Este artículo incorpora material de dominio público de sitios web o documentos del Ejército de los Estados Unidos .
La 44.ª Brigada Médica es una unidad del Ejército de los EE. UU. ubicada en Fort Liberty , Carolina del Norte , que brinda atención médica y servicios médicos a la comunidad de Fort Liberty y continúa la capacitación en su misión de apoyo de combate. Fue la segunda brigada médica operativa del Ejército de los EE. UU. y, cuando se desplegó en la República de Vietnam en 1966, la primera en apoyar operaciones de combate terrestre. Desde entonces, ha participado en todas las operaciones de combate terrestre importantes del Ejército de los Estados Unidos.
El Destacamento de Cuartel General y Cuartel General de la 44.ª Brigada Médica se constituyó en el Ejército regular el 30 de diciembre de 1965 y se activó en Fort Sam Houston, Texas, el 1 de enero de 1966 para su futuro servicio en Vietnam. La unidad se organizó según la Tabla de Organización y Equipo (TOE) 8-112E, con una dotación autorizada de 20 oficiales y 47 soldados. [9]
El primer teniente Byron L. Evans, oficial del Cuerpo de Servicios Médicos (MSC), fue el primer oficial en presentarse en el cuartel general del 44.º en Fort Sam Houston y asumió el mando el 7 de enero de 1966. El 25 de enero, el teniente coronel John W. Hammett, MSC, asumió el mando. Fue sucedido por el coronel Thomas P. Caito, MSC, el 7 de febrero. En Vietnam, el coronel (más tarde general de brigada) James A. Wier, oficial del Cuerpo Médico (MC), fue asignado como director de servicios médicos del 1.º Comando Logístico el 26 de enero y fue designado como oficial al mando de la 44.ª Brigada Médica, para unirse a la unidad en el país. [9]
El 31 de enero se emitieron las órdenes para el traslado del Cuartel General de la Brigada en abril desde Fort Sam Houston. La unidad sería asignada al Ejército de los Estados Unidos en el Pacífico al desembarcar. Las fechas de preparación se fijaron para el 1 de abril para el equipo y el 21 de abril para el personal. [9]
El personal del cuartel general de la brigada se presentó en Fort Sam Houston durante enero y febrero. La preparación para el entrenamiento en el extranjero se llevó a cabo en cooperación con el 67.º Grupo Médico y el Centro de Entrenamiento Médico del Ejército de los Estados Unidos, Fort Sam Houston, una organización separada y distinta de la Escuela de Servicio Médico de Campo que se encargó del entrenamiento inicial de los médicos de combate. El Cuartel General del Puesto de Fort Sam Houston proporcionó asistencia logística al 44.º para ayudar a cumplir con la fecha de preparación del equipo. Otras actividades en Fort Sam Houston incluyeron la preparación de los procedimientos operativos permanentes; el ensamblaje y embalaje de suministros, equipos y referencias administrativas y profesionales; y la organización del transporte. [9]
El 18 de marzo, un grupo de avanzada de la 44.ª Brigada Médica, compuesto por 8 oficiales y 10 soldados rasos, llegó a Vietnam para establecer la Brigada Médica (Provisional), que se convirtió en una unidad de trabajo de la Dirección Médica del 1.er Comando Logístico. El coronel Caito comandó el grupo de avanzada en ruta, mientras que el coronel Herbert R. Faust, veterinario del Cuerpo Veterinario (VC), permaneció en Texas para comandar el cuerpo principal. El 24 de marzo, el coronel Wier asumió el mando de la Brigada Médica (Provisional) y el coronel Caito se convirtió en el oficial ejecutivo. [9]
El cuerpo principal de la 44.ª brigada aterrizó en el aeropuerto de Tan Son Nhut el 21 de abril de 1966. La brigada médica provisional fue disuelta inmediatamente, mientras que el cuartel general y el destacamento del cuartel general de la 44.ª brigada médica establecieron sus oficinas y alojamientos en 24/8 Truong Quoc Dung, un grupo de villas alquiladas en los suburbios de Saigón. El cuartel general de la brigada, asignado al 1.er Comando logístico, entró en funcionamiento el 1.º de mayo y asumió el mando y el control operativo de todas las unidades médicas asignadas al 1.er Comando logístico. [9]
Cuando el grupo de avanzada del 44.º Regimiento llegó a Vietnam en marzo para establecer la Brigada Médica (Provisional), el 1.er Comando Logístico tenía el mando y control de las unidades médicas del país que no formaban parte de divisiones, brigadas independientes o unidades similares. Los Grupos Médicos 43.º y 68.º eran los principales comandos médicos subordinados dentro del 1.er Comando Logístico. [9]
La Dirección Médica, 1er Comando Logístico, fue creada para desarrollar, coordinar y supervisar planes y operaciones médicas, políticas de suministro y mantenimiento médico, estadísticas y registros médicos, actividades médicas y dentales profesionales, medicina preventiva y actividades de regulación médica. [9]
La Brigada Médica (Provisional) sirvió como vehículo de transición para transferir el mando y control directos de las unidades de apoyo médico del 1.er Comando Logístico a la 44.a Brigada Médica. El coronel Wier continuó dirigiendo a su personal en la Dirección Médica del Comando Logístico mientras también se desempeñaba como Comandante de Brigada. [9]
La misión del Cuartel General de la Brigada Médica (Provisional) era "Brindar servicio médico al Ejército de los Estados Unidos, Vietnam (USARV) a través del comando y control de las unidades operativas del sistema de servicio médico del 1.er Comando Logístico; desarrollar; [sic] refinar e implementar operaciones; reforzar el servicio médico de las divisiones del Ejército, brigadas separadas y otras unidades que tengan apoyo médico orgánico, según sea necesario; proporcionar personal y supervisión técnica sobre las actividades religiosas de las unidades asignadas y adjuntas; y realizar las operaciones generales de apoyo al servicio médico que incluyen la evacuación, atención y tratamiento de pacientes; suministro y mantenimiento médicos; y los servicios dentales, veterinarios, de medicina preventiva y de laboratorio". [9]
El comandante de brigada debía "dirigir el servicio médico del 1.er Comando Logístico y, como director médico, el 1.er Comando Logístico es responsable ante el Comandante General del 1.er Comando Logístico del cumplimiento de la misión general del servicio médico". [9]
Durante el tiempo en que funcionó la Brigada Provisional, parte del personal de la Dirección Médica del Comando Logístico fue transferido al Cuartel General de la Brigada; otros fueron transferidos a otros lugares; y algunos rotaron, de modo que cuando la 44.ª entró en funcionamiento, el único personal que quedaba en la Dirección Médica, aparte del coronel Wier, era una Sección Médica del Estado Mayor del Comando de Apoyo del Ejército de Campaña (FASCOM), compuesta por dos oficiales de planes, un oficial de suministros y mantenimiento, un suboficial médico jefe, un mecanógrafo y un conductor. [9]
La Dirección Médica estuvo ubicada físicamente en el Cuartel General del 1.er Comando Logístico durante todo el período, pero el 1 de octubre de 1966 todas las funciones de la sección fueron absorbidas por secciones de personal del 44.º, y la oficina en el Cuartel General Logístico se mantuvo únicamente para fines de enlace. El oficial de suministros continuó trabajando en el S-4 de la Brigada, el oficial asistente de planes pasó a ser el S-3 del 43.º Grupo Médico, mientras que el oficial de planes, el suboficial médico, el mecanógrafo y el conductor permanecieron en el Comando Logístico para fines de enlace. [9]
Después de que la 44.ª Brigada Médica entró en funcionamiento el 1 de mayo, la misión siguió siendo básicamente la misma que la de la Brigada Médica (Provisional). En un relato más detallado de la misión se afirmaba que el Comandante de la 44.ª Brigada Médica, en apoyo de los elementos del USARV, haría lo siguiente: [9]
El comandante de la brigada mantuvo su otra función, la de director médico del 1.er Comando Logístico. La organización del personal de la brigada siguió funcionando de manera similar, aunque con actividades y responsabilidades ampliadas. [9]
El coronel Wier se convirtió en cirujano del USARV el 10 de junio de 1966. El 13 de junio de 1966 se celebró una ceremonia de cambio de mando en el complejo de la 44.ª Brigada Médica, donde el coronel Wier entregó el mando de la brigada al coronel Ray L. Miller, MC. [9]
El mayor Stuart A. Chamblin, Jr., MC, sirvió como comandante adjunto de la Brigada Provisional durante el tiempo de su existencia. Se trasladó a los Estados Unidos a principios de mayo y el puesto permaneció vacante hasta el 6 de junio, cuando el teniente coronel Lewis VanOsdel, MC, se convirtió en comandante adjunto. Después de su rotación el 12 de septiembre, el puesto permaneció vacante hasta que el teniente coronel Robert E. Miller ocupó el puesto el 14 de noviembre de 1966. [9]
El 1.er Comando Logístico contaba con 58 unidades médicas el 1.er. 1.er. Comando, y 65 unidades bajo la 44.ª Brigada Médica cuando entró en funcionamiento el 1.º de mayo. El 31 de diciembre de 1966, la Brigada tenía el mando y control de 121 unidades. Las unidades veterinarias, dentales, de laboratorio médico y de medicina preventiva, el depósito médico y el cuartel general del grupo médico estaban organizados directamente bajo el Cuartel General de la Brigada, mientras que las unidades restantes estaban organizadas bajo los grupos médicos por área geográfica. La dotación total de la Brigada era de 3.178 efectivos el 1.º de mayo de 1966 y de 7.830 el 31 de diciembre. [9]
-*El 61.º Destacamento Médico (LB) era un destacamento de medicina preventiva, y el 61.º Destacamento Médico (MB) era un gran dispensario. Eran dos organizaciones separadas y distintas con la misma designación numérica, pero con códigos de identificación de unidad (UIC) distintos.
Situación del personal al 31 de diciembre de 1966 [9]
El helicóptero sanitario aéreo en Vietnam prestó apoyo a las operaciones de combate y brindó apoyo médico general a todas las fuerzas en el país. La misión secundaria incluía la entrega de sangre y suministros médicos de emergencia, así como el transporte aéreo de personal médico clave (es decir, equipos quirúrgicos, etc.). [9]
Las operaciones de combate se apoyaron con el despliegue de una o más ambulancias aéreas y ambulancias terrestres de apoyo directo a las tropas de combate. Las aeronaves recogieron a los heridos, no en un puesto de socorro, sino en el lugar de la lesión. En promedio, los heridos estaban en un hospital o eran tratados por un equipo quirúrgico en un puesto de evacuación en treinta minutos. Todos los heridos de combate fueron evacuados por aire al menos una vez antes de ser evacuados por aire fuera del país. [9]
Estadísticas de evacuación aeromédica 1966 [9]
Esto dio lugar a un cambio operativo en Vietnam, ya que la movilidad médica ya no dependía de las instalaciones de tratamiento, sino de las unidades de evacuación, lo que permitió establecer instalaciones médicas más o menos fijas en todo el país y permitirles instalar mejores equipos y, a su vez, brindar una mejor atención a sus pacientes. [9]
A lo largo de 1966, la 44.ª Brigada Médica operó 49 ambulancias aéreas, mientras que otras 12 eran parte del Pelotón de Ambulancias Aéreas, 15.º Batallón Médico, 1.ª División de Caballería (Aeromóvil). Las ambulancias aéreas de la Brigada estaban organizadas en dos compañías. Una Compañía Médica TOE (Ambulancia Aérea), la 498.ª tenía 25 aeronaves organizadas en cuatro pelotones de vuelo. La segunda compañía de ambulancias aéreas estaba organizada bajo el 436.º Destacamento Médico (AC) como cuartel general de la compañía con cuatro destacamentos médicos (RA) operando bajo su mando, denominados de diversas formas como la 436.ª Compañía Médica (Ambulancia Aérea) o la Compañía de Ambulancias Aéreas (Provisional). La 498.ª tenía la responsabilidad del apoyo de ambulancias aéreas a la Zona Táctica del II Cuerpo y la 436.ª tenía la responsabilidad de apoyar a las Zonas Tácticas del III y IV Cuerpos. [9]
En septiembre de 1966, las unidades de ambulancia aérea recibieron su primer envío de grúas para helicópteros dentro del país. Estas grúas se utilizaban para extraer pacientes de zonas inaccesibles donde los helicópteros no podían aterrizar, como bosques profundos o selvas, laderas de montañas, agua o pequeñas embarcaciones. [9]
La misión de regular el traslado de pacientes desde las áreas avanzadas a los hospitales capaces de proporcionar atención definitiva (Sistema de Evacuación Aeromédica Avanzada) pasó a ser responsabilidad de los grupos médicos por primera vez después de que la Brigada entrara en funcionamiento. Esto dio como resultado que el Oficial de Regulación Médica (MRO) de la 44.ª Brigada Médica se hiciera responsable de la evacuación general dentro del país. El aspecto inusual de esta situación fue que la República de Vietnam (RVN) representaba toda el área avanzada. Los grupos médicos controlaban el movimiento de pacientes (dentro del área) desde las áreas tácticas a los hospitales de su grupo. El posterior traslado de pacientes de un área de grupo a otra era coordinado por los MRO del grupo médico con el MRO de la brigada, que mantenía el control general para garantizar la utilización adecuada de todas las instalaciones médicas. Durante estos traslados, los pacientes nunca abandonan el área avanzada, mientras que en conflictos anteriores se trasladaban del área avanzada a la retaguardia del ejército de campaña. El Sistema de Evacuación Aeromédica Táctica comenzó con el traslado de pacientes desde la zona de combate (la RVN) al Comando del Pacífico de los Estados Unidos (PACOM) y el Sistema de Evacuación Aeromédica Estratégica comenzó con el movimiento de pacientes desde las instalaciones hospitalarias del PACOM a las del territorio continental de los Estados Unidos (CONUS). Las dos últimas fases fueron controladas directamente por la Fuerza Aérea, que era responsable de la evacuación aeromédica. Una Oficina de Regulación Médica Conjunta del Lejano Oriente (FEJMRO), una organización tripartita, mantuvo la responsabilidad de designar hospitales en el PACOM y el CONUS donde los pacientes pudieran recibir el tratamiento adecuado. Solo aquellos pacientes que requerían cuidados intensivos (por ejemplo, casos de quemaduras, amputaciones importantes o paraplejías) fueron enviados al CONUS. [9]
Estadísticas de hospitalización en 1966 [9]
La misión de la 44.ª Brigada Médica a lo largo de 1967 fue proporcionar apoyo médico de nivel militar al personal del Ejército de los Estados Unidos, al personal de las Fuerzas de Asistencia Militar del Mundo Libre y a otras categorías de personal según lo indiquen los cuarteles generales superiores. [10]
El 10 de agosto de 1967, la 44.ª Brigada Médica se separó del 1.º Comando Logístico y se asignó directamente al Cuartel General del Ejército de los Estados Unidos en Vietnam. La función y la supervisión reales de la misión de la Brigada se aclararon, pero la reasignación no las modificó en lo esencial. La ejecución de la misión de la Brigada se describió específicamente como: [10]
La 44ª Brigada Médica tendría las siguientes funciones: [10]
Con el énfasis creciente en el traslado de unidades desde el área de Saigon-Cholon-Tan Son Nhut, el cuartel general de la brigada se trasladó de sus villas suburbanas en 24/8 Truong Quoc Dung a los edificios 8528-8532 en Long Binh Post. La mudanza en dos fases se llevó a cabo a fines de septiembre de 1967. La proximidad geográfica cercana a la sede de USARV y la oficina del cirujano de USARV fue notablemente beneficiosa en términos de ahorro de tiempo y alivio de problemas de comunicación. [10]
La organización intergrupal e intragrupal se mantuvo esencialmente estable hasta el tercer trimestre del calendario. El 23 de octubre de 1967, el 67.º Grupo Médico entró en funcionamiento y las instalaciones médicas en el área de Saigón, la parte extrema occidental de la Zona Táctica del III Cuerpo y toda la Zona Táctica del IV Cuerpo se separaron del 68.º Grupo Médico y se asignaron al 67.º Grupo Médico. Esto dividió a un grupo geográfico previamente grande en dos grupos de tamaño más manejable y dio como resultado un mando y control más efectivos. [10]
Este cuadro refleja los cambios entre el 31 de diciembre de 1966 y el 31 de diciembre de 1967 [10]
La 222.ª Compañía de Servicios de Personal (PSC), una compañía de ayudantes generales (AG) con oficiales de personal del MSC asignados en lugar de oficiales del AG, fue asignada a la brigada en febrero y para el 31 de marzo había asumido funciones de personal para la brigada, incluidas las funciones administrativas que anteriormente cumplían los diversos comandos de apoyo de área. La 222.ª PSC organizó equipos separados estacionados en cada cuartel general de grupo y en el cuartel general de brigada, proporcionando servicios de personal de área con registros de personal centralizados en cada equipo. Aunque esto, en la mayoría de los casos, privó a los comandantes de unidad de un acceso fácil a los registros de personal de sus unidades, la mayor estandarización de los procedimientos, las acciones de personal y las funciones de gestión de personal superaron en gran medida este inconveniente. [10]
El 10 de agosto, cuando la brigada se convirtió en un comando importante bajo el Cuartel General de USARV, el impacto inmediato en la oficina S-1 fue el aumento de las condecoraciones procesadas como resultado de una mayor autoridad para aprobar condecoraciones. Esto requirió un aumento de personal para manejar la carga de trabajo y, a fines de 1967, había 3 soldados y un oficial dedicando todos sus esfuerzos al programa de condecoraciones. [10]
Con la llegada en septiembre del 67.º Grupo Médico y la subsiguiente división de las unidades ubicadas en la Zona Táctica del III Cuerpo entre los Grupos Médicos 67.º y 68.º, se impuso a la 222.ª Compañía de Servicios de Personal la obligación de proporcionar otro equipo de personal para prestar servicios al grupo y a las unidades adjuntas. Esto se logró aumentando el equipo que prestaba servicios al 68.º Grupo Médico y haciendo que el equipo prestara servicios a ambos grupos. [10]
En el último trimestre de 1967 se inició un programa para convertir algunos puestos militares en puestos de contratación civil local, conocido como "Programa 5 Civilización", cuya implementación estaba prevista para enero de 1968. Este programa convirtió los puestos de MOS de baja cualificación y de entrada básica en unidades médicas TOE en puestos civiles. [10]
A finales de 1967, las unidades de la brigada contaban con un total de 872 efectivos civiles de las fuerzas armadas locales. La mayoría de ellos trabajaban en los hospitales de evacuación de la brigada y se desempeñaban como asistentes de sala, personal de cocina y en el ámbito administrativo. Más del 90% del total de empleados participaban en la misión de asistencia a los pacientes. Varios empleados ayudaban al Noveno Laboratorio Médico como asistentes de laboratorio, mientras que otros realizaban trabajos de asistente dental en los destacamentos dentales (KJ) de la brigada. La Dirección de Personal Civil de la República de Vietnam tenía en marcha numerosos programas de formación para satisfacer los requisitos de la brigada en cuanto a puestos cualificados. [10]
Situación del personal al 31 de diciembre de 1967 [10]
La brigada continuó prestando servicios médicos de nivel militar en apoyo de las fuerzas aliadas en la República de Vietnam durante 1967 y los recursos médicos aumentaron en proporción al aumento de la fuerza de tropas. Las unidades de brigada proporcionaron servicios médicos en función de la zona mediante hospitales de campaña, de evacuación y quirúrgicos más cercanos a la zona de operaciones. La evacuación se realizó mediante ambulancias aéreas de reserva dentro de la zona de operaciones. En 1967 hubo un marcado aumento de las operaciones de combate en Vietnam. Por lo tanto, las unidades de brigada se enfrentaron a nuevos desafíos para proporcionar el servicio médico de nivel militar requerido. [10]
Estos desafíos fueron enfrentados con gran capacidad. Las fuerzas del ejército aliado llevaron a cabo numerosas operaciones ofensivas que se extendieron desde la Zona Táctica del I Cuerpo en el norte hasta el delta en el sur. Cada una de estas operaciones fue apoyada por unidades de brigada. Varias unidades de brigada fueron reubicadas para apoyar la cambiante situación táctica. A fines de 1967 se le asignó una misión adicional a la brigada, que consistía en brindar atención hospitalaria, médica y quirúrgica a los civiles vietnamitas heridos como resultado de acciones hostiles. Se asignaron trescientas camas de brigada para civiles vietnamitas para ayudar a satisfacer esta nueva necesidad. [10]
A principios de 1967, la brigada contaba con 49 ambulancias aéreas en una compañía de ambulancias aéreas y cuatro destacamentos médicos (RA) para proporcionar apoyo de evacuación primaria a las Fuerzas de Asistencia Militar de los Estados Unidos y del Mundo Libre (FWMAF). Se proporcionó apoyo a otras fuerzas según estuviera disponible, y las de los Estados Unidos y la FWMAF recibieron prioridad. El aumento de las tropas aliadas en Vietnam no estuvo acompañado de un aumento concomitante de los recursos de aviación médica y la mayor carga de trabajo de evacuación puso a prueba los recursos de evacuación aeromédica existentes. Por lo tanto, se solicitaron unidades de aviación médica adicionales para Vietnam en función de los aumentos proyectados en las Fuerzas de Asistencia Militar de los Estados Unidos y del Mundo Libre. Hasta que llegaron estas unidades de aviación médica adicionales, los mayores requisitos de evacuación se cumplieron con una asignación especial de seis helicópteros por parte de USARV para aumentar la capacidad de evacuación médica. Las aeronaves de asignación especial se asignaron a las unidades "Dustoff" de acuerdo con los requisitos de carga de trabajo demostrados. A finales de año, la brigada estaba realizando la misión de evacuación aeromédica con dos compañías de ambulancias aéreas y ocho destacamentos de ambulancias con helicópteros, lo que representaba el doble del número de ambulancias aéreas disponibles. Las unidades de ambulancias aéreas adicionales permitieron un mayor grado de flexibilidad en el estacionamiento, de modo de proporcionar un apoyo más ágil. Desde los helipuertos de base de la unidad, ampliamente dispersos, se desplegaron ambulancias aéreas individuales para aumentar la capacidad de respuesta a las fuerzas de combate que participaban en las operaciones. Un total de 88.696 pacientes fueron evacuados por unidades "Dustoff" durante 1967. [10]
Estadísticas de evacuación aeromédica 1967 [10]
El mantenimiento de las aeronaves requería una atención especial en todos los niveles de mando debido a las bajas tasas de disponibilidad de las mismas. Para proporcionar una mayor disponibilidad, se aumentaron las unidades de aviación no divisionales, equivalentes en tamaño a la compañía de ambulancias aéreas, con una capacidad orgánica de mantenimiento de nivel de apoyo directo. Además, estas mismas unidades recibieron apoyo de respaldo de las unidades de apoyo directo de nivel del ejército de campaña del 34.º Grupo de Apoyo General. Las unidades médicas no recibieron una capacidad de mantenimiento de nivel de apoyo directo como las unidades de evacuación no médica de tamaño similar. Dado que las unidades médicas recibían apoyo de las mismas unidades de apoyo directo que proporcionaban apoyo de respaldo a las unidades no médicas, la tasa de disponibilidad de aeronaves de las unidades médicas era menos favorable. La misión médica, junto con la ausencia de una capacidad orgánica de mantenimiento de apoyo directo, impulsó a las unidades de apoyo de mantenimiento de aeronaves a dar a "Dustoff" las más altas prioridades. Se hizo todo lo posible para cumplir con el objetivo del Departamento del Ejército de un 80% de disponibilidad de aeronaves, pero una tasa de disponibilidad del 70% se consideró aceptable debido a las limitaciones del apoyo de mantenimiento. [10]
Muchas misiones de evacuación sólo podían llevarse a cabo con la ayuda de una grúa debido a la densa vegetación de la selva. Las misiones con grúa, aunque extremadamente peligrosas y empleadas sólo como último recurso, a menudo proporcionaban la única oportunidad de evacuar a los heridos. [10]
En Vietnam no se introdujeron suficientes montacargas y las dificultades de mantenimiento que ello supuso redujeron el número total disponible para el uso de "Dustoff". Sólo cambiando los montacargas operativos de una unidad a otra, según fuera necesario, se cumplieron adecuadamente los requisitos de la misión de los montacargas. [10]
En 1967, las condiciones de vuelo en Vietnam resultaron ser una gran amenaza para la seguridad de las aeronaves médicas y sus tripulaciones, más que los daños de combate resultantes de la acción enemiga. Aunque algunos accidentes fueron causados por la falta de reacción adecuada de los pilotos ante una situación crítica, las causas más frecuentes de accidentes graves fueron el clima y la mala visibilidad. La mayoría de los pilotos médicos estaban cualificados para volar instrumentos, ya sea con una cualificación estándar del ejército o con una cualificación táctica. Sin embargo, después de llegar a Vietnam, las unidades no hicieron hincapié en la competencia en vuelo instrumental, lo que dejó al aviador medio con una capacidad mínima para hacer frente a las condiciones reales de vuelo instrumental que se le impusieron de repente. Al reconocer esta situación, el Comandante General de la 44.ª Brigada Médica tomó medidas correctivas, exigiendo a todos los aviadores médicos que practicaran vuelo instrumental en conjunción con las misiones asignadas mensualmente. [10]
En 1967, el equipo de protección para las tripulaciones aéreas era muy escaso como resultado de la asignación de unidades de aviación adicionales a Vietnam. Ni en Vietnam ni en los Estados Unidos se disponía de nuevas existencias de cascos balísticos y protectores de pecho. En consecuencia, la 44.ª Brigada Médica redistribuyó los activos entre todas las unidades de aviación médica con la orientación de que todos los miembros de la tripulación compartieran el equipo en la mayor medida posible. [10]
La naturaleza de las operaciones tácticas en Vietnam estableció que los destacamentos de ambulancias con helicópteros eran más adecuados que las compañías de ambulancias aéreas para apoyar las operaciones de estabilización. La compañía era demasiado grande para operaciones centralizadas en Vietnam y los pelotones tenían poca o ninguna capacidad para operaciones independientes sostenidas. Los destacamentos demostraron ser mucho más adecuados para Vietnam, ya que eran pequeños, capaces de operaciones independientes sostenidas y podían trasladarse fácilmente de un lugar a otro según lo dictara la situación táctica. [10]
La regulación médica en Vietnam se dividió en cuatro fases distintas que habían existido desde que la 44.ª Brigada Médica llegó a Vietnam en 1966. Durante 1967, las fases se hicieron más distintas debido a la mayor eficiencia que resultó de la aplicación de la experiencia a la regulación médica y al establecimiento de un sistema de evacuación aeromédica más definitivo en el país. [10]
La fase I implicó la evacuación de los pacientes desde el lugar de la lesión hasta el centro de tratamiento médico táctico de nivel de división (Echelon/Role II) más cercano. [10]
La fase II se superpuso a la fase I e incluyó la evacuación de los pacientes desde el lugar de la lesión o la compañía médica de avanzada de la división hasta el centro de tratamiento de la 44.ª Brigada Médica más cercano, capaz de proporcionar el tratamiento necesario e inmediato. Contrariamente al concepto clásico de evacuación, este puede haber sido un hospital quirúrgico, un hospital de campaña, un hospital de evacuación (todos de nivel Echelon/Role III) o una compañía de limpieza de nivel del ejército de campaña (Echelon/Role II). Los oficiales de regulación médica del grupo médico (MRO) ubicados en los cuarteles generales del grupo o en los puestos de mando avanzados del grupo tenían la responsabilidad principal del control de esta fase y el principal medio de evacuación era normalmente "Dustoff". [10]
La fase III implicaba el traslado de los pacientes a centros de tratamiento en el país para proporcionarles una atención definitiva adicional, una convalecencia en el país o una distribución uniforme de la carga de trabajo de los pacientes. Los pacientes de esta categoría generalmente tenían una duración prevista de hospitalización de menos de 30 días. La responsabilidad inicial de la fase III recaía en el MRO del grupo médico. Si se requería la evacuación a hospitales de otro grupo médico, se enviaba una solicitud al MRO de la brigada. En ese momento, el MRO de la brigada asumía la responsabilidad de la fase III y distribuía la carga de trabajo de los pacientes a los hospitales capaces de completar el tratamiento requerido. El principal medio de evacuación lo proporcionaban los aviones de ala fija de la Fuerza Aérea de los EE. UU., con la asistencia del "Dustoff". [10]
La fase IV incluía la evacuación a instalaciones de tratamiento fuera del país del Comando del Pacífico de los Estados Unidos (PACOM) o de los Estados Unidos continentales (CONUS) para un tratamiento definitivo prolongado o una convalecencia de más de treinta días. La fase IV era responsabilidad completa del MRO de la brigada y en noviembre de 1967 se inició un cambio en el procedimiento para las evacuaciones fuera del país. Aunque se hizo referencia al cambio como un "nuevo" sistema, no se iniciaron nuevos conceptos porque el "nuevo" sistema era una doctrina existente del Ejército. Sin embargo, no se había aplicado anteriormente a la evacuación aeromédica en Vietnam. [10]
Antes del cambio, los pacientes identificados por los oficiales médicos para ser evacuados fuera del país eran trasladados desde los hospitales al centro de concentración de heridos de la Fuerza Aérea de los EE. UU. más cercano. Allí, los pacientes eran regulados por la Oficina de Regulación Médica Conjunta del Lejano Oriente (FEJMRO) y se obtenía y registraba el hospital de destino PACOM o CONUS. Los oficiales de regulación médica de brigada y grupo recibían un informe "después del hecho" del número de pacientes evacuados fuera del país. [10]
Las principales desventajas incluían: [10]
A principios de noviembre se puso a prueba el "nuevo" sistema y poco después se puso en marcha. En este sistema, todos los hospitales enviaban una solicitud a sus respectivos MRO de grupo utilizando los formatos y códigos de diagnóstico establecidos en las normas vigentes y los enviaban al MRO de brigada. El MRO de brigada consolidaba los informes de grupo y los enviaba al FEJMRO, momento en el que se indicaba el hospital de destino de cada paciente. Esta información se pasaba de un grupo a otro de los hospitales, se cerraba el historial del paciente y se preparaba al paciente para su traslado a un centro de preparación de heridos y su posterior evacuación fuera del país. [10]
Inicialmente, se temía que este sistema requeriría demasiado tiempo para cumplir con los requisitos administrativos y que esto, a su vez, empantanaría un sistema ya "efectivo". Sin embargo, pronto se demostró que las solicitudes de evacuación urgentes podían procesarse en una hora, dependiendo de la disponibilidad de aeronaves. Se estableció un plazo de 36 horas para las solicitudes rutinarias a fin de proporcionar a los hospitales el tiempo necesario para preparar los registros clínicos y completar otros requisitos administrativos. [10]
Otro problema fue el de familiarizar al personal con el sistema para garantizar que los pacientes fueran asignados a instalaciones capaces de proporcionar una atención médica completa. Sin embargo, este problema se superó rápidamente y el sistema demostró ser muy eficaz. [10]
Las principales ventajas que se demostraron fueron el control directo de la evacuación al exterior por parte de la brigada de MRO y el hecho de que los hospitales ahora sabían a dónde se trasladaba a los pacientes. Una ventaja, no prevista, fue que se disponía mucho antes de información anticipada deseable sobre el número de pacientes que debían ser evacuados para la coordinación con los centros de preparación de heridos, el Comando de Transporte Aéreo Militar y los centros de tratamiento del PACOM. [10]
El sistema pasó su prueba más severa a fines de noviembre durante McArthur, cuando más de 400 pacientes fueron evacuados efectivamente a las instalaciones de tratamiento de PACOM. [10]
Estadísticas de hospitalización de 1967 [10]
La reasignación de la brigada directamente bajo la USARV requirió que la brigada creara una oficina de tiempo completo para procesar y validar las autorizaciones de seguridad para el personal de más de 8.000 miembros de la brigada. Dado que estas tareas habían sido realizadas anteriormente por el 1er Comando Logístico, fue necesario que la brigada estableciera un nuevo sistema de mantenimiento de registros, archivo y procedimientos de procesamiento de autorizaciones. La transición a una división importante dentro de la sección S-3 se completó simultáneamente con el traslado de la brigada al puesto de Long Binh a fines de septiembre de 1967. A principios de octubre de 1967, el S-3 estableció reuniones informativas diarias para el comandante general de la brigada y el personal. Los resúmenes de inteligencia constituyeron entonces rutinariamente una parte de las reuniones informativas en las que también se presentaban diariamente informes sobre operaciones, aviación y estado de las camas. [10]
La asignación del historiador de brigada al puesto S-2 dio lugar a que las funciones históricas también se asignaran a ese puesto. Las dos funciones separadas, aunque aparentemente incompatibles, resultaron ser bastante complementarias en su desempeño. [10]
En julio de 1967, por orden de la USARV, se inició un programa de satelización de suministros médicos. Inicialmente, se estableció el apoyo de unidades no divisionales, incluidas brigadas, batallones y otras unidades separadas asignadas a la USARV o a la MACV, a nivel de evacuación y hospital de campaña. Se hizo evidente que este arreglo era insuficiente, ya que las unidades estaban muy dispersas por toda la RVN. Los hospitales quirúrgicos, los dispensarios y las compañías de limpieza que operaban instalaciones de tratamiento médico tuvieron que incorporarse a la iniciativa de apoyo. [10]
La carga inicial del programa fue casi abrumadora debido a los limitados procedimientos de contabilidad a nivel de unidad que estaban en vigor en ese momento. El personal de suministros médicos limitados se vio además sobrecargado por existencias completamente inadecuadas con las que atender a sus nuevos clientes. No existían procedimientos de suministro estandarizados en vigor a nivel de unidad y se hizo evidente para el personal de la brigada que, sin acción de su parte, las unidades no podrían mantenerse a sí mismas ni a sus satélites. [10]
Para corregir estos problemas, la brigada tomó varias acciones: [10]
El 12 de marzo de 1967, la teniente coronel Rose V. Straley, del Cuerpo de Enfermeras del Ejército (ANC), fue asignada al cuartel general de la 44.ª Brigada Médica como su primera enfermera jefe. Tras la reasignación de la brigada directamente bajo la dirección de USARV, se fusionaron los cargos de enfermera jefe de USARV y de enfermera jefe de la brigada. La teniente coronel Jennie L. Caylor, la enfermera de mayor rango, asumió las funciones de enfermera jefe de la brigada el 27 de septiembre de 1967. [10]
A lo largo de 1968, la misión de la 44.ª Brigada Médica fue proporcionar apoyo de servicio médico al personal del Ejército de los Estados Unidos, al personal de las Fuerzas de Asistencia Militar del Mundo Libre y a otras categorías de personal según se indicase, para proporcionar hospitalización, atención médica y quirúrgica a los civiles vietnamitas heridos como resultado de acciones hostiles. [13]
Las 29 funciones específicas de la brigada se mantuvieron sin cambios desde 1967. [13]
El 4 de octubre de 1968, la 44.ª Brigada Médica trasladó su sede, pasando de los edificios temporales a un edificio permanente, el n.º 5743, situado junto a la carretera MacArthur Loop en el puesto Long Binh. Todas las secciones del personal de la brigada se consolidaron en el nuevo edificio, lo que proporcionó un aumento considerable del espacio de oficinas. El destacamento del cuartel general de la brigada y los puestos de alistados permanecieron en los edificios n.º 5523 a n.º 5525 en la antigua zona del cuartel general de la brigada, situados aproximadamente a 500 metros del nuevo edificio. [13]
En febrero de 1968 se produjo una importante reestructuración geográfica de los grupos médicos, cuando el 67.º Grupo Médico trasladó su sede de Bien Hoa, en la Zona Táctica del III Cuerpo (ZTC), a Da Nang y asumió la responsabilidad de la atención médica en la ZTC I. A finales de 1968, la mayoría de las unidades de la 44.ª Brigada Médica se desplegaron por zonas geográficas bajo el control de cuatro grupos médicos: el 67.º Grupo Médico en la ZTC I, con sede en Da Nang; el 55.º Grupo Médico en la ZTC II Norte, con sede en Qui Nhon; el 43.º Grupo Médico II ZTC Sur, con sede en Nha Trang; y el 68.º Grupo Médico, responsable de la atención médica en las ZTC III y IV, con sede en Long Binh. [13]
Las unidades de odontología, veterinaria, laboratorio y medicina preventiva, así como el depósito médico, pasaron a estar bajo el control operativo directo del Cuartel General de la 44.ª Brigada Médica. La llegada del 522.º Destacamento Médico (Equipo AF) (Servicios Profesionales Veterinarios) en marzo de 1968 proporcionó un elemento de mando y control para todas las unidades veterinarias de la brigada. Con la llegada de la 172.ª Unidad de Medicina Preventiva en junio de 1968, la estructura de mando se modificó para incluir dos unidades de medicina preventiva bajo el control operativo directo del cuartel general de la brigada. [13]
La única otra unidad subordinada importante que se reubicó durante 1968 fue el 9º Laboratorio Médico, que se trasladó de Saigón a Long Binh en noviembre. [13]
A finales de 1968 la 44ª Brigada Médica estaba integrada por 169 unidades, de las cuales 42 llegaron al país durante 1968. [13]
A continuación se presenta un resumen cronológico con información pertinente que describe la llegada de nuevas unidades durante el año 1968: [13]
Se desarrolló y publicó un programa de patrocinio para las unidades recién llegadas como reglamento de brigada. El objetivo del programa era garantizar que las unidades que llegaban se integraran al comando con el mínimo retraso y se les brindara el apoyo y la asistencia necesarios hasta que se volvieran operativas o autosuficientes. La unidad patrocinadora debía preparar un plan de apoyo para la unidad entrante que incluyera la llegada de su grupo de avanzada, el cuerpo principal y el equipo de la unidad. Debido al énfasis dado a la planificación avanzada detallada y al interés del comando, se logró una coordinación efectiva y las unidades que llegaban al país se integraron completamente a la brigada y a las operaciones en curso con un mínimo retraso. [13]
A principios de 1968, las actividades S-1 de la brigada se limitaban a las asignaciones de oficiales, premios y condecoraciones, supervisión del programa de seguridad y enlace de información pública con el Cuartel General de USARV. La principal agencia de acción de personal era la 222d Personnel Services Company ubicada en Long Binh Post, que a su vez colocó un equipo de servicio de personal en cada cuartel general de grupo médico. Cada equipo mantenía los registros de personal en el cuartel general del grupo médico. La autorización de asignación para los oficiales del Cuerpo Médico era retenida por USARV y realizada por consultores especializados ubicados en ese cuartel general. A principios de 1968, la Sección S-1 estaba compuesta por un oficial S-1 y tres jefes de rama: Rama de Personal de Oficiales, Rama de Premios y Control de Personal. Los informes de seguridad eran responsabilidad del Jefe de la Rama de Premios, mientras que el Jefe de Personal de Oficiales manejaba las actividades del Oficial de Información Pública (PIO). Todas las asignaciones y requisiciones de alistados eran realizadas por la 222d Personnel Services Company. [13]
Durante el año se realizaron numerosos cambios que dieron como resultado una revisión completa de las misiones y funciones, así como de la organización física de la Sección S-1. En marzo de 1968, la Sección S-1 se reorganizó para realizar las siete funciones básicas descritas en el FM 101-5, "Organización y operaciones del personal", como sigue: [13]
Para implementar plenamente las funciones descritas anteriormente, se organizó una rama de alistados, se instituyó un requisito de inventarios de MOS y se instituyó la gestión del personal alistado en áreas tales como distribución, promoción, monitoreo de la progresión de MOS e infusiones. Además, se estableció una rama PIO separada y se reclutaron especialistas en información para satisfacer los requisitos de información de la brigada. [13]
Los siguientes eventos notables afectaron significativamente las operaciones del S-1 en 1968: [13]
A principios de abril, el inspector general solicitó una revisión de los procedimientos de ascenso de los soldados rasos, lo que dio lugar a una revisión completa de los procedimientos de ascenso y del sistema de gestión interna de la brigada. [13]
Las principales actividades de la División de Recursos Humanos durante 1968 estuvieron relacionadas con una serie de recortes de personal instituidos por el Departamento del Ejército y los niveles de USARV. El primero de estos recortes, un plan de civilización llamado "Programa Seis", se inició en enero de 1968. Este plan exigía la pérdida de 317 plazas militares y su reemplazo por 476 civiles vietnamitas contratados y entrenados localmente. Se requirió un aplazamiento temporal durante el período de la Ofensiva del Tet, pero en mayo el programa se reanudó con una fecha de finalización programada para mayo de 1969. [13]
Para la selección de los puestos a convertir se utilizaron los siguientes criterios: [13]
En abril se puso en marcha el Programa de Fase I, que supuso la reducción de doscientos espacios, seguido en noviembre por la reducción de doscientos espacios adicionales en la Fase II. El resultado final en esta área fue la pérdida de 493 espacios en una reducción de MOS en noviembre. [13]
El 1 de enero de 1968, el mando contaba con 8.860 efectivos asignados. Al final del año, la dotación asignada era de 10.468 efectivos. [13]
Situación del personal al 31 de diciembre de 1968 [13]
Un área de especial énfasis durante 1968 fue la contratación de civiles vietnamitas. Al 31 de diciembre, 1.280 civiles estaban siendo utilizados en toda la brigada. Entre sus tareas se incluían trabajos como oficinistas, asistentes de ambulancia, policías de cocina, ayudantes de mecánicos, almacenistas, ayudantes de medicina preventiva y asistentes veterinarios. Para promover este programa, el 21 de octubre de 1968, el 68.º Grupo Médico estableció una clase de capacitación médica. Basada en el programa 91A del Centro de Capacitación Médica de Fort Sam Houston, esta serie de clases de ocho semanas seguidas de dos semanas de capacitación en el trabajo preparaba a los trabajadores vietnamitas para trabajos que anteriormente estaban exclusivamente ocupados por personal militar estadounidense relativamente poco calificado. La primera clase de treinta y tres estudiantes se graduó el 21 de diciembre de 1968 y sería seguida por un segundo grupo a principios de 1969. [13]
El 1 de octubre de 1968 se implementó un nuevo sistema para los oficiales del Cuerpo Médico. Anteriormente, todos los oficiales del Cuerpo Médico habían sido asignados directamente a las unidades de brigada por la oficina del cirujano de USARV. No se podían realizar transferencias dentro de los grupos médicos sin la aprobación tanto de la brigada como de la oficina del cirujano. Para corregir las deficiencias de esta situación, el comandante de la brigada, el general Neel, ordenó que todos los oficiales del Cuerpo Médico fueran asignados solo al nivel de grupo y que cada comandante de grupo determinara la unidad específica de asignación. La autoridad para reasignar oficiales entre grupos y para hacer asignaciones iniciales de grupo fue retenida por el Comandante General de la 44.ª Brigada Médica. Esta nueva política aumentó en gran medida la flexibilidad tanto del grupo como de la brigada al permitir la rápida reubicación de los oficiales del Cuerpo Médico para hacer frente a situaciones tácticas cambiantes. Bajo el sistema antiguo era posible que las transferencias se demoraran hasta siete días; sin embargo, bajo el nuevo sistema, la reubicación podía realizarse en 24 horas. La asignación de personal en otras ramas del Departamento Médico no se vio afectada por estos cambios. [13]
El 1 de diciembre de 1968, utilizando las capacidades informáticas de la 222.ª Compañía de Servicios de Personal, la División de Oficiales estableció un archivo de tarjetas para un mejor control de los oficiales del Cuerpo Médico. Se mantuvieron dos juegos de tarjetas en el archivo: un juego archivado para mostrar los recursos de cada unidad médica y el otro archivado según la MOS. Como resultado, el cuartel general de la brigada pudo presentar una imagen completa de los recursos del Cuerpo Médico tanto por unidad como por MOS. Este sistema mejoró enormemente la gestión de los recursos de los oficiales del Cuerpo Médico al permitir que el comandante de la brigada determinara inmediatamente el estado de cualquier MOS del Cuerpo Médico en la brigada y determinara las especialidades disponibles en cualquier hospital determinado. Los archivos se actualizaban constantemente manteniendo un flujo de entrada al sistema que mostraba los cambios en el deber, la MOS o la asignación. [13]
Los cambios más importantes en el personal alistado durante 1968 se relacionaron con las modificaciones en el sistema de ascensos alistados resultantes de los cambios 21 y 23 al AR 600-200 y el comienzo del sistema de ascensos centralizados E-8 y E-9. [13]
La llegada al país de once unidades de reserva durante 1968 creó un problema importante de infusión para la brigada. Sin embargo, la infusión estaba en camino de completarse a fines de año y la brigada en su conjunto estaba bien infundida. Si bien las unidades individuales pueden haber enfrentado problemas de infusión locales, la brigada contaba con los medios para la infusión general y se esperaba que la infusión completa de las unidades se completara según lo programado en 1969. [13]
La División de Moral y Bienestar se organizó el 15 de agosto de 1968 para establecer procedimientos y políticas en las áreas de fondos no asignados, seguridad, subvenciones y servicios especiales. [13]
Hasta la organización de una rama separada, las actividades relacionadas con los fondos no asignados se compartían como tareas adicionales entre los tres oficiales de la oficina S-1. Se encontraron muchos problemas en estas áreas, particularmente en los fondos no asignados. En agosto de 1968, la brigada tenía treinta fondos no autorizados para otros fines diversos, varios de los cuales se encontraban en serias condiciones financieras. Como primer paso para corregir esta situación, se distribuyeron cartas de instrucción de mando a todas las unidades instruyéndolas a presentar sus fondos para su revisión y autorización por parte del cuartel general de la brigada o a disolverlos inmediatamente de acuerdo con las directivas y regulaciones establecidas. El 28 de agosto de 1968 se aprobó el primer fondo para otros fines diversos de la brigada y para el 25 de noviembre, veinticinco fondos aprobados para otros fines diversos estaban en funcionamiento en instalaciones desde Phu Bi en el I Cuerpo hasta Can Tho en el área del IV Cuerpo. Los fondos no autorizados restantes fueron liquidados. [13]
El programa de seguridad de la brigada se sometió a importantes revisiones a partir del 4 de septiembre de 1968, cuando el mando hizo especial hincapié en la notificación rápida de accidentes para garantizar que se tomaran las medidas correctivas adecuadas para evitar que se repitieran. A través de la colaboración con USARV, se obtuvieron y distribuyeron muchos folletos y carteles de seguridad en toda la brigada como parte de un vigoroso programa de seguridad. En noviembre de 1968, se tomaron medidas de seguimiento durante las inspecciones del mando. Utilizando una lista de verificación de seguridad de la brigada, se prestó especial atención a la seguridad de los vehículos, el fuego, las armas y el agua. [13]
El programa de premios de brigada, que recibió la autoridad para otorgar premios hasta la Medalla Estrella de Bronce en agosto de 1967, alcanzó su punto máximo durante 1968. Mediante el uso de procedimientos de archivo y procesamiento simplificados, se procesaron un promedio de 200 premios por semana. Estos premios iban desde el Certificado de Logro de USARV hasta una Medalla de Honor recomendada para el Mayor Patrick Henry Brady . [13]
Condecoraciones otorgadas por mes [13]
La compañía de Servicios de Personal 222 brindó apoyo de personal a aproximadamente 165 unidades médicas independientes, procesando un promedio de 800 a 850 personas que entraban y salían de Vietnam cada mes durante 1968. El número total de registros mantenidos en un momento dado durante el año fue ligeramente inferior a 10.000. El cuartel general de la 222 en el puesto de Long Binh controlaba cuatro equipos separados ubicados en Long Binh, Nha Trang, Qui Nhon y Da Nang. Cada equipo brindó apoyo a un grupo médico más las unidades separadas que reportaban directamente al cuartel general de la brigada que estaban ubicadas dentro del área de responsabilidad del grupo médico. La sección AG, la sección administrativa y la rama de máquinas, que incluía una computadora Univac 1005, también estaban ubicadas en Long Binh. La fuerza de la unidad era la siguiente: [13]
El aumento de la fuerza estuvo determinado por la misión y la dispersión de la unidad para proporcionar apoyo descentralizado. [13]
The commander of the 222d served as Adjutant General for the 44th Medical Brigade. The 222d was commanded and staffed by Medical Service Corpe officers and an Adjutant General Corps (AGC) officer in contrast to other personnel service companies which were usually exclusively staffed by AGC officers. This system enabled young MSC personnel officers an opportunity to gain valuable experience in the personnel field.[13]
In early 1968 the lack of a brigade courier system resulted in a very slow, time-consuming distribution system. For example, distribution required from 20 to 25 days to travel from Da Nang to Long Binh. Additional time was required to return information to the sender. A courier system was instituted in August 1968 which expedited the exchange of information between medical units throughout Vietnam. The timeframe for exchange of information between Da Nang and Long Binh was reduced, in some cases, to three days. Related to this problem was the lack of effective and regular communication with the teams located throughout the country.[13]
The year 1968 can be divided into three distinct but somewhat overlapping phases. The first part of the year was concerned with a major relocation of medical units into the I Corps Tactical Zone (CTZ). This was followed and accompanied by a large-scale deployment of medical units into Vietnam. The third phase occurred during the latter part of the year when command and staff attention was directed to realignment and refinement of the field army medical service within the Republic of Vietnam.[13]
The first major operational event that occurred during 1968 was the redeployment of major US Army tactical units into I CTZ. This buildup consisted of approximately two divisions plus support troops. In order to provide medical support to these forces, brigade units were relocated into and within I CTZ as follows:[13]
The second phase involved the deployment of medical units from the continental United States (CONUS) into the Republic of Vietnam (RVN). In March, five medical units arriving in-country were assigned to the 67th Medical Group. These units were the 95th Evacuation Hospital and the 566th Medical Company (Ambulance) stationed at Da Nang, and the 27th Surgical Hospital, 520th Medical Company (Clearing), and the 238th Medical Detachment (KA) stationed at Chu Lai. By the end of April there were 20 brigade units employed in the I CTZ. To provide dental support for the increased number of troops in I CTZ, the 56th Medical Detachment was relocated from Camp Radcliff (near An Khe) to Phu Bai. During the period or this buildup, medical units subordinate to the 67th Medical Group supported Operation Pegasus in the relief of the siege of Khe Sanh and Operation Delaware in the A Shau Valley. Major army units supported were the 1st Cavalry Division (Airmobile), 101st Airborne Division, and the Americal Division.[13]
A second major operational event occurred during the year when major US tactical units were deployed to the Mekong Delta in IV CTZ. In order to provide medical support to the operations of the 9th Infantry Division in IV CTZ, a hospital unit arriving in-country was designated to be stationed in the Delta. This hospital, the 29th Evacuation Hospital, became operational at Can Tho during August 1968 and, together with the 3d Surgical Hospital, already located at Dong Tam, provided hospitalization in the Mekong Delta. The aeromedical capability in this area was doubled with the arrival of the 247th Medical Detachment (RA) at Dong Tam in December, joining the 82d Medical Detachment (RA), which had been stationed at Soc Trang since November 1964. At the end of 1968, the alignment of medical services provided efficient, responsive support to the operations of the U.S. Army and ARVN forces in the IV CTZ.[13]
In the third phase, measures were taken to refine and realign medical services within Vietnam. In order to ensure a more balanced alignment of evacuation and surgical hospitals in I and II CTZs, the following plan was implemented:[13]
The plan was implemented. During the first week of September the 2d Surgical Hospital was alerted for movement and directed to vacate and release facilities to the incoming reserve evacuation hospital. The 85th Evacuation Hospital was alerted to move to Phu Bai.[13]
Construction of the facilities for the 2d Surgical Hospital at Lai Khe did not proceed in accordance with the original schedule; because of this, the move of the 2d Surgical Hospital to Lai Khe was deferred and a provisional 100 bed hospital was formed at Phu Bai using the personnel resources of the 2d Surgical Hospital. In November 1968, the 85th Evacuation Hospital was moved to Phu Bai. During December the 2d Surgical Hospital moved to Lai Khe and the provisional hospital at Phu Bai was discontinued.[13]
This plan had the following effects:[13]
Other significant unit relocations which occurred during 1968 included:[13]
Two field hospitals (POW) arrived in RVN in October 1968. Both units, the 74th Field Hospital (POW) and the 311th Field Hospital (POW), were USAR hospitals that were called to active duty in May 1968. After a brief acclimatization period, each unit assumed the mission of providing complete medical and surgical care for a 250 bed Prisoner of War (POW) hospital.[13]
The 74th Field Hospital was located at Long Binh and assumed responsibility for medical treatment of prisoners of war in III and IV CTZs. The 311th Field Hospital was divided into two hospital units: the unit in Qui Nhon provided primary medical and surgical care while the unit located in the Phu Thanh Valley served as a convalescent center. These units would be consolidated upon completion of the new hospital facilities in the Phu Thanh Valley.[13]
Prior to the arrival of the field hospitals, the POW hospital mission was accomplished by two clearing companies (TOE 8-128G) The utilization of field hospitals, rather than clear-ng companies, to operate POW hospitalization facilities resulted in certain distinct and inherent advantages. The most obvious advantage was the increased number of beds operated by the field hospitals (250 beds) versus that of the clearing company (160 beds). Additionally, the organic professional capability of the field hospitals permitted these units to expand the POW mission in the areas of surgery, x-ray, pharmacy, and laboratory services. It was further recognized that the Army Nurse Corps officers assigned to the hospitals contributed greatly to the overall reduction in POW patient recovery time. This achievement was primarily due to their supervisory abilities as well as their individual nursing talents.[13]
In addition to publishing operations plans and orders implementing plans and orders of higher headquarters the 44th Medical Brigade published a plan to support contingencies which would require the brigade to rapidly deploy medical units in support of tactical operations. This plan provided for deployment of various types of units subordinate to the brigade.[13]
Implementing plans were published by each subordinate medical group and by the veterinary and dental command and control detachments. Specific units were designated to react within a short time frame to orders of the brigade headquarters. The result of this planning action was the establishment of a cross section of medical units capable of deploying within a minimum time.[13]
In October 1968, Headquarters, United States Army, Vietnam (USARV) directed the brigade to conduct a survey of medical resources on all major bases and tactical operating bases. Headquarters, Military Assistance Command, Vietnam (MACV) authorized the brigade to survey U.S. Army medical facilities throughout Vietnam and those U.S. Air Force and U.S. Navy medical facilities located on installations designated to be surveyed. The main purpose of the survey was to ensure that each geographic area in which USARV troops were stationed was provided adequate medical coverage without an overlap or duplication of medical resources. An additional objective was to obtain a clearer visualization of the manner in which the medical service functioned at each of the major logistical bases.[13]
The following 19 bases were selected by the brigade headquarters to be surveyed by medical groups responsible for medical care in their areas:[13]
The groups were not allowed to delegate responsibility for the conduct of the surveys to subordinate units. A detailed format was developed for the groups to utilize in documenting the results of each survey. This format, along with the requirement that the group headquarters conduct the surveys insured both comprehensiveness and standardization. Every aspect of medical support at a given base was required to be surveyed, to include preventive medicine, evacuation, hospitalization, laboratory service, dental service, veterinary service and dispensary service. At the end of 1968, the first two surveys had been completed and forwarded to Headquarters, USARV.[13]
During 1968, the mission of the Medical Regulating Office continued to be the control of patient evacuation within and out of the Republic of Vietnam. Accumulation of daily medical statistics for medical regulating purposes remained a function of the office. The Medical Record Statistics Division, USARV Surgeon's Office continued to function as the primary agency for medical records and reports.[13]
The importance of having a responsive medical regulating system was dramatically demonstrated during both the Tet Offensive and the May Offensive.[13]
During February and May, close coordination with the U.S. Air Force aeromedical evacuation team was necessary to preclude overloads at the casualty staging flights and to arrange additional special flights, which in some cases originated at alternate air fields not normally used for out-of-country evacuations. The support and cooperation of the U.S. Air Force played an extremely important role in the successful operation of the 44th Medical Brigade's medical regulating system.[13]
In early 1968, there were few scheduled in-country and out-of-country flights available which limited evacuation and created the need for nonscheduled special flights. Shortly after the Tet Offensive, the number of scheduled in-country flights by the 903d Aeromedical Evacuation Squadron was increased to seven. These flights included stops at every major airfield in Vietnam and thereby provided fixed-wing evacuation capability to every major brigade hospital. Out-of-country evacuation flights operated by the Military Airlift Command originated from casualty staging facilities located at Da Nang, Cam Ranh Bay and Tan Son Nhut and provided evacuation to Japan, Clark Air Force Base in the Philippines, Guam, Okinawa and Hawaii. With the increase in scheduled flights adequate coverage became available throughout Vietnam and allowed almost continuous medical evacuation.[13]
During the May Offensive, a total of 3,948 patients, 3,789 of which were U.S. Army personnel, were medically evacuated out-of-country to PACOM hospitals. These figures were the highest in the brigade's history.[13]
Hospitalization Statistics for 1968[13]
Hospitalization Statistics—Tet Offensive[13]
0001 Hours, 29 January 1968 — 2400 Hours, 3 February 1968
Total Direct Admissions = 3261
Total Injured as a Result of Hostile Action (IRHA) = 2171
Total Dispositions = 2342
31 Jan 1968- Hospitals experienced heaviest admission workload as outlined below:[13]
Total Direct Admissions = 707
Total IRHA = 541
Prisoner of War Patients as of 2400 hours, 28 January 1968 = 258
Prisoner of War Patients as of 2400 hours, 3 February 1968 = 386
Increase = 128[13]
Civilian War Casualty Program Patients as of 2400 hours, 28 January 1968 = 129
Civilian War Casualty Program Patients as of 2400 hours, 3 February 1968 = 505
Increase = 376[13]
44th Medical Brigade Daily Medical Statistics—Tet Offensive[13]
0001 Hours, 29 January 1968 — 2400 Hours, 3 February 1968
The brigade staff found it interesting to note the difference in the Tet and the May Offensives. During Tet, the enemy penetrated many cities and towns throughout South Vietnam. This action resulted in heavy civilian war casualties in addition to military casualties. Throughout the May Offensive, however, the enemy was unable to penetrate the cities to any great extent. As a result, the ratio of military casualties to civilian casualties was higher and resulted in a greater number of out-of-country evacuations.[13]
At the request of the brigade headquarters, the 7th Air Force Surgeon's Office inactivated the 25th Casualty Staging Flight (CSF) at Qui Nhon on 11 July 1968. This CSF had been utilized as a staging area for out-of-country evacuation of patients from the 67th Evacuation Hospital. Evacuation out-of-country from Qui Nhon was disadvantageous because all flights terminated at Clark Air Force Base. where it was necessary for patients regulated to Japan to remain overnight. As a result, patients lost at least one additional day prior to being further evacuated. After the 25th CSF was inactivated, all US military patients from the Qui Nhon area were evacuated to the 26th CSF at Cam Ranh Bay for further evacuation directly to Japan utilizing regularly scheduled Military Airlift Command flights. Korean patients were also evacuated to the 26th CSF for movement to Clark Air Force Base, and further evacuation to Korea. The primary advantages were the elimination of delays en route to destination hospitals and consolidation of out-of-country evacuations at casualty staging facilities serviced on a regular basis by Military Airlift Command flights.[13]
During 1968, the average daily beds occupied by MEDCAP patients throughout the brigade's medical treatment facilities rose from 61 per day in January to 285 per day in December. The brigade observed that as military activities decreased, the number of MEDCAP admissions increased. Civilian War Casualties accounted for approximately 27% of the total patients in brigade facilities. This figure remained fairly stable since April 1968. Following the May Offensive, the number of POWs hospitalized throughout the brigade remained constant at about 400 beds per day.[13]
Aviation activities at the beginning of 1968 were similar to those of 1967. Workload continued to increase slightly with a new high of 12,520 evacuated in January. The Tet Offensive in February substantially increased the workload to 16,885 and the all-time high of 21,915 patients were evacuated by brigade aircraft during the month of May. Workload throughout the remainder of the year was fairly level in the range of 14,000 to 15,000 patients evacuated monthly with the exception of August and September when evacuation rose to nearly 17,000 in each month.[13]
Air ambulance resources available to support the increased workload were two medical companies (air ambulance) located at Long Binh and Qui Nhon, and 8 medical detachments (RA) located at Gia Le, Phu Bi and Chu Lai in the I CTZ, Pleiku and Nha Trang in the II CTZ, Long Binh and Cu Chi in the III CTZ, and Soc Trang in the IV CTZ. With these units, the 44th Medical Brigade was authorized 98 aircraft which provided minimally adequate evacuation support to the theater. On numerous occasions this capability was severely strained and frequently on short notice aircraft and crews were moved from one tactical zone to another to support areas of increased activities. This was especially true in the I CTZ where, because of limited air ambulance coverage, the assets of II CTZ North were repeatedly called upon to provide additional aircraft and crews.[13]
Aircraft maintenance throughout 1968 was generally satisfactory. Minimum acceptable availability was established at 70% and this availability rate was maintained with several exceptions. During February when the number of aircraft damaged by hostile fire doubled, availability rates dropped to 63%, and at times to below 50%. Although the same number of aircraft were damaged by hostile fire during the May Offensive, aircraft availability was maintained at 74%. This high availability was attributed to increased field maintenance responsiveness and the use of float aircraft issued to the air ambulance units by the supporting maintenance activities. The problem of limited resources and large geographic areas to support required field siting of aircraft to support a conflict characterized by small unit engagements at scattered locations. Often as many as 26 aircraft were field sited at 20 locations. Although the field siting of aircraft at sites remote from maintenance facilities created problems, it provided a responsiveness to tactical units that could not be assured by conventional area support.[13]
On 1 July 1968, the 101st Airborne Division was redesignated as an airmobile division. The 50th Medical Detachment (RA), located at Gia Le was assigned to the division and became the nucleus of the air ambulance platoon of the 326th Medical Battalion. The loss of the 50th Medical Detachment (RA) had no adverse effects on the brigade aeromedical evacuation capability because the unit had previously directed the bulk of its resources in support of the 101st Airborne Division.[13]
The arrival in-country of four additional medical detachments (RA) in November and December significantly increased the brigade capability. The addition of these units resulted in the following benefits:[13]
The new units were distributed as follows:[13]
The requirement for a full-time aviation staff officer had long been recognized and the position was requested in an MTOE change submitted in February 1968. Approval was granted by USARPAC General Order Number 812, dated 9 December 1968. In addition to the aviation staff officer, a program was instituted to select and assign a company grade aviator to the brigade as the assistant aviation staff officer for a period of 90 days. The program ensured coverage in the aviation section during the absence of the aviation staff officer and allowed company grade officers an opportunity to gain valuable staff experience. Selection of officers alternated between the various air ambulance units in the brigade.[13]
In May 1968 the brigade was assigned a U-1A Otter fixed wing aircraft. After pilots were trained in May, the Otter became operational in June and proved to be a valuable addition to the brigade's aviation capability. It was used generally for the long-range transportation of medical personnel and critical supplies and equipment. Availability was excellent and utilization high. The Otter averaged 65 hours a month, with its high month being June when 96 hours were logged. At the end of 1968, the brigade was giving serious consideration to including a requirement for a fixed wing aircraft in the next brigade MTOE change submission.[13]
Aeromedical Evacuation Statistics 1968[13]
The success of the 44th Medical Brigade's mission accomplishment during 1968 was directly related to its communications facilities.[13]
The two primary nets within the brigade were the single side band (SSB) and the Dustoff (medical evacuation) radio nets. A discussion of the systems follows:[13]
1. During 1968 the Department of the Army approved a brigade request for thirty-eight AN/FRC-93 Collins SSB radios. Thirty of these radios were received and utilized in a brigade net and four internal medical group nets. The SSB nets were used primarily in the regulating of patients within the brigade and the exchange of command message traffic. The SSB brigade net allowed the brigade commander to communicate readily with even his most distant units.[13]
2. Dustoff radio nets utilized both FM and UHF radios. The primary FM net was composed of VRC-46s at the local Dustoff control stations and ARC-54s in the aircraft. The primary FM net was used to receive and relay Dustoff missions and for command and control of the aircraft. The UHF net was composed of VRC-24s at the local Dustoff control station and VRC 15s in the aircraft. The UHF net served as the back-up system for the primary FM net. The alternate FM net was utilized to relay information on the type of casualties aboard to the medical groups which in turn directed the aircraft to the appropriate destination hospital.[13]
Throughout 1968, the S-2 officer supervised the 44th Medical Brigade personnel security and intelligence program, directed the brigade historical program and was responsible for the preparation of activities and operations reports.[13]
In mid-1968, efforts were undertaken to establish a working relationship between the 521st Medical Detachment (QA), a medical intelligence unit under the Combined Materiel Exploitation Center at MACV and the 44th Medical Brigade. In late December, brigade headquarters hosted a conference which brought together members of the medical intelligence unit, commanders of the brigade prisoner of war hospitals in the 74th Field Hospital on Long Binh Post and the 311th Field Hospital in the Phu Thanh Valley, and brigade headquarters personnel. The result was the establishment of procedures to implement an open-ended study of medical records of VC/NVA prisoners of war who received treatment in U.S. Army medical facilities. Under the study, the prisoner of war hospitals would forward select medical information to the 521st Medical Detachment which in turn would use the data in compiling a study of non-effectiveness among VC/NVA troops.[13]
Throughout 1968, the mission of the brigade S-4 remained essentially unchanged, as follows: To advise and act for the brigade commander, as directed, in all aspects of medical and general supply, maintenance of equipment, transportation and services as pertains to the effective operation of all units assigned or attached to the brigade; to advise, assist and act for the brigade commander, as directed, in all aspects of construction and maintenance of medical facilities occupied or required for all units assigned to the brigade, and to serve as brigade claims officer.[13]
On 5 July 1968, the Staff Dietitian's activities were established as a staff section separate from the S-4. The organization of the S-4 Section again changed on 2 December to include a Brigade MUST Officer for "the purpose of coordinating all matters pertaining to MUST equipped hospitals.[13]
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The medical supply officer position within the brigade S-4 section was re-established during the March 1968[13]
The medical supply section continued to implement and refine programs that had been initiated during 1967. In addition, several new programs were developed. Among these were the following:[13]
General supply and maintenance support of brigade units was satisfactory throughout the year. Although there were no items or logistic services in chronic short supply, there were shortages of some items at any given time. Stationery and printing supplies, spark plugs and non-medical repair parts for medical equipment were often unavailable. Command assistance in dealing with support units and redistribution of brigade assets generally resolved problems caused by shortages.[13]
During the year the Commanding General, 1st Logistical Command established a program to assist other commanders with critical problems related to support provided by his command. This commander-to-commander program produced excellent results.[13]
Some units with personnel billeted in hotel-type quarters in metropolitan areas experienced a serious shortage of rations and fuel during the Tet Offensive in January. Accordingly, such units subsequently positioned a portion of their basic load of these supplies in their billeting areas.[13]
A vigorous command maintenance program was inaugurated in August 1968. The main thrust of this effort turned on command emphasis and traini.ng. The CMMI team was employed as an instructional activity. During inspections and special maintenance liaison visits, the team instructed commanders and maintenance personnel. The CMMI team completed its initial round of inspections in October. Second round inspections revealed substantial improvement in maintenance throughout the brigade.[13]
One of the principal problems in unit maintenance programs was a lack of knowledge among officers as to the meaning of command responsibility for maintenance. It was a common misunderstanding that the maintenance officer, not the line supervisor, was responsible for supervision of operator maintenance. Command emphasis was directed at correcting that view.[13]
During 1968 an extensive construction program was implemented that was designed to satisfy the current requirements as well as formulate a plan of action for future needs. While it was realized that there was a certain amount of rigidity inherent in any program that was developed on an annual basis, the program was a conscious effort by brigade to be responsive to immediate needs.[13]
Some of the major projects completed in 1968 were:[13]
The projected number of medical facilities scheduled for construction in 1969 exceeded that of any previous year in Vietnam. The projects vary from the construction of completely new hospitals to the renovation and up grading of existing facilities. Outlined below are some of the major projects planned for 1969:[13]
the permanent facilities to replace MUST equipment were in various phases of completion
Programs for construction in 1970 were being formulated at the end of 1968. It appeared that the major emphasis would be on upgrading and renovation rather than construction of new facilities. The basic and fundamental construction requirements relating to patient care were being met and continued to receive the highest priority of all construction projects.[13]
The mission of the staff dietitian remained unchanged throughout 1968 as "to be responsible for the food service program within the medical brigade; to supervise and to provide staff direction to food services and food service personnel for all elements of the brigade; provide supervision and guidance for food service programs to all elements of the brigade.[13]
Authorization for a dietitian (MOS 3420) in the Office of the Surgeon, USARV became effective 5 August 1968. The dietitian was assigned to the Professional Services Division as the USARV dietetic consultant with the additional duty of staff dietitian, 44th Medical Brigade.[13]
Although only two dietitians were authorized in the 44th Medical Brigade, there were five dietitians assigned during 1968. The dietitians were assigned as staff dietitians in each of the four medical groups. This number of dietitians equalized the workload in the supervision of food service activities in 32 medical units in the 44th Medical Brigade. Due to the large number of medical units in the 68th Medical Group, two dietitians were assigned to supervise food service activities in that medical group.[13]
During the first quarter of 1968, a severe shortage of food service advisors or technicians existed in medical units. Only 6 of the 14 warrant officers authorized were assigned. At the end of 1968 the authorized strength of 18 warrant officers (MOS 941A) was realized. Since the warrant officers lacked experience in hospital food service, it was necessary to institute an orientation and training program for those officers. Initial orientation was conducted by the brigade dietitian upon the arrival of each food service advisor or technician in-country C, Further training was continued by the medical group staff dietitian upon assignment to a hospital. As for the end of this reporting period, the authorized number of 55 hospital mess stewards (MOS 94F40) were assigned to medical treatment facilities in Vietnam.[13]
During 1968, the brigade staff dietitian reviewed, analyzed and evaluated space design and layouts for upgrading present medical food service facilities and planning new mess facilities for future medical units. Recommendations were made to the construction engineers. Dietitians were also tasked with the project of locating cantonment (now called garrison) mess equipment in the various depots and processing correspondence to secure the items to be installed in field ration messes in hospitals.[13]
On liaison visits to hospitals the staff dietitian observed that the majority of the incoming enlisted personnel assigned to hospital messes lacked experience in food preparation and service and were unfamiliar with hospital feeding. Also, supervisory personnel lacked experience and knowledge in hospital food service and were therefore unable to give the proper guidance and super11ision in the operation of patient feeding. The TO&E change authorizing hospital food service personnel and the arrival in-country of these personnel resulted in an improvement in modified diet preparation and ward food service to patients.[13]
The staff dietitian made1 37 staff visits to medical treatment facilities. Emphasis was placed on mess hall sanitation, space design and layout, procurement of garrison mess equipment training of cooks in preparation and service with particular emphasis on patient feeding on the ward, training or local Vietnamese national (LVN) personnel, mess management and administration standard hospital diets, procurement of supplemental foods and beverages for patient feeding, and organization of mess operation in the utilization of MOS 94F40 personnel.[13]
Five visits were made to mess facilities of the Free World Military Armed Forces to lend assistance with the garrison mess equipment program. Hospitals visited included the Republic of Korea Army hospitals in Vung Tau and Qui Nhon and the Australian hospital in Vung Tau. Permission was given by the medical group commanders, in the areas in which these hospitals were located, to permit the staff dietitians of the groups to give assistance to the hospital personnel on their regular consult visits in the area.[13]
Plans for the renovation of the 6th Convalescent Center mess hall were completed and approved. The construction was scheduled to be completed in the first quarter of 1969. The equipment was replaced with garrison mess equipment.[13]
The installation of equipment in the mess hall constructed at the 93d Evacuation Hospital in 1967 was completed in May 1968.[13]
Space design and layout for the renovation and enlargement of the mess hall of the Jd Field Hospital in Saigon was, in the planning stage at the end of 1968.[13]
During 1968, TO&E equipment was replaced with garrison mess equipment in all medical units within the 44th Medical Brigade except for those field ration messes in the I Corps Tactical Zone.[13]
Most equipment for the medical units in the I Corps Tactical Zone was located in the Saigon, Cam Ranh and Qui Nhon Support Commands and with the assistance of the personnel at the 32d Medical Depot, the equipment was in the process of being shipped to Chu Lai and Da Nang at the end of 1968.[13]
Two renovation or upgrading projects were accomplished for the field ration mess at the 29th Evacuation Hospital in Can Tho. Due to non-availability of garrison mess equipment in the Da Nang Support Command, the upgrading of the mess hall at the 27th Surgical Hospital in Chu Lai and the 95th Evacuation Hospital in Da Nang was not completed during 1968.[13]
Design and layout plans were completed for the mess hall of the 311th Field Hospital (POW) in Phu Thanh and construction began in September 1968.[13]
Standard Hospital Diets: 44th Medical Brigade Pamphlet 30-1 was published on 8 September 1968. This pamphlet included the type and general description and approximate dietary analysis of diets available.[13]
28 Day Master Hospital Menu: 44th Medical Brigade Pamphlet 30-2 contains the regular hospital diet based on the Department of the Army Supply Bulletin SB10-261 and the 14 modified diets most frequently ordered by medical and dental corps officers in hospitals throughout the command.[13]
The USARV medical treatment facilities subsisted on the field ration menu as established for all troops in RVN. Supplemental foods and beverages were ma.de available for issue through Class I facilities for patients on modified diets according to 44th Medical Brigade Pamphlet 30-2. Combat troops and hospital patients had priority for issue of fresh food items. The support and management of the entire subsistence program by 1st Logistical Command was commendable throughout 1968.[13]
The 28 Day Master Menu, SB10-261, dated 6 May 1968, was made available to field ration messes in II, III, and IV CTZ, to include hospitals, on 8 September 1968. Problems existed in subsistence supply to hospitals in I Corps Tactical Zone due to support by the U.S. Navy. A master menu was not available to hospitals serviced by the Navy which resulted in daily planning of menus after the food arrived in the units. In addition, most fresh fruits and vegetables were not made available to U.S. Army Units through the U.S. Navy during the first five months of the year. Since that time, the 1st Logistical Command solved this problem by shipping fresh fruits and vegetables from Dalat to units in I CTZ.[13]
Carbonated beverages were made available to post-operative patients through the local Post Exchange facilities which in turn billed U.S. Army Procurement Agency, Vietnam.[13]
A recommendation by the International Red Cross to purchase Nuoc Mam (fish sauce) £or POW patients in Vietnam was extended to Vietnamese patients in all hospitals. Local purchase of the sauce for each hospital was approved and was in the process of being procured at the end of 1968.[13]
During the year units of the Medical Brigade served a total of approximately 4,000,000 rations. Of these 1,700,000 were patient rations. Modified diets comprised approximately 9% of patients' rations.[13]
The starring guide utilized by Headquarters, USARV for the hiring of local Vietnamese National (LVN) personnel as mess attendants in the field ration messes in RVN presented a hardship to hospitals. The formula, allowing one LVN for the first 40 persons served and one employee for each 40 thereafter, was applied theater wide to messes without regard to the vastly different functions of hospital feeding. Several of the evacuation and field hospital messes were serving 650 - 700 rations per day including up to 200 bed patients with a total or 38 - 40 authorized military and civilian personnel. Other than the use of compartmented trays in lieu of China, the type of service, the menus ("A" rations) and the food service equipment were not markedly different from that found at the CONUS hospitals which would be staffed at least 100% higher. Recommendations, justification and job descriptions to obtain an increased authorization for local national employees for food service to patients of the wards were submitted and action was pending at the end of the reporting period.[13]
Transporting and service of food to the ward bed patients continued to be a problem for food service personnel in RVN. Bulk food carts presently in the medical supply system were a satisfactory food transporting system only for those hospitals having covered ramps and cement walkways to wards. In the MUST units, the bulk food cart could not be rolled into wards due to the two high sills located at the entrance ways. Additionally, these hospitals were usually placed on terrain where hard surface walkways were unavailable which also eliminated the use of mobile food carts. Since the introduction of the "A Ration" into the supply system in Vietnam on 8 September 1968, a new problem was experienced due to the lack of sufficient space on the bulk food cart for hot and cold food for bed patients.[13]
The mission of the brigade chief nurse was to advise the brigade commander on all aspects of the nursing service program within the command; coordinate overall nursing service activities; supervise and provide staff direction in professional matters pertinent to nursing service to all elements within the command.[13]
A total of 51 staff visits were made during the first quarter of 1968, 103 during 2d quarter, 46 during 3d quarter and 70 during 4th quarter. Emphasis was made on staffing needs, career guidance and standards of patient care.[13]
During the 3d quarter of 1968, a Chief Nurses Conference was held in each medical group with chief nurses of Navy, Air Force, Australian and Korean Hospitals in Vietnam as guests.[13]
Beginning the 3d quarter of 1968, monthly meetings of the chief nurses in the I CTZ were conducted with U.S. Army, Air Force and Navy chief nurses attending. The meetings were held at various installations and mutual problems were discussed. One result was the exchange or Navy Nurse Corps and Air Force Nurse Corps officers for a 2-week period between a surgical hospital and a Navy hospital ship.[13]
During the 4th quarter, a Nursing Conference was conducted in Saigon on 20 October and again on 17 December 19&80. Nursing consultants assigned to the MACV Surgeon's Office the Chief Nurse of the Ministry of Health — Government of Vietnam, Nursing Consultant with the nursing Branch of the U.S. Agency for International Development, the Chief Nurse of the Republic of Korea Forces in Vietnam, the Chief Nurse of the Air Force Casualty Staging Facility and the Chief Nurse USARV/44th Medical Brigade attended. Monthly meetings are planned in an effort to coordinate the programs of all agencies toward improving the profession of nursing in Vietnam.[13]
A total of seven units arrived in-country during 1968. Three of the units were reserve units and a total of ten nurses arrived with their respective units. The professional complement of all units was made up or active-duty fillers. A small cadre was kept for each unit, with the majority of officers being reassigned to other units in-country. The assignment of officers who had already adjusted to the situation in Vietnam made it possible for the new units to carry out their mission more rapidly and effectively.[13]
MTOE authorizations were received for the 8th Field Hospital and the 6th Convalescent Center. These authorizations combined the 8th, 9th and 523d Hospital Units and authorized a chief nurse for this facility. The 6th Convalescent Center had been operating with 12 ANC officers but did not have any authorizations.[13]
The living quarters for Army Nurse Corps officers throughout the command varied from tents to tropical buildings, to villas and trailers. Major difficulties were experienced by various units in obtaining items of furniture, such as chests of drawers, mirrors, washing machines, dryers, etc.; however, progress was made in resolving these shortages.[13]
The requirements for nurse anesthetists increased because of the change in type of patients admitted to the medical facilities in Vietnam and because of the additional medical units. The shortages of nurse anesthetists throughout the uniformed services was cause for concern and special effort was being made to analyze retention and training factors.[13]
Throughout 1969, the mission of the 44th Medical Brigade was to provide medical service support to United States Army personnel, Free World Military Assistance Forces personnel, and other categories of personnel as directed, and to provide hospitalization, medical and surgical care to Vietnamese civilians injured as a result of hostile action.[14]
The 29 specified functions of the brigade remained unchanged from 1967 and 1968.[14]
The year 1969 was a period of reorganization, consolidation, and realignment for 44th Medical Brigade units. A major consolidation of medical groups occurred on 15 June 1969 when the 55th Medical Group was reduced to zero strength and equipment status. The 43d Medical Group assumed command and control of all 55th Medical Group units. At the end of 1969, the majority of 44th Medical Brigade units were deployed by geographical area under the control of three medical groups: The 67th Medical Group in I Corps Tactical Zone (CTZ) with headquarters at Da Nang, the 43d Medical Group in II CTZ with headquarters at Nha Trang, and the 68th Medical Group responsible for medical care in III and IV CTZs with headquarters at Long Binh.[14]
During 1969 the 20th Preventive Medicine Unit and the 172d Preventive Medicine Unit were removed from the direct control of the brigade headquarters and reassigned along with their subordinate units to medical groups.[14]
On 1 January 1969, the S-1 section consisted of an S-1 and five commissioned branch chiefs: officer personnel, enlisted personnel, manpower control, morale and welfare, and the Information Office. Ten enlisted personnel were also assigned.[14]
With the arrival of an Adjutant General Corps (AG) Reenlistment Officer on 31 January, the Reenlistment Branch was established. The branch consisted of the reenlistment officer; two career counselors were assigned to, and worked from, the 222d Personnel Service Company.[14]
In April 1969, an assistant S-1 was appointed from within the section. The assistant S-1 also serves as the Chief, Manpower Control Branch.[14]
In April 1969, Headquarters and Headquarters Detachment of the brigade and the 658th Medical Detachment (Augmentation) (both commanded by the same officer) were placed under the supervision of the S-1. They had previously been responsible directly to the brigade executive officer.[14]
By June 1969, it became evident that the duties and responsibilities of the enlisted personnel branch were duplicating and overlapping those of the 222d Personnel Services Company. The enlisted personnel branch was discontinued.[14]
Weekly liaison trips to subordinate units continued throughout the year by the S-1 and his staff on a regularly scheduled basis. These visits proved to be most effective, especially during the second half of the year, as eleven units were redeployed and ten others were inactivated in 1969.[14]
At the beginning of the year the S-1 was also the acting inspector general for the brigade; however, in April 1969 the S-1 was relieved of this responsibility based on the recommendation of both the USARV Inspector General and the departing S-1.[14]
The brigade became involved in the troop withdrawal in July. Personnel and administrative functions involved in the redeployment or inactivation of units of the brigade were the responsibility of this section and were closely monitored by the S-1.[14]
Included in the first withdrawal beginning in July and continuing into August were all National Guard and U.S. Army Reserve medical units which had been activated in 1968. These included the 312th Evacuation Hospital, the 74th and 311th Field Hospitals, and eight smaller units, such as medical detachments and a dental KJ team. One of the many administrative requirements involved in the redeployment of these particular units was that of the return of all National Guard and U.S. Army Reserve personnel to the redeploying unit:[14]
The strength of the brigade, both military and civilian, continued to rise during the first six months of 1969, but in July, with the beginning of redeployment, coupled with a hiring freeze on local national personnel imposed in May, a downward trend began.[14]
The strength of the command as of 1 January 1969 was 10,468 assigned personnel. The strength of the command as of 31 December 1969 was 9,901.[14]
A personnel status of particular importance during the year was the initiation of projected requisitioning authorities.[14]
Personnel status, 1969[14]
Program 6 continued until a peak authorization of 465 spaces was reached on 30 June 1969. This program was a civilianization plan where military spaces were replaced by local national civilians on the basis of 1.5 civilian to 1 military. In general, this program had not been effective; the reduction of 317 military spaces which was imposed by Headquarters USARV required replacement by MOS and job description, and the availability of adequately trained local nationals was insufficient to meet these requirements. The actual assigned strength versus authorized strength under this program varied from 50 to 70 percent during the year.[14]
The responsibility for conducting medical training classes for local national personnel was transferred to the Civilian Training Institute at Long Binh. Classes were graduated in March and May 1969; the hiring freeze precluded further classes.[14]
In the spring of 1969, a shortage of company grade Medical Service Corps officers in MOS 3506 (Field Medical Assistant) developed. No officers in this MOS arrived during the months of March, April, and May. Due to redeployment and inactivation of units, the brigade gained sufficient MSC officers assigned and was able to in some cases, cancel requisitions, especially for field grade officers.[14]
A shortage of Army Nurse Corps (ANC) officers continued throughout the year. In March 1969, the brigade commanding general granted the group commanders authority to assign and reassign ANC officers within their respective groups, requiring only coordination with the office of the chief nurse.[14]
Group commanders retained the authority for assignment of Medical Corps (MC) officers, but in October, because of a developing shortage, the Medical, Surgical and neuropsychiatric consultants were granted authority to assign in oncoming MC officers (except MOS 3100—General Medical Officer) directly to hospitals and to monitor and control all reassignments of MC officers. A severe shortage existed throughout the year in MOS 3131 (Neurosurgeon).[14]
In March 1969, the information office began publication of a unit newspaper, "The 44th Brigadier." The paper was printed by the 222d Personnel Services Company. It was in multilith format, and is length varied from 10 to 14 pages. The primary purpose of this newspaper was to provide a means of exchanging information about brigade units located throughout RVN, from the DMZ to the delta. It also included the important function of providing command information.[14]
Also published by the information office during the year were two handbooks, "Guide for Information Officers" and "Guide to the Army Hometown News Release Program. The purpose of these publications was to provide necessary guidance to individuals who performed the information function as an additional duty within their particular units, but who have little background training in the information field.[14]
During the last two months of 1969, the information office began more extensive work in the area of television news coverage. One Command Information show was made by AFVN concerning the CHAMPUS program. Others were planned in the areas of mental hygiene consultation service, rabies, and accident prevention.[14]
On December 24, 1969, representatives from United Press International made a film of a Christmas party held at an orphanage in Tan Heip, Vietnam. This party was sponsored by the staff of the 93d Evacuation Hospital. The film was to be shown nationwide in the United States.[14]
During 1969, the morale and welfare branch continued to supervise and administer the following brigade programs:[14]
The awards program underwent considerable revision during 1969. In 1968 the average time elapsed from the date of receipt of a recommendation for a meritorious service award to the date the award element were forwarded to the individual concerned had been five to six weeks. By streamlining all phases of awards processing this time has been reduced to an average of ten to fourteen days, without sacrificing a high degree of evaluation and without additional personnel. Only those awards which had to be forwarded to Headquarters, USARV for approval required longer than two weeks for processing.[14]
During 1969, ten Meritorious Unit Commendations were awarded to brigade units. Twenty-one Meritorious Unit Commendation recommendations were submitted during the year and were still pending at the end of the year.[14]
Decorations awarded by month[14]
The 222d Personnel Services Company provided support to, approximately 150 separate medical units and processed an average of 700-750 individuals into and out of Vietnam each month during 1969. The total number of records maintained during the year averaged approximately 9,000. The 222d Personnel Services Company Headquarters at Long Binh Post controlled four separate personnel service teams which, until May 1969 were located at Long Binh, Nha Trang, Qui Nhon, and Da Nang. On 31 May 1969, the team at Qui Nhon was inactivated and the records maintained by this team were added to the team at Nha Trang. On 1 July 1969 an additional team was created and stationed at Cam Ranh Bay to support the 32d Medical Depot, and the 39th, 518th, 437th and the 176th Medical Detachments. Team A supported the 68th Medical Group and all non-group units in the III and IV Corps Tactical Zones, Team B supported the 43d Medical Group and the 934th Medical Detachment (KJ). Team C supported the 67th Medical Group and all non-group units in I Corps Tac tical Zone. The Adjutant General Office, Administrative Section, Data Processing Branch, and the Headquarters unit are stationed at Long Binh Post.[14]
Unit strength on 31 December 1969 was:[14]
The commander of the 222d Personnel Services Company served as adjutant general of the 44th Medical Brigade. The 222d Personnel Services Company was commanded and staffed by Medical Service Corps officers and Adjutant General Corps (AG) officers. This was in contrast to other personnel services companies which were staffed solely by AG officers. It was felt that this staffing provided the commanders of all supported units with staff personnel officers who better understood the medical mission and who were more capable of responding more efficiently and expeditiously to the needs of the command.[14]
During July 1969, the 222d Personnel Services Company assumed responsibility for preparation of morning reports of all units of the 44th Medical Brigade. This enabled the company to provide the commanders more reliable data and more accurate reports and records. Renewed emphasis on the accuracy of information obtained through the PERMACAP system and the use of the personnel information roster as an output of the 1002 computer were key points in improving the overall operations. As a result, the efforts of the 222d Personnel Services Company effected an error rate which was lower than any other major subordinate command of USARV util1zing the PERMACAP system. In June 1969, a brigade courier run, provided by the 222d Personnel Services Company, was expanded to include Nha Trang and Cam Ranh Bay. Through this system, the Commander and staff of the 44th Medical Brigade were capable of communicating with subordinate commanders within a matter of hours, with a more expeditious processing and distribution of all special orders. In November 1969, the 222d Personnel Services Company initiated a program of meeting all incoming Army Medical Department (AMEDD) officers at the 90th Replacement Battalion. This program involved reception of the officers by an enlisted representative of the 222d Personnel Services Company and escorting the officers to the USARV Surgeon's Office for interview and during their processing at the 90th Replacement Battalion. This procedure enabled most AMEDD officers to be on station at their unit of assignment within 24 hours after arrival at the 90th Replacement Battalion.[14]
The mission of the brigade S-3 section remained essentially unchanged throughout 1969. The four-part mission as stated in Medical Brigade Memo 10-1, dated 9 June 1969 was as follows:[14]
The S-3 section was divided into five major sub-sections: Plans, Operations, S-2, Medical Regulating, and. Aviation. 'The communications element, formerly the responsibility of the Aviation subsection, was transferred to Operations and is supervised by the Assistant Operations Officer who also served as the Brigade Communications Officer.[14]
The year 1969 could rightly be divided into four distinct periods. The first half of the year was a period of relative stability, some scaling down of medical activities but then an upswing in May as the result of the enemy's summer offensive. The second period of the year began with the first major troop reduction as the result of President Nixon's announcement. This exercise was designated Operation Keystone Eagle and the following 44th Medical Brigade units were redeployed to the Continental United States:[14]
The third period began with Operation Keystone Cardinal which was Phase II of the troop reduction program in Vietnam. Lessons learned from Keystone Eagle contributed to a more effective troop displacement during Phase II.[14]
Personnel turbulence and logistical implications, primarily involving the disposition of equipment, remained the major problems in redeployment activities.[14]
The following 44th Medical Brigade units were inactivated as a result of the Phase II troop reduction:[14]
The fourth period of the year began after Keystone Cardinal and essentially was a period of tranquility while the remaining units of the brigade prepared for the next announcement by President Nixon which would trigger Phase III in 1970.[14]
The year 1969 was a period of transition. In addition to units affected by the Keystone activities, other units were relocated in-country in order to balance the alignment of medical support in Vietnam. Most of the activity took place during the latter half of the year with the following major relocations being executed.[14]
In the area of training, during the period 16 – 21 October 1969, the 2d Surgical Hospital conducted a test of the mobility of MUST equipment under combat conditions. The test involved the temporary relocation of one air inflatable shelter, one expandable, one utility pack and other MUST peculiar equipment from Lai Khe to Di An. Upon completion of the test, the following observations were made:[14]
As the U.S. effort in the Republic of Vietnam has shifted to improvement and modernization of Republic of Vietnam Armed Forces (RVNAF), brigade units have become involved in on-the-job training for RVNAF units. The purpose of this training is to teach new skills or upgrade existing ones. The programs conducted are ones that are not normally available or are beyond the capabilities of the RVNAF school system. The following is a list of OJT programs which have been conducted by brigade units and the type of training provided:[14]
The primary area of planning during 1969 was centered around Keystone Eagle and Keystone Cardinal Intensive planning conferences were held prior to implementation of both redeployment phases. A major working document was published by the brigade headquarters on 20 September 1969 as Operations Plan 183-69. This plan was designed for Keystone Cardinal but was written to allow changes for subsequent redeployment actions. The CG, USARV appointed a USARV Redeployment Assistance Team (URAT) to assist smaller units in the necessary roll-up activities for units redeploying from Vietnam. A member of the brigade headquarters accompanied the team when it visited medical units.[14]
Several contingency plans were updated during the year as the result of changes in the brigade force structure. One major plan involved the rapid deployment of two surgical hospitals (MUST). During the year several surgical hospitals turned in their MUST equipment to depot stocks. This action occurred when the hospitals relocated to fixed type facilities vacated by other redeploying hospitals.[14]
A comprehensive study was completed in early summer 1969 regarding several major command and control elements of the brigade. Of the four medical groups, two were located in II CTZ; the 43rd and 55th Medical Groups, respectively. It was felt as a result of this study that one group could adequately provide command and control over brigade units in II CTZ. The 55th Medical Group was brought to zero personnel and equipment status. The remaining group, the 43rd Medical Group was selected primarily because of its proximity to the major tactical command in II CTZ, namely I Field Force, Vietnam.[14]
At the beginning of 1969, two hospitals were functioning solely in the capacity of POW hospitals; the 74th Field Hospital in Long Binh for POWs generated in III and IV CTZ and the 311th Field Hospital in Qui Nhon for POWs generated in I and II CTZ. When these US Army Reserve units redeployed in Keystone Eagle, their missions were assumed by the 50th Medical Company (Clearing) and the 17th Field Hospital, respectively. The professional complement for the Long Binh POW hospital (50th Medical Company) was provided by the 24th Evacuation Hospital, which was co-located with the POW facility. On 7 October 1969, new policies for the medical care and/or disposition of prisoners of war and detainees were established at a MACV sponsored Joint Services Conference. In essence, POWs and detainees in custody of U.S. Forces, if admitted to US hospitals would be retained and treated only until their Military Intelligence classification had been completed and their medical condition stabilized to a point permitting transfer to an appropriate Government of Vietnam facility. The POW census had declined to a point where the decision was made to discontinue the operation of hospitals solely for POW patients. The 17th Field Hospital was relieved of the POW mission on 7 October 1969 and relocated to An Khe. to operate a 100-bed facility. The remaining POW hospital at Long Binh was closed on 31 December 1969. POW patients continued to enter the hospital system but were not transferred to a centralized location. The ARVN hospital system also became more responsive to the receipt of POW patients.[14]
Average monthly POW beds occupied[14]
USARV published a directive on 20 August 1969 which governed the processing of returned, exchanged, or captured U.S. Army personnel. The directive tasked the 44th Medical Brigade with specific functions to perform in support of the program. The brigade operations officer was the medical coordinator for the program. During 1969, the 44th Medical Brigade processed a total of 18 RECAPS.[14]
In August 1969, a study was made to determine the feasibility of combining the 44th Medical Brigade headquarters with the Surgeon's Office, Headquarters, USARV into a functional medical command. This study indicated that there was an overlap and duplication of effort in the command, dental, veterinary, administrative and plans and operations functional areas. The study revealed that by combining the two staffs into a medical command, a 15 percent savings in personnel spaces could be generated. No functions presently performed by the Surgeon's Office or by the brigade headquarters would be deleted and the reduction in manpower would not decrease the efficiency of medical operations. The consolidation of these two elements was held in abeyance pending final USARV approval and availability of adequate real estate. Furthermore, a USARV directed action to its major subordinate components to conduct similar studies increased the slippage on the organization of the United States Army Medical Command, Vietnam (Provisional) until 1 March 1970.[14]
The mission of the medical regulating office continued to be the control of patient evacuation within the Republic of Vietnam and the coordination of patient evacuation to hospitals in PACOM and CONUS. Two agencies provided medical statistical data. The Medical Records and Statical Division, USARV Surgeon's Office was the primary agency for medical records and reports while the Medical Regulating Office of the brigade served as the agency which accumulated daily statistics for medical regulating and operational purposes.[14]
On 24 August 1969, as a part of USARV's effort to meet new troop ceilings imposed by the Keystone Eagle troop redeployment, the brigade headquarters was requested to reduce the Army patient strength in Vietnam to 2,000 provided the health and wellbeing of the patients were not jeopardized. A policy was established within the brigade to meet this requirement wherever possible, and the patient account was successfully reduced to the desired level and maintained at that level until 6 September 1996.[14]
Initial instructions issued by the brigade headquarters included assigning Army patient ceiling goals to each medical group, restricting elective surgery for Army patients and establishing a policy permitting the evacuation of patients out of country, if not medically contraindicated, without regard to the thirty-day evacuation policy whenever necessary to maintain the Army patient strength as close to 2,000 as possible during the period identified above.[14]
On 6 September 1969, the temporary ceiling of 2,000 total inpatients was lifted and the original DOD ceiling of 3,000 Army patients on census at all facilities was reinstated.[14]
A program was initiated in October 1969 within brigade hospitals to provide reconstructive surgery for ARVN patients hospitalized in nearby ARVN hospitals. The degree of participation was influenced by the medical mission and the capabilities and staffing of brigade hospitals. This program involved the utilization of brigade and ARVN medical facilities and staff, or any combination of them. Direct continuing coordination between the hospital commander and the local ARVN hospital commander was essential to ensure acceptance of the program and optimum participation by all concerned.[14]
Direct liaison was authorized between the brigade MRO and the USARV professional consultants in medicine, surgery and neuropsychiatry. The USARV consultant staff members provided both the professional staffs of each hospital and the brigade MRO necessary guidance concerning the USARV Surgeon's policies regarding specific surgical procedures for out-of-country evacuation. All cases requiring professional judgement were referred by the MRO to the appropriate professional consultant for final decision.[14]
As a result of monitoring medical attendant after-action reports, it was discovered that a majority of the physicians complains stemmed from a lack of knowledge concerning administrative actions required while in Japan. To alleviate this problem, an information letter was prepared utilizing information gathered by the brigade MRO and the Executive Officer. Further guidance would be provided to individual attendants upon receipt of United States Army Medical Command, Japan operational policy concerning medical attendants.[14]
Total operating beds operated by 44th Medical Brigade hospitals reflected a decrease throughout 1969 as a result of redeployment activities.[14]
During 1969, wounded in action admissions reached high points in March and again in May and then reflected a decrease which coincided with a decrease in friendly and enemy initiated combat activity.[14]
Hospital dispositions by medical evacuation out-of-country to PACOM or CONUS hospitals reached a high of 4,334 during May 1969 and a low of 1,789 during November 1969.[14]
The average daily census of Vietnamese civilians reached a high point of 556 during January 1969 and a low of 263 during October 1969. Care was provided for Vietnamese Civilians who were suffering from war related injuries and for those individuals requiring hospitalization for treatment not available at Government of Vietnam medical facilities.[14]
Hospitalization statistics for 1969[14]
44th Medical Brigade daily medical statistics—post Tet Offensive[14]
0001 hours, 23 February 1969 – 2400 hours, 28 February 1968
44th Medical Brigade daily medical statistics—post Tet Offensive[14]
0001 Hours, 12 May 1969 — 2400 Hours, 18 May 1968
Average daily census of Vietnamese civilians[14]
Average daily operating beds (all patients) 1969[14]
Aviation activities for 1969 were generally similar to those of 1968. Workload continued to increase slightly with a new high of 206,229 patients evacuated by brigade aircraft. This represented an increase of 16,775 patients over the previous high established in 1968. During March 10,139 missions were flown evacuating 21,843 patients for a monthly high. Workload throughout the remainder of the year was fairly consistent ranging from 15,000 to 17,000 patients evacuated per month. March and May were exceptions when patient evacuations rose to 21,843 and 20,565 respectively.[14]
Of the various types of aeromedical evacuation missions, the most hazardous continued to be missions where the patients required extraction utilizing the aircraft hoist and rescue seat (forest penetrator). During the year there was a significant increase in the number of hoist missions, particularly in the month of December 1969.[14]
In December 1969 there were 381 hoist missions of which 140 were performed by the 57th Medical Detachment (RA), the highest monthly figure for any brigade unit. Total hoist missions increased by 780 during 1969 for a grand total of 2,516 missions, another new high for the brigade.[14]
In 1969 medical evacuation aircraft were hit by hostile fire 309 times as compared to 386 times in 1968. This 16% decrease in hits was quite significant in that both the total number of patients evacuated and the number of potentially dangerous hoist missions increased considerably.[14]
Air ambulance resources available during 1969 included two medical companies (air ambulance) with locations at Long Binh and Qui Nhon and 11 medical detachments (RA) with locations as of 31 December 1969 at Quang Tri, Phu Bai, Da Nang and two detachments at Chu Lai in I CTZ; Pleiku, Nha Trang and Phan Rang in II CTZ; Cu Chi and Lai Khe in III CTZ; and Binh Thuy in IV CTZ. During 1969 it became necessary to relocate several of the RA teams in order to provide more responsive support. The relocations were presented in the chart on unit relocations in the S-3 Operations section for 1969. There were no major problems encountered with those moves. The moves continued to demonstrate the flexibility of the RA teams.[14]
Due to the disposition of medical units throughout all of Vietnam, the brigade was authorized the use of one U-1A Otter fixed-wing aircraft, above TOE authorization. The U-1A proved to be a valuable addition to the brigade's aviation capability.[14]
There were 116 UH-1H aircraft assigned to the brigade with an aircraft availability rate of 72 percent, which was 2 percent above the 1968 availability rate and was also 2 percent above the USARV minimum acceptable availability rate. Throughout the year there was a direct correlation between the number of patients evacuated, hours flown, times hit by hostile fire and aircraft availability. However, there were other variables such as accidents, non-scheduled maintenance and parts shortages that contributed to the rate. Mainly because of the variables mentioned, the availability rate for December 1969 was 8 percent.[14]
On 8 June 1969, the 551st Transportation Detachment was assigned to the 45th Medical Company (Air Ambulance) for direct support maintenance. The assignment of the 551st Transportation Detachment has enhanced the maintenance capability by improving the quality of work and contributed to the timely completion of ma1ntenance.[14]
Aeromedical evacuation statistics 1969[14]
The S-2 Section activities remained essentially unchanged from 1968. In maintaining the 44th Medical Brigade personnel security program, the section handled approximately 700 requests from subordinate units for either security clearance validations or for USAIRR checks, gave an estimated 400 security briefings/debriefings to headquarters personnel and processed 21 requests for revocation of security clearances.[14]
Only one security violation involving classified documents was processed during 1969. The resulting investigation determined that no documents had been compromised.[14]
In late November 1969, the S-2 as project officer for the implementation of the NESTOR Secure Voice Program, published and distributed implementing instructions to brigade units. When implemented, this program gave brigade units the capability of communicating with tactical elements in a secure mode, thus preventing enemy forces from acquiring vital intelligence data.[14]
Throughout 1969, the S-2, as a member of the Command Inspection Team had been able to analyze procedures implemented at several commands and developed a standardized SOP to allow each unit to benefit from the experiences of others. In December 1969, a complete thirty-four-page checklist for all S-2 activities including personnel, internal, communications and physical security as well as historical activities was published as an additional guide, assuring compliance with all pertinent regulations.[14]
The implementation of brigade staff visits on a monthly basis to the major subordinate units and selected units of their command has enabled the S-2 Section to evaluate systems and procedures implemented at the unit level in areas of internal, communications and physical security. The unit's historical files and activities were evaluated for adequacy and accuracy. Deficiencies noted during the staff visits were pointed out to the responsible individual during the visit, and many were corrected on the spot. The report of deficiencies noted was a valuable tool for subordinate units in preparation for command inspections and Annual General Inspections.[14]
Unchanged from the previous year, the S-4 mission remained, essentially stated as follows: To advise and act for the brigade commander, as directed, in all aspects of general supply, maintenance of equipment, transportation, and services as pertains to the effective operation of all units assigned or attached to the brigade; to advise, assist, and act for the brigade commander, as directed in all aspects of construction and maintenance of medical facilities occupied or required for all units assigned to the brigade, to include the acquisition of real estate and facilities; and to act for the brigade commander in matters pertaining to the coordination, supervision, and administration of area damage control and utility conservation programs; and to act as the Brigade Claims Officer.[14]
The logistical mission was successfully accomplished, although some problems were encountered from time to time during the course of 1969. However, these problems were resolved for the most part without having to resort to improvisation.[14]
There were no unresolved problems carried over from 1968.[14]
The S-4 Section was staffed at 100 percent authorized MTOE strength during most of 1969. The number of personnel authorized, nine officers and thirteen enlisted, was sufficient for performance of the section's mission. Records of personnel turnover reveal that seven officers and eight enlisted departed the section while six officers and seven enlisted were newly assigned.[14]
Medical supply of brigade units was satisfactory throughout 1969. There were no shortages of required items, and the system was responsive to the needs of the user.[14]
During the course of 1969, the medical supply section continued to refine and implement procedures for the effective management, acquisition, and control of medical stocks in units throughout the brigade. To this end, regulations were reviewed and revised as required, quality control data were published, facility stockage reports were analyzed and monitored to detect and anticipate problem areas, frequent courtesy visits were made to subordinate units to evaluate the adequacy of and compliance with established procedures, and a program was developed to assist units in eliminating excess medical equipment. To accomplish this, teams from the 32d Medical Depot were sent to the various hospitals to perform technical inspections of unit-identified excesses. The visits were prearranged on a scheduled basis so that all units could prepare and assemble excesses for inspection prior to the arrival of the teams. The teams began their visits in September and by the end of 1969 ten hospitals had been cleared of their excess, namely the 24th, 29th, 36th, 67th, 71st, 85th and 91st Evacuation Hospitals and the 8th and 17th Field Hospitals. As a result of this program, much excess was redistributed to satisfy equipment shortages in other units, and some excess equipment was retrograded out-of-country as surplus to the command.[14]
Three MUST hospitals were closed during 1969, the 3d, the 18th, and the 22d Surgical Hospitals, located at Dung Tam, Camp Evans, and Phu Bai, respectively. The 22d Surgical Hospital was zeroed out and applied against the Keystone Cardinal force-reduction increment; while the 3d and 18th Surgical Hospitals relocated into fixed facilities, the 3d to Can Tho and the 18th to Quang Tri. Close-down operations went smoothly despite the fact that there were both Army standard and MUST peculiar equipment to segregate, inspect, clean, and process. Some of the MUST equipment from these hospitals went into depot storage in-country and some of the equipment was retrograded to Okinawa.[14]
A program was initiated in August 1969 to upgrade the medical equipment of residual brigade hospitals, the term "residual" meaning those hospitals to remain in Vietnam under then-existing plans. Designed to obtain equipment suitable for use in fixed, semi-permanent facilities, capable of providing the type of diagnostic and therapeutic service required under a longer-term evacuation policy, the program was started by conducting a survey of professional personnel in selected brigade hospitals for the purpose of identifying general equipment requirements. The survey was completed in November 1969. Subsequently, the medical supply section, screening the survey data, developed a consolidated standard item requirements listing. The requirements totaled 262 separate line items, forty-seven of which were Acquisition Advice Code "L." "Non-standard" requirements were not developed by the end of 1969 even though the survey data were available. The reason for this was the lack of manufacturer's catalogs. Catalogs had been requested at the start of the project, but the number received was not sufficient to begin on this phase of the project before the end of the year. The required catalogs were expected to be on hand by the end of the first quarter of calendar year 1970, at which time work on the project would resume. The cost of the equipment upgrade program was expected to be approximately $500,000 per hospital. Four to eight residual hospitals were planned, meaning that the total cost of the program would be between two and four million dollars. It was anticipated at the end of 1969 that all required upgrade equipment, both standard and non-standard, would be placed on order during the second quarter of 1970.[14]
By USARV directive a medical Supply satellization program was initiated in September 1969 for all MACV advisory teams. Arranged so that these teams would draw supplies directly from the nearest brigade hospital, the program reduced the number of customer accounts that had to be managed by the medical depot, resulting in a corresponding decrease in the depot's administrative workload. Since the number of line items required to support the teams was negligible and essentially common to brigade hospitals, and since the number of customers to be supported was not excessive, with only one hospital satellited with more than four teams, the, program posed no hardship on the hospitals and proved overall to be a worthwhile undertaking.[14]
Non-medical support of brigade units—that is, maintenance support, supply support, and services support—was, by and large, satisfactorily provided by 1st Logistical Command activities. In the area of supply support, however, some items were intermittently or chronically in short supply.[14]
M-151A1 ¼-ton trucks, 3/4-ton ambulances, replacement motors, sandbags, and lumber were items in chronic short supply.[14]
Because of the difficulty of obtaining replacement vehicles, many units were obliged to operate with less than their authorized complement. Hardest hit were the ambulance companies, which operated for most of the year with only 66 percent of their authorized ambulances, the remainder being on requisition, due out on back order from CONUS. At the close of 1969, many requisitions for ambulances were six months old. This shortage made it necessary for ambulance companies—and other affected units as well—to optimize the service capability of all remaining on-hand vehicles. This was accomplished by a concomitant measure of success by stressing and enforcing on a command-wide basis the proper and timely execution of preventive maintenance services, and also by conserving wherever possible on the use of vehicular assets. as an example of the latter, the 418th Ambulance Company ceased providing ambulance escorts to convoys operating in and around the Cam Ranh Bay area but continued, on the other hand, to provide medics in support of this requirement; only the medics that supported the requirement were transported in vehicles that made up the convoy, not ambulances. This, of course, satisfied the medical coverage requirement, yet at the same time conserved on ambulance usage.[14]
Sandbags became in critical supply around mid-summer and remained so for the rest of 1969, during which they were authorized for use by tactical elements only, making it necessary for all brigade units to use expedient materials for constructing protective shelters and revetments. Expedients included material such as artillery ammunition boxes, 55-gallon drums, salvaged crating material, etc.[14]-
Lumber, sizes 1x, 2x, 4x, to include plywood, became in critical supply during the summer and also remained chronically short through the end of 1969. to ensure that lumber was used only for the most pressing requirements throughout Vietnam USARV established a monthly allocation where in-country supplies were issued to major subordinate commands on a percentage basis, determined according to the number of critically urgent, engineer-approved construction projects in each command. This was a departure from previous procedures in that lumber was formerly allocated to construction activities only. Under the new system, each major subordinate command had to submit a monthly forecast of urgent projects along with a detailed justification for the lumber required in support of them. Lumber allocations to the brigade during the period July through December were approximately one-fourth of that which the headquarters had requested, and the majority of all received lumber went to the 32d Medical Depot to satisfy packing and crating material requirements. The lumber shortage delayed the start and completion of several brigade construction projects. It also prevented subordinate units of the brigade from doing any appreciable amount or self-help work to improve or renovate facilities. However, according to the Assistant Chief of Staff, G-4, USARV, the lumber position was expected to satisfy normal construction requirements by February 1970.[14]
As in 1968, vehicle repair parts, stationery, printing supplies, and other items ware intermittently in short supply throughout the year. Command assistance in redistribution of brigade assets generally resolved problems caused by those shortages.[14]
Maintenance programs and logistical readiness throughout the command improved as a result of vigorous supervisory emphasis and follow-up by the maintenance section of the brigade. This policy, implemented initially in August 1968, was a carry-over from the preceding year. Also as in 1968, the CMMI team continued to as an instruction activity, making frequent liaison visits for the purpose of instructing equipment users, maintenance personnel, and commanders on materiel management and preventive maintenance techniques. The results obtained by this approach were very encouraging: CMMI scores for 1969 improved considerably over those of the previous year. The average CMMI score in 1968 was below 70 percent, a failing score; the average for 1969 was a greatly improved 78 percent. Of the 123 units inspected, 79 percent were rated satisfactory while 21 percent were unsatisfactory.[14]
Two force reductions occurred during the calendar year, one during the period June through August 1969, code-named Keystone Eagle, and the other during the period October through December, code-named Keystone Cardinal. Together, these reductions totaled 65,000 troops. The general supply and maintenance section was responsible for the logistical planning and execution of Keystone Eagle and Cardinal which entailed the following:[14]
Although instructions were given out initially in a rather piecemeal fashion because of policy and procedural changes emanating from USARV, a very workable plan was developed by the time that Keystone Cardinal got underway. Published as Annex F to Brigade Operations Plan 183-69, it proved effective in guiding, monitoring, and controlling redeployment actions. Two important lessons that were learned from the force reductions were:[14]
During the first half of 1969, the policy on new construction in Vietnam was liberal, just as it had been in 1968; and there were sufficient funds available to satisfy most medical construction exigencies as well as to satisfy brigade upgrade plans. Starting in June, however, USARV curtailed all but the most essential construction. The impact that this had on the brigade was rather awesome. Prior to the curtailment, the brigade had fifty-six approved construction projects, the cost of which totaled a little more than thirteen million dollars. After reviewing these projects, USARV cancelled half of them because they did not fall within the urgency criteria established. Those projects which were approved, totaling approximately six million dollars, a decrease of fifty percent from the pre-curtailment figure, were primarily upgrade projects which had to do with improving utilities, like water, sewage, electrical, and air-conditioning systems.[14]
The mission of nursing services was to advise the brigade commander on all aspects of nursing service program within the command; coordinate overall nursing service activities; supervise and provide staff direction in professional matters pertinent to nursing services to all elements within the command.[14]
The functions of nursing services include:[14]
A total of 180 staff visits were made to hospital units during 1969. Emphasis was made on staffing needs, career guidance, and standards of patient care. During 2d quarter a liaison visit was made to the Americal Division to visit the aid stations. The feasibility of assigning a Medical-Surgical Nurse (MOS 3448) to the Office of the Division Surgeon and/or sending medical surgical nurses from nearby hospitals on periodic visits to the division medical companies were discussed.[14]
A total of 727 Army Nurse Corps officers were interviewed, oriented and assigned. The major problem area was the delay in in-processing occurring at the 90th Replacement Battalion, resulting in officers remaining there 2–5 days awaiting orders and transportation. This has been resolved since early November 1969 when a 44th Medical Brigade personnel team was initiated to meet all incoming AMEDD officers and bringing them directly to the Personnel Branch Office or the Surgeon where orders were cut. The system greatly expedited reception and in-processing.[14]
During the first quarter of 1969 a one-day conference was conducted for the Chief Nurses of 68th Medical Group.[14]
During the first and second quarters monthly meetings of the Joint Civilian Nursing Committee were conducted. Those participating were nurses from the U.S. military, Vietnam Ministry of Health Bureau of Nursing, USAID Nursing Division and ARVN. The purpose of these meetings was to help upgrade nursing in Vietnam, both civilian and military.[14]
During the 3d quarter of 1969, the first conference for all Army Chief Nurses in Vietnam was conducted in Saigon. It was recommended that a conference be held at least once a year and preferably every six months.[14]
During inactivation and redeployment of hospitals, nurses who had more than thirty days remaining in-country were interviewed and, as far as possible, reassigned according to their preference. Several units were also relocated during the year.[14]
A sixty-day wearing test of the jungle hat for female nurses was conducted by 160 nurses. Almost 100 percent recommended that the jungle hat be authorized for wear. It was felt that the jungle hat was more attractive, did not blow off, protected the hair, and was more comfortable than the baseball style cap currently authorized. The results of the test were forwarded to Department of the Army.[14]
Continued improvement was made in the living quarters for Army Nurse Corps officers. Much of the improvement was made by self-help, but some air-conditioning was installed. Quarters at the 67th Evacuation Hospital and the 12th Evacuation Hospital were partially if not completely air-conditioned.[14]
First Lieutenant Sharon Ann Lane was killed by shrapnel from a 122mm rocket while on duty at the 312th Evacuation Hospital. One of eight U.S. servicewomen to die in Vietnam, she was the only one to be killed due to enemy action. Several nurses have received minor fragment wounds during mortar and rocket attacks.[14]
In all hospitals where Vietnamese Civilian personnel have been hired for Nursing service duties, intensive on the job training programs have been initiated._It was necessary to teach English classes and to teach basic nursing procedures. This was an excellent learning experience for the young nurses and clinical specialists.[14]
Participation in MEDCAP activities has continued to be of great interest to the nurses. They have participated in programs at schools, orphanages, hospitals, clinics, and leprosariums.[14]
Although only two dietitians were authorized in Vietnam, five were assigned in country at the end of 1969. In addition to the staff dietitian, 44th Medical Brigade, there was one dietitian assigned to each of the three medical groups of the brigade. As of 1 January 1970, the fifth dietitian would be assigned to the 3d Field Hospital in Saigon.[14]
With the close cooperation of the personnel sections of USARV and the 44th Medical Brigade, the staff dietitian had been very successful in ensuring that highly trained hospital food service personnel coming to Vietnam remained in 44th Medical Brigade units. Beginning in September 1969, one staff dietitian or the food service supervisor of the brigade interviewed and assigned 94F E6s and E7s. This ensured a more equitable distribution of well-trained mess stewards. The improved quality of supervisory personnel has greatly assisted the units in their food service program. These hospital-trained stewards were much more able to give proper guidance and supervision in the area of patient feeding.[14]
Seven dietitians attended the dietetic conference held in Delat on 23–24 August. The program was coordinated with the United States Army Procurement Activity, Vietnam (USAPAV), Dalat Field Office. The USAPAV representative presented an informative and interesting briefing on the procurement and distribution of fresh fruits and vegetables in Vietnam. The conference provided an opportunity for the exchange of ideas on improvement of food service operations and the discussion of problem areas.[14]
A Best Mess Award Program was established in the 67th Medical group. The commanding officer presented the first award to the 27th Surgical Hospital in June 1969. The program was designed to promote the highest possible standards of food presentation, service, sanitation and management within the messes of the command. The quarterly award was a rotating trophy which was retained by the winning unit until a new winner was selected. A permanently retained plaque was also presented to the winning mess.[14]
Nuoc mam was received by the brigade hospitals for the Vietnamese patients. This was a result of a recommendation that providing nuoc mam be extended to all Vietnamese patients after the International Red Cross requested that it be purchased for POW patients. By the end of 1969, $3,000 had been expended to purchase nuoc mam for brigade units during the year.[14]
The staff dietitian instructed ten Thai mess sergeants in a class on formal nutrition as a part of a training program instituted by 1st Logistical Command for the Royal Thai Army Volunteer Force in Vietnam. The dietitian also assisted the II Field Force, Vietnam food service officer in developing a 28-day cycle menu which was more acceptable to the Thai Army which would be implemented by the 1st Logistical Command in 1970.[14]
The dietitians in each medical group were able to concentrate more on training activities for both Vietnamese and military food service personnel in 1969. Vietnamese had been dubbed in on a hospital sanitation film and was being shown to Vietnamese local national employees in 44th Medical Brigade units. The group dietitians were able to function more effectively as dietetic consultants since delegating more of their administrative and food service inspection functions to the group food service warrant officers and food service supervisors. Unfortunately, in Vietnam unit sanitation was an ever-continuing problem. In many cases commanders, executive officers and mess officers, due to lack of knowledge, seemed unable to demand the minimum standards required by Army regulations. Only by these continuing monthly group inspections did the units maintain desirable standards of sanitation.[14]
During 1969 units of the Army Medical Service fed approximately 3,300,000 rations of which 1,100,000 were patient rations.[14]
Staff visits were made to medical treatment facilities throughout 1969. Emphasis was placed on procurement of garrison mess equipment; training of cooks in preparation and service of food with particular emphasis on patient feeding on the wards; training of local national personnel; mess management and administration; procurement of supplement foods and beverages for patient feeding; and assisting in closing some hospital food services as units were redeployed or inactivated under Operation Keystone.[14]
Renovation of the 6th Convalescent Center's mess hall was completed in June 1969. The original facility was inadequate in construction, design, kitchen equipment and layout. After the renovation, it was possible to comfortably feed 3,000 meals daily.[14]
The 67th Medical Group completed the initial installation of garrison mess equipment. These were the last hospital units of the 44th Medical Brigade to utilize garrison mess equipment.[14]
The 20th Preventive Medicine Unit moved from their old mess ball at Bien Hoa to a new facility at Long Binh Post.[14]
Hospital food service at the 17th Surgical Hospital, 22d Surgical Hospital, and 17th Field POW Hospital was phased out, and mess equipment in these units was turned in or relocated to other 44th Medical Brigade units.[14]
The 18th Surgical Hospital moved from Camp Evans to Quang Tri during November 1969. Mess equipment was relocated to the new unit mess hall, which was cleaned, painted, and rescreened for the move. All installation was completed with the exception of the dishwasher.[14]
USARV medical treatment facilities subsisted on the field ration A menu as established for all troops in Vietnam. The support that Class I facilities gave the hospitals was commendable. The only area where real supply problems continued to exist was Can Tho. They had difficulty throughout 1969 with fresh produce and were not always able to get milk or ice cream for the hospital. There had been some improvement in the situation during December 1969, and 1st Logistical Command felt that a recent reorganization of the Class I supply point at Can Tho would remedy the ongoing problems.[14]
The 28-day Master Hospital Menu, 44th Medical Brigade Pamphlet 30-1 was revised on 1 November 1969 so it would be compatible with the new 28-day Master Menu published as Supply Bulletin 10-261, dated 22 August 1969, then in use for troop feeding in Vietnam.[14]
The 44th Medical Brigade Food Service Regulation 30-1 was revised effective 1 November 1969.[14]
The 44th Medical Brigade did not publish an Army Medical Service Activities Report covering its work in Vietnam from January to March 1970, instead relying on the staff of the United States Army Medical Command, Vietnam to cover their work as part of the USAMEDCOMV's annual report. In some instances, they covered the period from 1 January to 28 February 1970 well, in others they did not.[15]
On 1 March 1970, the United States Army Medical Command, Vietnam was organized as a result or consolidating the 44th Medical Brigade and the USARV Surgeon's Office. The Medical Command organization eliminated duplication of effort, reduced manpower requirements by 17 percent and provided a headquarters that would be more responsive to drawdown requirements.[15]
The 43d Medical Group, with headquarters at Nah Trang, was inactivated 7 February 1970. The 43d Medical Group was responsible for field army level medical support in the area or operations of II Corps Tactical Zone/Military Region II (MR II). With the inactivation of the 43d Medical Group the responsibility for the medical units within the geographic area of MR II was divided roughly in half. The 67th Medical Group assumed the responsibility for the northern half and the 68th Medical Group assumed the responsibility for the southern half.[15]
The concept of a medical battalion composed entirely of helicopter ambulance and ground ambulance units was developed. This battalion would have sole responsibility for combat evacuation, both air and ground within its area of operation. To implement this concept, the 61st Medical Battalion was organized at Qui Nhon during January 1970 and assigned a mix of an air ambulance company, helicopter ambulance detachments, ground ambulance companies and ground ambulance detachments. After a three-month period of testing and observation of the 61st Medical Battalion, the 58th Medical Battalion was organized at Long Binh along similar lines.[15]
This concept provided a better utilization of evacuation assets, improved response, improved maintenance and better command and control. Direct command, control and supervision was provided by a senior experienced Medical Service Corps aviator with extensive experience in medical evacuation, both ground and air.[15] Abandoned at the end of the war, the concept would be revived again in the 1990s based on lessons re-learned during Operation Desert Storm.
Decorations awarded by month[15]
The brigade S-1 also processed eight Distinguished Flying Crosses and two Legions of Merit in January and eleven Distinguished Flying Crosses and three Legions of Merit in February, although these were passed to USARV for final approval, as the brigade commander did not have approval authority for those awards.[15]
January and February 1970 were spent planning, and then executing, Operation Keystone Bluejay, the third increment of troop withdrawals from Vietnam.[15]
Additionally, the 57th Medical Detachment (RA) was relocated from Lai Khe to Binh Tuy, effective 19 February, the first of many unit relocations during the year, the rest of which would be executed under the auspices of USAMEDCOMV.[15]
Hospitalization statistics for 1970[15]
Average daily census of Vietnamese civilians[15]
Average daily operating beds (all patients) 1970[15]
Aeromedical Evacuation Statistics 1970[15]
Customer demand satisfaction rate
The primacy indicator of supply responsiveness and effectiveness was the customer demand satisfaction rate. The rate for standard stocked items for December 1969 was 89.1%.[15]
The rate for non-standard stocked items was not as high as for standard stocked items. This was to be expected since the items were not normally stocked by CONUS depots and therefore procurement had to be initiated each time a requisition was received. The rates for nonstandard stocked items were:[15]
Requisitioning objectives
The dollar value of the requisitioning objective at the end of December 1969 was $11.1 million.[15]
In February, the jungle hat was approved for female nurses.[15]
A shortage of quarters for female officers at residual hospitals was recognized in February. A memorandum for record was sent to the USARV Deputy Commanding General by the brigade commander requesting trailers at the residual hospitals.[15]
The last of the tent quarters went with the closure of the 2d Surgical Hospital at Lai Khe before its subsequent inactivation on 10 March 1970.[15]
Eyeglass fabrication in Vietnam[15]
Attesting to the quality of the 44th Brigadier in comparison with other multilith newspapers was its 3d place award in March 1970 in the USARV Newspaper Contest for 1969. The newspaper placed third in a field of 24 similar multilith-produced newspapers.[15]
Although the 44th Medical Brigade headquarters had been reduced to zero strength and all personnel had been reassigned to the United States Army Medical Command, Vietnam (Provisional) on 1 March 1970, the brigade itself was still considered deployed by the Army and would remain deployed until December 1970. on 2 December 1970 Brigadier General Thomas redeployed to the United States to assume command of Brooke Army Medical Center, and on 14 December an enlisted color guard consisting of an E-6 and an E-5 carried the 44th Medical Brigade's colors to Fort Meade, Maryland, where the brigade had been formally transferred. On 14 December the Army formally established the United States Army Medical Command, Vietnam as a table of Distribution and Allocation unit, and the (Provisional) designation was dropped from its name.[15]
There had long been a medical command and control headquarters at Fort Meade, Maryland. The 68th Medical Group had been the senior command and control headquarters from when it was activated on 27 July 1954 until it deployed to the Republic of Vietnam in early 1966.[16] To replace it, the 18th Medical Brigade was transferred from Fort Lee, Virginia, where it had been stationed since its activation on 18 August 1967,[17] with an effective date of 14 March 1968.[18]
On 16 December 1970, First U.S. Army General Order number 450 directed two actions. First, Headquarters and Headquarters Detachment, 18th Medical Brigade was inactivated and second, Headquarters and Headquarters Detachment, 44th Medical Brigade was reorganized and assigned to First Army. Personnel and equipment requirements of the 44th Medical Brigade were filled from assets made available by the inactivation of the 18th Medical Brigade. Mission, organization, structure, and MTOE of the two brigades remained the same. The net effect of General Order 450 was the redesignation of the 18th Medical Brigade as the 44th Medical Brigade. Preservation of the 44th's distinguished history was the decisive factor in the inactivation of the 18th Medical Brigade and its replacement by the 44th Medical Brigade, previously operating in the Republic of Vietnam.[19]
The following units were attached to the 44th Medical Brigade upon its activation:[19]
The following attached units were inactivated on the dates indicated:[19]
Officer strength as of 31 December 1970 was 40:[19]
Officer strength as of 31 December 1971 was 48:[20]
Total enlisted strength as of 31 December 1970 was 597.[19]
Total enlisted strength as of 31 December 1971 was 379.[20]
Personnel figures as of the end of 1970 showed the brigade was assigned approximately 125% of its assigned MTO strength. Excess personnel were generated as a result of the inactivation of the 28th General Hospital on 28 December 1970.[19]
Personnel figures as of the end of 1971 reflect that at the end of the year, the Brigade was assigned approximately 75% of its MTOE authorized strength. The decrease of personnel was the result of the early release programs directed by the Department of the Army.[20]
Due to an acute enlisted personnel shortage at the Fort Meade hospital, a request was submitted to the Commanding Officer, Fort George G. Meade, to attach the 44th Medical Brigade and all of its subordinate units to the Fort George G. Meade Medical Department Activity (Kimbrough Army Hospital). The request for attachment was not favorably considered.[21]
Units attached to the brigade were responsible for the scheduling and presentation of general, specialist, unit training, and the conduct of field exercises.[19]
The 44th Medical Brigade was tasked to provide 58 enlisted medical MOS slots for the operation of Kimbrough Army Hospital. In addition, the brigade coordinated an OJT/MOS proficiency program with Kimbrough Army Hospital, EPES Dental Clinic, First U.S. Army Medical Laboratory, and the Walter Reed Army Institute of Research. Normally seventy to eighty personnel participated in this second program on a ninety-day rotating basis in 1970, which increased to eighty to ninety per rotation in 1971.[19][20]
Funding deficiencies experienced by First Army made cancellation of all field training scheduled for the latter part of 1970 necessary.[19]
The following units successfully completed an operational readiness training test during the period 30 April to 24 May 1971:[20]
The following units conducted a field training exercise during September 1971:[20]
The 44th Medical Brigade supported Reserve and ROTC Summer Camp during the period 6 March through 30 September 1971 at Indiantown Gap Military Reservation, Pennsylvania, Camps Pickett and A.P. Hill, Virginia, Camp Drum, New York, and Fort George G. Meade, Maryland. Support included medical subjects instruction, equipment and facility displays, medical evacuation (air and ground), billeting escort, and equipment.[20]
The third annual Expert Field Medical Badge test was conducted in October 1971. Seven individuals received the award.[20]
The following units participated in a Command Post Exercise on 20–27 December 1971:[20]
Logistical and maintenance support provided the brigade in 1970 and 1971 were considered adequate.[19][20]
Implementation of "G" series medical MTOEs was only partially accomplished in 1970 because of restrictions placed on fund expenditures.[19] Updates of all "G" series MTOEs were completed in 1971.[20]
All subordinate unit small arms storage areas were consolidated at Brigade level in September 1971.[20]
All units attached to the 44th Medical Brigade accomplished the changeover from M-14 to M-16 rifles during September 1971.[20]
Brigade personnel are continuously involved in all areas of patient care through special programs mentioned in the Training section.[19][20]
Both air and ground evacuation support of the First U.S. Army/Military District of Washington area of operations was provided by units of the 44th Medical Brigade. Evacuation missions were performed in support of training and contingency operations.[19][20]
Elements of the 44th Medical Brigade provided medical and related support during the May 1971 demonstrations in Washington, D.C. Brigade personnel and equipment, configured as an ambulance company and provisional truck company, operated under the control of the Commanding General, Military District of Washington.[20]
The brigade area was located in the 2400 area of Fort Meade.[22] This area was bounded on the North by LLewellyn Avenue and on the West by Kimbrough Army Hospital.[23] Occupying facilities constructed for World War II, none of the buildings remain, and 2022 Google Earth imagery shows the area occupied by parking lots and outbuildings supporting the Kimbrough Army Health Clinic, or returned to native vegetation.
The 591st Medical Company (Ambulance) and the 414th Medical Detachment were both inactivated in June, 1972.[22]
On 23 June 1972, Hurricane Agnes struck a five-state area causing disaster of major proportions. Fort Meade was called upon to assist in a multitude of areas ranging from Search and Rescue operations to reconstruction of lines and communications in the stricken areas. The maximum troop strength committed was 286 personnel, the majority of which came from the 76th Engineer Battalion. Elements of the 1st Squadron, 6th Armored Cavalry, 42d Transportation Battalion, 44th Medical Brigade, and 519th Military Police Battalion were also deployed to assist civil authorities.[22]
A series of MTOE actions took place in 1973, including:[24]
On 19 March 1973, the Headquarters and Headquarters Detachment, 44th Medical Brigade was inactivated at Fort Meade, Maryland.[24]
The brigade was reactivated on 21 September 1974 at Fort Liberty, North Carolina, assigned to the XVIII Airborne Corps. The 44th Medical Brigade deployed in support of XVIII Airborne Corps operations in Grenada, Panama, and Iraq, the last of which earned the brigade another Meritorious Unit Commendation. On 16 July 1992, the brigade became a separate major subordinate command with a general officer commanding. Following the reorganization, the 44th Medical Brigade participated in Operation Uphold Democracy, Operation Enduring Freedom, and most recently, Operation Iraqi Freedom. The brigade has also participated in hurricane relief efforts, including those following Hurricane Andrew, Hurricane Katrina, and Hurricane Rita. The brigade was converted to a Medical Command on 16 October 2001 and became a multi-component unit. While at Fort Liberty the brigade had become an Airborne unit, but as part of its conversion the 44th lost this designation. Only headquarters elements and a very limited number of its subordinate units had actually been on jump status, and the reorganization from a command back to a brigade removed headquarters elements from jump status. The unit was redesignated as the 44th Medical Brigade on 21 April 2010.[25]
[48]
44th Medical Brigade
Operation Desert Shield[49]
Operation Desert Storm[49]
Units of the 44th Medical Brigade:[51]
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