Navy Medicine November-December 1943
Jennifer Mitchum

December marked the second anniversary of Pearl Harbor. Since then, the Allies mounted an effective defense, denying the enemy Australia and evicting the Japanese from several Pacific islands including Tulagi, Guadalcanal, and New Georgia. Moreover, Allied forces had captured parts of New Guinea. Many miles north, American forces had also reclaimed the Aleutians. In the latter part of October, Allied forces also seized the Treasury Islands to the south of Bougainville. In the Pacific, the war had notably changed from defense to offense.

Similarly, in the Mediterranean theater, the Allies had driven the Germans and Italians out of North Africa. In July and September 1943, the Allies successfully invaded Sicily and Italy, respectively. As a result, Italy capitulated in September 1943.

Bougainville

Bougainville Island was the last Japanese stronghold in the Solomons. By controlling Bougainville, Allied planes could constantly attack Rabaul and prevent the enemy from supporting its bases on New Guinea and New Britain. Allied troops landed halfway up the west coast of Bougainville on the morning of 1 Nov. Although the area was swampy and offered no satisfactory anchorages, it wasn't heavily defended.

Navy Medicine Ashore

Three medical companies of the First Marine Amphibious Corps and the headquarters company of the Third Medical Battalion, landed with the invasion troops and established three field hospitals between 1 and 13 Nov. One 400-bed hospital unit was set up within hours after landing. The company "E" medical
facility, set up 7 Nov, served as the division hospital.

Battle Casualties and Disease

In taking Bougainville, there were 276 Allied troops killed, 94 missing, and 1,097 wounded.(1) In comparison, the 30,000-man Japanese force suffered 13,000 fatalities; 3,000 were killed in action and the rest died from malaria, beri beri, dysentery, and tetanus.(2)

Disease incidence was relatively low among Allied troops with 5,004 cases reported.(3) The two main groups needing treatment were those who had acquired diseases prior to coming to Bougainville and those
suffering from combat fatigue and "war neurosis". For instance, all the 296 malaria cases were the result of previous exposures.(4) Medical personnel issued large doses of atabrine as a suppressant and treatment. The low incidence of malaria resulted from effective control measures--construction of roads, sewage systems, use of aerosol-pyrethrum, etc.,--and not because the island was less malarious.(5) Similarly, troops who had been in Samoa showed a high incidence of filariasis; 92 cases were reported.(6) The First Corps Medical Battalion also treated 24 cases of gas gangrene in which six deaths occurred.(7) MOB-8 on Guadalcanal reported 20 cases, with one death.(8) The majority of the personnel experienced mild diarrhea and 103 had dysentery, but the use of sulfonamide reduced the duration and severity of both.

The largest number of casualties on Bougainville suffered from either "war neurosis" or combat fatigue. Combat fatigue cases totaled 749 and war neurosis cases totaled 140.(9) The First Corps Surgeon described combat fatigue cases as those in which the men were dazed or confused but could be temporarily rehabilitated and returned to duty although they may have broken down again later under combat conditions. War neurosis cases were described as those men who became a menace to themselves and others and needed to be sent out of the combat zone for rehabilitation.

Navy Hospitals

Many wounded leaving Bougainville and other points were transferred to Navy medical facilities on Guadalcanal, Vella La Vella, and other islands in the Central and South Pacific. Mob-8 on Guadalcanal
continued to serve as the focal point for Navy medicine in the Solomons. At Mob-8, medical personnel
rendered final treatment to some patients and prepared others either for evacuation further south or stateside. Between 1 June and 31 Dec, 11,105 patients were treated at Mob-8; 5,343 were evacuated from there. The majority, 4527, left by ship.(10)

In New Zealand, medical personnel at Mob-6 in Auckland received and treated 747 patients.(11) At Base Hospital No. 4 in Wellington, 118 and 485 patients were admitted in November and December,
respectively. Between the time it was commissioned in March and year's end, 8,960 patients had been
admitted.(12) Combat casualties continued to arrive, but in fewer numbers. There were also fracture and burn cases. Malaria, however, was the worst problem. Clinical symptoms of malaria often recurred in patients, in some cases up to 10 times. Patients were given 2 weeks of therapy with quinine and atabrine.

The patient census of Mob-7 Noumea, New Caledonia, reached a year high on Christmas Eve with 1,626 patients in the hospital. By year's end, Mob-7's total capacity hovered slightly over 2,000.(13)

Penicillin in the Pacific

In November, medics at Mob-5 Noumea, New Caledonia, used penicillin to treat a patient stricken with osteomyelitis with multiple wounds.(14) This was believed to be the first time penicillin was used in the South Pacific. Following that incident, penicillin was the treatment of choice with several diseases and injuries. Subsequently, medical personnel forwarded results to BUMED to aid headquarters in its evaluation of "the wonder drug."

Similarly, Base Hospital No. 3, Espiritu Santo, New Hebrides treated 41 cases with penicillin.(15) Medical personnel administered the drug by I.V. and intramuscular injection. In six of the cases, the patient's conditions did not respond to the drug. Nonetheless, penicillin proved effective in treating gonorrhea and blood stream infections. With penicillin now available in increasing amounts, Allied medical personnel would no longer have to depend solely on the less effective "sulfa" drugs.

The Gilberts

Early in 1942, Japanese forces seized the Gilbert Islands in the Central Pacific. By the close of 1943, however, Allied forces were in a position to win them back. Conquest of the Gilberts would provide the first stepping stones on the way to Tokyo. The first target in the Gilberts was Tarawa Atoll. Subsequently, they would invade Makin.

Tarawa

Some historians describe Betio Island as "the most heavily defended atoll that would ever be invaded by Allied forces in the Pacific."(16) In the Tarawa Atoll, smaller than New York's Central Park, this island presented two major problems for American forces; it was heavily fortified and was fringed by a thick coral reef. There were approximately 5,000 elite Japanese naval infantry forces on Betio. They were equipped with
everything from tanks to 8-inch naval guns and had spent the preceding 15 months turning Betio into a fortress.

Prior to landing, Allied naval and air bombardment attempted to soften up the beachhead, but for the most part the defenses were still strong. The Japanese remained well entrenched in pill boxes and barricades within yards of the beach, waiting for the invaders, and were fanatical in their resolve to die to the last man.

The Landings

About 125 amphibious tractors put the initial assault troops ashore. In attempting to do so, 323 of the 500 men operating the amphibious tractors were killed, wounded, or missing in action.(17) Ninety of these vehicles fell prey to enemy gunfire and were lost either in deep water, on the offshore reef, or burned as a result of gas tanks igniting. Others were wrecked on beaches by underwater mines or succumbed to
mechanical failure. When their landing boats hung up on reefs, marines had to wade about a thousands yards to shore under withering fire which decimated entire units. Moreover, the enemy prevented some units from landing until D+1 day.

Navy Medicine Goes to Work

Four aid men landed with each assault company. In some assault companies 50 to 70 percent of the marines became casualties.(18) Because of the high volume of casualties, corpsmen could only render the most necessary first-aid on the beach. They used first-aid kits and boat-bags and employed whomever they could to help evacuate the wounded to transports.

By the end of D-Day, approximately 5,000 marines had gone ashore, of which 1,500 were dead or wounded. On D-Day+1, collecting medical companies--consisting of a medical officer, 11 hospital corpsmen, 3 marines, and 1 jeep ambulance--went ashore with the second wave of troops and began setting up evacuation
points on the beach. Transport medical sections, which also arrived that day, assisted.

Casualties were evacuated to the end of the pier, where, if necessary, they received further treatment before being transferred back to transports by boats. The majority of the wounded were brought aboard the transports within 2 hours of their injuries, but some had to wait as many as 12 hours because of heavy enemy fire.

Early casualty numbers of USS Heywood (AP-12) attest to the difficulties the attackers experienced. Upon its arrival at noon on D-day + 1, 277 marines and sailors were brought aboard for treatment.(19) The next day, two medical companies of the Second Medical Battalion came ashore and established blackout
surgery areas and were ready for operations within 12 hours.

Tarawa was extremely costly to both Americans and Japanese before the enemy garrison of about 5,000 was annihilated. The victors lost 980 marines and 29 sailors died; 2101 were wounded.(20) Hell in a very small place, a term used to describe another battle in a later war, was the most accurate assessment of the Tarawa experience. Virtually at sea level, Betio offered no cover, no shade from the blistering temperatures, no drinking water, and no relief from choking dust. Working in bunkers freshly purged of their Japanese
occupants, Navy corpsmen and doctors administered treatment under hellish enemy fire. Twenty- six
corpsmen and two physicians lost their lives. For their bravery, Tarawa corpsmen earned three Navy Crosses and 12 Silver Stars.

Sanitation

After the island was secured, conditions surrounding the burying of the dead, distribution and disposal of food and waste initiated sanitation problems. Decaying corpses littered the landscape. Food trash and feces had been left uncovered. There were also crater holes, garbage and trash dumps, open heads, and
ration dumps. Fly- and mosquito-breeding areas were everywhere. Dysentery was the greatest threat at the time.

On 23 Nov, personnel began the slow, arduous task of burying the dead. By 3 Dec, most of the
cadavers were buried, and sanitary toilets, screened galleys and mess halls, and fly traps were slowly being constructed.

On 24 Nov, hospital ship USS Solace (AH-5) rendezvoused with evacuation vessels and received 234 of Tarawa's wounded.(21) She then sailed for Hawaii, disembarked patients, and then headed for San Francisco with more patients. USS Relief (AH-1) also came to Abemama but wasn't needed. Subsequently, she retired to Funafuti Atoll, Ellice Islands, and served as a base hospital there until January.

Makin Taken

Troops landed at 0830 on 20 Nov on islets in the Makin Atoll and faced little resistance. Within a few days, organized resistance ceased. In seizing Makin, Army casualties were relatively low with 64 killed and 150 wounded.(22) Because casualties ashore were low, medical facilities proved adequate. Except in isolated cases, evacuation to transports was prompt and transport medical facilities were fully utilized. By 24 Nov, the
majority of those wounded had been removed from clearing stations.(23) Transports put out to sea nightly about an hour before sundown and returned after sunrise. Forty patients were evacuated by flying boat to Funafuti and then to Pearl Harbor via land plane.(24)

Problems at Sea

Before dawn on 24 Nov, Japanese submarine-launched torpedoes struck USS Liscome Bay (CVE-56) off Makin and it sank with great loss of life. Destroyers USS Morris (DD-417), Hughes (DD-410),
Hull (DD-350), picked up the survivors. Aboard USS Morris, medical officers and corpsmen treated about 60 survivors. Most were covered with oil and were seriously burned. Aboard USS Hughes, medical personnel received survivors for about 2 hours following the carrier escort's demise. Like on USS Morris, mostof the survivors were coated with fuel oil. To correct this, the medical officer set up burn teams. They consisted of two non-medical assistants who removed oil from patients, cleansed burns, and applied sulfa powder or boric acid ointment dressing. Subsequently, pharmacist's mates carefully segregated the patients at the after dressing station. Two trained officers administered morphine and morphine tags, sulfathiazole and several first-aid treatments.

Abemama

Once Tarawa was secured, the Second Marine Division proceeded to take Abemama which proved to be the easiest of all the operations. The Abemama operation resulted in only three American casualties--one killed and two wounded. The Japanese forces were either killed or committed suicide.(25) Abemama was
secured on 26 Nov.

Changes and Additions

The average patient census for Navy hospitals in 1943 more than doubled that of the previous year, escalating from 13,274 to 39,723.(26) Consequently, the Navy Medical Department continued to expand
rapidly. Additional wards and other buildings were being constructed at existing hospitals and four base
hospitals, and a mobile hospital and several dispensaries were commissioned in the closing months of 1943. In the United Kingdom, four more dispensaries, ranging from an 87-bed to a 500-bed unit, were also
commissioned.

At Pearl Harbor, HI, Base Hospital No. 8 was established on 1 Nov and replaced Mob-2. Personnel from Mob-2 became part of the new base hospital while plant and equipment were transferred to USNH Aiea Heights, which had been constructed adjacent to Mob-2. Base Hospital No. 9 Oran, Algeria, was
commissioned on 19 Nov with a bed capacity of 500. In Sydney, Australia, Navy medical personnel took over an Army facility and commissioned it U.S. Naval Base Hospital No. 10 on 4 Dec; on 24 Dec, the hospital unit
of CUB Three on New Georgia was established as Base Hospital No.11 Munda. Incidentally, Mob-12,
destined for the Russell Islands, would not set sail in December as planned. Problems prevented the group not from leaving the states until late spring 1944.

At BUMED, several divisions were reorganized in November including the administrative, planning, and finance divisions. On 13 Nov, a post-war planning board was established. The Navy Medical Department also established a material division to handle the procurement of medical supplies and materials. Although it
was housed in the Naval Medical Supply Depot, Brooklyn, it was administrated separately. BUMED also established a liaison office.

References

1. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap 3, p 71.

2. The History of the Medical Department of USN in WWII, Vol. I: A Narrative and Pictorial Volume, 80.

3. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap. 3, p 76.

4. Ibid., p 75.

5. Ibid., p 72.

6. Ibid., p 75.

7. Ibid.

8. Ibid.

9. Ibid.

10. Historical Data of U.S. Naval Hospital No. Eight 1943. Unpublished paper, p 54.

11. Annual Sanitary Report of U.S. Fleet Hospital No. 106 1944, Unpublished paper, p 1.

12. History of USN Base Hospital No. 4 (March 17, 1943-December 31, 1943), p 2.

13. Historical Data U.S. Naval Mobile Hospital No. 7 1943, Unpublished paper, p 24.

14. Historical Data U.S. Naval Mobile Hospital No. 5 1943, Unpublished paper, p 20.

15. Historical Data for U.S. Naval Base Hospital No. 3, 26 Nov 43, p 3.

16. Alexander JH. "Red Sky In The Morning," Proceedings; 1993 119(11), p 41.

17. Morison SE. Aleutians, Gilberts and Marshalls June 1942-April 1944, p 186.

18. The History of the Medical Department of the USN in WWII,Vol. I: A Narrative and Pictorial Volume, p 166.

19. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap. 5, p 6.

20. Morison SE. Aleutians, Gilberts and Marshalls June 1942-April 1944, p 184.

21. Ibid., p 23.

22. Ibid., p 134.

23. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap. 5, p 18.

24. Ibid.

25. Ibid.

26. The History of the Medical Department of the USN in WWII, Vol. I: A Narrative and Pictorial Volume,
p 1.