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MEDICAL HISTORY OF 304th BOMBARDMENT WING (M) SUPPLEMENTAL REPORT NO 1 1 July 1944 - - - 30 September 1944
ADMINISTRATIVE HISTORY
The 304th Bombardment Wing (M) is assigned to the FIFTEENTH AIR FORCE. The headquarters is located at SPINAZZOLA, ITALY. During the period covered by this supplement, the Wing was engaged in the Italian campaign, and participated in the campaign for southern FRANCE, under A NINTH T'ACTICAL AIR FORCE, UNITED STATES ARMY.
On the 30th of September 1944 there were four (4) officers assigned to the Medical Section, Headquarters and Headquarters Squadron of the Wing, and twelve (12) enlisted men. This denotes a loss of one enlisted man, who was transferred to the 455th Bombardment Group and returned to this headquarters on Detached Service. By authority of TO and E 1-112 dated 29 June 1944, the Military Occupational Specialties (MOS) for the enlisted personnel has been changed in several categories. The complete roster and changes are shown below:
NAME RANK ASN COMPONENT DUTY PETERS, RALPH S. Lt Col, MC 0-295234 Q.A.C. Wing Surgeon HOLTEN, CLARENCE W. Major, MC 0-1233290 Q.A.C. Asst Wing Surgeon MCAULEY, WILLIAM J. Captain, MC 0-1348677 A.U.S. Squadron Surgeon TODD, JAMES F. 1st Lt, MAC 0-1540232 A.U.S. Asst to the Surgeon
Trapps, Edno A. T/Sgt 34271345 A.U.S. Chief Clerk (502) (Reclassified from Medical NCO (673) 14 August 1944) Grossman, John A. S/Sgt 35667936 A.U.S. Med Adm. Spec. (673) (Reclassified from Med Clerk (067) 14 August 1944) Holston, Harold I. Sgt. 39555944 A.U.S. Sanitary Tech. (196) Shaw, Floyd (-) Cpl. 39091321 A.U.S. Auto Equip. Oper. (345) Jones, Walter H. Pfc. 11420195 A.U.S. General Clerk (055) Jones, Walter H. - Transferred to the 776th Bomb Squadron, 24 August 1944.
Mayo, Carroll J. S/Sgt. 34271213 A.U.S. Chief Clerk (502) (Reclassified from Medical NCO (673) 14 August 1944) Green, Raymond E. S/Sgt. 37363301 A.U.S. Surgical Tech (861) (Reclassified from Medical NCO (673) 14 August 1944) Christopher, Noble (-) Cpl. 35494903 A.U.S. Medical Tech. (409) Turner, Howard W. Cpl. 35510769 A.U.S. Medical Tech. (409) Swinkowski, William P. Cpl. 39394365 A.U.S. Surgical Tech. (861) Hodge-Colombani, A. Cpl. 32701115 A.U.S. Surgical Tech. (861) Moot, Robert O. Pfc. 33413014 A.U.S. Medical Clerk (405) Hollock, John (-) Pfc. 33467918 A.U.S. Auto Equip Oper. (345)
Awards conferred to medical personnel during this period are the awards of the Air Medal to Lt Col RALPH S. PETERS, MC, Surgeon; to Major CLARENCE W. HOLTEN, MC, Asst Surgeon; to Captain W. J. MCAULEY, MC, Squadron Surgeon. Total awards conferred to flying personnel during the previous period for this headquarters includes: Silver Star - 1, Distinguished Flying Cross - 4, Oak Leaf Cluster to Distinguished Flying Cross - 1, Air Medal - 14, First Oak Leaf Cluster to Air Medal - 3, Second Oak Leaf Cluster - 1, Third Oak Leaf Cluster to Air Medal
The usual recreational and morale activities were carried out during this period, including U.S.O. shows, movies three times a week, a bowling program with S/Sgt. Joe Louis as the coach, organized athletics, baseball, basketball and volley ball. A truck was sent to the beach near Trani, Italy four times weekly for those interested in swimming and sunbathing. Rest camps were utilized to the fullest: Sergeant Dent, Isle of Capri, Village Miramare, San Spirito and Don Guanero by all members of this headquarters. These factors all contributed to the high morale in this unit.
There are some personnel problems in the headquarters medical personnel, although it is felt that solutions are in the making. At the present time the TO calls for a Technical Sergeant (502) as Chief Clerk. Since the responsibilities, coordination with the Groups, the amount of paper work required of this man in this key position it is highly desirable that the TO be changed to allow for a Master Sergeant's rating. This position is a much more highly specialized job and requires a much better trained and qualified individual than a similar position in a group. The enlisted man holding this position must have tact, diplomacy, excellent judgment and a keen appetite plus the problems he has to face, and an ability to handle and deal with staff in several organizations as well as with his own unit. In order to make a smooth, coordinated functioning this position requires. Such a man in this field office is Technical Sergeant Edno A. Trapps, who has put in long hours of hard, never begrudging, tireless and efficiently. Through his faithful and loyal service this medical section has been able to carry out all of its problems of administration and operations to a high degree.
Staff Sergeant John A. Grossman is to be commended for his excellent work in preparation of reports and charts, especially in checking and correcting all reports on Care of Flyers. His untiring efforts in going through the monotonous task of reviewing many records and his faithful devotion to duty is to be highly commended. Through his efforts it has been possible to consolidate accurately all medical data for the Groups assigned to this Wing.
The Wing Commander Colonel GEORGE W. McDONALD, AC, was promoted to Brigadier General, USA, on the 11th of September 1944. His keen interest in the problems of sanitation and health of the command has greatly aided the Medical Department in the employment of control measures for combatting diseases and maintaining the health of the command at a high standard.
The 53d British Transfusion Unit Type (T), RAMC, came to this headquarters on the 12th of September 1944 for delivering whole blood to be used for the 304 and 5th Wings in SOUTHERN ITALY in the treatment of battle casualties. Approximately ninety (90) percent of the personnel of Type Type donated blood freely for this life-saving measure.
Frequent inspections of the Groups assigned to this Wing were made by the Surgeon or his assistants in order to ascertain and maintain a high standard of sanitation in all units. All available training materials, training aids, posters, newspapers and literature have been distributed to the Groups for training of combat crews and ground personnel.
ENVIRONMENTAL SANITATION:
a. Malaria. Malaria has been considered our greatest threat in environmental sanitation and as such it has received considerable attention. From the earliest days of spring down to the present time a methodical campaign has been waged against the anopheline mosquito. Medical and non-medical men designated as malaria control personnel surveyed the entire area surrounding the individual groups and the Wing Headquarters. Having made an estimate of the situation these men called their Italian labor forces for an extensive drive against possible mosquito breeding places. Streams were cleared of debris and overhanging brush, marsh lands were drained and oiled, ponds and cisterns were sprayed regularly with diesel oil. The first three (3) months has shown a shift from clean up work to that of maintenance and policing. Weekly surveys are carried out by trained crews, who visit all possible breeding places for mosquitoes and new ditching from those areas. Following these surveys all new and old collections of water are sprayed with diesel oil to prevent the development of mosquitoes and to kill all larvae that are already present. The environs of the town of SPINAZZOLA, headquarters of the 304th Bomb Wing, may be considered typical of the malaria problem in this area so further elaboration will be made on their program.
It was found necessary to clean all canals, streams, and ponds at two (2) month intervals to prevent lush growth of vegetation from blocking these areas. This policing activity represented the largest expenditure of labor during July and early August. With the onset of the desert rains the tactics were changed considerably. It was found that spraying the marshly areas with diesel oil and weekly flushing of the small brooks with crude and diesel oil kept the breeding of mosquitoes down to a minimum. For the past month various survey crews have scoured our countryside looking for mosquito larvae, but have fortunately been unable to find any.
Having won the battle of the larvae, our forces next turned to the extermination of any stray adults, which may have developed in areas not accessible to our men, such as undiscovered water cached in rain barrels or back yard bird-baths. All sleeping and working quarters have been sprayed nightly with aerosol bombs and monthly with DDT. Each man has been required to sleep under a mosquito net, and weekly bed checks have been made to insure that they have been correctly set up. Atabrine has been taken daily by all men with a check roster for the enlisted personnel.
The results of our campaign have been most gratifying since only one (1) man in the organizations serviced by the headquarters dispensary came down with malaria. The man caught have contracted his malaria prior to his assignment to duty with this headquarters since this is the first Unit in activation that the mosquito hasn't been a major problem in this area, and it is the first war problem in recorded history that the Italian soldier hasn't always suffered of malaria during the Fall or American-inhabited areas.
The success of this campaign was largely due to the Wing Headquarters aggressiveness following Col. ARNOLD JOHNSON, who heads the Italian Labor Office which supervises sanitary projects of city and municipal groups, and made continual surveys of the area to ascertain where sprayed DDT was necessary.
b. Fly Control. Fly control was given special attention since adequate fly control on the premises of mess establishments was carried throughout approximately with the number of flies present. All kitchens and dining rooms were adequately screened, sprayed monthly with DDT, and fly traps set up in strategic places. Additional fly paper was made from resin and castor oil to augment the issue of A.G. Fly preventers. Enlisted men were advised to keep their mess halls closed after they were properly cleaned it came to the high incidence of flies in the quarters.
The above precautions would be even more effective with adequate fly free. However in the town of SPINAZZOLA we have combated an almost insurmountable obstacle. The Italians in this area never had had high standards of sanitation and I personally doubt if they ever will have. Refuse is dumped into the streets at night, debris are filthy, and plumbing is almost medieval or non-existent in a majority of the homes. Children defecate in the streets, behind stores and buildings, in the park, or any other easily accessible area. In the absence of toilets, "aloe beds" are still in vogue in the majority of the homes. The "thunder mugs" are emptied every morning or night into the city sewer drains. To combat all these breaches in the primary rules of sanitation in spite of the Town Major, civilian mayor and local authorities was almost. Ten (10) additional street cleaners were hired, warnings against committing nuisances were posted and announced by the town crier, and offenders were given jail sentences of five days. The water supply is poor but the general sanitation of the city remains fairly to poor. These accumulation of human fecal material undoubtedly act as reservoirs for intestinal diseases and the swarm of flies act as ideal vectors.
Policing the latrines and stables, spraying these and other buildings with DDT, and cleaning the filth from the streets every day has decreased but certainly not eliminated the local fly population. Further work with the Italians will be made.
c. Water. The water supply for the city of SPINAZZOLA has had a welcome change since the last medical history report. The repair work on the main reservoir was finally completed in July and it is no longer necessary to rely upon the inadequate 10,000 gallon emergency reservoir. There was some confusion about the chlorination of the new reservoir during the first week of its usage. However, a new chlorinating unit was installed by the Corps of Engineers and competent personnel was assigned to maintain the unit. During the months of August and September the main complaint was the erratic electric current, which furnished power to the reservoir pump. Practically every rain storm produced a temporary shut down in the Italian electric power. This led, on several occasions, to an exhaustion of the reserve supply in the reservoir and the temporary shutting off of the city water supply.
d. Ice Cream. During August, three (3) samples of the ice cream being served at the Red Cross Snack Bar were sent to the 26th General Hospital Laboratory for examination. All three (3) samples showed heavy contamination with Enterococcus organisms and unfit for human consumption. The results of the examination were telephoned to the Surgeon's Office FIFTEENTH AIR FORCE, and the contamination was found at the Ice Cream Plant at BARI. The local use of the ice cream was stopped immediately on receipt of the reports and within a week there was quite a noticeable drop in the number of gastroenteritis in this area.
e. Ice. During June the ice from the SPINAZZOLA plant was considered unfit for use in drinks, but satisfactory for ice box usage. This decision was based on unsatisfactory reports in two (2) samples of ice sent to the 26th General Hospital Laboratory, plus frequent inspections, in which it was found the water was inadequately chlorinated and that considerable dirt was showing or dropping into the freezing molds. This insanitary condition was remedied during July by placing the supervision of the plant under enlisted personnel rather than Italian civilians. Two (2) samples of ice were sent to the 26th General Hospital, BARI, with a satisfactory report. Ice was then considered safe for all cooling purposes. Weekly inspections and monthly water samples are being made to maintain the sanitary standards of the ice plant.
OPERATIONAL HISTORY
a. Descriptive Narrative. During the month of July 1944, the 304th Bombardment Wing (M), continued its operations as a part of the Strategic Air Force. Operations were hindered by unfavorable weather, yet nineteen (19) missions were flown. The strategic objects and the July operations were:
(1) the destruction of Axis oil facilities (2) the destruction of Axis Industrial plants (3) the interdiction of communication lines and supply routes in FRANCE, the BALKANS, and NORTHERN ITALY. The more difficult targets for this month were VIENNA, BLECHHAMMER, PLOESTI, MUNICH, and FRIEDRICHSAFEN A.G. Excellent results were attained in all these objectives.
Operations during the month of August 1944 were the most successful of this Wing. Twenty-two (22) missions were flown against targets in GERMANY, FRANCE, CZECHOSLOVAKIA, ITALY, AUSTRIA, HUNGARY, YUGOSLAVIA, and POLAND attacking similar types of targets as those in JULY. Of importance was the support of this Wing in the invasion of SOUTHERN FRANCE, targets being bridges and gun emplacements.
Again during the month of September unfavorable weather hindered operations, only fifteen (15) missions being flown. Targets consisted mainly of marshalling yards and bridges, also oil, industrial and harbor installations. Targets were located in HUNGARY, YUGOSLAVIA, ITALY, AUSTRIA, GERMANY, POLAND, AND GREECE. Results of bombing for the month of September were excellent.
Mission levels attained by each Group as of 30 September 1944 is shown below in comparison with dates of first mission.
GROUP FIRST MISSION (MISSION LEVEL)
450th Bombardment Group 19 March 1944 (104)
449th Bombardment Group 2 May 1944 (98)
455th Bombardment Group 5 May 1944 (83)
456th Bombardment Group 10 May 1944 (92)
b. Professional Narrative. Air Base Group aid equipment was supplied to the 449th Bombardment Group on 1st of September, since this Group was located fourteen (14) miles from the nearest Field Hospital over extremely poor roads, it was given priority on this equipment. Fortunately this Group was given an excellent tuffa stone building for use as a dispensary with adequate space for setting up thirty six (36) beds. The care of sick and wounded in this Group is now considered excellent, and the evacuation of casualties over many miles of rough roads has been reduced to a minimum.
The medical and surgical care of sick and wounded in all Groups of this Wing has been maintained at a high standard. Unit surgeons have used the medical equipment available and also have been able to improvise heat lamps, operating tables, operating chairs, and other useful items in the dispensaries.
The 1st Platoon of the 8th Field Hospital and the 1st Platoon of the 34th Field Hospital still provide adequate and excellent medical care for Groups in this Wing. All seriously wounded personnel returning from combat missions are flown directly either to FOGGIA or BARI and admitted to the Station or General Hospital respectively, without having the combat ship with wounded aboard stop at the home base. This reduces the time factor in evacuation of seriously wounded, and is considered a valuable asset in lowering the mortality rate. It also cuts down unnecessary handling of wounded personnel.
c. Narrative of Medical Problems. Of particular interest during the three month period of July, August, and September was the problems in preventive medicine. These problems were mainly in the control of venereal diseases, intestinal diseases, respiratory diseases and insect borne diseases, and each will be taken up separately.
Our venereal disease rate for the entire Wing has progressively increased month by month during the quarterly period and the peak was reached by the end of September, when the rate was seventy seven (77) per thousand per annum. This rate has been consistently above the FIFTEENTH AIR FORCE rate except for the month of July when our rate was fifty three (53) per thousand per annum, and the FIFTEENTH AIR FORCE rate was sixty one (61) per thousand per annum. There was not one particular Group in this headquarters, which kept our rate high. The 456th Bomb Group had the highest rate in July, but has shown a progressively decreasing rate for the next two months. During the month of August, the highest rate was attained by the 450th Bomb Group and then in September by the 449th Bomb Group. The 449th Bomb Group started its combat service without any venereal disease, but over a period of months has had a slow but steady rise in rates. Nearly every case of venereal disease has been in ground personnel. Several factors have contributed to the low rate among flying personnel. First, the desire of flying personnel to complete the combat tour and return to the States in as short a period of time as possible may be the the prime factor. Knowledge that venereal disease, its complications and treatment may be prolonged depending on the individual concerned, with a resultant loss in time, thus causing the individual to drop behind his crew in completing the tour, prevents the officer or enlisted man from exposing himself unnecessarily. Secondly, the average combat crew member have a slightly higher moral aspect and intelligence in regards to venereal disease than many men here or the ground personnel. The greatest number of cases is found in privates and corporals, generally those individuals, who do not have the intelligence to get ahead. Education of the individual soldier has been stressed in control measures. Training films, lectures to members of the squadrons, free distribution of mechanical prophylactics, patrolling of known prostitution stations, approved recreation facilities, and administrative action have been used in an attempt to reduce the high incidence of venereal disease.
Control of intestinal disease required sound maintenance of strict sanitary discipline; the fly-proofing of all latrines, mess halls, and kitchens, use of DDT spray regularly in all of the above buildings, the proper preparation of all foods either cooked or uncooked, teaching of sanitation to Italian KPs and laborers, and instruction of the individual soldier in eating in only authorized places. In spite of strenuous sanitation in all units of this Wing the intestinal disease rate has been consistently above Air Force Level during the past three months. The 450th Bomb Group has had a fairly low rate for this quarter, while the other groups have each contributed to our high rate. This high rate can be attributed entirely to breaches in sanitary discipline, causing outbreaks of common diarrheas. In one instance it was due to contaminated ice cream, in other instances European screening and poor fly control measures. The Wing rate dropped rapidly in September although there was no decrease in flies from the surrounding country, but all buildings were screened and sanitation was stressed as a command function in an effort to reduce this rate. Results of efforts of all personnel improved highly satisfactory. Whereas the rate for the Wing in August was one hundred and six (106) per thousand per annum, it was reduced to forty two (42) per thousand per annum in September. With continued efforts it is felt that this rate can be kept at a minimum.
Rapid survey infections have not been too much of a problem for this three month period. During July and August dust from the roads from the prevailing winds may have contributed to the rise in respiratory infections in the Groups. Oiling of the roads, convoys, and areas around our base halls has materially reduced the quantity of dust that was breathed daily.
Through adequate malaria control measures such as reducing the number of breeding places for mosquitoes, oiling, draining, ditching, and personal measures, the number of cases of malaria reported have been at a minimum. Control of malaria has not been a serious problem in this Wing. Nearly every case of malaria reported in the Wing was either acquired prior to assignment to one of the Groups or picked up in one of the nearby cities where the individual did not use repellent or take the necessary preventive precautions.
AVIATION MEDICINE:
Thirty-one (31) officers and enlisted men appeared before the FIFTEENTH AIR FORCE Disposition Board during the period covered by this section of the history.
Pilots 6 Co-Pilots 4 Bombardiers 5 Navigators 8 Gunners 3 Engineers 5
The following dispositions were made by the board:
The number of dispositions are too small to arrive at any conclusions as to trend. The above distribution is merely cited as a matter of interest and experience.
Combat injuries were not previously analyzed in the history of this Wing, since our period of operation has been of such a short duration. From April 1st 1944 through 30th September 1944, five hundred and seven (507) combat injuries were incurred, which can further be broken down into the following categories:
TYPE WIA KIA Flak 185 5 German and Machine Gun 25 7
OPERATIONAL ACCIDENTS: Take off 56 42 Landing 106 9 Ditching 24 14 (Drowned - 5 MIA - probably drowned)
Relation of aerial injuries directly due to enemy action as related to type of position in the aircraft to enemy fire is shown in accompanying charts (See Tabs #11 and #12). Positions in regards to the protective armor in accordance over the waist area, but relates them away from the belly, which leaves combat crews vulnerable to flak in areas not briefed, and to enemy fighters. Two (2) waist gunners and four (4) officers, while they were not wearing protective armor.
Frostbite in the waist for members of operating has not been a major problem. Twenty-two (22) cases have been encountered; eleven (11) occurred from equipment failure, while eleven (11) others failed to protect themselves properly against low temperature.
One death occurred due to lack of oxygen in the case of an upper turret gunner. Investigation revealed that this occurred over the target area, due to vibrations or enemy fragments apparently caused him to neglect checking his oxygen and or oxygen equipment in working order. Artificial respiration and pure oxygen failed to revive the gunner. Some question was considered as to the mode of this death, since the wound was lacerated between the guns and the turret, but is felt that this occurred secondarily to the lack of oxygen.
Frequent, thorough briefing of combat crews on protective clothing, protective armor and use of oxygen has been found to be necessary to prevent breaches in combat discipline. This has been done by the Unit surgeons as soon as the replacement crew arrive and continued with lectures and training films, when available. The Wing Training Section instructs an information file in which these medical problems are discussed by the Wing Surgeon. These information files are to be distributed to all squadrons for use in their training program.
STATISTICAL HISTORICAL MATERIAL
a. Percentage rosters of charts maintained for the information of the Wing Commander and the Wing Surgeon are submitted as enclosures.
b. The following charts and summaries are submitted, as taken from the Care of Flyer and Weekly Statistical Health Reports (WSR), as enclosures:
(1) Average daily non-effective rate (Flying Personnel only) (2) Absolute Attrition Chart (Combat) (3) Incidence of Respiratory Diseases (4) Incidence of Common Communicable Diseases (5) Incidence of Intestinal diseases (6) Incidence of Venereal Diseases (7) Summary of report of Casualty (July, August, September) (8) Health Summary of Command (Combat Ground personnel by flying personnel) both hospitalized and treated men by Groups. (9) Wing Monthly Health Bulletin (Consolidated Data - July, August, and September) (10) Statistics - Hq & Hq Squadron, 304th Bomb Wing (11) Positional Injury in Plane (12) Location of Wounds Incurred in Action.
SPECIAL
On the 9th of August 1944, Lt Col RALPH S. PETERS, MC, Wing Surgeon had the opportunity of visiting the 5th Army, as an exchange liaison officer between the Air Corps and Ground Forces. He was flown from the base airport in a P-47 type fighter to CECINA, ITALY. From there he was driven by jeep to the headquarters of the 1st Armored Division. While a one way airminded medical he made an visit at night several miles along the Arno River to three evacuation points, he visited medical battalions and noted the collection points; and observed cases in military field use work at that time in forward to his organization. The exchange help was most rich and helpful in aiding better liaison and coordination between ground and air forces, helping each to evaluate its problems separate; to working together as a team.
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