Navy Medicine September-October 1944
Jennifer Mitchum

In the Central Pacific, U.S. forces continued an offensive that would eventually take them to the Imperial Palace. The first 6 months of 1944 were decisive with Kwajalein, Eniwetok, Saipan, Tinian, and Guam falling successively. To neutralize the Carolines, American air and sea forces raided heavily fortified Truk and neighboring islands in the spring of 1944. Next, U.S. forces would move against the Palau Islands, which are about 1,200 miles west of Truk, and Morotai Island in the Netherlands East Indies.

Peleliu and Angaur

Planners chose Peleliu, on the southern end of the Palaus, for the first beach assault. On 15 Sept, the troops that went ashore met little mortar or small arms fire. The enemy had retreated inland to more
defensible positions. Within 2 days, troops captured their prime objective, Peleliu airfield.

On 17 Sept, Army troops proceeded to land on nearby Angaur. They quickly overran the island and organized resistance ceased on 20 Sept. In taking the island, 237 Americans were killed.(1) Two transport medical beach parties went ashore and operated two care stations until 21 Sept. At one station, doctors and corpsmen mainly treated accidental wound fragment injuries, minor coral cuts, sunburn, chafed skin, sore feet, and other illnesses; less than half the casualties resulted from direct enemy action.(2) Moreover, the Army quickly established the 17th Field Hospital, a 500-bed unit which was augmented with 100 beds from USS Solace (AH-5), and the 41st Portable Surgical Hospital, a 300-bed facility. By F+2, both were receiving patients.(3)

Meanwhile, the Japanese forces had emerged on Peleliu. From fortifications carved out of solid rock bluffs further inland, the enemy fought with tenacity. Army troops on Angaur returned to Peleliu to assist marines in eliminating the defenders cave by cave. Casualties mounted with every inch of ground gained.

Initially, fierce fighting ashore prevented medical companies from landing. Thus, transport beach
medical parties tended to casualties during the first 5 to 10 days. In addition to its field units, the Army assigned two corpsmen per platoon or 40 corpsmen per battalion ashore.(4) However, stretcher bearers,
regimental and battalion medical units, and malaria control and sanitary units eventually landed.(5)

Evacuation

Rough terrain made land evacuation difficult on both Angaur and Peleliu. In some instances, Navy medical personnel lowered litter casualties over high rocky cliffs by ropes and pulleys.(6) Moreover,
collecting companies relied on Army quarter-ton trucks, Dodge ambulances, and, most often, DUKWs (amphibious trucks) to plough through mud and swamp to bring casualties to seaward evacuation points.

There, at the reef's edge, doctors and corpsmen determined the severity of injuries and provided
whatever medical attention possible before evacuating casualties to LSTs (landing ship, tank) and LCVPs (landing craft, vehicle, personnel) that would take the wounded to transports and hospital ships. This new type of medical section, known as the "Reef Beach Medical Section," facilitated seaward evacuation. Furthermore, LST-225 served as a casualty transfer point and lay about 1,500 yards off the Peleliu shore.(7) Aboard
LST-225, Navy medical personnel rendered additional first-aid treatment and triaged wounded before
evacuating them further out to transports and hospital ships. Such transfer points at sea helped eliminate
confusion in the evacuation process.

Transports were key in the Navy Medical Department's care program. Less than an hour after troops landed on Peleliu, specialized medical teams aboard transports were busy treating everything from shrapnel and blast wounds to neurosis.(8) The use of penicillin and whole blood were essential in preserving lives. Consequently, Navy Medical personnel on some transports established blood banks for their ships. For
example, servicemen aboard attack transport Fayette (APA-43) donated almost 30 quarts of "O" type blood, as well as other types for cross matching.(9)

Hospital ships Samaritan (AH-10), Bountiful (AH-9), Solace (AH-5) and Relief (AH-1) began arriving in the Peleliu-Angaur area F+3 and served much like floating ambulances, receiving patients from the beaches and other vessels, and evacuating them to rear bases. Samaritan and Bountiful left the area with wounded almost immediately while Solace and Relief remained in the area for several days. A member of USS Solace observed the severity of the battle stating, "The patients we were receiving were shot up as badly as any we had seen so far...both sides were taking a shellacking."(10) The Navy medical team aboard Solace handled over 1,000 cases in the Palaus operation; over 800 were battle casualties.(11)

In the 10-day period prior to medical companies sufficiently setting up ashore, 3,756 casualties were evacuated seaward from Peleliu. Most were by transports. Between 15 Sept and 14 Oct, 5,554 casualties were evacuated by sea and 258 by air during the Palaus operation.(12)

Sanitation and Disease

Peleliu's tropical climate and swampy conditions coupled with corpses and waste made the island a fly and mosquito haven. To rid the island of insects and other pests, sanitation control units sprayed the area with DDT.

Sanitation and malaria control units had difficulties instituting preventive and suppressive measures because of the Palaus climate and terrain. Due to inadequate sanitation, some men developed enteritis and fungus infections. Malaria incidence, however, was low. In the Army's 81st Division, which was
encountering malaria for the first time, seven cases were reported. In the veteran First Marine Division, 72 members were hospitalized for recurrent malaria between 24 Sept and 1 Oct. Only four cases were serious enough to be evacuated and the others required only a few days of hospitalization.(13)

The Palaus Secured

By 30 Sept, the southern Palaus were secured although many defenders remained in isolated pockets of the islands. It would take a little over 2 months to eliminate this resistance. The First Marine Division received the brunt of the fighting as 46 percent (5,031) of the division became casualties. Navy Medical
Department casualties were also high with 1 doctor and 45 corpsmen being killed and 7 doctors and 208 corpsmen wounded.(14) The Army suffered a little over 1,900 casualties and the Peleliu Island Command had almost 200.(15)

Morotai

The day troops invaded Peleliu, Army troops landed virtually unopposed on Morotai Island. Small enemy parties tried to launch banzai attempts. However, American troops wiped out these banzai charges, while losing 31 (killed or missing) and 85 wounded. Other defenders died while trying to escape to

Halmahera by barge and a few took to the mountains.(16) Almost immediately, American personnel began building an air base.

The Ulithi Islands

On 23 Sept, the Army proceeded to occupy several islands in the Ulithi Island group which was 500 miles north of the Palaus. The Japanese had evacuated the islands a month earlier. Thus, casualties were extremely light.

With occupation of the Palaus, Morotai, and Ulithi, the Americans controlled the approaches to the Philippines and now had the advanced bases needed to support MacArthur's return to the Philippines.

Leyte

General Douglas MacArthur's dream from the moment he was ordered to evacuate the Philippines in 1942 that he would one day return to liberate the islands from the Japanese. MacArthur's goal became a
reality on 20 Oct, when he and thousands of American troops waded onto the beaches of Leyte island in the Philippines.(17) Once secured Leyte was to be the staging area for liberating the rest of the archipelago.

Enroute aboard transports, Navy physicians and corpsmen immunized sailors and soldiers against cholera, typhus, and plague. Moreover, atabrine was used as a malaria suppressant. Although no serious
epidemics were reported, many experienced diarrhea.

Leyte's terrain, which consisted of many extinct volcanoes, knifelike spurs and ridges, and deep ravines, formed an effective barrier between the island's eastern and western coastal areas. Thus, while
plodding American foot soldiers endured the muddy jungle and dodged snipers' bullets on the northeastern beaches, the Japanese fortified on the western side. Therefore, U.S. troops were able to establish beachheads relatively easily and initial casualties were comparatively light. At the end of the second day, there were 83 killed and 145 wounded.(18)

Navy Medicine

For the most part, the Navy Medical Department handled beach medical activities and evacuation of troops. Transport medical beach parties, consisting of a medical officer and 8 corpsmen, went ashore and set up aid stations. Army medical collecting units, consisting of an Army doctor, a dental officer, and two
Army corpsmen, accompanied Navy medical beach personnel, and usually brought wounded back to aid
stations within 20 minutes of their injuries.(19) Moreover, the Army established a battalion clearing station about 300 yards inland the day after the initial landings.

Evacuation

Torrential rains turned roads and airfields into beds of mud making ambulances useless. LVTs (landing vehicle, tank), DUKWs, and more often Weasels were used to gather and transfer wounded from inland
positions. In some instances, collecting section personnel showed their ingenuity. For example, personnel laced wounded to bamboo pole-attached stretchers, and then yoked the entire contraption to water buffalos which dragged the patients to where they could be transferred for evacuation to the beaches. Once on beaches, amphibious vessels ferried wounded to transports and hospital ships.


Casualties came aboard transports usually within an hour and a half of their injuries. Subsequently, medical personnel performed several tasks including suturing abdomen, chest, and scalp wounds, performing
debridement, and dusting wounds with sulfonamide powder. At least 3 doctors and 20 corpsmen served
aboard each transport.(20)

Two Army hospital ships as well as Army-staffed Navy hospital ships USS Mercy (AH-4) and Comfort (AH-3) operated in Leyte Gulf. Moreover, hospital ships Solace, Relief, and Bountiful were stationed at Ulithi and ready to assist. As in other Central Pacific operations, hospital ships continued to serve much like floating ambulances, transferring casualties to rear base medical facilities.

Hospital ships remained in the area only a few hours at a time. Thus, surgically augmented LSTs were used extensively. These LSTs had a complement of 5 surgeons and 35 corpsmen and could berth
approximately 350 casualties.(21) Aboard LST-464, which had a more substantial medical facility, patients received definitive treatment. In addition to being a care facility, LST-464 served as a blood bank. However due to poor sanitation and illumination, LSTs were not ideal substitutes for hospital ships.

The Battle of Leyte Gulf

From 23-26 Oct, American ships and planes battled enemy air and sea forces in the largest naval battle in history.(22) To counter the overwhelming U.S. power in the Pacific, what was left of the Japanese fleet attempted to disrupt the Philippines invasion. As the battle raged across hundreds of square miles, U.S.
submarine, surface, and air forces combined to defeat the Japanese Navy.

Kamikazes

Desperate to turn the tide, the Japanese launched a new weapon, the kamikaze, named for the divine wind which dispersed a 13th century Mongol invasion fleet. Using their aircraft as guided bombs Japanese pilots deliberately plunged into American ships. The first organized kamikaze attack occurred on 25 Oct when five enemy pilots dove into U.S. escort carriers in Leyte Gulf, sinking one and damaging three others. The next day, more kamikaze attacks took place, causing further damage and demonstrating a terrifying new aspect of the Pacific war.

The Saga of the Princeton (CVL-23)

Although kamikazes were the newest Japanese weapon, conventional bombs continued to take a heavy toll. One such example was the destruction of USS Princeton. The story of this light carrier also highlights the problems doctors and corpsmen faced treating an overwhelming number of casualties amidst raging fires and chaos.

After two Japanese bombs penetrated Princeton's flight deck spreading fires and choking smoke throughout the ship, the cruiser Birmingham (CL-62) came alongside to assist. Shortly thereafter, an
explosion shattered Princeton hurling large fragments of steel and parts of bodies into the air and onto Birmingham. More than 200 of the ship's crew were killed and over 400 wounded.(23) But despite their anguish and agony, all hands were said to have performed admirably even in the face of death. The executive officer of Birmingham commented on the situation stating, "...Men with legs off, with arms off, with gaping wounds in their sides, with tops of their heads furrowed by fragments, would insist, 'I'm all right. Take care of Joe over there,' or 'Don't waste morphine on me Commander, just hit me over the head.'"(24)

Following the attack, the junior medical officer, initially the only doctor aboard, and about 15
corpsmen devoted a few minutes to each of the patients--stopping hemorrhages, administering morphine, sprinkling wounds with sulfa powder, and bandaging the wounded. The ship's company, trained in first aid, helped out considerably by freeing Navy medical personnel to treat shock and severe hemorrhages. Within a few days, Navy medical personnel assigned to other ships came aboard to assist those on Birmingham. Moreover, hospital ship Samaritan (AH-10) relieved the ship of some of its casualties.

Apart from the few abdominal operations, Navy medical personnel did not render definitive treatment. Instead they attempted to save as many lives as possible by first rendering the most basic treatment to the greatest number. This practice helped lower the mortality rate. Among the 420 wounded aboard Birmingham, only 8 cases were fatal.(25)

By the evening of 26 Oct, the U.S. fleet had all but destroyed what remained of the Japanese fleet. Even though the Japanese Navy would not seriously threaten the Allied advance toward Tokyo, the kamikazes had opened a new and very destructive chapter in naval warfare.

References

1. Van der Vat D. The Pacific Campaign, p 347.

2. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap. 9, p 5.

3. Ibid., p 12.

4. Ibid., p 3.

5. Ibid., p 4.

6. Ibid., p 6.

7. Ibid., p 7.

8. Ibid., p 8.

9. Ibid., p 9.

10. Daly, HC. The U.S.S. Solace Was There, p 558.

11. Ibid., p 571.

12. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap.9.p 11.

13. Ibid., p 19.

14. Medical Department of the United States Navy in World War, Vol. II: A Compilation of the Killed, Wounded, and Decorated Personnel, p 2-60.

15. Ibid, p 14.

16. Morison SE. Leyte: January 1944-January 1945, p 24.

17. Karig W, Harris R, Manson F. Battle Report: Victory in the Pacific, p 11.

18. The History of the Medical Department of the U.S. Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 186.

19. U.S. Navy Medical Department Administrative History, 1941-1945, Vol. I: Narrative History, chap10, p 4.

20. Ibid., p 8.

21. Lane D. The Evolution of Tactical Employment of Hospital Ships in the United States Navy, p 8.

22. Van der Vat D, p 352.

23. Blassingame W. Medical Corps Heroes of World War II, P 129.

24. U.S. Navy Medical Department Administrative History, 1941-1945,Vol. I: Narrative History, chap.10,p13.

25. Ibid., p 15.