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Chapter XI

Contents

CHAPTER XI

The Pacific: August 1944 Through 1946

In the summer of 1944, shortly before the invasion of the Philippines, a major reorganization of U.S. Army forces in the Pacific Ocean Areas (Central and South Pacific Areas) took place (map 9). It marked an attempt to make the Army parallel with the Navy in the command structure there, as well as a shift of troops to the west. Army forces in the Central and South Pacific Areas were newly organized into U.S. Army Forces, Pacific Ocean Areas, under Lt. Gen. Robert C. Richardson, with headquarters at Fort Shafter, Hawaii. The Central and South Pacific Base Commands were its major area commands. Tactical elements formerly subject to Army commands in the South Pacific Area, including the half dozen divisions and the Thirteenth Air Force which had comprised the bulk of its combat forces, had been moving into the boundaries of the Southwest Pacific Area command since the New Georgia campaign of mid-1943. The newly created South Pacific Base Command remained responsible for some months for the logistic support, including medical supply, evacuation, and rehabilitation, of some of its former troops, now in the northern Solomons. Army organization in the Southwest Pacific Area remained unchanged at this date except for the acquisition of the tactical elements from the South Pacific.

The Air Transport Command continued to function throughout the Pacific. After 1 August 1944, its Pacific Division consisted of three wings, the West Coast Wing with headquarters in California, the Central Pacific Wing with headquarters at Hickam Field, Hawaii, and the Southwest Pacific Wing, which had headquarters first at Brisbane, then at Hollandia, and in 1945 in the Philippines. The routes of the two last named cut across the territory of the Pacific Ocean Areas and the Southwest Pacific Area. During 1944 additional Air Transport Command bases were established in the Southwest Pacific Area-at Nadzab (New Guinea), Kwajalein, Saipan, Hollandia, and Biak. The three medical air evacuation squadrons which served the Pacific Wing transported patients thousands of miles by air eastward to fixed hospitals at rearward bases and in western United States. During the period July 1944- June 1945, air evacuees from the Southwest Pacific Area and the Pacific Ocean Areas totaled over 24,000, approximately a third of the evacuees from all oversea areas to the United States during that year.

A wing surgeon for the Central Pacific Wing and one for the Southwest Pacific Wing supervised medical and sanitary work at the bases of the routes. The medical staffs at the bases were responsible for sanitation, mosquito control sick call, minor complaints, and care of all cases not requiring hospitaliza-


452-3

Map 9.- U.S. Army Commands in the Pacific, August 1944.


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tion. As in other areas, Army or Navy hospitals near the bases afforded hospitalization to Air Transport Command personnel.1

Although a single command with jurisdiction over all U.S. Army forces in the Pacific was not established until April 1945, in 1944 the War Department and the Surgeon General's Office tended increasingly to consider the Pacific as a whole when reviewing and reappraising medical problems. They attempted to coordinate several phases of medical service for Army troops in the three areas, amounting by the close of June 1944 to over 1 million. Late in 1944, The Surgeon General expressed concern over the lack of qualified consultants in the Pacific and made efforts to have them sent to the theater. He also dispatched a medical supply mission,-headed by Col. Tracy S. Voorhees, JAGD, to the Pacific to attempt some integration of the procedures for handling medical supplies throughout the three areas.

The mission noted the adverse effect which the complex Army command setup in the Pacific had had on the distribution of medical supplies throughout the region. Three separate Army area commands had prevailed, and no well-coordinated system for redistributing any excess stocks on an equitable basis throughput the three had been developed. Surplus medical stocks had accumulated in the Central and South Pacific Base Commands; the 6 to 10 divisions which had trained in those areas during 1941-44 had left large stocks of medical supplies behind, being furnished new combat supplies for their advance into forward islands. The critical shortage of water transportation had contributed to the failure to ship these supplies forward.

The mission reported that the lack of unified command in the Pacific thwarted its efforts to transfer excess medical stocks from the Pacific Ocean Areas to the Southwest Pacific Area, as well as its efforts to transfer excess personnel handling medical supplies to areas where they were needed. Hence it failed to establish, as it had succeeded in doing in the European theater, a coordinated system of medical supply for future operations in the Pacific.2 The conclusions of the mission were corroborated by The Surgeon General and his Deputy Chief of Plans and Operations (Col. Arthur B. Welsh, MC) when they visited the theater early in 1945. General Kirk reemphasized at that time the lack of coordination in the logistic plans of the South and Southwest Pacific Areas and the need for conceiving of the Pacific areas as a single theater of operations.

    1 (1) Quarterly Report, Medical Department Activities, Pacific Division, Air Transport Command, 3d quarter, 1944. (2) History of the Medical Department, Air Transport Command, May, 1941-December 1944. [Official record.] (3) Correspondence between Col. Walter S. Jensen, MC, Head-quarters, Army Air Forces, Pacific Ocean Areas, and the Air Surgeon, August-September 1944. (4) Annual Report of the Air Surgeon, Fiscal year, 1945.
    2 (1) Letter, The Surgeon General, to Chief Surgeon, U.S. Army Forces in the Far East, 25 Oct. 1944. (2) Report No. 35, Air Evaluation Board: Medical Support of Air Warfare, Southwest Pacific Area. (3) Memorandum, Col. T. S. Voorhees, for The Surgeon General, 18 Jan. 1945, subject: Confidential Notes on Pacific Trip. (4) Voorhees, Tracy S. : Story of Pacific Trip, Oct.-Dec. 1944. in Colonel Voorhees' personal file. (5) Radio messages, War Department, to Commanding General, Central Pacific Area, and Commander in Chief, Southwest Pacific Area, and replies, May 1944.


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PACIFIC OCEAN AREAS

At the time of its organization in August 1944, USAFPOA (U.S. Army Forces, Pacific Ocean Areas) comprised, in addition to its two area commands (Central and South Pacific Base Commands), the Tenth U.S. Army and the Army Air Forces, POA. The latter was created as a top air command when the general reorganization took place. In April 1945, the Western Pacific Base Command (the Marianas, Iwo Jima, and the Palau Islands) was added as a major element. The combined Army-Navy command under Adm. Chester W. Nimitz, Commander in Chief, Pacific Ocean Areas, continued to direct the operation of ground and air, as well as naval units. Two Army Medical Department officers remained as liaison officers with his staff at Pearl Harbor, participating in the joint Army-Navy planning. Late in 1944, they aided in formulating medical phases of the plans for taking Iwo Jima and Okinawa. When Admiral Nimitz; established an advance headquarters on Guam in January 1945, one of these officers went there with the advance element of its medical section.3

Brig. Gen. John M. Willis, MC (fig. 101), became Surgeon, U.S. Army Forces, Pacific Ocean Areas, in November 1944, relieving Brig. Gen. Edgar King, who had been assigned to that position for a few months after holding the top Army medical assignment in the Central Pacific for about 5 years. General Willis served on the special staff of Lt. Gen. Robert C. Richardson, Jr., Commanding General, U.S. Army Forces, Pacific Ocean Areas, and Commanding General, Hawaiian Department, at the latter's headquarters at Fort Shafter (fig. 102).

Most of the staff of the former surgeon, Central Pacific Area- those officers who had had typical base medical duties- were transferred to the office of the Surgeon, Central Pacific Base Command, Col. Paul H. Streit, MC (fig. 103). That portion of General King's staff which had been engaged in operational planning-in estimating the medical troop and supply requirements for movement into the Marshall Islands, the Marianas, and the Western Carolines- was transferred with him to the office of the Surgeon, U.S. Army Forces, Pacific Ocean Areas. During the late months of 1944, several Medical Department officers from the Central Pacific Base Command served on the staff of the Surgeon, U.S. Army Forces, Pacific Ocean Areas, in various capacities- as dental surgeon, veterinarian, laboratory consultant, and director of nursing. Other posts-those of surgical consultant and neuropsychiatry consultant, for example- were filled by attachment from the South Pacific Base Command. The staff of the Surgeon, Pacific Ocean Areas, at this period was thus unorthodox, being made up in large measure of officers actually assigned to other commands. At the same time the number of occupied islands for which General

    3 (1) Whitehill, Buell: Administrative History of Medical Activities in the Middle Pacific. [Official record.] (2) History of U.S. Army Forces, Middle Pacific, and Predecessor Commands During World War II, 7 December 1941-2 September 1945. [Official record, Office of the Chief of Military History.] (3) See footnote 2 (3), p. 454.


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Willis was responsible was increasing, and full-time consultants were needed to advise him.

In the course of his investigation of the status of medical supply in the Pacific late in 1944, Colonel Voorhees obtained certain data on medical organization in the Pacific Ocean Areas for The Surgeon General, who was on the eve of a trip to the Pacific. Colonel Voorhees noted that only 18 of the 34 officers requested for General Willis' office had been tentatively approved and that the 18 included several division malariologists charged to the office because the table of organization for the Army division had no place for them. Thus, a number of the 25 officers actually on duty were not included in the official allotment. Colonel Voorhees considered General Willis' allotment too small and the office of the Surgeon, Central Pacific Base Command, also at Fort Shafter, overstaffed for the reduced scope of work facing it at the beginning of 1945. Although Colonel Voorhees called attention to the similarity of the situation in the Pacific Ocean Areas to that which he had noted in the China-Burma-India theater, no such amalgamation as he achieved in the latter took place in the Pacific Ocean Areas. On the other hand, Col. Arthur B. Welsh, MC, who visited the Pacific Ocean Areas command with The Surgeon General early in 1945, favored a larger office at Central Pacific Base Command headquarters.


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He did not consider an amalgamation of the two medical offices feasible, probably because a separate medical section handling details of administration for medical units and installations on the Hawaiian Islands freed the Surgeon, USAFPOA, for the large task of medical planning for forward areas.

What General Willis considered an adequate allotment for his office was obtained only in the middle of 1945, when the War Department approved 45 officers and 64 enlisted men for the office. Until that time the surgical consultant, the orthopedic consultant, and the neuropsychiatric consultant served in General Willis' office oil detached service from the Central and South Pacific Base Commands-the office had only the medical consultant actually assigned to it-while a sanitary engineer sent by the Surgeon General's Office was attached to the medical section in the status of "attachment of officer for training."4

Central Pacific Base Command

The Central Pacific Base Command encompassed the islands of Hawaii and later the so-called "Marshall-Gilberts Army Area." The office of its surgeon, Colonel Streit, had a number of sections performing the orthodox duties of a base surgeon's office; his staff also included eight part-time consultants whose primary assignments were as staff officers in hospitals. Medical Department officers in Hawaii were now little concerned with problems of de-

    4 (1) See footnotes 2(1) and (3), p. 454; and 3(1) and (2), p. 455. (2) Annual Report, Medical Section, Pacific Ocean Areas, 1944. (3) Memorandum, Acting Chief, Preventive Medicine Service, Office of The Surgeon General, for Chief, Operations Service, Office of The Surgeon General, 3 Nov. 1944, subject: Medical Officers for Assignment to Pacific Ocean Areas. (4) Report, Col. Arthur B. Welsh, MC, 7 Mar. 1945, and inclosures thereto, subject: Visit to Pacific Theater.


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fense; they were chiefly occupied with training and giving logistic support to the tactical units invading the Marianas and Ryukyus and to the army garrison forces which settled on those islands. They provided fixed hospitalization for patients returned from the westward islands and directed a reconditioning program in the larger hospitals in Hawaii. As in the case of the base sections and bases in the Southwest Pacific Area, it was found feasible, in a Static situation, to give Medical Department officers more direct authority over local installations. In August 1944, Colonel Streit was made Commanding Officer, Medical Service, Central Pacific Base Command, and in this capacity had command control of all Medical Department units and installations on Oahu and of their movements within its boundaries. Types of units and installations which he controlled included: General, station, field, and portable surgical hospitals; medical groups; medical battalions; collecting companies; clearing companies; veterinary detachments and hospitals; dental clinics; medical laboratories; medical supply depots; malaria control and survey units; sanitary companies; ambulance battalions and companies; two Medical Department concentration centers; and a convalescent and reconditioning center. Numerous units which belonged to divisions staging or training on Hawaii were placed under Colonel Streit's command. Officers on Colonel


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Streit's staff functioned, as he did, in a dual capacity. For the purposes of administering the Medical Service, Central Pacific Base Command, Colonel Streit's office was organized in accordance with the usual staff pattern, with an S-1, S-2, S-3, and S-4.5

South Pacific Base Command

After August 1944, when the Services of Supply, South Pacific Area, was abolished and the U.S. Army Forces, South Pacific Area, was reorganized into the South Pacific Base Command, the area declined steadily in importance. However, the new South Pacific Base Command was still responsible for logistic support of the three Army divisions (the 37th, 93d, and Americal Divisions) under XIV Corps which had moved to the Solomon Islands and for support of the 25th Division at New Caledonia until it left for the Philippines in December 1944. It continued to afford hospitalization to these troops for some months. With the abolition of the Services of Supply, South Pacific Area, the service commands on the various islands were absorbed by the island commands, and some of the island commands were reduced to subbases. The Thirteenth Air Force had started moving to the Southwest Pacific Area.

As of August 1944, only a little over 110,000 troops (including those of the 25th Division which had a strength of 14,500) were in the South Pacific Area. The great majority of this force was concentrated on New Caledonia, Fiji, Espiritu Santo, Guadalcanal, Efate, and the Russell Islands. Of these, the first four had island commands with surgeon's offices, while the last two were organized as subbases. The transfer of the former service command surgeon (who had usually acted as an island surgeon on the staff of the commander of the island command as well) to the staff of the island commander had little effect on the responsibilities of the service command surgeon except that it gave him definite responsibility for supervising the dispensaries of ground force and air force units located at the base. On Guadalcanal, for instance, a dispensary officer in the island surgeon's office supervised the work of about 60 dispensaries in the fall of 1941.

Brig. Gen. Earl Maxwell remained as Surgeon, South Pacific Base Command until November 1944, when Col. Laurent L. LaRoche, MC (fig. 104), succeeded him. Except for relief of the four original consultants and their partial replacement by Medical Department officers already in the area, personnel of the office underwent little change until May 1945. At that date the surgeon's section of the South Pacific Base Command (including the consultants) was made the surgeon's section for Army Service Command O, intended for logistic support of the invasion of Japan and transferred to the Philippines to await its mission. The office of the Surgeon, New Caledonia

    5 (1) Annual Report, Medical Department Activities, Central Pacific Base Command, 1944. (2) See footnotes 3(l) and 3.2, p. 455. (3) Interview, Col. Paul H. Streit, MC, 21 May 1945. (4) History of the Central Pacific Base Command During World War II. [Official record, Office of the Chief of Military History.]


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Island Command, took over the duties of the base command's medical section in addition to those for New Caledonia.6

In late 1944, scenes of U.S. Army activity in the South Pacific Base Command had shrunk to three main locales at Nouméa and nearby areas on New Caledonia, and on Espiritu Santo and Guadalcanal; troop strength had dropped below 100,000. Despite the decline, the South Pacific Base Command and the naval command in the area were continuing an aggressive program of con-struction and were exhibiting a tendency to hang on to units and supplies which could be better used in the Southwest Pacific Area. Consequently hospitals in the South Pacific islands were only half full and enormous surplus stocks of medical supplies were still there. On 1 January 1945, a general hospital (1,500 beds), 5 station hospitals (totaling 1,550 beds), and a field hospital were idle in the South Pacific islands. The Southwest Pacific Area. had an option on

    6 (1) See footnote 3(2), p. 455. (2) History of the South Pacific Base Command During World War II. [Official record, Office of the Chief of Military History.] (3) Annual Report, Medical Department Activities, South Pacific Base Command, 1944. (4) Quarterly Reports, Medical Department Activities, Headquarters, XIV Corps, 1st and 2d quarters, 1944. (5) Annual Report, Surgeon, Headquarters, Island Command (Russell Islands), 1944.


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surplus units and stocks, but the South Pacific Base Command was slow in declaring them surplus. The Pacific still did not constitute a single theater in terms of Army command, and as late as February 1945 the Southwest Pacific Area command was uninformed as to what medical units it could obtain from the South Pacific Base Command.7

Another late-date problem in the coordination of higher command policy was noted by The Surgeon General's inspection party which visited the base command early in 1945: the Navy was still failing to give adequate command support to the program for inspection of food conducted by Army veterinary officers assigned to the Joint Purchasing Board in Wellington, New Zealand. This situation straightened out a few months later when arrangements were made for assigning additional Army veterinarians to the Board to inspect the foods bought in New Zealand, as well as for forwarding the veterinarians' reports direct to the office of the Surgeon, South Pacific Command.8

Tenth U.S. Army and Okinawa Island Command

Throughout 1944: several divisions, mostly attached to XXIV Corps, were trained in Hawaii. Some, temporarily attached to various amphibious corps, took part in joint Army-Navy assaults on Saipan and Guam in the Marianas, as well as the Palau Islands in the Western Carolines. The XXIV Corps (the 7th and 96th Divisions), originally scheduled for the Yap operation, was sent to Leyte and from the fall of 1944 to February 1945 came under the control of the Southwest Pacific Area Command. From September 1944 on, the major ground combat command under the Commanding General, Pacific Ocean Areas, was the Tenth U.S. Army, which had headquarters at Schofield Barracks on Oahu and invaded the Ryukyus in the spring of 1945. All Army divisions in Hawaii not charged with defense of the islands, as well as three Marine divisions, were assigned to the Tenth U.S. Army. Col. Frederic B. Westervelt, MC (fig. 105), who had been on the medical planning staff of Admiral Nimitz, became Surgeon, Tenth U.S. Army; by the end of August 1944 a surgical consultant, a medical consultant, a dental surgeon, a veterinarian, and a neuropsychiatrist had been assigned to his staff. An orthopedic consultant was assigned in February 1945.

The XXIV Corps, now in Leyte, was placed under the Tenth U.S. Army for the invasion of the Ryukyus and thus came under control of the Commanding General, Pacific Ocean Areas. From the middle of February to April 1945, the small office of the Surgeon, XXIV Corps, on eastern Leyte was busy with readying troops medically for the invasion. It drew up a medical plan, and under its supervision vitamin tablets were distributed; troops were immunized for tetanus, smallpox, cholera, typhoid, and typhus; and troop units

    7 (1) See footnotes 2(3) and 2(4), p. 454. (2) Annual Report Medical Department Activities, South Pacific Area, 1945.
    8 (1) Memorandum, The Surgeon General, for Commanding General, Army Service Forces, 10 Mar. 1945, subject: Report of Inspection. (2) See footnote 4(4), p. 457. (8) [History], Surgeon's Section, U.S. Army Forces in the South Pacific Area and South Pacific Base Command.


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were up to their full strength in medical officers. Malaria control and survey units were assigned to XXIV Corps during the planning period.

Several divisions of Tenth U.S. Army (in addition to XXIV Corps) trained throughout the winter of 1944-45 in Hawaii. During the planning period the Tenth U.S. Army Surgeon was aided by the surgeons of several other major commands with headquarters on Oahu: the U.S. Army Forces, Pacific Ocean Areas; the Army Air Forces, Pacific Ocean Areas; and various Navy commands. The joint planning of these headquarters for malaria control measures to be adopted during combat, based on the experience of the South Pacific Area, was a notable feature of the medical plans for the Okinawa campaign. Troops were given Atabrine during the preinvasion period and the use of larviciding teams in division areas during combat materially reduced the mosquito population.

The medical consultant of the army was attached to III Amphibious Corps (consisting of three Marine divisions), which had been added as a second corps to the Tenth U.S. Army, and aided in coordinating medical policies of the two corps. An island command was established for Okinawa on Oahu early in January, and its medical section was provided with a nucleus staff. In addi-


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tion, 12 officers and 22 enlisted men of the Tenth U.S. Army medical section were placed on special duty with the island command medical section.

An "operational group" of the Tenth U.S. Army's medical section left Oahu for Okinawa on 5 March 1945; a corresponding group of the island command medical section left on the same day. Practically all personnel of both medical sections were on Okinawa by the middle of April. All medical units landing during the early days of April were under control of the two corps of the Tenth U.S. Army. Then ensued a period during which additional units landing were controlled by the island command. In the early days of May, the Tenth U.S. Army assumed control of a majority of medical units ashore and was responsible for hospitalization and evacuation from divisions, through hospitals, to surface and air holding stations, while the island command retained control of air and surface evacuation from the island. On 7 May, Headquarters, Medical Service, Tenth U.S. Army, was established under the command of the Surgeon, Tenth U.S. Army, and to it were assigned all the combat medical units except those under XXIV Corps and those concerned with supply and sanitation, which remained under island command control. Island Command, Tenth U.S. Army, had full responsibility for all evacuation from Okinawa and established an evacuation center made up of divisional medical units. By the close of the Okinawa campaign at the end of June 1945, Island Command, Okinawa, was operating 35 Medical Department units, including 10 field, station, and portable surgical hospitals, and 15 Army and Navy malaria and epidemic disease control units which were directed by a malaria and insect control headquarters in the field. The reception of more than 1,000 sick and wounded Japanese prisoners of war had placed a heavy burden on the hospitals. Plans had been formulated for the establishment of 14 additional station and general hospitals. A total of about 400 officers of the Medical, Dental, Veterinary, and Sanitary Corps and about the same number of nurses were serving in subordinate units within Okinawa Island Command.9

Army Air Forces, Pacific Ocean Areas

As a phase of the reorganization in the Pacific in August 1944, AAFPOA (Army Air Forces, Pacific Ocean Areas) was created, with headquarters at Hickam Field, under the command of Lt. Gen. Millard F. Harmon. It consisted of Army Air Forces units in the Central and South Pacific Areas. Major components in the fall of 1944 were the Seventh Air Force (the direct descendant of the old Hawaiian Air Force), which was made a tactical air.

    9 (1) Annual Report, Medical Department Activities, Tenth U.S. Army, 1944 (2) See footnote 3 (1) and (2), p. 455, (3) Report of Operations in the Ryukyus Campaign, 26 Mar-30 June, 1945, Tenth U.S. Army, ch. 11, sec. XV: Medical. (4) Report of Surgical, Medical, and Orthopedic Consultants for Operational Reports of Okinawa Campaign, 30 June 1945. [Official record.] (5) History, Medical Section, Headquarters, Tenth U.S. Army, 1 Jan-15 Oct. 1945. (6) Quarterly Reports, Surgeon, XXIV Corps, 1st and 2d quarters, 1945. (7) See also Medical Department, United States Army. Preventive Medicine in World War II. Volume VI. Communicable Diseases: Malaria. [In press.]


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force, and XXI Bomber Command, which had begun moving into the Pacific Ocean Areas from the United States. Col. Walter S. Jensen, MC (fig. 106), became Surgeon, AAFPOA, while Col. Ralph Stevenson, MC (fig. 107), was Surgeon, Seventh Air Force (based on Saipan from December 1944 to mid-1945 and afterward on Okinawa), and Col. H. H. Twitchell, MC (fig. 108), was Surgeon of XXI Bomber Command.

The XXI Bomber Command became a major element of the strategic Twentieth Air Force which carried out long-range bombing missions in both the China-Burma-India theater and Pacific Ocean Areas in an airstrike against Japanese industry. Although its operations were to be aimed at a single enemy-Japan-its bombardment wings were based in two areas under sepa-rate commands. Hence direction of the operations of elements of the far-flung Twentieth Air Force was vested in the Joint Chiefs of Staff in Washington, where the Force was served directly in the staff of Army Air Forces headquarters. Under this system of remote control from Washington, Gen. Henry H. Arnold, Commanding General, AAF, served as commander of the Twentieth Air Force, and the Air Surgeon, Maj. Gen. David N. W. -Grant, as its surgeon.


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In order to coordinate the operations of XXI Bomber Command-based in Hawaii for some months after it began moving into the theater-with those of the Seventh Air Force, the Commanding General, AAFPOA (General Harmon), was made Deputy Commanding General, Twentieth Air Force; his surgeon, Colonel Jensen, became deputy surgeon for the air force as well as Surgeon, AAFPOA. The bombardment wings of XXI Bomber Command moved into the Marianas between October 1944 and mid-1945, making the command's first raid on Tokyo in November 1944. They were based at airfields on Saipan, Guam, Tinian, and Iwo Jima. Other elements of the command settled on Okinawa and Ie Shima after June 1945. The surgeon of XXI Bomber Command and Surgeon, AAFPOA (Deputy Surgeon, Twentieth Air Force), were both located at their respective headquarters on Guam after early 1945.

Besides the usual dispensaries maintained by the bombardment and air service groups of XXI Bomber Command, 100-bed dispensaries, in reality small hospitals, were operated by the bombardment wings, whenever elements of the wing were not too dispersed to make a small hospital practicable. The command found that these installations served to decrease the loss of man-days resulting from. hospitalization of air force personnel in hospitals not under air force control. Air force surgeons were, particularly loath to lose the flying


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time of the highly specialized men who manned the long-range B-29's. Moreover, the wing dispensaries proved of value in relieving the regular fixed hospitals of some of their burden during periods of heavy evacuation from invasions. More serious cases among air force patients were sent to hospitals maintained by the Army Garrison Forces on Saipan or returned to hospitals in the Hawaiian Islands. Medical supplies were furnished XXI Bomber Command elements through the usual Army Garrison Force channels on the various islands.10

Colonel Jensen, who had recently been executive officer for the Air Surgeon in Washington, worked in close cooperation with the Air Surgeon's Office to build up, in accord with the latter's policy for all oversea air forces, special medical components and practices removed from the control of the local Army command. Besides a drive to have station and general hospitals assigned to

    10 (1) Army Air Forces Letter 20-3, 8 Apr. 1944, to Chief of Air Staff, and others. (2) Narrative of Experiences of the Medical Section, Headquarters, XXI Bomber Command, for 1 March-31 December 1944. [Official record.] (3) Quarterly Reports, Medical Section, Twentieth Air Force, 1st, 2d, and 3d quarters, 1945. (4) Memorandum, Col. Walter F. Jensen, MC, for the Air Surgeon, 10 Apr. 1944, subject: Administrative Responsibilities, Twentieth Air Force, Management Control.


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XXI Bomber Command, the Air Surgeon's Office and the Surgeon, AAFPOA, made efforts throughout 1944: and early 1945 to set up a central medical establishment in both the Seventh Air Force and the XXI Bomber Command larger than the Seventh Air Force. This was the same type of unit that had been established shortly before in the Eighth and Ninth Air Forces in the European theater and in the Thirteenth Air Force in the South Pacific Area. The Air Surgeon's Office made strenuous efforts to get approval for a table of organization for a combined central medical establishment and convalescent center, but by June 1945 this proposal had been definitely turned down. However, during late 1944 and 1945 Headquarters, AAFPOA, took over a number of rest and recreation camps and formed the Army Air Forces Pacific Ocean Areas Rest and Recreation Center. These camps had been established for Seventh Air Force personnel by a committee of Honolulu civilians soon after the beginning of the war at the request of the Seventh Air Force surgeon (Col. A. W. Smith). Located at Hawaiian beaches, ranches, and mountain resorts, they were used by thousands of combat crewmen of the Seventh and Twentieth Air Forces.

The Surgeon, AAFPOA, did not appear greatly interested, on the other hand, in the efforts of the Air Surgeon's Office to develop another unit which the latter office favored, the "Air Force Insect Control Unit." No particular problem had arisen in his area with respect to Army Air Forces' responsibility for airplane spraying of DDT; the work had been successfully handled informally. After a Navy malaria and epidemic disease control unit (attached to Naval Construction Battalions) did the initial job of spraying, the island surgeon (who might be an air, ground, or naval officer) took charge, and the Army Air Forces simply furnished the planes which he asked for. Apparently, Colonel Jensen did not feel that the prestige of Army Air Forces would be materially enhanced by the recognition of a special "air force insect control unit."

SOUTHWEST PACIFIC AREA

From August 1944 to April 1945, the top structure of theater organization in the Southwest Pacific Area underwent no major changes except for the establishment of a top air force headquarters, the Far East Air Forces, to coordinate the activities of the Fifth and the newly arriving Thirteenth Air Forces. Several important subordinate commands were added as additional Army elements formerly in the Central Pacific and South Pacific Areas moved into the Southwest Pacific Area. The Eighth U.S. Army built up in the theater after September 1944 on the eve of the Leyte invasion. With the progress of the Luzon campaign, the headquarters of practically all the major commands, including their medical sections, moved from New Guinea to Luzon.


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Allied Headquarters, U.S. Army Forces in the Far East, and Services of Supply Headquarters

Col. George W. Rice, MC, continued as Surgeon, General Headquarters, until September 1944. Because of his experience and extensive knowledge of the area, he was transferred at that time to the position of Surgeon, Eighth U.S. Army, exchanging assignments with Col. John F. Bohlender, MC (fig. 109), and soon becoming elevated to the rank of brigadier general. The title, "Surgeon, GHQ," ended with the departure of General Rice, for Colonel Bohlender not only worked through G-4, General Headquarters, but was specifically assigned there. With the aid of one enlisted man, he continued his predecessor's work on the medical phases of the campaign plans initiated by G-4 at General Headquarters, coordinating plans for water evacuation with the Navy and those for air evacuation with the Far East Air Forces and the Pacific Wing, Air Transport Command. Plans were then worked out in greater detail by Medical Department officers at the headquarters of U.S. Army Forces in the Far East and the Services of Supply. General Headquarters moved from Brisbane to Hollandia in August 1944, to Leyte in October, and to Manila in February 1945.11

Throughout most of 1944, the office of the Surgeon, USASOS (U.S. Army Services of Supply), had also been at Brisbane, but in September, when the northward movement of troops resulted in a shift of Services of Supply headquarters, this office moved by echelons to Hollandia, then in early 1945 to Leyte, and finally in March and April to Manila. In March 1945, General Denit commented upon the diffusion of offices under his control by noting that he then had medical offices for the Services of Supply in three places-an office with the advance echelon in Manila, one at main headquarters on Leyte, and one with the rear echelon in Hollandia. As surgeon for the U.S. Army Forces in the Far East, he had a few officers working under his direction at that command's two headquarters in Manila and Leyte. During the shift of forces from New Guinea to the Philippines, the coordination of medical planning by these small offices was difficult.

The total officer personnel on General Denit's staff was even less than it had been during the period 1942-August 1944 and totally inadequate for diffusion among several physical locations. In February 1945, for instance, only 22 officers were under his direction, 4 working with the theater headquarters and 18 at Services of Supply headquarters. Of the latter number, exactly half were on detached service only; that is, their principal assignments were with other commands. The Services of Supply medical office still had no chief of preventive medicine at that date. The only assignments to preven-

    11 (1) Report, Chief Surgeon, General Headquarters, U.S. Army Forces, Pacific, 9 June-Dec. 1945. (2) Quarterly Report, Surgeon, 2d Port of Embarkation, 4th quarter, 1942. (3) Memorandum, Col. J. F. Bohlender, MC, to Surgeon, U.S. Army Services of Supply, 17 Sept. 1944. (4) Essential Technical Medical Data, U.S. Army Services of Supply, 20 Nov. 1944. (5) Letter, Surgeon, U.S. Army Services of Supply, to The Surgeon General, 12 Oct. 1944.


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tive medicine functions were those of a venereal disease officer and a nutrition officer. By May, however, preventive medicine had become a recognized entity. The office then had, in addition to a deputy chief surgeon, executive officer, historian, and nutrition officer, chiefs of the following divisions: Administra-tive, Supply, Personnel, Hospitalization, Evacuation, Plans and Training, Preventive Medicine, Dental, Veterinary, Nurses, and Consultants.12

A small allotment for administrative positions hampered not only enlargement of General Denit's scattered staff but the development of an adequate medical staff at the headquarters of base sections and bases as well. In the fall of 1944 the War Department allotment of Medical Corps officers for overhead- that is, the medical sections at headquarters of U.S. Army Forces in the Far East and of the Services of Supply and its area commands-was 134 officers. Of these, only eight could be colonels. The chiefs of divisions in General Denit's office at Services of Supply headquarters and his consultants, as well

    12 (1) Annual Report, Chief Surgeon, U.S. Army Services of Supply, 1944. (2) 2d Lt. R. C. Folwell, MAC, Historical Division, U.S. Army Forces Western Pacific, for the record, no date, subject: Information Concerning the Office of the Chief Surgeon, USASOS and AFWESPAC. (3) Letter, Chief Surgeon, U.S. Army Services of Supply, to The Surgeon General, 23 Mar. 1945. (4) Minutes, Conference of General and Special Staff Sections, Headquarters, U.S. Army Services of Supply, 5 Sept. 1944. (5) Memorandum, Chief Surgeon, U.S. Army Services of Supply, for Chief of Staff, 16 May 1945, subject: List of Key Personnel in the Medical Section, With a Brief Summary of Their Duties.


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as the surgeons of bases and of base, intermediate, and advance sections, had a claim on the rank of colonel.

The difficulty of obtaining sufficient officers of adequate rank for important administrative assignments in the Services of Supply setup led the theater surgeon to activate the headquarters of six "hospital centers" in late 1944 and early 1945 at bases in New Guinea and the Philippines. The table of organization for headquarters of the hospital center amounted to 8 officers (including a lieutenant of the Army Nurse Corps), 1 warrant officer, and 23 enlisted men. Hospital centers were not needed in the Southwest Pacific Area. In contrast to the situation in the European theater, fixed hospitals were located in close proximity to the base headquarters rather than at various sites within a large base section. Moreover, general hospitals did not usually remain for any length of time at a single location in the Southwest Pacific Area (most of the bases being of short-range value); hence the specialization in handling certain types of cases which administration under fully developed hospital centers would have fostered was never feasible at the New Guinea and Philippine bases. The table of organization for the headquarters of hospital centers served, however, to give the theater surgeon a number of additional positions, some carrying advanced rank, to which he could assign Medical Department officers. For the most part, such personnel did not perform the duties of the positions to which they were assigned but the duties of the staff of a base surgeon's office. Most of the officers and a good many of the enlisted men assigned to the so-called, "hospital centers" were placed on detached service or temporary duty with the base surgeon's office. In a good many instances, the officers had already been serving for some time as base surgeons or in the base surgeon's office. They were then assigned to the centers, being promoted to the next higher rank, but placed on detached service in their former positions. In the case of three or four of the "hospital centers," a small portion of the assigned staff did perform a few of the duties-such as the operation of a pool of vehicles and a postal service-for the hospitals assigned to the center, but under the circumstances which prevailed in the Southwest Pacific Area such services could be more advantageously performed by the base surgeon's office for all installations located at the base. Although it was expected that the headquarters of hospital centers in the Philippines, transferred in some cases from New Guinea with a fairly complete roster of personnel, would administer the large network of hospitals designed to take care of evacuees from the invasion of Japan, as matters turned out they were never called on to do so. The headquarters of hospital centers served, therefore, the primary purpose, important to the theater surgeon, of augmenting the staffs of base surgeons.13

    13 (1) Letter, Chief Surgeon, U.S. Army Services of Supply, to Lt. Col. Lamar C. Bevil, MC, Office of The Surgeon General, 16 Oct. 1944. (2) Deputy Chief Surgeon, to Chief Supply Officer, Advance Echelon, Services of Supply, 22 Dec. 1944. (3) Quarterly Reports, 25th, 26th, 27th, 29th, 30th, and 31st Hospital Centers, 1945.


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The lack of an efficient medical supply system, together with acute shortages prevailing in some areas, especially during the early days of heavy combat on Leyte, was considered by the Voorhees mission a serious defect in medical administration in the Southwest Pacific Area. A basic cause, the mission found, was the prevailing practice of requisitioning on a theaterwide basis. Since command was highly decentralized and depots in New Guinea and the Philippines were spread over a distance of 2,500 miles, direct requisitioning on San Francisco by a particular base would have been more efficient. Moreover, medical supplies for the Philippines might come in at any point in the theater. They were moved from base to base chiefly by water, and many difficulties had to be overcome before hospitals and dispensaries could receive medical supplies: an uncharted coast, congested ports, inadequate facilities for overland transport, and heat and humidity which hampered movement and caused swift deterioration of items and containers. The mission failed to establish in the Southwest Pacific Area, as well as in the Pacific Ocean Areas, any coordinated and workable system of medical supply for future operations. Its major contributions were certain measures which it advocated to meet the heavy demands for troops on Leyte, and its recommendations as to individuals to fill certain medical supply posts.14

In early 1945, The Surgeon General and his Deputy Chief of Plans and Operations, Col. Arthur B. Welsh, MC, visited the Southwest Pacific Area and inquired into the status of medical service in Australia, at several New Guinea bases, and on Leyte. At that date the Surgeon, U.S. Army Forces in the Far East and U.S. Army Services of Supply, as well as the Surgeon, Eighth U.S. Army, and the surgeon with G-4 of General Headquarters, were on Leyte. Col. Maurice C. Pincoffs, MC, and the consultants were on Luzon. Back in Hollandia were the rear echelons of the theater command and the Services of Supply and their medical sections.

Colonel Welsh was "not particularly impressed with the theater organization from the medical viewpoint." He observed failure on the part of the theater command to consult General Denit on theaterwide medical problems and noted conflicting claims by General Denit and the medical officer at G-4, USAFFE, as to responsibility for medical planning for combat operations. Lacking knowledge of the plans of the Pacific Ocean Areas command for future operations, medical officers in the Southwest Pacific Area found it difficult to arrange for the transfer of excess medical units from the South Pacific Base Command to the Southwest Pacific Area. Colonel Welsh stressed the need for organizing Army troops in the Pacific into a single theater. The Surgeon General reported to General Somervell that the theater surgeon lacked sufficient officers of high grades to staff his own office and those of the surgeons of base sections and other headquarters. Many hospital staff officers in the Southwest Pacific Area had been removed

    14 (1) See footnote 2 (3) and (4), p. 454.


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to fill administrative positions at various headquarters or had been used in dual assignments; the morale of hospital staffs had been weakened and hospital administration had been crippled.15

Armies and Air Forces in New Guinea and the Philippines

By September 1944, major combat forces with surgeons' offices in the Southwest Pacific Area were the Sixth and Eighth U.S. Armies, the 14th Antiaircraft Command, and the Far East Air Forces, which included the Fifth and Thirteenth Air Forces. At this time the Sixth U.S. Army surgeon's office was at Hollandia, New Guinea (where most of the staff medical sections of top commands were congregated late in the year) ; it was occupied with planning the medical aspects of the coming campaigns on Leyte and Luzon. As of 1 October, shortly before Sixth U.S. Army headquarters took the field, the office of its surgeon, Col. (later Brig. Gen.) William A. Hagins, MC, was composed of 22 Medical Department officers, including, in addition to dental and veterinary officers, officers assigned to inspection, supply, statistics, and operations, as well as 3 malariologists. The staff varied little in number during the Philippine campaigns (although there were many changes in personnel), but a surgical consultant was added late in 1944, and a medical and an orthopedic consultant from the Services of Supply headquarters served for a time on temporary duty. No neuropsychiatric consultant was assigned to the office of the Sixth U.S. Army surgeon during the campaigns on Leyte and Luzon until early June 1945 when the fighting was practically over; hence policy in the handling of psychiatric cases was not issued from the army level but remained a matter for determination by divisional neuropsychiatric consultants.

The Sixth U.S. Army included several corps during its Philippine campaign. The corps surgeon's office typically included two or three Medical Corps officers, two Medical Administrative Corps officers, and a few enlisted men. Besides the customary duties, the corps surgeon in the Southwest Pacific Area bad to make frequent trips by air to divisional staging areas on scattered islands to determine the readiness of Medical Department units of the various divisions for combat. To inspect medical units preparing for the invasion of Mindanao, for example, the Surgeon, X Corps, visited, in addition to the Leyte staging area controlled by X Corps, the staging area of the 24th Infantry Division on Mindoro, and that of the 31st Infantry Division on Morotai. After a trip to Davao in the 24th Division staging area on 1 June 1945, he was missing in action. Apparently his plane had been shot down after one of his customary low-level reconnaissance flights over the frontlines to view the terrain preparatory to planning the advance of field medical units into enemy territory.

    15 (1) See footnotes 4(4), p. 457; and 8(l), p. 461. (2) Interview, Dr. Maurice C. Pincoffs, 22 May 1952.


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For the Leyte and Luzon invasions the Sixth U.S. Army had attached to it an "army service command," consisting of troops from the Services of Supply, which was to found bases when the landing forces were firmly established. These service troops included the medical sections for Base K established on Leyte and Base M established on Luzon. After the Leyte landings in mid-October, the Sixth U.S. Army surgeon's office worked at several locations on the island; with the move of Sixth U.S. Army to Luzon early in 1945 it made similar rapid moves.16

Eighth U.S. Army headquarters arrived in New Guinea in September 1941, taking over control of combat units in Netherlands New Guinea, the Admiralty Islands, and Morotai from the Sixth U.S. Army. Col. George W. Rice, MC (promoted to brigadier general in June 1945), shortly became Eighth U.S. Army surgeon, replacing Colonel Bohlender, the original surgeon who had arrived in Hollandia with the advance echelon of the headquarters. In October 1941, Colonel Rice had on his staff a medical consultant, a surgical consultant, a neuropsychiatric consultant, a preventive medicine officer, a dental officer, and a veterinarian. Surgeons were assigned at that date to the following units of the Eighth U.S. Army: I Corps, XI Corps, and eight infantry divisions (the 6th, 31st, 33d, 38th, 40th, 41st, 43d, and 93d).

Eighth U.S. Army followed Sixth U.S. Army from New Guinea into Leyte and later carried out the amphibious operations in the southern Philippine Islands, Mindanao, and the central Visayas (as well as two operations on Luzon), while Sixth U.S. Army went on to the main invasion of Luzon. The medical section of Eighth U.S. Army shifted from Hollandia to Leyte in three echelons during the period from November 1944 to January 1945, leaving an officer and two enlisted men in Hollandia to follow them later in January. During the first half of 1945, the army medical section drew up plans for coming operations in the archipelago, inspected the training and supply of units, and supervised the medical service in the forward areas of the army in the central and southern Philippines-Leyte-Samar, Cebu, Negros, Panay, Mindoro, Palawan, and Mindanao and the Zamboanga Peninsula-and in its rear areas in New Guinea. It kept in close touch with medical service of the Sixth U.S. Army in Luzon.17

A major ground force command in addition to the Sixth and Eighth U.S. Armies was the 14th Antiaircraft Command, which had been activated at Brisbane in November 1943. A staff surgeon's office was set up for the command in March 1944. At first distributed over Australia and New Guinea, antiair-

    16 (1) Quarterly Reports, Surgeon, X Corps, 3d and 4th quarters, 1944, and 1st quarter, 1945. (2) Quarterly Reports, Surgeon, I Corps, 1944 and 1945. (3) Quarterly Reports, Surgeon, XIV Corps, 4th quarter, 1944, and 1st quarter, 1945. (4) Report of Operations in the Luzon Campaign, 9 Jan 1945-30 June 1945, Sixth U.S. Army. (5) Quarterly Reports, Surgeon, Sixth U.S. Army, 1st and 2d quarters, 1945. (6) Quarterly Reports, Surgeon, XXIV Corps, 2d, 3d, and 4th quarters, 1944.
    17 (1) Quarterly Reports, Surgeon, Eighth U.S. Army, 2d, 3d, 4th quarters, 1944, 1st and 2d quarters, 1945.(2) See footnote 11 (4), p. 468.


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craft troops later spread to islands north of New Guinea and then into the Philippines. In the middle of 1944, only about half of the approximately 50,000 troops of the command were under its direct control, the rest being under the administrative as well as operational control of Sixth U.S. Army and XIV Corps. In the fall of 1944, the surgeon's office was still in Brisbane, although his malariologist maintained an office at the command's advance echelon in Finschhafen in order to indoctrinate units in malaria control. The scattered character of the command and -the attachment of a goodly portion of its units to other commands created some obstacles to centralized control of its medical service. The surgeon's office found it difficult to estimate the medical personnel needed by the antiaircraft units attached to other commands and to obtain statistics on their disease rates as well as to supervise the work done by the medical detachments of the scattered units.18

The medical section of the highest headquarters of the Army Air Forces in the Southwest Pacific Area, the Far East Air Forces, was at Hollandia, New Guinea (Base G), in the fall of 1944. It coordinated the medical activities of its two major components, the Fifth and Thirteenth Air Forces; air force elements were scattered over Australia and New Guinea and later the Philippines. In November the medical section transferred with Headquarters, Far East Air Forces, to the Philippines and by the end of March 1945 was near Tolosa on the Gulf of Leyte. Headed by Col. Robert K. Simpson, MC, it contained only about half a dozen medical officers. The strength of the Far East Air Forces varied from about 135,000 to about 145,000 from the fall of 1944 to the spring of 1945. An attempt was made to develop the central medical establishment for use in the Southwest Pacific Area. One had been organized at Guadalcanal in June 1944 as a unit of the Thirteenth Air Force, evolving concurrently with the central medical establishments for the Eighth and Ninth Air Forces in Europe. The establishment set up in the Thirteenth Air Force in the South Pacific Area grew out of the work of examination and disposal of flying personnel by flight surgeons which had been originally done in the Auckland rest area of New Zealand and later at a screening center established on Guadalcanal in April 1944.

The Second Central Medical Establishment, organized originally with 10 officers and 25 enlisted men, was not very active during its early months at Guadalcanal. In September 1944, after the transfer of the Thirteenth Air Force to the Southwest Pacific Area, this unit was assigned to the Far East Air Forces and in November to the Far East Air Forces Combat Replacement and Training Center at Nadzab, New Guinea. Plans were made for a research section to study factors affecting the health and safety of flying personnel and

    18 Quarterly Reports, Medical Department Activities, 14th Antiaircraft Command, Jan. 1944-June 1945.


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the methods and equipment to aid them to survive in cases of crashes over sea and jungle areas. The establishment was also to include a screening center to examine flying personnel before granting them leave, a central medical board to review the status of individuals whose physical or mental fitness for flying was in doubt, an aircrew indoctrination section, and a rehabilitation section. Not all of these units ever developed, nor did some others which were proposed. Frequent changes in location of the central medical establishment, the separation of some of its elements from each other, the scattering of air force units in many locations, and the interference of theater organization apparently prevented its progress along the lines that Medical Department officers in the Far East Air Forces and the Office of the Air Surgeon would have liked. Moreover, the end of the war removed any need for it and for two more such establishments requested for the Far East Air Forces.19

The Air Surgeon (Maj. Gen. David N. W. Grant) accompanied by the Surgeon, Far East Air Forces, and the Surgeon, Army Air Forces, Pacific Ocean Areas, visited air force units on New Guinea, the Philippines, and various islands in November 1944. General Grant attempted to enlarge the medical service within the Far East Air Forces by advocating a large increase in personnel-the addition of 61 medical officers and 80 dental officers-and other measures. He declared that doctors in the theater Services of Supply organization did not understand the "highstrung, sensitive mechanism" of aviators; only flight surgeons could keep aviators in flying condition. General Grant stressed the need for central medical establishments to classify and dispose of flying personnel discharged by the general hospitals. He also urged the desirability of direct control of general hospitals by the Far East Air Forces, pointing out that a precedent for such control had already been established in the Mediterranean theater.

Although his recommendations were largely sustained by the Far East Air Forces, both the theater medical staff and the Chief Surgeon, USASOS (General Denit), were unalterably opposed to control of hospitals by the air forces. The U.S. Army Services of Supply continued to control the fixed. hospitals of the Southwest Pacific Area; the air forces in the area (and in the South Pacific) were restricted to control of 25-bed portable surgical hospitals assigned to them, and hospitals, termed dispensaries, operated by the XXI Bomber Command. The assignment of a flight surgeon to General Carroll's office as a liaison officer from the Far East Air Forces proved helpful in convincing medical officers of the latter headquarters that the staff of the Services

    19 (1) See footnote 2(2), p. 454. (2) Memorandum, Commanding Officer, 2d Central Medical Establishment, Special, for Chief Surgeon, Headquarters, U.S. Army Forces in the Western Pacific, 25 July 1945, subject: Location of Medical Installations. (3) Quarterly Reports, Medical Department Activities, 2d Central Medical Establishment, Special, covering period, 5 June 1944-31 Dec. 1945. (4) Link, Mae Mills, and Coleman, Hubert A.: Medical Support of the Army Air Forces in World War II. Washington: U.S. Government Printing Office, 1955, pp. 751-756.


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of Supply medical section understood the "peculiar and highly sensitive characteristics of Air Corps personnel."20

Base Sections and Bases: Australia, New Guinea, and the Philippines

In the latter part of 1944, the area organization of the U.S. Army Services of Supply in Australia was declining, while it was still building up in New Guinea and just getting underway in the Philippines. Base Section, USASOS, established in June 1944 with headquarters at Brisbane, administered Army medical service for all troops in Australia with only three area subcommands- Bases 2, 3 (later absorbed by the base section), and 7 at Townsville, Brisbane, and Sydney, respectively. In the fall of 1944 this, medical office consisted of eight officers, including a veterinary consultant, a dental consultant, and a nutrition consultant, four enlisted men, and six civilians. Since war had moved far away from Australia, Medical Department officers stationed there were able to give more time and effort to acquainting themselves with recent developments in medical and dental techniques; in 1944 a number of interallied dental meetings and conferences took place. Liaison with local Australian authorities continued in connection with the program for control of venereal disease, food inspection, and the maintenance of adequate nutritional standards, as well as with respect to medical service provided for Australian civilians employed by the U.S. Army. At the end of 1944, one general and three station hospitals sufficed to care for troops remaining in Australia. After further retrenchment, including consolidation of Army and Navy medical facilities, in the first 6 months of 1945, less than half a dozen officers and a few enlisted men and Australian civilians comprised the medical section of Australian Base Section.21

In the fall of 1944 Intermediate Section, with headquarters at Oro Bay, controlled all seven New Guinea bases (including the last one, Base H, established on Biak Island). During that period the chiefs of technical services at the New Guinea bases were given command control of the installations maintained by their services. The base surgeon was thus placed in actual command of medical units, hospitals, and other medical installations at the base.22 As in the case of the Central Pacific Base Command, the surgeon re-

    20 (1) Letter, The Surgeon General, to Chief Surgeon, U.S. Army Services of Supply, 28 Nov. 1944. (2) Letters, Chief Surgeon, U.S. Army Services of Supply, to The Surgeon General, 7 and 8 Dec. 1944. (3) Memorandum, the Air Surgeon for Commanding General, Army Air Forces, 23 Nov. 1944, subject: Reports on Special Mission. (4) See footnote 2(2), p. 454. (5) Quarterly Reports, Medical Department Activities, Headquarters, Far East Air Force, 3d and 4th quarters, 1944, and 1st and 2d quarters, 1945. (6) Letter, Chief Surgeon, U.S. Army Services of Supply, to The Surgeon General, 18 Nov. 1944.
    21 (1) Quarterly Reports, Medical Department Activities, Base Section, U.S. Army Services of Supply, 3d and 4th quarters, 1944, 1st quarter, 1945. (2) Quarterly Report, Medical Department Activities, Australian Base Section, U.S. Army Forces in the Western Pacific, 3d quarter, 1945. (3) See footnote 11 (4), p. 468.
    22 Letter, Surgeon, Intermediate Section, to Chief Surgeon, U.S. Army Services of Supply, 2 Sept. 1944.


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ceived the full control over the medical resources of the command which staff surgeons invariably welcomed.

By the end of 1944 several New Guinea bases, especially those at Milne Bay, Port Moresby, and Lae, had declined markedly in importance. Base G at Hollandia, on the other hand, was receiving a large share of the evacuees from the Philippines. The base at Biak (Base H) was also getting many casualties and was the point of departure for air evacuation to the United States. In February 1945, when the Services of Supply was building up its bases in the Philippines, all seven New Guinea bases were placed under the newly established New Guinea Base Section (successor to Intermediate Section) with headquarters at Oro Bay. Although the New Guinea Base Section surgeon originally had a full complement of staff officers, before the end of March a number of the members of his medical section were sent forward to bases in the Philippines.23

The original bases in the Philippines were developed by the Army Service Command which accompanied Sixth U.S. Army and established the Services of Supply bases in the wake of the army. At Hollandia in the fall of 1944 it assembled the nucleus organization, including medical sections, of the two bases initially established in the Philippines, Base K at Tacloban, Leyte, and Base M, originally at San Fabian, Luzon (January-April 1945), and finally at San Fernando, Luzon. Army Service Command moved to Leyte in the late fall of 1944 and put together at Tacloban the organization for two additional bases of minor importance, Base R which was to be at Batangas on Luzon and Base S to be on Cebu. Early in 1945, Army Service Command moved. on to Luzon where, renamed Luzon Base Section, it reverted to the control of the Services of Supply and directed the activities of Base M and three subbases.

The medical organization of the bases established in the Philippines was largely a repetition of that of the New Guinea bases, although the medical section that entered a Philippine base was usually more nearly full fledged than the usual office which had had to tackle the initial medical job at a Now Guinea location. The San Fernando Base (Base M), for example, had about 25 Medical Department officers assigned to it from the outset. Besides the base surgeon and the usual dental officer, veterinarian, and medical supply officer, the Philippine bases had in their initial setup certain medical assign-ments which some of the New Guinea bases (or, at least, those earliest established) had not received until they had been in existence for some months: A malariologist, a port surgeon, an area command surgeon, a hospitalization officer, an evacuation officer, and a personnel officer. The assignment of one or more venereal disease control officers to the Philippine bases from the out-

    23(1) Quarterly Reports, Medical Department Activities, various New Guinea bases, 3d and 4th quarters, 1944, and 1st and 2d quarters, 1945. (2) Quarterly Report, Medical Department Activities, Intermediate Section, U.S. Army Services of Supply, 3d and 4th quarters, 1944. (3) See footnote 11 (4), p. 468.


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set betokens the Medical Department's memory of the high venereal disease rates that had prevailed among U.S. Army troops in the Philippines before the war. An early attempt was made to sponsor measures, including the adoption of special local legislation, which had been found effective in coping with the problem in Australia.24

Several Medical Department officers present in the early days of the Leyte invasion left a graphic picture of the geographic, climatic, and administrative obstacles which they encountered in getting the medical service of Base K into running order. Like the other Army logistic officers, they encountered the adverse weather and terrain which Sixth U.S. Army engineers had prophesied would make the founding of a base in Leyte Valley a difficult undertaking. On the 13th day of the invasion, the Base K surgeon, Lt. Col. Paul 0. Wells, MC (fig. 110), reported:

Have been in this base for 8 days and have spent most of that time on reconnaissance. I am sorry to have to report that it is the most undesirable terrain on which to build a base that I have ever seen * * *. Every service is scrambling for suitable area and it is not to be had. I would estimate that only 5-4001o of the land can be used for dumps or any other installation. The remainder is swamp and rice paddy * * *. There are some optimists who think that they can hang hospitals on these hill sides but I am convinced that they cannot do so without the use of more earth moving equipment than the engineers can make available for hospital construction * * *.

The civilian population here is in good shape with 3 months supply of looted rice and two hospitals running with native doctors. The civilian situation around Dulag is bad since the town and adjacent district was destroyed and there are several thousand huddled on the beach without much food and no shelter or medical care. The PCAU [Philippine Civil Affairs] units were swamped and have called for help. Sent one doctor down and they have been given Jap medical supplies. Have no other supplies of my own as yet so have to refer them to 6th Army. Col. Hagen [Hagins, Sixth U.S. Army Surgeon?] will give them help as the military needs will permit. Wish I could do more.25

Within a few days, Colonel Wells had been able to survey much more desirable valley terrain around Burauen but could not locate his hospitals there as it was necessary to place them close to other base installations near the port of Tacloban. On 22 November he recounted additional difficulties.

Jap bombing has slacked off considerably though we have had a number of planes crash dive on ships with heavy casualties in some cases.* * * the ship on which the 101st and 91st Station Hospitals were located was one of the victims. They lost a total of 4 killed, 4 missing and 6 injured at latest report.* * * I continue to have serious difficulties In retaining suitable sites for hospitals. Have been allocated and subsequently lost a majority of the desirable area in the base. The latest happened today when I lost the site of my convalescent hospital to an air strip (They have had to give up on one of the strips because of the mud, etc.) and the site of a 500 bed station to an ordnance dump!* * *

    24 (1) Historical Record of Army Service Command, 23 July 1944 to 13 February 1945. (M-1 Operation). [Official record.] (2) Quarterly Reports, Medical Department Activities, Bases K and M, 4th quarter, 1944, 1st quarter, 1945. (3) Krueger, Walter: From Down Under to Nippon. Washington: Combat Forces Press, 1958, p. 353. (4) See footnote 12 (1), p. 469.
    25 (1) Cannon, M. Hamlin: Leyte: The Return to the Philippines. United States Army in World War II. Washington: U.S. Government Printing Office, 1954, ch. XI. (2) Letter, Lt. Col. Paul O. Wells, MC, to Brig. Gen. Guy B. Denit, 1 Nov. 1944.


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The need for beds is critical with only about 150 vacant beds in the base. Had a conference with Colonel Hogan [Hagins?] today and he wanted to know how many beds I could provide in 48 hours. I told him none unless he could get the hospital equipment unloaded from the ships and some engineer effort on hospital construction. Sixth Army is still in control here and sets all priorities on unloading and engineer effort. He stated that he was presenting the facts to the Chief of Staff this afternoon and insisting on immediate action. He was very critical of the 6th Army Engineer.

We have had two mild typhoons and one other alarm. Have kept my hospitals back a distance from the open beach in anticipation of possible big blows from the open sea. Couldn't have gotten them on the beach anyway in view of the number of headquarters arriving here.26

As late as 9 January 1945, a Medical Corps officer with Advance Headquarters, USASOS, corroborated Colonel Wells' account of his difficulties.

From the planning stage we have progressed to the construction and development era. * * * To be frank with you, we love it. We always work best with our feet on terra firms, and canvas overhead. * * * in fact we are very well pleased with the cooperation we have received from everyone. We are doing our damnedest to help, but we feel that it will take an act of God to correct the deficiencies present in this Base. We do not understand how Colonel Wells has been able to remain a sane person after what he has gone through.

    26 Letter, Lt. Col. Paul O. Wells, MC, to Brig. Gen. Guy B. Denit, 22 Nov. 1944.


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He has had to deal with Sixth Army, GHQ, ASCOM, USAFFE, USASOS, ADSOS, Base "K," Leyte Engineer Command, Eighth Army, XXIV Corps, Philippine Civil Affairs Units, and other agencies too numerous to mention.

Colonel Voorhees noted extreme confusion with respect to the channels of medical supply as well:

The red tape passed any belief. Even a radio requisition had to go from the medical supply officer to the Base Headquarters, from Base Headquarters to Advance [should be "Army"] Service Command Headquarters (known as ASCOMI; I felt that the accent should be strongly on the first syllable), from there to Sixth Army Headquarters, from there to USASOS Headquarters at Hollandia, and from there to Intermediate Section 1,000 miles farther away at Oro Bay.

This was, of course, an extreme situation which developed in the course of establishing, during heavy combat, a large new base at the end of an extended supply line. But similar difficulties, though in less severe form, attended the early stages in developing medical service at other bases in the Philippines.27

Public Health in the Philippines

The Philippine Islands were the major region of the Southwest Pacific Area where U.S. Army doctors had responsibility for reestablishing public health services for a people formerly under enemy domination.28 Effective health measures in these island possessions after more than 2 years of Japanese domination would contribute significantly to the regeneration of American prestige. The civil affairs program in the Philippines was a wholly unilateral operation of the United States, and the U.S. Army planned as well as administered it. Hence policy and top direction of the program stemmed from a staff section created at the top U.S. Army headquarters-Headquarters, U.S. Army in the Far East-in November 1944. The Civil Affairs Section, USAFFE, which had general responsibilities for coordinating all matters of civil administration until responsible government could once again be established throughout the archipelago, had the specific responsibility for planning and supervising health and sanitary measures. Other tasks which it undertook, such as the restoration of destroyed or damaged public utilities, were, as elsewhere, closely related to the public health program. Colonel Smith, recently theater malariologist, was put in charge of the small medical section. As in other theaters, a similar medical section was created in G-5 at lower levels of command, both area and tactical.

A Civil Affairs Detachment was formed at Headquarters, USAFFE, to develop Philippine Civil Affairs Units. The first eight such units to be created, made up largely of personnel from the First Filipino Regiment and

    27 (1) Letter, Maj. U.S. Steinberg, to Col. R. O. Dart, MC, 9 Jan. 1945. (2) See footnote 2(3) and (4), p. 454. (3) Letter, Lt. Col. David A. Chambers, MC, to Brig. Gen. Guy B. Denit, 28 Dec. 1944. (4) Engineers of the Southwest Pacific, 1941-1945, vol. VI; Airfield and Base Developments. Washington: U.S. Government Printing Office, 1951, pp. 311-312.
    28 Civil Affairs in New Guinea, New Britain, and the Admiralties had been handled by the Australian-New Guinea Administration Unit (ANGAU).


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the Second Filipino Battalion of the U.S. Army, were trained by this detachment at Oro Bay, New Guinea.29 Eventually 30 units were developed, all being used during the campaign for the Philippines. One of the 10 officers in each unit was a medical officer and 4 or 5 of the 39 enlisted men had medical duties. Many of the personnel, particularly the officers, had received training at the civil affairs training schools in the United States. The civil affairs units were attached to army commands (the Sixth and Eighth U.S. Armies) at the army, corps, or division level or to base commands. Eventually they worked in every province of the archipelago.

In the early stages of a campaign, Philippine Civil Affairs Units were usually allocated to the division or corps. When Sixth U.S. Army went into the Leyte campaign, for example, two Philippine Civil Affairs Units were attached to X Corps, two to XXIV Corps, two to the Army Service Command, while two were kept in reserve under Sixth U.S. Army control. Initially the units were further attached by corps headquarters to the divisions. Services which their personnel could perform at the corps or division level in the initial stages of a campaign included giving initial care to wounded and sick refugees in Army hospital units, salvaging Japanese medical supplies for use among Filipino civilians, hunting out civilian doctors, and establishing dispensaries and some hospitals for civilians. The successive phases of divisional, corps, and Army control of civil affairs units passed quickly, of course. In Tacloban, for example, responsibility for civil affairs passed from divisional to Sixth U.S. Army control late in October 1944, and Base K relieved X Corps of responsibility in Leyte Valley on I January 1945. The greatest difficulty encountered by medical officers assigned to the units was a lack of medical supplies for civilian use. Shortages were due, as were shortages of relief supplies in general, to shipping shortages and the inadequate capacities of ports. As in other areas it was necessary to divert to civilian use medical stores intended for troops.

The largest task of restoring normal health facilities lay in Manila, where widespread destruction in the wake of prolonged street-to-street combat intensified health problems. The rapid rehabilitation of Manila was important not solely because it was the capital and the, key city for economic renaissance of the Philippines. At that date it was considered vital to supply lines for an invasion of Japan, and for a few months the U.S. Army had the additional motive of self-interest in reestablishing good health conditions and preventing epidemics in the city.

Eight Philippine Civil Affairs Units accompanied XIV Corps as it fought its way into Manila in February 1945. One entered the burning city on 5 February, 2 days after the first troops went in. Reports of widespread disease, starvation, and death reached the advance echelon of General Headquarters

    29 The Civil Affairs Detachment, U.S. Army Forces in the Far East, corresponded to the European Civil Affairs Division, the training entity of the European theater, while the Philippine Civil Affairs Units were similar to units which performed the fieldwork in the European theater.


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located north of Manila. Colonel Pincoffs, Chief Medical Consultant, USAFFE, was sent forward with other officers to survey the city and found a complete breakdown of water, sewage, lighting, telephone, and transportation systems. Those civilian hospitals still in operation were overcrowded with wounded citizens and lacked medical supplies, as well as food, water, and light. Bodies were "stacked like cordwood" in the morgues; many lay in the streets. No organized medical service existed; the central office of the Manila Department of Health had been abandoned and three Government hospitals were the only elements of the city health service in operation. The civil affairs units were attempting, with the aid of the Surgeon, XIV Corps, who had his own wounded to care for, to distribute food and medical supplies to the population.

Colonel Pincoffs recommended the establishment of a provisional Department of Health and Welfare under American auspices and outlined the needs in Medical Department officers and units. Near the end of February, President Sergio Osmena asked General MacArthur to appoint a U.S. Army officer to take charge of the task of reestablishing the Manila Department of Health and Welfare. A provisional department was created at the beginning of March when Headquarters, USAFFE, took over direct control of civil affairs in Manila from Sixth U.S. Army. Colonel Pincoffs was attached to the Civil Affairs Section, USAFFE, and made Director of Health and Welfare of Greater Manila, with responsibility for administering a citywide public health program. He remained in charge of this office, located at the San Lazaro Contagious Disease Hospital, until May. With the aid of American Army doctors, the Philippine Civil Affairs Units, and Filipino physicians, he set about the task of getting citywide reports on communicable diseases as a prelim-inary measure to-ward checking incipient epidemics. Cholera, smallpox, and plague were the three diseases most dreaded by the civilian population. Many cases of tuberculosis were discovered. Diarrhea, dysentery, and the venereal diseases were the maladies which occurred with the greatest frequency during the early months.

Manila was divided into eight districts, in each of which operated a civil affairs unit, which was attached to Headquarters, USAFFE, and supervised by the latter's civil affairs section. The medical officer of each unit was made the district health officer, and his office obtained and forwarded to the San Lazaro headquarters the daily reports on cases of communicable diseases at the civilian hospitals. Later an epidemiologist was assigned to each health district and a clinical consultant to the San Lazaro headquarters. The latter checked for undetected cases of disease at hospitals throughout the city. The development of a statistics section at the headquarters, the reestablishment of requirements for the issuance of death certificates, and the restriction of burial to cemeteries run by the provisional health department were additional steps taken to reestablish normal controls over information on the incidence of communicable diseases.


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The Division of Sanitation of Colonel Pincoffs' department, run by Col. Gottlieb L. Orth, MC, checked all water points for contamination during a 3 months' period while the Japanese kept Manila on short water rations by holding the major water reservoir in the mountains. Its chief job, however, was to clean up the city, a task carried out in each of the eight city health districts by a malaria control unit, now called a "sanitary group." The first and worst of the unorthodox tasks which the sanitary groups had to perform in Manila was the burial of thousands of dead. Other jobs were the cleaning of the city block by block, the restoration of public and private facilities for the disposal of sewage and garbage, as well as the abattoirs, and the inspection of public eating and drinking places. Colonel Orth's staff and the district sanitary groups also tackled the task of insect and rodent control, maintaining flycatching stations which checked on the results of regular spraying of Manila with DDT by planes of the Far East Air Force.

The period of control of the Manila public health service by Headquarters, U.S. Army Forces in the Far East, and its successor, U.S. Army Forces, Pacific, ended on 1 August 1945. Preceding months witnessed a gradual, well-planned transfer of control from the Army to the civilian authorities of Manila. The Philippine Civil Affairs Units were withdrawn from the city during April and May, being replaced by similar units provided by the Philippine Government. Civilian district health officers were chosen, but Sanitary Corps officers assigned to the districts continued to aid with the collection of reports on communicable diseases, the distribution of medical supplies, and the sanitary inspections of civilian hospitals and refugee centers. On 1 August the Army turned over the Department of Health, now staffed by Filipino civilians, to the Philippine Government.30

Thus Army tactical elements and then U.S. Army Forces in the Far East exercised successively the major responsibility for reestablishing a public medical program in the Philippines. Apparently the intent of Headquarters, USAFFE, was that the tactical commander should retain responsibility for all civil administration and relief until the theater headquarters of the Philippine Government should assume it.31 The Services of Supply and its elements had little responsibility. However, the base surgeons were called upon to furnish

    30 (1) Pincoffs, M. C.: Health Problems in Manila. Transactions, American Clinical and Climatological Association, vol. LVIII, 1947. (2) History of U.S. Army Forces in the Far East, 1943-1945. [Official record, Office of the Chief of Military History.] (3) Letter, Surgeon, U.S. Army Forces in the Far East, to The Surgeon General, 23 Mar. 1945. (4) Report of Civil Affairs Operation on Leyte-Samar by Chief of Civil Affairs, Headquarters, Sixth U.S. Army, 4 March 1945. (5) Memorandum, Col. M. C. Pincoffs, MC, for Commanding General, U.S. Army Forces in the Far East, 17 Feb. 1945, subject: Report on Civilian Health and Welfare in Manila in Relation to Disease Control and Care of Battle Casualties. (6) Interview, Col. Maurice C. Pincoffs, MC, 22 May 1952. (7) Letter, Col. Maurice C. Pincoffs, MC, to Brig. Gen. Guy B. Denit, 20 June 1945. (8) Letter, Col. Maurice C. Pincoffs, MC, to Col. John Boyd Coates, Jr., MC, USA, Director, The Historical Unit, U.S. Army Medical Service, 1 Sept. 1955.
    31 In some areas of the Philippines responsibility for civil affairs passed from Army control (with more responsibility shared by the base), directly to the Commonwealth Government, without an Interim period of control by theater headquarters.


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medical supplies for civilian relief. In Base K, the base surgeon set aside two small station hospitals for the care of civilians. Moreover, in performing the base surgeon's usual duties in the control of venereal disease and the prevention of malaria and other insectborne diseases-for example, the spraying of entire towns in the base section with DDT-the base surgeon contributed to the protection of civilian health.32

DEVELOPMENTS AFTER APRIL 1945: THE PACIFIC THEATER

In April 1945 General MacArthur, while retaining his Allied command unchanged, was made Commander in Chief of AFPAC (U.S. Army Forces, Pacific). For the first time U.S. Army forces in the Pacific (with the exception of the Twentieth Air Force and troops assigned to the North Pacific Area) were placed under a single command to constitute one Army theater of operations for the entire Pacific. The two major area commands under AFPAC were the U.S. Army Forces in the Far East and the U.S. Army Forces, Pacific Ocean Areas. In June, the former command was absorbed by the U.S. Army Forces, Western Pacific, and the latter was superseded by the U.S. Army Forces, Middle Pacific, consisting of Hawaii and other islands.

Surgeon, U.S., Army Forces, Pacific, and Subordinate Medical Elements

U.S. Army Forces, Pacific, had no surgeon until June 1945. At that time Brig. Gen. Guy B. Denit (who had acted in the dual assignment of Chief Surgeon, U.S. Army Forces in the Far East, and Chief Surgeon, U.S. Army Services of Supply) was made Chief Surgeon, General Headquarters, U.S. Army Forces, Pacific. In his new assignment he headed an office which exercised general technical supervision over the medical service within all the following major commands under the U.S. Army Forces, Pacific: U.S. Army Forces, Western Pacific (which took over the former functions of both USAFFE and USASOS) and U.S. Army Forces, Middle Pacific, which were the two main territorial commands (map 10) ; the Far East Air Forces; the Sixth U.S. Army; and the Eighth U.S. Army. At the close of June 1945, Army strength in the Southwest Pacific Area totaled 866,214 and Medical Department strength 69,665. General Denit served additionally as Surgeon, U.S. Army Forces, Western Pacific, until August, when a separate surgeon was appointed for that command.

Thus after June 1945 a surgeon headed a complete medical section at an Army theater headquarters for the entire Pacific (except the North Pacific Area). The office remained in Manila throughout 1945 and in the months just

    32 Quarterly Reports, Medical Department Activities, Bases K and M, October 1944-December 1945. (2) Annual Report, Medical Department Activities, Base M, 1946. (3) Quarterly Report, Medical Department Activities, Base R, February-December 1945. (4) Quarterly Report, Medical Department Activities, Base S, 4th quarter, 1945. (5) Quarterly Report, Medical Department Activities, Base X, 3d quarter, 1945.


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before the Japanese surrender was occupied with making medical plans for the expected Allied invasion of Japan. General Denit apparently intended originally to keep his main office small, as had been his medical staff at his principal office at Headquarters, U.S. Army Forces in the Far East, and to restrict it to policymaking. The medical section at Headquarters, U.S. Army Forces, Western Pacific, would contain personnel to handle medical supply, medical records, hospitalization, and so forth. However, since his office supervised medical service for troops scattered throughout the Pacific and since increased incidence of certain diseases- trenchfoot and venereal disease, in particular- was anticipated with the invasion of Japan, the office underwent temporary expansion. At the end of 1945 it consisted of 40 officers and 57 enlisted men. Throughout the latter months of the year, General Denit had consultants for a few months in the fields of medicine, surgery, neurosurgery, neuropsychiatry, and nutrition, but practically all of these had left by the end of the year. In October 1945 a "veterinary consultant," a "nursing consultant," and a "dental consultant" were appointed; these were relatively permanent positions.

The unification of Pacific areas into a single theater responsible for striking directly at Japan facilitated cooperation between the medical service of the Army and that of the Navy in making invasion plans. It also made possible a concerted effort by the Surgeon General's Office and the theater medical organization to build up well-developed medical staffs for high-level commands in the Pacific. Many Medical Department officers had noted that the division of the Pacific into separately controlled areas, remoteness of these areas from the United States, the complexity of the command structure, and the concen-tration on problems of the European theater at the expense of the Pacific areas had led to insufficient contact between the Surgeon General's Office and medical authorities in the Pacific. The Director of the Control Division, the Surgeon General's Office, commented early in 1945, shortly after his trip to the Pacific, upon the waste in personnel, as well as supplies, that had occurred on some islands and at certain levels of command and concluded that "theater walls have been too often wafer-tight compartments." The lack of adequate staff, especially consultants, at the headquarters of higher commands which he had observed throughout the Pacific (as well as in the China- Burma-India theater) was immediately attributable to the limits placed by the area's top Army commands upon suballotment to the medical service. It was ultimately attributable, he emphasized, to the War Department, which had set the area's allotment in the first place. Central planning of oversea medical staffs by the Surgeon General's Office, furthered by direct contact between The Surgeon General and his staff and the War Department General or Special Staffs in drawing up these plans, was sorely needed.33

    33 Memorandum, Col. Tracy S. Voorhees, JAGD, for Maj. Gen. George F. Lull, 29 Jan. 1945, and inclosure, subject: Suggestions as to Need for Changed Methods in Utilization Overseas of Medical Department Units.


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Map 10.- U.S. Army Forces, Pacific, June 1945


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During the summer months before the sudden surrender of Japan, the Surgeon General's Office and the Pacific theater surgeon engaged in concerted planning of this type. The latter made known his needs for officers with various types of training, especially those who could fill administrative positions. He asked the Surgeon General's Office for men qualified to replace those chiefs of surgery in his general hospitals who were being returned to the United States after long service in the Pacific, and for additional officers trained in venereal disease control. The Surgeon General's Office calculated needs for officers trained in some other special fields-pathologists and bacteriologists in laboratories-and selected men with such skills to send to the Pacific. The surrender of Germany had made it possible to release for the Pacific officers experienced in medical administration who were serving in the European and Mediterranean theaters.

The Director of the Control Division, the Surgeon General's Office, promoted the development of a consultants' system comparable to that which had worked so profitably in Europe. Shortly before the Japanese surrender, he issued a report which compared the medical service afforded in the Pacific theater, particularly in the Southwest Pacific Area, with that in the European theater, relating difficulties encountered in medical service in the former directly to organizational handicaps which had faced the medical section at the highest level of command in the Southwest Pacific Area: its position at a level which restricted its power to function in forward areas and which limited its access to high command and its participation in planning the medical support of forward movements. He called attention to the lower priority of the Pacific theater compared with that of the European and Mediterranean theaters, especially for medical specialists. He recommended measures designed to improve the quality of medical service in the Pacific preparatory to the expected invasion of Japan, including the assignment of specialists who had served in Europe and North Africa as consultants. He stressed the importance of vesting technical control over all medical service in the Pacific in the Surgeon, U.S. Army Forces, Pacific. The Surgeon, U.S. Army Forces, Western Pacific- that is, the surgeon of the communications zone- should act as his deputy, he thought. Furthermore, the Pacific theater surgeon should take an active part in planning the medical support for the invasion of Japan. A medical staff of adequate size, including consultants, might function either in the office of the theater surgeon or in that of the surgeon of the communications zone, he thought, but in either case its work should be directed by the theater surgeon.

The theater surgeon sent Col. Maurice C. Pincoffs, MC, to Washington to obtain additional Medical Department officers for administrative positions in the theater, especially an officer with expert knowledge of trenchfoot and one trained in venereal disease control. He requested four officers who had had training at the Command and General Staff School at Fort Leavenworth, Kans., and at the Medical Field Service School at Carlisle Barracks, Pa., for the positions of corps and division surgeons, a nurse with administrative experience to


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act as chief nurse, and a chief quarantine officer from the U.S. Public Health Service. Entry into Japan would greatly magnify problems of quarantine. Colonel Pincoffs discussed personnel problems with officers of the Surgeon General's Office and higher elements of the War Department. General Denit himself went to the United States for consultation on these matters soon afterward. Since no invasion of Japan took place, the more fully developed theater surgeon's office and the innovations in medical service advocated by the Surgeon General's Office and the theater surgeon were never fully tested.

In the autumn, after the Japanese capitulation, the principal Army medical offices supervised by the theater surgeon were practically the same as those which he had directed since June: the medical offices of the two territorial commands, the U.S. Army Forces, Western Pacific, and the U.S. Army Forces, Middle Pacific; the office of the surgeon of the Far East Air Forces (renamed Pacific Air Command in December) ; and the medical sections of two ground commands, the Eighth U.S. Army occupying Japan and XXIV Corps occupying Korea. During the fall General MacArthur made Tokyo his headquarters for the discharge of his duties as SCAP (Supreme Commander for the Allied Powers). General Headquarters, SCAP, was at the top of an additional chain of control, its functions being primarily concerned with the Allied occupation of Japan rather than with the internal administration of the U.S. Army. The major medical work of this command was its program for rehabilitation of public health services in Japan.

The sudden surrender of Japan presented the U.S. Army medical service with the immediate problem of providing medical care for liberated prisoners of war and internees of the Allied countries in addition to that of serving the occupation troops. An advance echelon of General Denit's office, located in Tokyo and headed by Col. A. H. Schwichtenberg, MC, took care of these duties in the latter months of 1945. Besides advising on hospitalization, evacuation, and preventive medicine for the occupation forces, this office served as a clearinghouse for officers and special committees sent by the War Department or General Denit's office to Japan during the early months of occupation to make technical studies; for example, for the Committee for the Technical and Scientific Investigation of Japanese Activities in Medical Sciences which inquired into Japanese research on the prevention of tuberculosis, new dengue vaccines, antimalaria drugs, and drugs for the treatment of leprosy. Another group of officers served on the commission established by General MacArthur to investigate the effects of the atomic bomb in Japan.34

    34 (1) Administrative History, Medical Section, U.S. Army Forces, Pacific. [Official record, Office of the Chief of Military History.] (2) Annual Reports, Medical Department Activities, U.S. Army Forces, Pacific, 1945, 1946, 1947. (3) Annual Report, Medical Department Activities, Far East Command, 1947. (4) Letter, Chief Medical Consultant, Office of The Surgeon General, to Chief Surgeon, U.S. Army Services of Supply, 25 June 1945. (5) Notes in Pacific Medical Conference, 3 Aug. 1945, by Director, Control Division, Office of The Surgeon General. (6) Memorandum, The Surgeon General, for the Chief of Staff, 10 Aug. 1945, subject: Report With Recommendations as to Medical, Surgical, and Neuropsychiatric Problems in the Pacific. (7) Memorandum [letter], Brig. Gen. Guy B. Denit, to Col. Maurice C. Pincoffs, MC, 25 May 1945. (8) Letters, Col. Maurice C. Pincoffs, to Brig. Gen. Guy B. Denit, 8 June 1945; Brig. Gen. Guy B. Denit, to Col. Maurice C. Pincoffs, 20 June 1945.


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U.S. Army Forces, Middle Pacific

U.S. Army Forces, Middle Pacific, which largely superseded U.S. Army Forces, Pacific Ocean Areas, on 1 July 1945, took over the latter's subordinate commands-three area commands, the Tenth U.S. Army, and AIRMIDPAC. The most recently created of its subordinate area commands was the Western Pacific Base Command (map 9), established the preceding April. It had the same logistic responsibility that the Central and South Pacific Base Commands had within their respective boundaries. It included the Army garrison forces on islands of the Marianas and Western Carolines-Saipan, Guam, Tinian, Iwo Jima, Peleliu, Ulithi, and Angaur; it had headquarters on Saipan. Col. Eliot G. Colby, MC, was surgeon and cooperated closely with the surgeons of various Navy commands in the area. On Saipan, Guam, Tinian, Angaur, and Iwo Jima a command termed "army garrison force" was the top command for Army troops on the island; each had the usual surgeon's office Until V-J Day many general and station hospitals and a variety of surgical, veterinary, dental prosthetic, and optical repair detachments were briefly stationed on these islands. The Western Pacific Base Command gave medical support to the invasion of Iwo Jima and Okinawa and made plans to furnish personnel, units, and supplies for the expected invasion of Japan. After the Japanese surrender, medical service still had to be provided for Army garrison forces stationed on some of the islands-Saipan, Tinian, and Iwo Jima-and throughout 1946 a small surgeon's office existed at command headquarters on Saipan (moved to Guam in October of that year).35

The other two area. commands subordinate to U.S. Army Forces, Middle Pacific-the Central and South Pacific Base Commands (map 9) -were undergoing further decline in 1945. In October, shortly after V-J Day, the office of the Surgeon, Middle Pacific, Brig. Gen. John M. Willis, contained 31 Medical Department officers. This number represented substantial growth since the establishment of the predecessor command (U.S. Army Forces, Pacific Ocean Areas) in the middle of the preceding year, but was not up to the existing allotment of 45 officers. Although consultants were still assigned, several were soon released. The medical consultant and laboratory consultant became members; of the atomic bomb commission which went to Hiroshima and Nagasaki for 90 days' study of the effects of the atomic bomb on these cities and their inhabitants. In November 1945, when the Central Pacific Base Command was discontinued and its elements transferred to the direct control of Headquarters, U.S. Army Forces, Middle Pacific, the staff of the base command surgeon was transferred to the office of the Surgeon, U.S. Army Forces, Middle Pacific.36

    35 (1) Annual Report, Veterinary Service, Headquarters, U.S. Army Forces, Middle Pacific. (2) See footnote 3(l) and (2), p. 455. (3) Annual Reports, Medical Department Activities, Western Pacific Base Command, 1945, 1946.
    36 (1) General Orders No. 61, Headquarters, U.S. Army Forces, Middle Pacific, 20 Oct. 1945; and No. 75, 1 Nov. 1945. (2) Annual Report, Medical Department Activities, Headquarters Detachment, Oahu Medical Service, Army Ground Forces, Pacific, 1946. (3) See footnote 3 (1), p. 455.


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In the South Pacific Base Command, the staff surgeon's office in New Caledonia supervised medical service for the remaining Army service troops, which by September 1945 had dwindled to about 14,600 men. Most of the 209 Medical Department officers who served the command were stationed on the two islands of troop concentration, New Caledonia and Guadalcanal. The chief Medical Department installations and units- including a 1,000-bed general hospital and a 50-bed station hospital on New Caledonia, a 500-bed station hospital on Guadalcanal, and a few platoons of medical supply depot companies- were also on these two islands. During 1945, the widespread use of DDT dramatically decreased the rates of incidence of malaria and filariasis in the South Pacific Base Command, both diseases being chiefly transmitted in this region by the same mosquito vector. The abatement of most other Army health problems in the South Pacific islands derived mainly from the absence of combat and the decline of troop strength.37

U.S. Army Forces, Western Pacific

The Manila office of the Chief Surgeon, U.S. Army Forces, Western Pacific (General Denit was surgeon during the period June-August 1945 and Brig. Gen. Joseph I. Martin from the latter date to January 1946), had essentially the same job as the office of the Surgeon, U.S. Army Services of Supply, Southwest Pacific Area, had had. The area which it served at its inception in June 1945 (map 9) included more than 10,000 islands, extending along the 6,000-mile route of advance from Australia to Japan. Of its subordinate territorial commands, Australia Base Section, with headquarters at Sydney, had only a skeletal organization; the last remaining Australian bases, at Townsville -and Sydney, were discontinued in June 1945. New Guinea Base Section and Philippine Base Section had several subordinate bases each. Army Service Command I, formed on 1 August 1945 by merging the island commands established on Okinawa and Ie Shima, also came under the control of U.S. Army Forces, Western Pacific.

During the summer of 1945, while bitter local fighting was still going on in the Philippines, the medical section of U.S. Army Forces, Western Pacific, distributed large-scale shipments of whole blood from the United States to Manila and Leyte and directed large-scale air evacuation. The operations of nearly every division of the surgeon's office were being expanded to meet the demands of the expected invasion of Japan. Plans were under way for expansion of hospital beds in Manila. At the time of the surrender Manila had one of the largest medical depot systems developed in any theater of operations during the war. A major continuing problem in the Philippines which reached its peak in mid-1945 was the control of venereal disease among troops. Two officers from the Surgeon General's Office made a special survey of the situation. Throughout the spring and summer of 1945 the War Department and theater

    37 Annual Report, Medical Department Activities, South Pacific Area, 1945.


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headquarters, (Headquarters, AFPAC) brought pressure on the Western Pacific command and all its subordinate tactical and area commands to take measures, including those for the repression of prostitution, to lower mounting venereal disease rates among troops in the Philippines.

After the Japanese surrender the major problems of the medical section at Headquarters, U.S. Army Forces, Western Pacific., were the usual ones involved in readjusting medical facilities, Supplies, and personnel to meet the needs of a rapidly shifting military population. The rear bases in New Guinea were being "rolled up," and troops and units were being sent forward to the Philippines and Japan. Men and units in forward areas were being returned to the United States. Hospital beds were reduced 'by more than half between V-J Day and the end of 1945. Permanent buildings occupied by general hospitals in the Philippines were returned to civilian authorities. Medical care for prisoners of war liberated in Japan and China was a heavy responsibility in the last months of 1945. Emergency packs of medical supplies, assembled by the medical depots -of Base X in Manila, were dropped by air to thousands of Allied prisoners of war in remote, areas of China and Japan until these men could be evacuated. The surgeon's office, U.S. Army Forces, Western Pacific, supervised this immediate job and the longer range ones, continuing into 1946, of evacuating and hospitalizing the recovered Allied soldiers and civilians. The disposal of surplus medical supplies, which continued into 1946, was largely handled by a "surplus property disposal officer" in the surgeon's office. He visited the New Guinea bases and made arrangements for the sale of nearly 5 million dollars' worth of medical supplies and equipment, including a general hospital at Biak, to the Netherlands Government. The Office of the Chief Surgeon, U.S. Army Forces, Western Pacific, also assisted with some phases of medical service in the Philippine Army, including the giving of physical examinations to about 150,000 Philippine Army personnel being demobilized and processing their medical papers. In April 1946, similar work was begun for the 37,000 Filipino troops to be turned over to the new republic on 1 July 1946.

The formal dismissal of the Combined Advisory Committee on Tropical Medicine, Hygiene, and Sanitation took place shortly after the Japanese surrender. The committee had remained somewhat dormant throughout 1945 while General Headquarters, under whose aegis it met, had gone forward to Hollandia and Manila. It had continued in existence however because General MacArthur wanted its aid if future combat operations should again call for close coordination of preventive measures against disease between the Australians and Americans. It was formally dissolved as of 1 November 1945, and the Western Pacific command attended to the details of winding up its affairs.38

    38 (1)Semiannual Reports, U.S. Army Forces, Western Pacific, 1 July-31 Dec. 1945, and 1 Jan.- 30 June 1946. (2) Memorandum, Col. M. C. Pincoffs, MC, for Chief Surgeon, U.S. Army Forces, Western Pacific, 25 Sept. 1945, subject: Combined Advisory Committee oil Tropical Medicine, Hygiene, and Sanitation. (3) Letter, Adjutant General, U.S. Army Forces Western Pacific, to Chairman, Combined Advisory Committee, 14 Oct. 1945, subject: Discontinuance of the Combined Advisory Committee, etc.


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Map 11.- New Guinea Bases, U.S. Army Forces, Western Pacific, June 1945

Territorial commands of U.S. Army Forces, Western Pacific.- The three major territorial commands under U.S. Army Forces, Western Pacific, in April 1945, were the Australian, New Guinea, and Philippine Base Sections (maps 11, 12). Only the last of these was of importance. Australian Base Section, with headquarters at Sydney by late June 1945, lasted as a skeleton organization throughout the year and the New Guinea Base Section until August 1945, when it was dissolved and its four remaining bases-at Lae, Finschhafen, Hollandia, and Biak-placed directly under U.S. Army Forces, Western Pacific. These declined and by April 1946 all had closed.39

The Philippine Base Section developed during the spring of 1945 from the former Army Service Command and assumed charge of directing Services of Supply activities, first on Luzon and later throughout the Philippines.40 When it was established in April, it controlled all five bases in the Philippine Islands: The earlier established Base K on Leyte and Base M at San Fernando, Luzon, and the recently established Base R at Batangas Bay, Luzon, Base S at Cebu City, Cebu, and Base X (merged with Philippine Base Section from April to July) in Manila. These various bases came under direct control of U.S. Army Forces, Western Pacific, in October. During the period February-April 1945, Medical Department officers assigned to the former Army Service Command were occupied in establishing medical service on Luzon, with concentration in the area of Greater Manila. During March, they evacuated about 3,500 patients from Luzon by plane and hospital ship, and located buildings in Greater Manila

    39 Quarterly Reports, Medical Department Activities, New Guinea Base Section, 2d and 3d quarters, 1945.
    40 A Luzon Base Section lasted from mid-February to April 1945, when the Philippine Base Section took control of all the bases in the Philippines.


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Map 12.-Philippine Bases, U.S. Army Forces, Western Pacific, June 1945

to house several hospitals and a medical supply depot for the base section and put these installations into operation. In April seven dispensaries, including three dispensaries to serve the port and a dental dispensary, were functioning. Manila became the largest center of fixed hospitals in the Southwest Pacific, Area in the expectation that a large hospital center would receive thousands of patients from an invaded Japan. The problem of venereal disease among troops crowding into Manila after fighting through the Luzon campaign was one of the most serious faced by the base section. Venereal disease control officers assigned to tactical elements (Sixth U.S. Army, XIV Corps, and 37th Division) and to the base section cooperated in efforts to prevent venereal disease, opening eight prophylactic stations in March. The problem continued in succeeding months as soldiers spent their leave in the urban areas of the Philippines.


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When a single base section was set up for all the Philippines in April, its staff medical section became a full-fledged one. A major job in Manila was work done in connection with hiring medically trained Filipino civilians for the U.S. Army. Although a civilian employment service did the actual hiring, personnel of the surgeon's office (of the combined Philippine, Base Section and Base X headquarters when they were operating jointly during the period April-July, and of Base X alone when they were separate) established job classifications and pay scales for this group, and maintained records on them. In addition, they supervised the work of Filipino civilian employees used by all medical units in the Philippine Base Section Area Command.41

Shortly after the Japanese surrender, two large area commands in the Philippines began clearing up regions occupied by the Sixth and Eighth U.S. Armies after the departure of troops and handling arrangements for the surrender and disarmament of Japanese troops in the Philippines. These were the Southern Islands Area Command, which included the Middleburg and Hollandia areas of Netherlands New Guinea, as well as the southern islands of the Philippines and the islands of Biak, Wakde, and Morotai, and the Luzon Area Command, including a few islands adjacent to Luzon. A few Medical Department officers directed the medical work connected with the removal of the Japanese. The medical section of Luzon Area Command, for instance, drew up the plan for evacuating sick and injured Japanese prisoners of war from Luzon; it made detailed arrangements for assembling evacuees at chosen locales, providing temporary hospitalization for them on Luzon, and specifying methods of evacuation. In November the two area commands were split into smaller area commands in charge of various Army divisions; these continued the cleanup.42

The tactical forces: occupation of Japan and Korea.-On 1 July 1945, the Eighth U.S. Army was given -responsibility for all tactical troops in the entire Philippine Archipelago, taking over Luzon from the Sixth U.S. Army. With the end of the Luzon campaign, the Sixth U.S. Army surgeon's office at San Fernando, Pampanga, Luzon, was free, to begin training and equipping medical units preparatory to the expected invasion of Japan. In July, corps and subordinate units were transferred and regrouped in anticipation of the invasion. Following the sudden Japanese capitulation, the office of the Surgeon, Sixth U.S. Army, moved in September with the headquarters to Kyoto, Japan, where it undertook duties typical of a medical staff office with an army of occupation. Early in 1946, the Eighth U.S. Army took over the entire task of Japanese occupation.

The Eighth U.S. Army had originally occupied only northern Japan. In August 1945 its surgeon, General Rice, arranged, after conference with officers at General Headquarters and Headquarters, Army Forces, Western Pacific, for hospital ships, as well as medical supplies and equipment, for evacuating

    41 Report, Medical Department Activities, Philippine Base Section, 25 Sept. 1945.
    42 Report, Medical Department Activities, Luzon. Area Command, 17 Oct. 1945.


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Allied prisoners of war and civilian internees from Japan. In late August, his office was established in the Customs House in Yokohama and began the work of caring for and evacuating these groups, while providing the usual medical service for elements of the Eighth U.S. Army. The office of the Surgeon, XI Corps, settled in September in Tokyo, and the office of the Surgeon, XIV Corps, moved in the same month from Luzon to Sendai in northern Honshu. A medical liaison group at Base X in Manila aided with the transfer of medical units and supplies from that base to the Eighth Army in Japan. For fulfilling initial medical responsibilities toward those freed from the Japanese camps, the Eighth U.S. Army surgeon had organized four medical teams to go to the various camp areas. These arrived in Yokohama on 30 August. Supplementing the work of the so-called "recovery teams," they gave initial care to the sick and evacuated the prisoners of war and internees to Tokyo. On 3 September, the 42d General Hospital, which had arrived in Tokyo near the end of August, assumed charge of the liberated, processing medical records related to them. At Atsugi airfield, whence they were started on their way home, via Manila, a medical clearing company, operating under the direction of the Eighth U.S. Army surgeon, served as a holding station to arrange the order of transport. Most of the liberated prisoners and internees, amounting to about 24,000, had been evacuated from Japan before the end of September.

Throughout the summer and early fall of 1945, the medical sections of two service commands, Army Service Commands O and C (with the Sixth and Eighth U.S. Armies respectively) and their bases were built up in the Philippines in anticipation of the Japanese occupation. Their medical sections had obtained information on diseases endemic in the areas which they expected to occupy, requisitioned the necessary medical supplies, and trained enlisted men in newly assigned duties. The channels of command established for the move to Japan were similar to those that would have been followed had an invasion been necessary, in that the base commands developed within the service commands were temporarily assigned to corps or divisions. After a. month or two of development at their Japanese sites, they were placed again under the Army service commands.

When the Eighth U.S. Army took over control from the Sixth U.S. Army early in 1946, Army Service Command O was absorbed by Army Service Command C, whose medical section was given direction of the base medical sections. Medical sections were in operation at major bases at the Japanese cities of Kobe, Kure, Nagoya, Fukuoka (on Kyushu Island), and Yokohama. The size of these medical sections varied considerably, usually being smaller than those that had existed at the larger New Guinea and Philippine bases. At the beginning of 1946, the Kure Base medical section had, in addition to the surgeon, an executive officer, a veterinarian, a port surgeon and venereal disease control officer, a chief nurse, a medical inspector, an administrative officer, and seven enlisted men. These officer assignments were more or less


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typical. A base venereal disease control officer was particularly necessary, for in the early days of the occupation the rise in incidence of venereal disease among American troops in Japan presented a major problem.43

The XXIV Corps on Okinawa had been selected for the occupation of Korea shortly before the Japanese surrender. While still on Okinawa, the office of the Surgeon, XXIV Corps, and that of the Surgeon, Army Service Command 24, prepared medical plans for the allocation of medical responsibilities during the occupation. The office of the corps surgeon opened in Seoul, Korea, on 11 September. It established dispensaries and began reconnaissance for hospital sites. The medical inspector examined bars and restaurants, and the veterinary inspector, slaughterhouses and food storage plants. The venereal disease control officer inspected geisha districts and houses of prostitution and recommended sites for prophylactic stations. Late in 1945 the longer range programs, such as typhus control and reimmunization of troops, to be undertaken during the Korean occupation, were initiated. The medical office of Army Service Command 24 operated at the command's headquarters, known as ASCOM City, near Inchon. Various types of hospitals and other Medical Department units served at Inchon, at ASCOM City, and at Seoul in the northern sector at Taejon in the central sector, and at Kwangju and Pusan in the southern sector. Troops given medical service, totaling about 811000 in November 1945, were those of XXIV Corps (6th, 7th, and 40th Divisions), the Fifth Air Force, the military government, and Army Service Command 24.44

In mid-1945 the office of the Surgeon, Far East Air Forces, was in Manila. It supervised the work of medical sections of the Clark Field headquarters of the Fifth Air Force, of the Leyte headquarters of the Thirteenth Air Force, and of the Hollandia headquarters of the Fax East Air Service Command. During this lull in combat, it made special effort to standardize the technical medical work among air force troops by having surveys and recommendations made in three fields; namely, psychiatric problems, ophthalmological problems, and dental deficiencies. An extensive survey of procedures in air evacuation within and from the Pacific theater was also made. An officer was sent to the European theater to acquaint medical units to be shifted from Europe to the Pacific with the medical problems which they might encounter in their new

    43 (1) Quarterly Report, Medical Section, Eighth U.S. Army, 3d and 4th quarters, 1945. (2) Quarterly Report, Medical Department Activities, XIV Corps, 2d quarter, 1945. (3) Quarterly Re-ports, Medical Department Activities, X Corps, 1945; and fiscal report, January 1946. (4) Quarterly Reports, Medical Department Activities, XI Corps, 1945 and 1st quarter, 1946. (5) See footnote 38(l), p. 492. (6) Periodic Reports, Surgeon, U.S. Army Service Command C, August-December 1945. (7) Periodic Reports, Medical Department Activities, Kobe Base, August 1945-December 1946. (8) Periodic Reports, Medical Department Activities, Kure Base, July 1945-Jan. 1946. (9) Quarterly Report, Medical Department Activities, Otaru Base, November-December 1945. (10) Quarterly Re-port, Medical Department Activities, Nagoya Base, 4th quarter, 1945. (11) Final Report, Medical Department Activities, Kyushu Base, 9 Dec. 1945-2 Apr. 1946. (12) Annual Report, Medical Department Activities, Yokohama Base, 1946.
    44 (1) Quarterly Report, Medical Department Activities, XXIV Corps, 3d and 4th quarters, 1945. (2) Quarterly Report, Medical Department Activities, U.S. Army Service Command 24, 4th quarter, 1945. (3) Annual Report, Medical Department Activities, U.S. Army Forces in Korea, 1948.


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location. Shortly after the Japanese surrender, the Far East Air Forces dropped emergency supplies, including medical supplies, to prisoners of war and internees held by the Japanese, and an officer of the medical section hastened to Japan to supervise their evacuation from Japan by air. An officer of the Second Central Medical Establishment (by then reassigned to Far East Air Forces headquarters) also went to Japan to interrogate Japanese specialists in aviation medicine on equipment developed for the protection of fliers and on their research into aviation medical problems.

Late in 1945, the Fax East Air Forces was renamed Pacific Air Command, absorbing former components of Army Air Forces, Middle Pacific. The medical section of Pacific Air Command, which moved in toto to Tokyo only in May 1946, directed the medical service of five greatly reduced components: the Fifth Air Force, with headquarters at Nagoya, Japan; the Thirteenth Air Force, with headquarters at Fort McKinley, Luzon; the 1st Air Division (former Eighth Air Force) in the Ryukyus; the Twentieth Air Force, which included the XX and XXI Bomber Commands in the Marianas; and the Seventh Air Force, with headquarters at Hickam. Field.45

Launching the Army's Public Health Program in Japan and Korea

For several years after the close of the war, the U.S. Army undertook long-range public health programs in both Japan and Korea.46 During the months of 1945 when the Army's plans for an invasion of Japan were being drawn up, the G-5 system for the conduct of civil affairs employed in other theaters was developed; advance planning for the revival of public health facilities in Japan took advantage of the experience with public health programs in Europe and the Philippines. However, the sudden capitulation of Japan presented the Medical Department with larger immediate responsibilities over a much wider area than would have been the case had the Army undertaken an invasion. At the same time it simplified the task; the administration did not go through the usual steps of control by division, corps, and army but was promptly divorced from a complex chain of command.

The organization that directed the program during the postwar years was set up on 2 October 1945, when a Public Health and Welfare Section was established at the staff level at General Headquarters, Supreme Commander for the Allied Powers. Col. (later Brig. Gen.) Crawford F. Sams, MC (fig. 111), formerly Surgeon, U.S. Army Forces in the Middle East, and more recently assigned to G-4 of the War Department General Staff, was made chief of the section and headed the program during most of the years of the occupation.

    45 (1) Quarterly Reports, Medical Department Activities, Headquarters, Far East Air Force, 1st, 2d, 3d quarters, 1945. (2) See footnotes 2 (2), p. 454 ; and 19 (4), p. 475. (3) Annual Report, Medical Department Activities, Pacific Air Command, 1946. (4) Annual Report, Medical Department Activities, Fifth Air Force, 1945.
    46 The military government in the Ryukyus (Okinawa) was initially run by the Navy, but the Army assumed control in July 1946, when the large task of providing dispensary service, camp sanitation, and quarantine service for Okinawans repatriated from Japan was still under way.


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His office was originally responsible for the prevention of diseases in the civil population of both Japan and Korea (later of Japan only), for the establishment of normal procedures for health control, and for promoting public health and welfare activities and the establishment of health facilities. Colonel Sams thus headed what became one of the largest health programs ever undertaken among the population of an occupied country. Early in 1946, his office was faced with epidemics of smallpox and typhus near Kobe and Osaka. In addition, epidemics of smallpox, typhus, and cholera occurred in China. As thousands of Japanese were returning to their native country from China, the Public Health and Welfare Section, SCAP, undertook a quarantine program for the incoming repatriates in order to prevent transmission of these diseases to Japan and U.S. Army troops occupying that country.

From September 1945 when American troops entered southern Korea to June 1949 when they withdrew, the U.S. Army undertook a similar health program among Korean civilians. In the last months of 1945 military government activities, including the health program, were conducted as a staff responsibility. When the U.S. Military Government was established in Korea early in 1946, the military governor created a Department of Public Health and Welfare in Seoul; it had top responsibility for the program. The account


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of the Army's protracted public health work in Japan and Korea falls outside the scope of this volume, as it belongs to the history of the Occupation period.47

SUMMARY: MEDICAL ADMINISTRATION IN THE PACIFIC

After 7 months' experience with medical administration in the Southwest Pacific Area, the Chief Surgeon, USAFFE (General Denit), wrote to the Chief Surgical Consultant, the Surgeon General's Office (Brig. Gen. Fred W. Rankin), as follows:

I have been able, to some degree, to put into effect some of my ideas, but you are quite correct in stating that our problems here are entirely different from those in ETO. In fact the staff relationships and procedures are so complicated that I often find myself bewildered in attempting to carry out my functions.

Later, after Army troops in the Pacific areas had been organized into a single theater of operations, he analyzed the difficulties which the geographic features of the combat areas in the Pacific had imposed upon the administration of Army medical service:

You are of course aware that the geographic problems peculiar to this theater have imposed decentralized operations to an extent never before required. "Perimeter warfare," with the establishment of large bases separated by thousands of miles of ocean or jungle and connected only by communications systems taxed to capacity in the transmission of urgent business and further isolated by difficulties of transportation, has made it essential to delegate considerable authority to subordinate commands. The higher headquarters, of course, have coordinated activities by frequent inspections. Nevertheless, a successful operation of such a system is obviously dependent upon the assignment of highly qualified personnel to positions of authority in the subordinate commands. Unusually large numbers of such key personnel are required and they are woefully lacking.48

This brief summary points out some of the basic obstacles encountered in administering Army medical service in the Pacific. The scattering of the land masses over long stretches of water led to a complex division of responsibilities among Army and Navy commands and to considerable decentralization of authority to lower commands. From the beginning of the war until April 1945, most Army forces in the Pacific region were organized into three elements, each of which constituted an orthodox Army theater organization. Not until April 1945 was Army organization in the Pacific revamped into the structure characteristic of a single theater of operations. During this period medical staffs were theoretically necessary for both a theater and a Services of Supply headquarters in each of three "theaters" of the Pacific-the Central, South, and Southwest Pacific Areas-as well as for numerous bases and base sections,

    47 (1) See footnote 3(2), p. 455. (2) Letter, Col. Maurice C. Pincoffs, MC, to Brig. Gen. Guy B. Denit, 20 June 1945. (3) Report, Public Health and Welfare in Japan, no date, but includes 1948, by Brig. Gen. Crawford F. Sams, Chief, Public Health and Welfare Section, General Headquarters, Supreme Commander for the Allied Powers. [Official record.] (4) Annual Report, Medical Department Activities, Headquarters, U.S. Military Government in Korea, 1946. (5) Historical Report, Allied Operations in Southwest Pacific Area, vol. I, supplement: MacArthur in Japan, The Occupation, chs. I and VI. [Official record, Office of the Chief of Military History.]
    48 (1) Letter, Brig. Gen. Guy B. Denit, to Brig. Gen. Fred W. Rankin, 10 August 1944. (2) Letter, Brig. Gen. Guy B. Denit, to Chief, Personnel Service, Office of The Surgeon General, 16 June 1945.


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field armies, air forces, and subordinate commands which formed links in the chain of evacuation by land, sea, and air. This situation led to the demand for the unusually large number of Medical Department personnel for administrative positions noted in the theater surgeon's analysis.

In the Central and South Pacific Areas, where the top U.S. Army headquarters never moved to a location in advance of the Services of Supply headquarters, medical service was so organized within the command structure, by the use of the same Medical Department personnel at both headquarters, as to minimize the demand for officers to fill the higher administrative positions. In the Southwest Pacific Area, on the other hand, during part of the period 1942-April 1945, considerable numbers were needed to staff the medical sections of both U.S. Army Forces in the Far East and the Services of Supply, whose headquarters were located at some distance from each other. At the same time the allocations of Medical Department officers to these headquarters were too low to permit of a well-developed staff at either. Much of the demand for key personnel in administrative positions in all these areas resulted from the necessity of assigning medical staffs to scattered bases, with relatively scant numbers of troops, which because of the geographic layout could not be amalgamated into fewer bases.

In the Central and South Pacific Areas, medical service received direction from a surgeon's office at the highest level of Army command. The use of a single surgeon for both theater and Services of Supply headquarters prevented any uncertainty as to what medical officer was in the administrative position of major importance. In the Southwest Pacific Area, on the other hand, considerable confusion, aggravated during the period September 1942 to August 1944: by the presence of a surgeon with ill-defined duties at the Allied command headquarters, prevailed with respect to this point. No single medical office was situated for any length of time at a headquarters which had authority to issue technical medical instructions to all Army troops in the Southwest Pacific Area.

The Southwest Pacific Area, which had more Army troop strength than either of the other two Pacific Areas, was the least satisfactory of all the major theaters of operations insofar as the organization of medical service within the command structure before June 1945 was concerned. Many Medical Department officers who served there, as well as men who went out on special missions, emphasized the detrimental effects of its position within the command structure. In the absence of a single surgeon with power to put plans into effect on the theaterwide basis, it was difficult to shift hospitals, medical personnel, and medical supplies to localities or commands where they were most needed. Neither the highest U.S. Army headquarters nor the Allied headquarters had a group of consultants to direct a theaterwide consultants' system. Neither had a preventive medicine division to supervise a theaterwide system of disease prevention in an area where environmental disease hazards made a strongly organized preventive program necessary. The more centralized


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control over antimalaria efforts and other preventive programs which developed in the Southwest Pacific Area with time was achieved only the hard way after experience forced a recognition of the necessity for it.

In addition to the lack of a single medical office vested with centralized responsibility, the many changes in command structure and in jurisdiction of commands, together with the frequent moves of multitudinous headquarters (or parts of them) to new locations, were prejudicial to close liaison of offices in the Southwest Pacific Area with each other. Medical Department officers, particularly those who came from civilian life, were often uncertain as to how the structure above them worked and as to what their own medical responsibilities were.. Frequent shifts in command structure tended to confuse their understanding of the channels of communication and to make more difficult the coordination of medical reports. Officers who came into the Southwest Pacific Area on special medical missions without having spent sufficient length of time there to study Army organization in the area in detail stated that they found its complex command structure an almost insurmountable barrier to effective conclusion of their missions.

Decentralization of medical responsibility forced upon base and base section surgeons, and surgeons of other small commands in the Southwest Pacific Area, more diverse and nonmedical duties and problems than were the lot of most such staff surgeons in other theaters. Some, base and base section surgeons enjoyed more control over the medical resources allotted to the command which they served than did surgeons in similar positions elsewhere, since they had command control over the medical units and installations of the base or base section. Surgeons with this authority were better able to see to it that the medical resources within their small areas were employed to the best advantage. However, the decentralization of command which was capable of leading to more economic and efficient use of medical resources within a small local command tended to hinder effective use of the total medical resources of the Southwest Pacific Area.

Another factor, not alluded to in the passage quoted but frequently pointed out by Medical Department officers in administrative posts, was the lack of contact between Medical Department officers in the theater and the Surgeon General's Office. This derived in part from the great distance between the Southwest Pacific Area and the United States. In the case of some officers, the lack of awareness of developments at home sprang from the fact that they had come to their assignments from other oversea areas where they had been stationed during the prewar years; they had not been in close contact with the Surgeon General's Office during the planning period of 1940 and 1941. Hence they were less well informed as to the broad preventive medicine program formulated by the office and the medical consultants system than were those who were sent overseas by the Surgeon General's Office. Officers of the Surgeon General's Office exhibited, in their turn, a good deal of uncertainty as to what surgeon they should address when they wrote letters outlining


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proposals for improvement of one phase or another of medical service. Their channels of information were apparently inadequate to give them satisfactory information on the medical responsibilities of commands not in accord with the Army doctrine that they had studied; the many changes in high levels of command in the Southwest Pacific Area compounded the uncertainty. While it seems that, given the geographic features of the area, a high degree of decentralization of command would always have prevailed, smoother working of the medical service could presumably have been achieved by the early establishment and consistent maintenance of a full-fledged medical section at General MacArthur's Allied headquarters.

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