth Air Force, later made bombardment wings, were organized with flight surgeons assigned to each. By the end of 1943, about four-fifths of the approximately 5,000 troops of the Fifth Air Force had moved northward to the Darwin area of Australia or to New Guinea-the majority beyond the Owen Stanley Mountains. 35

    35 (1) See footnote 11 (1), p. 415. (2) Annual Report, Medical Department Activities, Fifth Air Force, 1943. (3) Annual Report, Surgeon Advance Echelon, Fifth Air Force, 1942. (4) Memorandum, Surgeon Fifth Air Force for The Air Surgeon, 1 Mar. 1943, subject: Report of Medical Activities.


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During 1942 and part of 1943, the lift of thousands of patients over the Owen Stanley Range to Port Moresby was accomplished by Australian and American transport planes without benefit of medical personnel. Although various official reports noted the lack of an effective system of air evacuation from New, Guinea, no basic change took place until the arrival of the 804th Medical Air Evacuation Transport Squadron in June 1943. This unit was originally assigned to the Services of Supply, but the Fifth Air Force soon succeeded in getting all personnel of the squadron except the nurses transferred to the jurisdiction of its 54th Troop Carrier Wing. By the end of the year it had gained control of the nurses as well. Nevertheless, air evacuation continued to be hampered by difficulties in coordinating the efforts of General Headquarters, Services of Supply, and the air force elements. Problems continued under discussion throughout 1943. 36

Like other air forces, the Fifth Air Force possessed a number of dispensaries equipped with beds. By the end of 1943, it had 12 with from 3 to 40 beds each in northeastern Australia and eastern New Guinea. Five of the 25-bed portable surgical hospitals (with capacity for expansion to 50 beds each), which the Services of Supply had designed for use by task forces far forward, were assigned to the Fifth Air Force and were operating at Finschhafen and in the Markham Valley of New Guinea. The Fifth Air Force surgeon voiced the common complaint of some oversea air force surgeons that the hospitalization of patients in fixed hospitals of the Services of Supply was unsatisfactory in some respects. Officers no longer fit for flying were returned to duty in New Guinea, lie averred, by hospital boards unversed in the factors which should be considered in determining fitness for flying. Fifth Air Force patients discharged by general hospitals in Australia (no general hospitals were operating in New Guinea in 1943) were not returned promptly to their units in New Guinea. In order to maintain more effective control over air troops in general hospitals in Australia, the Fifth Air Force stationed a medical officer in Brisbane and one in Sydney. These men kept the air force units informed on the status and disposition of their troops hospitalized in Australia. They served as effective links for the air force elements in New Guinea with base section surgeons in Australia, as well as with Australian medical authorities. 37

In June 1944, the Far East Air Forces and its service command were established with headquarters at Brisbane including not only the Fifth Air Force but also the Thirteenth Air Force, which was being transferred from the South Pacific. Col. R. K. Simpson, MC, who had served briefly as Fifth Air Force surgeon, became Surgeon, Far East Forces, when the headquarters of the Fifth

    36 Air Evaluation Board, Report No. 35, The Medical Support of Air Warfare in the South and Southwest Pacific, 7 December 1941-15 August 1945.
    37 (1) See footnotes 6(4), p. 411; 18(9), p. 423; 27(l), p. 430; 35(2), p. 436; and 36. (2) Report of Inspections, 4 to 24 Oct. 1943, by Chief, Operations Division, Office of the Air Surgeon. (3) Letter, Headquarters Advance Echelon, Fifth Air Force, to Commanding General, Fifth Air Force, 20 Apr. 1944, subject: Request for Assignment of Hospitals.


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Air Force became headquarters for the new top air force command. He headed a small coordinating medical office. The Advance Echelon, Fifth Air Force, then at Owi Island in the Schouten group off northwestern New Guinea, was made Headquarters, Fifth Air Force, and Lt. Col. Alonzo Beavers thus became surgeon for the entire Fifth Air Force. Towards the close of 1944, personnel of the Far East Air Forces totaled about 135,000.

During the stay of the Thirteenth Air Force in the South Pacific Area the medical sections of its headquarters and its service command headquarters had functioned jointly at a single office. In June, the office of the air force surgeon moved from Guadalcanal to Los Negros in the Admiralty Islands. Col. Kenneth J. Gould, MC (fig. 99), succeeded Colonel Frese as surgeon in September 1944. The service command surgeon's staff remained at Guadalcanal, performing medical tasks connected with the shift of air force units to the Southwest Pacific Area. In January 1945, it moved to Morotai, where it undertook medical planning for the move of Thirteenth Air Force units into the Philippines. The frequent moves of commands and subordinate elements to scattered islands led to the same demand for large numbers of Medical Department officers for administrative positions which was evident in theater organization and which the Thirteenth Air Force had experienced since its early days in the South Pacific.

Intratheater air evacuation was handled by three medical air evacuation transport squadrons assigned to the 54th Troop Carrier Wing of the Fifth Air Force. Besides the unit already assigned to the Fifth Air Force, a second air evacuation transport squadron (the one which had performed a large share of the evacuation by air which the South Pacific Combat Air Transport Command had accomplished) became available when it accompanied the Thirteenth Air Force to the Southwest Pacific Area. A third squadron arrived from the United States in mid-1944. The wing level from which the squadrons were controlled was too low a level from which to effect coordination of air evacua-tion with General Headquarters and U.S. Army Services of Supply. The problem of theaterwide coordination was not solved until mid-1945.

As of August 1944, when personnel of the air forces comprised about 17 percent of the theater's troop strength, of the 32 malaria survey units in the theater, 5 were assigned to the Fifth Air Force and 3 to the Thirteenth Air Force. Of the 55 control units, 10 were assigned to the Fifth and 5 to the Thirteenth Air Force. The Thirteenth had had no malaria control or survey units under its control until it moved to the Southwest Pacific Area, as the Malaria and Epidemic Control Board had exercised full direction over the operations of all such units in the South Pacific Area. In the Southwest Pacific, air elements were located on islands where no Services of Supply bases existed (Morotai, for example), and the air forces needed such units for a preventive program among its own troops.


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One unusual development occurred in medical administration for the air forces when the theater command took over, late in 1943, several medical supply platoons (aviation) originally requested by the Fifth and Thirteenth Air Forces, as well as the single medical air evacuation transport squadron (the 804th) then in the area. Only one of the supply units was assigned to the Fifth Air Force and none to the Thirteenth. Instead, the Southwest Pacific Area command, finding the units which the air forces had designed more suited for handling medical supply during the early stages of amphibious operations than were the larger medical supply units, assigned them to the Services of Supply and to Sixth U.S. Army. After repeated requests the Fifth Air Force received a second medical supply platoon (aviation), and when the Far East Air Forces was created in June 1944 the two units assigned to the Fifth Air Force were transferred to the Far East Air Service Command. Other such units arrived in the theater but were assigned to the armies and to the Services of Supply. The Air Evaluation Board, which was sent by the War Department to the Southwest Pacific Area in 1944 and 1945 to appraise the effectiveness of air operations there, sustained the claims of the Far East Air Forces that the number of medical supply platoons (aviation) assigned to it was insufficient. In the case of these units, as with the first. medical air evacuation


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transport squadron sent to the Southwest Pacific Area, the air forces actually lost control of their own specially developed units to the Services of Supply. 38

Sixth U.S. Army

The man originally chosen for the position of Sixth U.S. Army surgeon,, Col. John Dibble, MC, was killed en route to the Southwest Pacific Area in a plane, crash off Canton Island. Col. (later Brig. Gen.) William A. Hagins, MC (fig. 100), who arrived in Australia in early March 1943, took his place. During the early months in Australia, Colonel Hagins and his staff were located at the army's headquarters at Camp Columbia near Brisbane. His medical office included an executive officer, operations and training officer, officers to head supply and statistics, and a Dental Corps officer and a Veterinary Corps officer to lead their respective branches. In May, a venereal disease control officer was added at the instance of the theater command.

With the exception of special features for malaria control, the Sixth U.S. Army's medical organization at army, corps, and division level differed little from that of armies in the Mediterranean and European theaters. Below the office of the army surgeon were the staff of the Surgeon, I Corps, at Rockhampton, Queensland, and the surgeons' offices of several divisions in eastern New Guinea and northeastern Australia. In the middle of 1943, the 24th, 32d, and 41st Infantry Divisions, and the 1st Cavalry Division were assigned to Sixth U.S. Army, which also had operational control of the 1st Marine Division at this date.

At intervals, the medical staff of Headquarters, I Corps, or of the various divisional headquarters, as well as those of Sixth U.S. Army headquarters, were split between a forward and a rear echelon. The division surgeon's office typically included a division medical inspector, a division dental surgeon, a veterinarian, and perhaps an executive and a medical supply officer.

Malaria, and at times scrub typhus, was a. serious problem to medical officers serving with Sixth U.S. Army. Prevention of malaria in forward areas called for tremendous efforts in spraying ponds and other breeding places in New Guinea, filling holes, and clearing out undergrowth and brush in camp areas, as well as training divisional troops in methods of control. In 1943, the menace of malaria hung like a pall over divisional elements recalled to Australia from combat in New Guinea. Convalescent areas and rest camps were set up in Queensland to care for men recovering from the disease. Many chronic, debilitated, relapsing cases of malaria of the 32d and 41st Divisions were. reconditioned in the Sixth U.S. Army Training Center at Rockhampton.

    38 (1) General Order No. 5, Headquarters, Far East Air Forces, 15 June 1944. (2) General Order No. 53, Headquarters, U.S. Army Forces in the Far East, 14 June 1944. (3) Annual Report, Medical Department Activities, Fifth Air Force, 1944. (4) Monthly Reports, Thirteenth Air Force Service Command, May 1944-April 1945. (5) See footnotes 14(3), p. 419; and 36, p. 437. (6) Quarterly Report, Medical Department Activities, Far East Air Forces, 2d quarter 1944. (7) Quarterly Report, Surgeon, Thirteenth Air Force, 3d quarter 1944.


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In June 1943, Colonel Hagins and a few of his staff joined the forward echelon (known as the Alamo Force) Sixth U.S. Army in New Guinea near Milne Bay. Thereafter Colonel Hagins' staff, usually split into two and sometimes three echelons, moved to many locations in the course of the war. The forward echelon remained at Milne Bay until October 1943, moving then to Goodenough Island and early in 1944 to Cape Cretin on the Huon Peninsula of New Guinea. Throughout all this period, a rear echelon remained behind at Camp Columbia, joining the forward echelon at Cape Cretin in February 1944. The reunited surgeon's office moved to the vicinity of Hollandia (Base G) in June. There it remained until fall when the move into the Philippines began.

By 1 July 1944, when the entire medical section of Sixth U.S. Army was near Hollandia, it had enlarged to 16 Medical Department officers and 1 warrant officer. These included, besides the surgeon and his executive, two supply officers, a personnel officer, a statistical officer and his assistant, a hospitalization and evacuation officer and his assistant, a dental surgeon and his assistant, a combined veterinary officer and medical inspector and his assistant, a malariologist, an operations officer, a task force surgeon, and a surgeon for the Alamo Scouts. The two last named were special assignments of Medical Department


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officers in an army on the move. The Eighth U.S. Army surgeon also served temporarily with the office. Throughout 1944 many gains and losses occurred in Sixth U.S. Army's medical staff, several malariologists being added.

To the task forces (typically a reinforced division) which operated in New Guinea and the small outlying islands, units over and above the organic medical service, including many mobile units devised by Colonel Carroll and his staff, had to be added. Whenever a task force was set up for a specific operation, a surgeon, sometimes the commanding officer of a medical unit, was chosen, and a member of the medical section at Sixth U.S. Army's forward echelon acted as liaison officer with the task force surgeon. 39

CONTROL OF MALARIA AND OTHER TROPICAL DISEASES

The program for malaria control in the Southwest Pacific Area got off to a late start. No malaria control or survey units arrived until March 1943 after high malaria rates had occurred in New Guinea. At the close of 1942, a rate of over 1,000 cases per 1,000 men per year occurred among troops at Milne Bay. About 30.3 percent of the hospitalized cases among U.S. Army troops between 3 October 1942 and 3 April 1943 were due to malaria; battle casualties accounted for only 2.75 percent. 40 Rates were lowered at a later date, but the antimalaria program in the Southwest Pacific Area was characterized by considerable administrative confusion during 1943 and was never under strongly centralized control until late in the war.

A number of factors influenced the effectiveness of antimalaria efforts: the degree of familiarity of individual Army doctors with malaria, the support given the program by line officers, the numbers of trained personnel and quantities of antimalaria supplies and equipment available, and the advance planning done by the Surgeon General's Office. In July 1943, the War Department Chief of Staff (General Marshall) made the following appraisal: "Apparently the trouble in the past has been that priorities for munitions overrode those for the necessary screening and other materiel to provide protection at the bases, also there has not been sufficiently rigid sanitary discipline as to the individual soldier." Medical Department officers who had a major share in administering the program also pointed to low priorities for antimalaria supplies and to inadequate support of the program by some line officers. Many, including Colonel Carroll and the Chief of the Tropical Disease and Malaria

    39 (1) Periodic Reports, Medical Department Activities, Sixth U.S. Army, 1943, 1944. (2) Report of Medical Department Activities, Alamo Force, June-December 1943. (3) Quarterly Reports, Medical Department Activities, Headquarters, I Corps, 1943. (4) Annual Report, Surgeon, 24th Infantry Division, 1943. (5) Annual Report, Surgeon, 32d Infantry Division, 1943. (6) Annual Report, Surgeon, 41st Infantry Division, 1943. (7) Annual Report, Surgeon, 1st Cavalry Division, 1943. (8) History, U.S. Army Forces In the Far East, 1943-1945. [Official record, Office of the Chief of Military History.] (9) Letter, Maurice C. Pincoffs, M.D., to Col. John Boyd Coates, Jr., MC, USA, Director, The Historical Unit, U.S. Army Medical Service, 1 Sept. 1955, and inclosure.
    40 Memorandum, Lt. Col. Paul F. Russell, MC, for The Surgeon General, 1 July 1943, subject: Malaria in South and Southwest Pacific Area.


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Control Section of the Surgeon General's Office, ascribed a good deal of the difficulty to the lack of centralized control over the program. 41

The high command in the Southwest Pacific Area adopted several measures, beginning in September 1942, designed to cope with the malaria threat. In an interview with Colonel Rice, who had just been appointed Surgeon, GHQ, General MacArthur stressed the part which malaria had played in his defeat in the Philippines and urged intensive effort to prevent high malaria rates in New Guinea. In the same month, Gen. Sir Thomas Blamey, Commander, Allied Land Forces, sent Col. N. Hamilton Fairley, Director of Medicine, Australian Army Medical Corps, and an Australian chemist to London and Washington to convince British and American authorities of the gravity of the malaria threat to Allied forces in the Southwest Pacific Area; in the United States they pressed for large-scale manufacture of antimalaria supplies, especially Atabrine. This drug became the chief substitute for quinine as a suppressant of malaria among U.S. Army troops in malarious areas, but was still in short supply during the early months of 1943. 42

Early in 1943, General MacArthur took a further step to deal with the malaria problem. The arrival of the 1st Marine Division, with high malaria rates, from the South Pacific Area and the high incidence of malaria in troops of the 32d Division in New Guinea made it clear that a control program should be directed from General Headquarters, whence control over the operations of tactical forces was exercised. General Blamey and General MacArthur agreed that cooperation between Australian and American forces fighting in close proximity in New Guinea was essential. In March, General MacArthur appointed the Combined Advisory Committee on Tropical Medicine, Hygiene, and Sanitation, made up of specialists from the military forces of both countries. The committee's function was to advise him on measures for the prevention and treatment of tropical diseases in the Allied forces, on "medical implications in any present or future theaters of operations," and on means of preventing the introduction and spread of tropical diseases into Australia by troops returning from malarious regions. In recognition of the strong interest

    41 (1) See footnotes 12(l), p. 416; and 40, p. 442. (2) Lt. Col. Paul F. Russell, MC, Chief, Tropical Disease and Malaria Control Section, Office of The Surgeon General: Abstract of Report and Recommendations Regarding Malaria and Its Control Among American Forces in the Southwest Pacific Area, 25 May 1943. (3) Letter, Col. Percy J. Carroll, MC, to Lt. Col. Paul F. Russell, MC, 18 June 1943. (4) Memorandum, Chief Surgeon, U.S. Army Services of Supply, for Commanding General, U.S. Army Services of Supply, 7 Oct. 1943, subject: Organization for Malaria Control, Southwest Pacific Area. (5) Parrish, Susan F.: Summary, Preventive Medicine at USAFFE Level, Organization for Malaria Control, no date. [Official record.] (6) For greater detail, see Medical Department, U.S. Army, Preventive Medicine in World War II. Volume VI. Communicable Diseases: Malaria. Washington: U.S. Government Printing Office. [In press.]
    42 (1) Letter, Maj. Gen. George W. Rice, to Editor, Historical Division, Office of The Surgeon General, 19 June 1951, and inclosure. (2) Fairley, Col. N. Hamilton: Results of Mission to USA and UK regarding Malaria, Anti-Malarial Drugs, and Other Essential Supplies for the Control of Malaria, no date. [Official record.] (3) Combined Advisory Committee on Tropical Medicine, Hygiene, and Sanitation: Review of Activities From the Inception of the Committee to 30 June 1944. [Official record.] (4) See footnotes 12(3.), p. 416; and 41(6). (5) Walker, Allen S.: Australia in the War of 1939-1945. Clinical Problems of War. Canberra: Australian War Memorial, 1952, p. 84.


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of the Australians in keeping tropical disease out of the continent, Colonel Fairley was made chairman. Col. Maurice C. Pincoffs, MC, Chief of Professional Services, Headquarters, USAFFE, served as secretary to the end of the war. He and Colonel Fairley were the committee's most active members; they worked in close cooperation. The theater malariologist and the Fifth Air Force surgeon also served on the committee.

The Combined Advisory Committee devoted itself to the consideration of the total problem of control of tropical diseases, giving attention to cholera and other diseases, including some which are not solely tropical, such as smallpox. It was concerned with control by environmental means, suppressives, vaccines, or other methods. It issued broad directives applicable to the ground, naval, and air forces of all the Allies. By virtue of its location at General Headquarters, it was able to press for priorities for shipment of antimalaria supplies to the Southwest Pacific Area. A serious handicap to the committee's work, on the other hand, was its lack of a regular source of information on the incidence of tropical diseases among troops. Since the separate commands were not required to furnish statistical reports to it on disease incidence, it had to depend upon committee members to make available whatever information they gleaned in the course of their other official duties. Nor was it regularly informed of impending operations. Hence whatever knowledge it possessed of tropical diseases to be expected by Allied troops invading enemy-held areas could not be put to effective use for planning preventive measures during specific campaigns. The committee encountered no major difficulties in getting its general recommendations accepted, since it was located at General Headquarters and since members of the committee served the subordinate commands in other capacities. In the opinion of its secretary, the committee filled in some measure the gap in the medical section at theater headquarters resulting from the lack of a preventive medicine division. However, the committee's functions were advisory; it never had control over the actual operations of the men and units engaged in malaria control- the malariologists and the malaria control and survey units. After General Headquarters had moved to Hollandia in 1944 and was poised to go on to Leyte, it became difficult for the committee to hold effective meetings, since some of its members had primary duties with headquarters of commands located elsewhere. 43.

The malariologists and control and survey units came into the theater in early 1943. In answer to the request of the Surgeon General's Office for the number of these needed in Southwest Pacific Area, General Headquarters asked the War Department on 1 December 1942, on the recommendation of Colonel Carroll (then at U.S. Army Services of Supply headquarters), for 1 malariolo-

    43 (1) Suggested Combined Advisory Committee on Tropical Medicine and Hygiene, 19 Feb. 1943, by Gen. T. A. Blamey. [Official record.] (2) See footnotes 14(l) and 14(7), p. 419; and 42(3), p. 443. (3) Letter, Adjutant General, General Headquarters, Southwest Pacific Area, to Commander Allied Land Forces, Commander Allied Air Forces, and Commanding General, U.S. Army Forces in the Far East, 2 Mar. 1943, subject: Combined Advisory Committee on Tropical Medicine, Hygiene, and Sanitation.(4) Minutes, Meetings of Combined Advisory Committee, 13 Mar. 1943-31 Aug. 1944.


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gist, 6 assistants, 3 survey units, and 12 control units. At this date none of the units were ready, but after War Department approval of the proposed organization late in the year, some of the malariologists and parts of units were sent to Australia by air. By February 1943, three full survey units had arrived at Brisbane, but more than a month's delay ensued before they reached New Guinea on 22 March. Control units did not arrive in New Guinea. until June. Meanwhile, in February, Col. Howard F. Smith of the U.S. Public Health Service, who had worked on quarantine problems in the Philippines and was General MacArthur's family physician, was made theater malariologist at Headquarters, U.S. Army Forces in the Far East. 44

As a result of shifting top commands, the organization for malaria control in the Southwest Pacific Area was less stable than that in the South Pacific. Originally, the theater malariologist appointed in February 1943 was assigned to the office of the Surgeon, U.S. Army Forces in the Far East. He remained there until the following September, when the special staff, USAFFE, was discontinued. From September to the end of the year, he was in the office of the Services of Supply surgeon. Malaria records and reports were handled all this time by the office of the Surgeon, USASOS; thus from February to September 1943, the theater malariologist was at a headquarters other than that where statistics on malaria incidence among troops were maintained. 45

The Chief of the Tropical Disease and Malaria Control Section of the Surgeon General's Office, Lt. Col. Paul F. Russell, MC, was sent to the Southwest Pacific Area (as well as the South Pacific) by The Surgeon General in mid-1943, shortly after the malaria control organization there got under I way, to investigate control measures. By then, the 32d U.S. Division had been incapacitated for some months by high malaria rates (including high relapse rates) after being evacuated from combat in New Guinea, and a similar fate threatened the 41st Division in the Buna-Gona area. Malaria had also forced the evacuation of the 6th and 7th Australian Divisions from New Guinea, and of the Americal Division and the 1st and 2d Marine Divisions from Guadalcanal, in all six Allied divisions in the Southwest and South Pacific Areas. At this date, the organization for malaria control consisted of 1 malariologist, 7 assistant malariologists, 3 malaria survey units, and 12 malaria control units, with additional trained personnel and units requested. The buildup of the malaria control organization was slow because antimalaria units could not be activated and sent from the United States until the theater organization had become convinced of their value and had requested them. 46

    44 (1) Memorandum, Capt. Harold M. Jesurun, Assistant Malariologist, for Division Surgeon, 41st Infantry Division, 29 Apr. 1943, subject: Medical History, Malaria Survey Units in New Guinea. (2) See footnote 14(5), p. 419. (3) Letter, Col. George W. Rice, MC, to Col. Percy J. Carroll, MC, 13 Nov. 1942, and attachment. (4) Interview, Thomas A. Hart, M.D., formerly of 6th Malaria Control Unit, June 1951. (5) Staff Memorandum No. 3, U.S. Army Forces in the Far East, 27 Feb. 1943.
    45 See footnote 41 (5), p. 443.
    46 McCoy, Lt. Col. Oliver R. The Tropical Disease Control Division, 1 July 1946. [Official record.]


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Colonel Russell noted that the Surgeon General's Office had designed the network for malaria control in the expectation that it would function as a single entity under a theater surgeon, with authority stemming from the theater commander through the theater surgeon; it was meant to undertake control measures in the ground, service, and air forces alike. He noted some Past failures of commanding officers to carry out the official directives for malaria control. In his opinion malaria control personnel in the Southwest Pacific Area could not function effectively, for they were split between two headquarters. The chief 'malariologist, who was also medical inspector, and his assistant were at this time assigned to the Chief Surgeon, USAFFE, while the other assistant malariologists and the control and survey units were assigned to the Chief Surgeon, USASOS. Although the chief malariologist and his assistant had technical control over the assistant malariologists, the latter group had no authority to deal with the air forces or the armies on malaria control problems. Colonel Russell remarked that the anopheles did not respect command channels and that it infected men within specific areas regardless of the command to which they were assigned.

Colonel Russell advised separating the position of chief medical inspector for the theater from the job of chief malariologist and making the latter responsible solely for malaria control. He advocated making the theater malariologist, Colonel Smith, "chief medical inspector" and his first assistant malariologist, Colonel Orth, "medical inspector (special) malariologist." Both were to remain at USAFFE headquarters in their new assignments, but the theater malariologist, who should have direct operational control over antimalaria personnel, could best function from the Advance Base, New Guinea. The theater malariologist and the Surgeon, USAFFE, concurred in the main with Colonel Russell's recommendations. They believed that the Services of Supply should furnish malaria control personnel and units with rations, quar-ters, and supplies but that the U.S. Army Forces in the Far East should retain full control over the assignments and operations of all elements of the malaria control organization. 47

In June 1943, Colonel Russell's recommendations were largely put into effect, although no such separation of the duties of medical inspector and theater malariologist as he suggested appears to have been carried out. Colonel Smith- sometimes termed "medical inspector special (malariologist) " and sometimes "theater malariologist"- and Colonel Orth- variously termed "chief malariologist" and "assistant theater malariologist"- and the other malariologists, called "assistant medical inspectors special (malariologist),"

    47 (1) See footnote 41(2), p. 443. (2) Check Sheet, Theater Malariologist, for Chief Surgeon, U.S. Army Forces in the Far East, 31 May 1943, subject: Comments in Reports by Lt. Col. Russell Relative to Malaria Control. (3) Memorandum, Chief Surgeon, U.S. Army Forces in the Far East, for Assistant Deputy Chief of Staff, United States Army Forces in the Far East, 31 May 1943. (4) Memorandum, Adjutant General, United States Army Forces in the Far East, for Commanding General, U.S. Army Services of Supply, Southwest Pacific Area, 28 Feb. 1943, subject: Assignment of Malariologists and Malaria Survey Units.


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were all assigned to the office of the Surgeon, USAFFE. Any of the malariologists (except the theater malariologist and his assistant) might be attached to the staff of a commander to advise him on control measures and to supervise the control work undertaken within his command. Although the control and survey units were assigned to the Services of Supply for administrative purposes, jurisdiction over their operations and movements was vested in USAFFE headquarters. Normally they would be assigned -to area commands of the Services of Supply (that is, base sections or bases), but they might be attached to various other commands. Movements of antimalaria units within a base were to be effected by the base commander on request of the senior malariologist, USAFFE, on duty in the base. USAFFE headquarters would direct the movements of the units from one base to another. Regardless of the command to which they were attached or assigned, both malariologists and antimalaria units were to remain under the direct supervision of the theater malariologist.

These arrangements satisfied Medical Department officers immediately concerned with the malaria control program, but difficulties persisted. The Fifth Air Force surgeon, for instance, wanted all antimalaria. units operating with the air force assigned to it, and General Headquarters at times demanded the assignment of these units to task forces. Tactical commands showed unwillingness to recognize the desirability of distributing antimalaria. units on the basis of theaterwide needs. 48

In any case, the scheme mapped out in June was short lived. When the segments of the offices of the chiefs of technical services assigned to Headquarters, U.S. Army Forces in the Far East, were transferred in the fall of 1943 to Services of Supply headquarters, the malariologists were transferred with Colonel Carroll. The latter pointed out the division of authority that the transfer produced; responsibility for malaria control was now vested in the headquarters of three mutually independent commands, the Services of Supply, the Sixth U.S. Army, and the Fifth Air Force, each of which had charge of the program within its own command. In the combat areas of New Guinea, Colonel Carroll noted, troops of the Sixth U.S. Army, the Fifth Air Force, and the Services of Supply were commonly stationed close to each other; mosquitoes bit all impartially. Colonel Carroll emphasized the need for uniformity in discipline and education with regard to malaria and for standardization of treatment of the disease. He recommended that theater headquarters give authority, by formal statement, to the organizational elements for malaria control, now entirely under the Services of Supply, to operate throughout all areas of the theater occupied by American troops, regardless of command. Headquarters, U.S. Army Forces in the Far East, issued such a statement in November 1943. The Commanding General, USASOS, was to have control of

    48 (1) Memorandum, Adjutant General, U.S. Army Forces in the Far East, for Commanding Generals, Sixth U.S. Army, Fifth Air Force, U.S. Army Services of Supply, 15 June 1943, subject: Organization for Malaria Control. (2) See footnote 41(3), p. 443. (3) Letter, Lt. Col. G. L. Orth, MC, to Lt. Col. D. A. Chambers, MC, 21 July 1943, and reply, 9 Aug. 1943. (4) Letter, Lt. Col. D. A. Chambers, to Lt. Col. G. L. Orth, MC, 22 Sept. 1943.


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the movements of personnel and units of the organization for malaria control, not only those assigned to the Services of Supply which he could move about freely within and among bases but also of those attached to the Sixth U.S. Army and the Fifth Air Force. In the case of the latter two commands the concurrence of the respective commanding general had to be obtained in order to move a unit. The Commanding General, USASOS, was to publish the official instructions on malaria control, discipline, standards of suppressive and curative treatment, and on investigations of malaria among Army troops; be was to receive all formal reports on malaria from other commands.

Some difficulty continued, however, as long as the heads of the malaria control organization were under the Services of Supply- that is, throughout the last 3 months of 1943- in spite of additional official utterances asserting the independence of the malaria control organization and reemphasizing the obligations of commanders for carrying out malaria control measures. The Sixth U.S. Army wanted the assistant theater malariologist, Colonel Orth, then located at Advanced Section headquarters in New Guinea, assigned to that army. Late in the year, the assistant malariologists were unable to visit tactical units of the Sixth U.S. Army or Fifth Air Force until they obtained permission for each trip from those commands. At that date, all assistant malariologists were assigned to the 8th Medical Laboratory because of the desire of the Commanding General, USASOS, that they not be carried as part of the overhead of his headquarters. Their commanding officer was too low in the hierarchy to permit effective appeal whenever the assistant malari-ologists encountered stumbling blocks. 49

In January 1944, when General Denit was made both theater surgeon and Services of Supply surgeon, Colonel Smith was made "chief malariologist and medical inspector," U.S. Army Forces in the Far East. Direction of the antimalaria program continued to be exercised from the USAFFE level throughout the life of that command. During 1944, an adequate number of skilled personnel and units arrived in the theater; some were transferred from the Central and South Pacific Areas. Near the close of August 1944, the Southwest Pacific Area had 18 malariologists and 32 survey and 55 control units, a considerably higher number than were sent to any other theater of operations during the course of the war. Ten more units were en route to Hollandia at that date. As the Services of Supply received additional units, it became, more amenable to releasing them to the tactical forces.

    49 (1) See footnote 41(4), p. 443. (2) Memorandum, Chief Surgeon, U.S. Army Services of Supply, for Chief of Staff, 22 Oct. 1943. (3) Memorandum, Assistant Adjutant General, U.S. Army Forces in the Far East, for Commanding Generals, Sixth U.S. Army, Fifth Air Force, U.S. Army Services of Supply, 24 Oct. 1943, subject: Organization for Malaria Control and Amendment of 1 Nov. 1943. (4) Memorandum, Assistant Theater Malariologist for Chief of Professional Service, Office of the Chief Surgeon, U.S. Army Services of Supply, 17 Nov. 1943. (5) Letter, Chief Surgeon, U.S. Army Services of Supply, to Assistant Theater Malariologist, 1 Dec. 1943., (6) Memorandum, Assistant Adjutant General, U.S. Army Forces in the Far East, for Commanding Generals, Sixth U.S. Army, Fifth Air Force, U.S. Army Services of Supply, 14 Antiaircraft Command, 22 Dec. 1943, subject: Operation of Malaria Control. (7) Letter, Director, Tropical Disease Control Division, Office of The Surgeon General, to Chief Surgeon, U.S. Army Forces in the Far East, 26 Jan. 1944.


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The assistant theater malariologist- Colonel Orth, until late, 1944, when he relieved Colonel Smith- functioned under the Services of Supply, which employed the bulk of the antimalaria personnel at the New Guinea bases, With the aid of a few enlisted men and an occasional officer, he directed malaria control operations in New Guinea from Headquarters, Intermediate Section, located at Oro Bay, and later from other bases in Now Guinea and the Philippines. His office issued a monthly bulletin, Malaria, which kept antimalaria personnel informed of the latest measures being taken in New Guinea, of the location of personnel and units engaged in the prevention program, and of new developments in the control of mosquitoborne diseases in other oversea theaters. Its chief task was to move antimalaria personnel and units to the areas where they were most needed- the New Guinea bases, intermediate towns along the northern coast of New Guinea, and to Goodenough Island, New Britain Island, and Manus Island in the Admiralties. During 1944, many were concentrated around Oro Bay (Base B), Lae (Base E), at the important base of the Fifth Air Force at nearby Nadzab, and at Finschhafen (Base F). 50

Additional campaigns to control dengue, scrub typhus, and other endemic diseases were undertaken by the malaria control organization. Since dengue is mosquitoborne, antimosquito efforts contributed to the prevention of dengue fever as well as malaria. Army experience with miteborne typhus, or so-called "scrub typhus," in Now Guinea was more serious than that with louseborne epidemic typhus in the Mediterranean and European theaters, for both the sick rates and the mortality rates for scrub typhus in New Guinea were higher than for louseborne typhus in these other theaters. Scrub typhus assumed more of a threat temporarily than even malaria, when relatively high mortality rates occurred during a few of the New Guinea, operations. Cases appeared during the early days of combat before destruction of the mite vector throughout an invaded area, could be undertaken. During 1942-43, 957 cases of scrub typhus, with a case fatality rate of 5.9 percent, occurred among troops in bases north of Australia.. On Goodenough Island, a small epidemic of 75 cases occurring during the period 1 November 1943-15 January 1944 resulted in 19 deaths. Small outbreaks continued with the advance along the northern coast of New Guinea, two of the more serious developing during the Owi-Biak and Sansapor landings in the period May-August 1944.

Army doctors lacked a thorough acquaintance with scrub typhus and with various fevers of undetermined origin, as many fever cases were diagnosed.

    50 (1) Memorandum, Chief Surgeon, U.S. Army Forces in the Far East, for The Surgeon General, 23 Sept. 1943, subject: Medical Department Units. (2) See footnotes 44(4), p. 445; and 49(2), p. 448. (3) Memorandum, Lt. Col. G. L. Orth, MC, for Surgeons, Sixth U.S. Army, Fifth Air Force, and others, 22 Nov. 1943, subject: Movement of Organization for Malaria Control. (4) Assistant Theater Malariologist for Surgeon, Advance Echelon, General Headquarters [Southwest Pacific], 1 Jan. 1944. (5) Memorandum, Maj. Donald S. Patterson, Malariologist, U.S. Army Services of Supply, for U.S. Army Services of Supply Malaria Control Components, 28 June 1944, subject: Standard Operating Procedure. (6) News Letter: Malaria? Headquarters, Malaria Control, South-west Pacific Area, monthly from 15 Dec. 1943 through July 1945. (7) Circular No. 34, U.S. Army Forces in the Far East, 19 Apr. 1944, subject: Malaria Control.


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A special group of investigators, headed by the president of the Army Epidemiological Board, was sent to New Guinea by the Surgeon General's Office in conjunction with the U.S.A. Typhus Commission. It began investigations of scrub typhus near Buna and Oro Bay in the fall of 1943 and continued with the advance along the New Guinea coast and neighboring islands to the Philippines and Japan. An intensive control program was instituted; the use of clothing impregnated with dimethyl phthalate and the burning of the kunai grass which harbors the mite carrier, at as early a stage during the combat phase as possible, became the chief means of preventing the disease. The malaria control and survey units carried it out with the aid of the Engineer Corps, unit commanders, and others. The rates of incidence for scrub typhus among U.S. Army troops in the area never became as high as those for malaria. 51

    51 (1) Maxey, Kenneth F.: Scrub Typhus (Tsutsugamushi Disease) in the U.S. Army During World War II. In Rickettsial Diseases of Man. Washington: American Association for the Advance-ment of Science, 1948, pp. 36-46. (2) Report on Activities of the Army Epidemiological Board for 1943. (3) Memorandum, Director, U.S.A. Typhus Commission, for the Secretary of War, 26 Nov. 1945, subject: Termination of the U.S.A. Typhus Commission. (4) See also Medical Department, United States Army. Preventive Medicine in World War II. Volume VII Communicable Diseases: Arthopodborne Diseases Other Than Malaria. [In preparation.]

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