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Chapter VIII

Contents

CHAPTER VIII

Procurement of Civilian Personnel

ZONE OF INTERIOR

Overall Employment

A considerable number of civilians worked in headquarters offices, most of them in the Surgeon General's Office where their numbers in the early stages of mobilization grew slowly enough to permit an effective classification of skills. Many who entered the Office at this time developed their own potentials to a point where, before the war was over, they were performing a large portion of the duties normally assigned to officer personnel. It was thus possible to keep down the requirements for officers, and even to release some officers for oversea service. It was these civilian employees who furnished the continuity so necessary to the smooth running of an office, at a time when both law and War Department policy put severe limitations upon the length of time Regular Army officers might remain in nontroop duty assignments. The tabulation which follows shows both the rise in the number of civilians employed in the Surgeon General's Office, especially during the year ending on 30 June 1941, and the growing proportion they bore to the officer and nurse personnel assigned to the Office.1

30 June 1939:

Number

Officers

31

Civilians

161

Nurses

3

Total

195

30 June 1940:

Officers

40

Civilians

201

Nurses

3

Total

244

30 June 1941:

Officers

98

Civilians

717

Nurses

4

Total

819

1Annual Reports of The Surgeon General, U.S. Army. Washington: U.S. Government Printing Office, 1939 to 1941, inclusive.


248

The great expansion of the hospital system after the calling up of the National Guard and the introduction of selective service in 1940 was largely responsible for an increase in civilian employment to supplement the supply of enlisted men assigned to hospitals-an increase bringing the proportion of civilians on hospital staffs considerably above the 20 percent which The Surgeon General had considered the maximum desirable.

More than 3,000 civilian employees of the Medical Department at large were paid from various special funds during the fiscal year 1939. Of these, 595 were paid from the Medical and Hospital Department, Army, appropriation; 600 from Veterans' Administration funds; and 1,985 were paid by the Civilian Conservation Corps. These numbers grew rapidly during 1940 and 1941 (table 18).

As the figures demonstrate, the most important of these funds as a source of civilian employment during 1939-41 came to be the Medical and Hospital Department Fund, which was appropriated by Congress to finance strictly Medical Department activities, exclusive of the pay of military personnel. In addition, the Veterans' Administration, lacking adequate hospital beds of its own, and the Civilian Conservation Corps, wholly dependent for long-term hospitalization on the Medical Department, each year paid the latter to care for certain of their patients in the Department's hospitals; the money could be used for all expenses incident to patient care, including the pay of civilians.

In addition to the above, a number of civilians in hospitals were employed under the Construction and Repair of Hospitals Fund, another separate appropriation of Congress. Exact figures on civilians paid from this fund are lacking. Appropriations for the year ending on 30 June 1940, however, were sufficient to cover 52 "positions." Budget estimates for the following year covered 724 positions, but as further appropriations raised the total amount of the fund from $2,892,886 to $4,489,886, the number of civilians employed may have been considerably higher.2 The fund was used particularly for hospital maintenance and was disbursed by the Medical Department. During this period, however, it was legally a Quartermaster fund.3

Until 1940, the Office of The Surgeon General acted as the employing agent for civilians in all installations of the Medical Department and kept records on them. In September 1940, however, when it became evident that the numbers employed would increase greatly, the authority to employ civilians in station hospitals was delegated to the corps area surgeons, The Surgeon Gen-

2The Budget of the United State Government. Washington: U.S. Government Printing Office, Fiscal Years Ending 1942 and 1943.
3The U.S. Office of Education also appropriated money to be used by State authorities in conducting vocational courses for servicemen on or off military posts. Some civilian instructors were employed at the medical replacement training centers; information is lacking, however, as to whether any or all of them were paid from this fund. (Letter, The Adjutant General, to Chief of Staff, General Headquarters, and Commanders of Arms and Services, February 1941, subject: Assistance From Civilian Educational Institutions.)


249

Table 18.-Civilians employed by the Medical Department from various funds, March 1940-December 1941

Fund

1940

1941

March

June

September

December

March

June

September

December

Medical and Hospital Department:

District of Columbia

150

146

157

239

534

813

954

925

Elsewhere

724

913

1,143

3,572

8,730

18,396

22,297

26,425

Total

874

1,059

1,300

3,811

9,264

19,209

23,251

27,350

Civilian Conservation Corps:

District of Columbia

138

148

138

122

34

41

17

14

Elsewhere

1,628

1,587

1,376

989

774

751

565

486

Total

1,766

1,735

1,514

1,111

808

792

582

500

Veterans' Administration:

District of Columbia

84

85

98

102

106

116

6

6

Elsewhere

495

544

488

409

495

491

513

359

Total

579

629

586

511

601

607

519

365

Total Medical Department:

District of Columbia

372

379

393

463

674

970

977

945

Elsewhere

2,847

3,044

3,007

4,970

9,999

19,638

23,375

27,270

Grand total

3,219

3,423

3,400

5,433

10,673

20,608

24,352

28,215


Source: Civilian Personnel Division, Office of The Surgeon General, U.S. Army.


250

eral retaining the right in connection with general hospitals.4 Under this arrangement, The Surgeon General continued to control all the funds but allotted certain amounts to the corps area surgeons; whereas, previously, he had allotted funds to the individual stations. The Surgeon General's Office constructed tables showing job titles, numbers, and grades to guide those actually engaged in staffing installations.

At the end of July 1945, the Department had in its employ more than 70,000 civilians in the United States, most of whom were under the jurisdiction of the service commands.5 On 30 June 1945, about 8,100 civilians were employed in activities under the direct command of The Surgeon General. The majority of these worked in medical depots; others were assigned to the Army Medical Center, the Army Medical Library, and the Army Medical Museum, all located in Washington, D.C. The Surgeon General's Office itself employed 1,402, about 200 of this number being in his Personnel Service, which at that time included both the Military and Civilian Personnel Divisions.6

Contract Surgeons

Among civilian employees were a few contract surgeons7 and specialists, the latter engaged temporarily for particular cases. Early in 1941, civilian physicians began to be used for other purposes when the Secretary of War, acting on the recommendation of The Surgeon General, created the Board for the Investigation and Control of Influenza and Other Epidemic Diseases in the Army. The board was composed of outstanding civilian doctors and Medical Corps officers, the former acting as consultants to the Secretary of War to advise The Surgeon General on problems of infectious diseases in the Army.8 Civilian members were to be paid a per diem of $20 plus transportation expenses. Eventually, this board comprised about 200 members, divided into various commissions. Civilian consultants had been used during the First World War; the creation of the new board meant the revival of an important practice which continued throughout World War II.

Nursing Personnel

To help perform nursing duties for the Army in the United States, sizable numbers of civilians were obtained. The number of civilian graduate nurses so

4(1)Letter, Office of The Surgeon General (Lt. Col. F. C. Tyng), to Surgeons, Corps Areas and Departments, 12 Sept. 1940, subject: Use of Civilian Personnel in Army Hospitals. (2) Letter, The Adjutant General, to Commanders of Arms and Services, Commanding Generals, all Corps Areas, and Commanding Officers of Exempted Stations, 21 Oct. 1940, subject: Provision for Civilian Employees in Hospitals of Exempted Stations.
5Monthly Progress Report, Army Service Forces, War Department, 31 Aug. 1945, Section 5: Personnel and Training.
6War Department Civilian Personnel Statistics Bulletin, vol. 3(12), June 1945, p. 5.
7
On 30 June 1939, 31; on 30 June 1940, 28; and on 30 June 1941, 36.
8Letter, The Surgeon General, to The Adjutant General, 27 Dec. 1940, subject: Establishment of Board for Investigation of Influenza and Other Epidemic Diseases in the Army, and 1st endorsement thereto, 11 Jan. 1941, reprinted in Bull. U.S. Army M. Dept. No. 64, 1942.


251

employed amounted to somewhat more than 1,000 in April 1945,9 a figure that was probably close to the peak, since, with the return of nurses from overseas, civilian nurses were released from Army hospitals.

The influx of civilian nurses' aides into Army hospitals was considerably larger. The Office of Civilian Defense and the American Red Cross cooperated in training such personnel and, by March 1942, had some 12,000 to 15,000 in training. In January 1945, The Surgeon General informed the Red Cross that the quota for paid nurses' aides was set at an additional 5,000, and he requested the latter to train and recruit that number; later, however, on War Department orders, he withdrew the request. An agreement was thereupon made whereby further recruiting would cease and only those already in training would be hired.10 The peak strength of nurses' aides-paid and unpaid-serving in Army hospitals reached about 2,000 (in June 1945);11 it seems likely that more than half of that number were in the paid category.

The cadet nurse program also furnished a large quota. During the period from 15 June 1944, when the first cadet nurses were placed in Army hospitals, to 1 October 1945, The Surgeon General received from the Civil Service Commission a total of 9,891 cadet nurse applications for service in Army hospitals. Of this number, 5,688 cadets were accepted and assigned to hospitals; 3,953 of these completed the course, and 1,674 were on duty on 1 October 1945. A total of 61 were dismissed or resigned during the whole period. There is no record of the total number who accepted Army Nurse Corps commissions upon completing the course, although it is known that 93 who had had senior cadet nursing experience in Army hospitals had been commissioned up to 1 January 1945.12 Some, either not physically qualified for or not desiring a commission, served in civilian status after graduation.

Occupational Therapists

At the time the United States entered the war, only 12 graduate occupational therapists were working in Army hospitals. Their numbers increased only slowly before late 1943. In August of that year, The Surgeon General, pointing out that their work was of professional character and formed an important part of the treatment given to patients especially in orthopedic and neuropsychiatric cases, stated that of the 71 then employed in Army hospitals in

9Civilian Nurses in Army Hospitals. Am. J. Nursing 45: 263, April 1945.
10(1) Letter, Surgeon General Kirk, to Mrs. Walter Lippmann, National Director, Volunteer Nurses' Aid Corps, American Red Cross, 1 Jan. 1945. (2) Letter, Surgeon General Kirk, to Basil O'Connor, Chairman, American Red Cross, 6 Jan. 1945. (3) Memorandum, Deputy Assistant Chief of Staff, G-1, for Deputy Chief of Staff, 13 Jan. 1945, subject: The Surgeon General's Campaign for Red Cross Nurses' Aides.
11
Information furnished by Resources Analysis Division, Office of The Surgeon General.
12(1) Memorandum for Record, Capt. J. D. Boole, MAC, 2 Oct. 1945. (2) Annual Report, Valley Forge General Hospital, 1945. (3) Memorandum, Brig. Gen. R. W. Bliss, Assistant Surgeon General, for Director, Bureau of Public Relations, War Department, 27 Jan. 1945, subject: WAC Technician Program.


252

the United States, about 25 were probably not qualified. He succeeded at that time in getting the authority to pass upon qualifications of therapists procured in the service commands by compiling lists of qualified individuals from which the appointments were to be made. He also obtained the right to pass on the professional qualifications of those whose names the service commands submitted to him. However, responsibility and authority for the employment of occupational therapists remained with the service commanders. Procurement increased rapidly after this date, and in August 1945, the Army was employing a peak strength of 447 graduate occupational therapists and 452 apprentices in more than 70 of its hospitals.13 None served overseas during the war.

Dietitians and Physiotherapy Aides

Women dietitians and physiotherapy aides served in civilian status until 1942. Their number increased during the emergency until, by May 1941, dietitians on duty in Army hospitals numbered 103, and physiotherapy aides, 47. At that time, there were 350 vacancies for dietitians and 125 for physiotherapy aides.

Nonprofessional Personnel

In addition to the professional and trained personnel, the Medical Department employed large numbers of civilians in clinical and administrative positions and as laborers and skilled workmen. The turnover in these jobs was more rapid than in the professional categories and also required on-the-job training for many of the people recruited.

Red Cross Workers

The number of Red Cross workers in Army hospitals in the United States likewise increased. Although statistics are not complete, the American National Red Cross reported that on 30 November 1942 a total of 244 paid staff workers were serving in 22 general hospitals and 787 in 122 station hospitals in the Zone of Interior. As regards the volunteer staff, the Red Cross reported that it would be "fairly accurate to say" that 1,300 were serving in Army hospitals in November 1942 and 7,500 in December 1944, the last month in the war period for which figures are available. Shortly after the war, there were 1,213 paid workers in 203 station hospitals. Numbers in general hospitals at that time are not available.

13(1) Letter, The Surgeon General, to Commanding General, Army Service Forces, 13 July 1943, subject: Occupational Therapy Personnel, with 2d endorsement thereto, 7 Aug. 1943. (2) Letter, The Adjutant General, to The Surgeon General and Service Commands, 12 Aug. 1943, subject: Occupational Therapy Personnel in Zone of Interior General Hospitals. (3) The Surgeon General's Letter No. 149, 12 Aug. 1943.


253

Red Cross workers assigned to hospitals overseas were of course not military personnel, but they occasionally performed work in the wards in addition to preparing patients for the operating room.14

OVERSEA THEATERS

Under regulations in existence even before the establishment of any theater of operations, theater commanders were authorized to facilitate the use of local civilians within their commands to the extent needed to prevent diminution of the efficiency of their troops.15 However, while the Surgeon General's Office was aware that local labor would be used-as is shown by a reference to it in TOE 8-500, published on 23 April 1944 and revised on 18 January 1945-no general policies were established which specifically promoted the use of such manpower sources outside the continental United States.16

The Medical Department's use of civilian employees in oversea areas developed in accordance with policies and conditions in these areas. The theater commander established policies applicable to the entire theater and not solely for the benefit of the Medical Department. By virtue of their location, relative stability, and type of function, installations in the communications zone or base sections were able to utilize such personnel on a greater scale than those troops in combat areas.17 The actual procurement, administration, and payment of extra-Army personnel usually was effected through nonmedical channels, such as base section headquarters.

Types of Personnel Utilized

Civilian labor used by the Medical Department overseas may be divided into four general classes: (1) Professional (including certain "subprofessional" personnel such as laboratory technicians and nurses' aides);  (2) clerical (including messengers and interpreters); (3) skilled; and (4) unskilled.

The professional category of civilian employees was relatively unimportant, because highly trained civilians were rarely available overseas. However, in certain emergency situations, they were temporarily helpful.

14In field hospitals, Red Cross workers "assisted in removing bloody or torn clothing, removing excess blood from the patient, removing his shoes and washing his face and hands under the guidance of medical authorities." Occasionally, where there were not enough psychiatrists on the staff of a convalescent hospital, a Red Cross social worker was asked to conduct the interviews in which patients "ventilated" their personal anxieties. (Letter, C. H. Whelden, Jr., Chief Statistician, American National Red Cross, to Max Levin, Office of The Surgeon General, 6 June 1952, with enclosure thereto.)
15War Department Field Manual 100-10, Field Service Regulations, 9 Dec. 1940, p. 121; and 15 Nov. 1943, p. 151.
16The oversea portion of this chapter is very largely a condensation of a manuscript, "Medical Department Utilization of Civilian and POW Labor Overseas in World War II," prepared by Cpl. Alan M. White in the Historical Unit, U.S. Army Medical Service, under supervision of the authors of this volume. The major sources for Corporal White's work are the periodic reports of medical units and headquarters, too numerous to list here.
17(1) Letter, Lt. Col. Irvine H. Marshall, to Col. C. H. Goddard, Office of The Surgeon General, 1 Aug. 1952. (2) Letter, Col. I. A. Wiles, to Col. C. H. Goddard, Office of The Surgeon General, 14 Aug. 1952.


254

Civilian surgical teams contributed much to the care of casualties at the time of Pearl Harbor, and in the invasion of Luzon, volunteer Philippine doctors and nurses worked with Medical Department personnel in certain Army hospitals which were flooded with casualties. Immediately after the fall of Rome, 12 young Italian-American graduates of the University of Rome Medical School, who had been interned in Vatican City during the German occupation, together with Italian doctors and medical students recruited by them, served as prophylactic station attendants in the Italian capital.18 In Australia, the services of a few physical therapy aides were obtained, and in various theaters, small numbers of Catholic nuns, missionary or native, were utilized as nurses. Civilian nurses' aides worked in some Army hospitals in France, the Philippines, and China, and sometimes there were as many as 50 in a single hospital. Laboratory assistants and other technically trained individuals were used when available.

Civilian clerical workers were used in various types of Medical Department units, but particularly in fixed installations. Typists, stenographers, and clerks were employed in all theaters, but, of course, in such areas as New Guinea, Burma, parts of Africa, and some of the Pacific islands, the educational level of the population was not high enough to make many available for service in hospitals.

The skilled workers probably were the most valuable of the Medical Department's civilian employees. Especially in the North African theater and Southwest Pacific Area, the Medical Department had to do a great deal of its own construction because of the shortage of Engineer personnel. Carpenters, plumbers, masons, electricians, and painters were hired in these areas and elsewhere to supplement the meager strength of the hospitals' utilities departments both in construction and in maintenance work.19 The services of other skilled civilians, such as barbers, tailors, and cooks, were less essential but were often used by Medical Department units. Skilled workers were more plentiful in the North African-Mediterranean and European theaters than elsewhere and, hence, were used more extensively there, but the 95th Station Hospital at K'un-ming, China, reported having hired "carpenters, masons, plumbers, tinsmiths, etc." in 1944, and the 49th General Hospital in Leyte, the Philippines, in 1945, listed 49 skilled workers (including carpenters, plumbers, electricians, and mechanics) among its 353 civilian employees.

Unskilled workers were by far the most important category of civilian employees numerically, not only because the Medical Department needed a great deal of heavy labor but also because this was the category most available; indeed, in most areas, there was a very large supply of unskilled labor. Employees of this class performed such diverse duties as ditching, draining, spraying, and oiling required in malaria control projects; clearing undergrowth

18Annual Report, Surgeon, Mediterranean Theater of Operations, U.S. Army, 1944.
19Letter, Col. I. A. Wiles, to Col. C. H. Goddard, Office of The Surgeon General, 17 Sept. 1952. (Although the construction of hospitals in North Africa and Europe usually was accomplished by the Engineers, a great deal of minor construction was left for the unit personnel, and this was often more than the hospital utilities sections could handle.)


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from hospital sites; aiding in construction work; cleaning dirt and rubble from buildings and grounds; landscaping and gardening; waste disposal and sanitation ; "kitchen police" and mess help; cleaning of hospital wards; movement of supplies and equipment and litter bearing.

Resultant Savings of Military Personnel

The use of civilians, prisoners of war, and similar local labor made it possible to release Medical Department enlisted men for service as combat troops, to relieve such men from unskilled and routine work for more technical duties within the Medical Department itself, and in certain instances to effect considerable reductions in the table-of-organization strength of units. By this means, the 814th Hospital Center, in the European theater, in January 1945, was able to order its attached general hospitals to reduce their enlisted complements to 400, instead of the 450 allotted by the relevant tables of organization. It further directed its attached station hospitals and smaller units to reduce their enlisted strength 20 percent. This resulted in a total saving of nearly 800 Medical Department enlisted men. The 815th Hospital Center, located in the Seine Base Section (Paris), European theater, was able by the employment of local labor, in 1945, to reduce the aggregate military strength of its general hospitals by 557 men (table 19).

TABLE 19.-Economies in enlisted personnel through utilization of local labor, 815th Hospital Center, 
European theater, 1945

General hospital

T/O capacity (number of beds)

Authorized T/O enlisted strength

Reduced enlisted strength

Percent saving

1st

1,500

562

450

19. 9

191st 

1,500

562

450

19. 9

194th

1,000

450

375

16. 7

198th 

1,000

450

375

16. 7

203d

2,000

641

550

14. 2

217th

1,500

562

450

19. 9


Source: Annual Report, 815th Hospital Center, European Theater of Operations, U.S. Army, 1945.

The Situation in the Various Theaters

The number of civilians hired by a particular Medical Department unit depended not only on that unit's needs in a particular situation, but also on the availability of local labor. In the European theater, an attempt was made to develop a plan for civilian employment in Army hospitals based on the patient census, but this proved impossible because it was found that a unit's personnel needs were more dependent on the type of buildings in which it operated than on the number of patients in its care. The numbers of civilian employees in Army hospitals overseas thus varied widely from theater to theater


256

and, within a theater, from hospital to hospital. Even within a particular hospital, there were substantial fluctuations over relatively brief periods.20

Southwest Pacific theater

The variety of situations within a given major area is illustrated by the Southwest Pacific. Civilians were used in headquarters and in hospitals in Australia, but the manpower shortage there did not permit their employment in great quantity on that continent. In New Guinea, native litter bearers were used to carry casualties over the rugged Owen Stanley Mountains and to bring casualties to collecting points on the beaches during amphibious operations (fig. 36). Few natives, however, were employed by the hospitals, although in 1944 the 2d Station Hospital, west of Lae, had from 15 to 20 native workers who were used for common labor outside the hospital (fig. 37). At Milne Bay, approximately 100 natives per month were used by malaria control units in the summer of 1944.21

FIGURE 36.-Native litter bearers carrying a wounded American soldier from the frontlines, vicinity of 
Buna, New Guinea, November 1942.

20This is perhaps one reason for lack of comprehensive statistical information concerning employment by the Medical Department of civilians in oversea areas.
21See footnote 17(2), p. 253.


257

FIGURE 37.-Natives building a covered bomb shelter, under the direction of a medical technician, 
Southwest Pacific Area, January 1944.

In the islands north of Australia, the average number of natives employed per day in 1943 for purposes of malaria control exceeded 1,000 and reached 2,000 in 1944.22 The picture in regard to hospital employment was very different in the Philippines. The 49th General Hospital had 60 workers on 1 January 1945, 353 on 31 March, 448 on 30 June, and a peak of 465 on 30 September 1945. The 125th Station Hospital averaged 180 Philippine employees daily in the first quarter of 1945, and 150 in the second.

A recent rough estimate based on recollection alone indicates that, at the peak of activity at Base K in Leyte (that is, about the end of 1944 and the early part of 1945), 2,500 civilians were employed by the Medical Department within the area covered by that command.23 This was equal to about 4 percent of the military medical personnel of the entire theater.

South and Central Pacific theaters

In the South and Central Pacific Areas, there were relatively few civilian employees outside the Hawaiian Islands. This may have been because many of the natives in the Japanese mandated islands were hostile to the American forces, because shortages of military labor were infrequent, or because Navy

22Letter, G. L. Orth, to Col. C. H. Goddard, Office of The Surgeon General, 17 Sept. 1952. 
23See footnote 17(2), p. 253.


258

FIGURE 38.-Indian laundry workers, 371st Station Hospital, Rāmgarh, India, 28 February 1945.

construction personnel and corpsmen were sometimes used to build and work in Army hospitals.24

In the Central Pacific, the number of civilians employed by the Medical Department remained relatively constant throughout the war, totaling 526 in December 1941 and 464 in August 1945. The peak of employment was reached with 656 in June 1942. Apparently, a large proportion of civilian Medical Department personnel in this area was located at old Tripler General Hospital or the 218th General Hospital as it was later known. This, the largest hospital in the Hawaiian Islands, was authorized to employ as many as 168 civilian employees (including several with strictly medical duties) in 1942.

China-Burma-India theater

The China-Burma-India theater was probably the region with the most acute shortage of medical personnel, a shortage caused in part by its responsibility for the care of Chinese Army personnel, and it seems likely that most Medical Department units in that theater used natives for common labor (fig. 38).

The 20th General Hospital in 1944 (at Margherita, Assam, India) employed 120 natives in the mess department and 100 more for general mainte-

24Two exceptions may be noted: Some native labor was used in construction of the 222d Station Hospital on Banika Island in the Russells, and native labor was used to clear ground preparatory to the actual construction work on the 48th Station Hospital at Guadalcanal.


259

nance. When the 18th General Hospital shifted from Assam to Burma in 1945, it took 165 civilians with it. Only 125 of these were actually employed by the hospital, however, since 40 were used as "aiyahs" and "personal bearers." In 1943, the 95th Station Hospital at Ch'ung-ch'ing, China, employed 15 Chinese nurses in lieu of its American nurse contingent, Army nurses having been excluded from China on General Stilwell's orders. In its first year of operation (1942), the 159th Station Hospital at Karachi, India, hired 100 native laborers. From 100 to 500 laborers were engaged in various malaria control projects in the Calcutta area in early 1943. In Burma, native litter bearers were used. During 1944, the number of civilian personnel used by the Medical Department in the China-Burma-India area was, at the lowest, equal to 10 percent of the strength of the military elements of the Department in that area.

Africa-Middle East theater

In the Africa-Middle East theater, native employees, used primarily in malaria control and waste disposal and other sanitary activities, were hired in considerable numbers. In 1943, there were over 100 employed at the 67th Station Hospital in Accra, and at Roberts Field, Liberia, the employment of over 1,800 natives at all times during 1944-a number considerably greater than the entire Medical Department military personnel in the Africa-Middle East area-was estimated to have saved the labor of 800 to 1,000 troops. Natives were used in malaria control operations in the Persian Gulf Command. Civilians were also employed there in hospital work, and the number in relation to that of military medical personnel in the Command was considerable (table 20).

TABLE 20.-Ratio of civilian hospital workers to military medical personnel, Persian Gulf Command, 30 
April 1943-31 July 1945

Date

Civilian hospital workers1

Military medical personnel2

Ratio of hospital workers to military medical personnel (percent)

1943

30 April

197

1,812

10.9

31 December 

419

3,067

13.7

1944

31 August

703

2,017

34.9

31 December

421

1,980

21.3

1945

31 July 

64

496

12.9

1From table 13, "Distribution of U.S. Army civilian employees in the Persian Corridor, 1943-45," in Motter, T. H. Vail: The Persian Corridor and Aid to Russia. United States Army in World War II. The Middle East Theater, Washington: U.S. Government Printing Office, 1952, p. 500.
2From unadjusted data in table 31 for dates shown therein and from pertinent issues of "Strength of the Army" for other dates.


260

North African-Mediterranean theater

In the North African-Mediterranean and the European theaters, possibly because operating conditions were more uniform than in other areas, various hospitals of like type tended to engage more equal numbers of civilian employees than did similar hospitals elsewhere. Even so, variations in numbers of civilian personnel utilized by like medical units in both theaters existed. The number of French and Arab civilians utilized by Army hospitals in North Africa and the number of Italian civilians used by such hospitals in Italy depended very largely on the availability of Italian service troops, since the latter, after the organization of Italian service units in late 1943, were almost universally preferred to the civilians. For a general hospital not using Italian troops, the average number of civilians employed in the North African theater was probably from 150 to 200, although as many as 275 were used on occasion. The normal civilian complement for an evacuation hospital in similar circumstances was about 50, but at times well over 100 civilian workers were employed.

Available statistics do not justify generalizations about the number of civilians normally employed in station and convalescent hospitals and in malaria control and other Medical Department units.25 However, if the average number of personnel, not including U.S. troops, that were used in Medical Department installations at the end of the war be taken as a criterion of the strength of civilian employment prior to the use of Italian service personnel, it is likely that as many as 4,000 civilians were employed in the Medical Department in the North African theater about the time of the invasion of Italy (table 21). This was equal to 7 percent of the strength of the Medical Department elements in the theater on 31 October 1943.

European theater

The high educational level of the civilian population in Europe, as compared with that of peoples in other parts of the world, meant that it was possible to utilize European indigenous labor in a wider variety of occupations than elsewhere and to place greater reliance upon their ability to perform relatively unskilled tasks. This partly explains why the number of civilians employed by the Medical Department was greater in the European theater than in any other oversea area. Shortly after V-E Day, the number of civilians so employed in medical installations of the communications zone alone exceeded 20,000 (table 22). However, the fact that the Army overseas had its greatest strength in that theater, helped to produce the same result. Indeed, the number of civilians employed in the communications zone Medical Depart-

25Station and convalescent hospitals and malaria control units in the North African theater employed civilians, but statistics of the number used are available only in isolated instances. The 7th Station Hospital at Oran at one time employed 80 French civilians, and an unspecified number of civilians were used in malaria control work.


261

TABLE 21.-Utilization of civilian workers and Italian prisoners of war, by Medical Department service-type units, Mediterranean theater, 1 May 1945

Type of unit1

Number in theater

Civilian workers

Italian prisoners of war

Number

Average per unit

Number

Average per unit

General hospital:

2,000-bed

2

---

0

204

102

1,500-bed

9

119

13.2

815

90.5

Station hospital:

750-bed

1

---

0

33

33

500-bed

17

219

12.8

1,423

83.7

250-bed

2

---

0

223

111.5

150-bed

1

---

0

35

35

Malaria survey detachment

1

---

0

170

170

Malaria control detachment

10

25

2.5

1,707

170.7

Medical base depot company

4

20

5

224

56

Medical general dispensary

2

16

8

---

0

Medical general laboratory

1

---

0

65

65

Medical service battalion

1

10

10

112

112


1One medical laboratory, 6 prophylactic platoons, 13 veterinary food inspection detachments, 2 veterinary evacuation detachments, and 1 hospital train used no local labor.

Source: "Digest of Principal Type Service Units Utilized in MTO," compiled by G-4 Section, Mediterranean Theater of Operations, U.S. Army; revised November 1945, pp. 8-12.

ment activities around V-E Day was equivalent to about 5 percent of the number of troops utilized in the entire medical service of the theater, and while civilians also were used in the combat zone, they probably did not raise this percentage by a very great amount.26 Thus, it appears that in relation to the military strength of the Medical Department in the European theater the number of civilians employed by that branch of the Army was less than it was in many other places.

Since labor was scarce in Great Britain and strictly rationed by the British authorities, an Army hospital there usually employed no more than from 20 to 30 civilians. On the Continent, an entirely different situation prevailed. General hospitals in France at times had from 600 to 700 civilians in their employ, although the average may have been somewhat lower. In April 1945, the 11 general and 3 station hospitals of the Seine Section had a total of 7,513 civilian employees, an average of 609.9 per general and 268.0 per station hospital; and in May 1945, the 203d General Hospital established what was probably an oversea record with 1,248 civilian employees. When they were not using German prisoners of war instead, most evacuation hospitals in the European theater employed from 60 to 80 civilians, although as many as 120

26Letter, Brig. Gen. Alvin L. Gorby, to Col. C. H. Goddard, Office of The Surgeon General, 30 July 1952.


262-263

TABLE 22.-Medical Department civilian labor, Communications Zone, European theater (exclusive of headquarters), June-December 1945

Type

15 June 1945

15 July 1945

15 August 1945

15 September 1945

15 October 1945

15 November 1945

15 December 1945

General (all branches of Army):

Number

171,477

156,025

154,787

131,818

101,452

89,151

81,729

Mobile:1

Number

38,908

31,587

24,281

21,887

14,677

11,330

12,212

Percentage of general

22.7

20.2

15.7

16.6

14.5

12.7

14.9

Static:2

Number

132,569

124,438

130,506

109,931

86,775

77,821

69,517

Percentage of general

77.3

79.8

84.3

83.4

85.5

87.3

85.1

Clerical:3

Number

15,009

15,323

15,882

15,463

13,545

13,180

12,750

Percentage of general

8.8

9.8

10.3

11.7

13.4

14.8

15.6

Male:

Number

6,419

6,816

7,503

7,581

6,548

6,379

6,236

Percentage of clerical

42.8

44.5

47.2

49.0

48.3

48.4

48.9

Female:

Number

8,592

8,507

8,379

7,882

6,997

6,801

6,514

Nonclerical:

Number

117,558

109,115

114,624

94,468

73,230

64,641

56,767

Percentage of general

68.6

69.9

74.1

71.7

72.2

72.5

69.5

Medical Department:

Number

20,099

15,418

12,133

10,220

7,223

5,083

3,650

Percentage of general

11.7

9.9

7.8

7.8

7.1

5.7

4.5

Mobile:1

Number

3,086

2,170

2,356

2,947

1,051

707

559

Percentage of Medical Department civilian labor

15.4

14.1

19.4

28.8

14.6

13.9

15.3

Percentage of general mobile

7.9

6.9

9.7

13.5

7.2

6.2

4.6

Static:2

Number

17,013

13,248

9,777

7,273

6,172

4,376

3,091

Percentage of Medical Department civilian labor

84.6

85.9

80.6

71.2

85.4

86.1

84.7

Percentage of general static

12.8

10.6

7.5

6.6

7.1

5.6

4.4

Clerical:3

Number

963

757

573

519

412

344

341

Percentage of Medical Department civilian static

4.8

4.9

4.7

5.1

5.7

6.8

9.3

Percentage of general static clerical

6.4

4.9

3.6

3.4

3.0

2.6

2.7

Male:

Number

329

231

199

171

139

91

93

Percentage of Medical Department clerical

34.2

30.5

34.7

32.9

33.7

26.5

27.3

Percentage of general static male clerical

5.1

3.4

2.7

2.3

2.1

1.4

1.5

Female:

Number

634

526

374

348

273

253

248

Percentage of general static female clerical

7.4

6.2

4.5

4.4

3.9

3.7

3.8

Nonclerical:

Number

16,050

12,491

9,204

6,754

5,760

4,032

2,750

Percentage of Medical Department civilian labor

79.9

81.0

75.9

66.1

79.7

79.3

75.3

Percentage of general static nonclerical

13.7

11.4

8.0

7.1

7.9

6.2

4.8


1Employees working from day to day in whatever locality their services were required. Includes all civilians, other than German nationals, employed in Germany.
2Employees residing in the locality of their employment.
3Office workers, including clerical and administrative personnel such as clerks, typists, stenographers, and accountants. These are not necessarily the total of such workers since there also may have been office workers among the mobile employees.

Source: (1) Progress Report, Communications Zone, U.S. Army Forces, European Theater, for months shown. (2) Circular No. 72, Headquarters, Communications Zone, European Theater of Operations, U.S. Army, 22 May 1945.


264-266

were "profitably" employed in one instance. In the medical units of the Continental Advance Section, European theater, in February 1945, civilian labor reached a peak of 1,770 workers against an enlisted strength of 7,871, or 1 civilian for every 4.4 enlisted men.

As late as June 1945, the United Kingdom employed 8.9 percent of the total communications zone Medical Department civilian employees while it had only 5.3 percent of communications zone employees in general. Indeed, while the two ratios tended to approach each other, this situation was in existence even at the end of August 1945 (table 23).

TABLE 23.-Geographic distribution of medical personnel, European Theater of Operations, Communications Zone,1 April 1945 to October 1945, inclusive2

Group

1945

April3

May3

June

July

August

October

Total manpower:

General (all branches of the Army):

Total

1,076,445

1,185,957

1,130,948

1,134,845

1,142,590

947,520

United Kingdom:

Number

114,729

105,644

103,414

88,542

80,226

49,281

Percent of general manpower

---

---

9.1

7.8

7.0

5.2

Medical Department:

Total

183,632

196,426

191,762

142,892

116,732

89,887

United Kingdom:

Number

60,550

59,247

50,595

35,019

28,173

12,135

Percent of Medical Department manpower

---

---

26.4

24.5

24.1

13.5

Total troops:

General (all branches of the Army):

Total

569,635

571,284

522,211

497,162

491,437

458,581

Percent of total general manpower

---

---

46.1

43.8

43.0

48.3

United Kingdom:

Number

93,479

80,989

70,657

57,925

51,349

30,778

Percent of total troops

16.4

14.2

13.5

11.7

10.4

6.7

Medical Department:

Total

125,868

123,338

114,228

86,393

68,379

58,621

Percent of total Medical Department manpower

---

---

59.5

60.4

58.5

65.2

United Kingdom:

Number

54,674

50,846

41,292

29,898

23,371

10,305

Percent of Medical Department troops

43.4

41.2

36.1

34.6

34.2

17.6

Total prisoners of war working:

General (all branches of the Army):

Total

263,318

351,968

400,518

454,625

463,577

387,487

Percent of total general manpower

---

---

35.4

40.0

40.5

40.8

United Kingdom:

Number

20,755

24,905

25,222

23,501

23,390

15,666

Percent of total prisoners of war working

7.8

7.1

6.3

5.2

5.0

4.0

Medical Department:

Total

39,064

54,782

53,882

39,325

33,966

24,043

Percent of total Medical Department manpower

---

---

28.0

27.5

29.0

26.7

United Kingdom:

Number

5,876

8,401

7,518

3,857

4,140

1,549

Percent of total Medical Department prisoners of war working

15.0

15.3

14.0

9.8

12.2

6.4

Total Italian service unit personnel:

General (all branches of the Army):

Total

37,776

38,712

39,976

34,291

32,789

0

Percent of total general manpower

---

---

3.5

3.0

2.8

0

United Kingdom:

Number

0

0

0

0

0

0

Percent of total Italian service unit personnel

0

0

0

0

0

0

Medical Department:

Total

3,436

2,919

3,559

2,095

2,254

0

Percent of total Medical Department manpower

---

---

1.8

1.4

1.9

0

United Kingdom:

Number

0

0

0

0

0

0

Percent of total Medical Department Italian service unit personnel

0

0

0

0

0

0

Total civilian workers:4

General (all branches of the Army):

Total

20,516

223,993

168,243

148,767

154,787

101,452

Percent of total general manpower

---

---

14.8

13.1

13.5

10.7

United Kingdom:

Number

---

---

7,535

7,116

5,487

2,846

Percent of total civilian workers

---

---

4.5

4.8

3.5

2.8

Medical Department:

Total

15,264

15,387

20,093

15,079

12,133

7,223

Percent of total Medical Department manpower

---

---

10.4

10.5

10.3

8.0

United Kingdom:

Number

---

---

1,785

1,264

662

281

Percent of Medical Department civilian workers

---

---

8.9

8.4

5.5

3.9


1All strengths from Progress Report, Communications Zone, European Theater of Operations, U.S. Army, for corresponding months. General and Medical Department data exclude headquarters personnel.
2September has been omitted as a result of numerous errors in the corresponding issue of the Progress Report. 
3All data exclusive of civilian workers in the United Kingdom.
4Does not include U.S. civilians or British civilians employed on the Continent.

In 1944 in the South Atlantic, the Medical Department had a daily average of 150 employees, used mostly in malaria control work, which was greater than one-fourth of the average military strength (534) of the Department in the theater for the year. In the Caribbean Defense Command, the peak civilian-employment totals in 1943 and 1944 included 10 civilians in the Office of the Surgeon, Antilles Department, and approximately 270 workers engaged in malaria control duties in the Panama Canal Department. These alone, without considering hospital workers and sanitation workers in areas outside the Panama Canal Department, were equal to about 6 percent of the mean Medical Department military strength in the Caribbean during 1944 (4,425).27

27Mean strengths are the average of the adjusted strength on 31 January, 30 April, 31 July, and 31 October 1944, and 31 January 1945 as shown in table 31.

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