As part of the process of trying to identify / eliminate small Pacific islands taken by the Americans in early 1945, I’ve been reading loads of books and articles, while grinding through all manner of documentary evidence.
So far, the single thought that strikes me most is that anyone ill or wounded encountered by US Military forces in the Pacific would be processed and treated by its military hospital infrastructure. And so I quickly pivoted to trying to understand how US Military field hospitals worked in 1945…
The 1945 bed problem
In early 1945, the immense logistical challenge that US military planners faced in the Pacific was how to put enough beds in place to support not only an assault force, but also an occupation force. Japan was going to need a lot of field hospital beds, and the practicalities of war often meant that these had to be in place elsewhere in the Pacific before any large actions were set in motion. This is a side of war at scale that few people ever properly consider or think about.
Hospital ships were a huge help close to the front lines, but these were relatively few, and had only limited capacity. What people needed on the ground (and not too far back from the front line) were actual field hospitals.
You can therefore track the situation in the Pacific theatre of war by seeing where the 24th Field Hospital was located:
| New Caledonia | Jul 6, 1943 | Jul 21, 1943 |
| Guadalcanal | Jul 31, 1943 | Sept 6, 1943 |
| New Georgia | Sept 7, 1943 | Feb 7, 1944 |
| Guadalcanal | Feb 8, 1944 | Mar 20, 1944 |
| Emirau | Apr 1, 1944 | Jun 15, 1944 |
| Luzon | Jan 11, 1945 | Sept 6, 1945 |
| Honshu | Sept 17, 1945 | Dec 14, 1945 |
From this table, and given that we’re specifically interested in the early 1945 time-frame, I’m going to drill down into what happened when the 24th Field Hospital moved to Luzon in the Philippines.
Luzon
The American fight to reclaim the Philippines (having had Japan steal the islands from the US at the end of 1941) started with a gargantuan sea battle in Leyte Gulf in October 1944 (arguably the largest naval battle ever fought). This was paralleled by a land attack on the island of Leyte in the Central Philippines that continued through to the end of 1944. As the Japanese war planners had already worked out, however, the US’ real target there was actually Luzon.
We can see how this played out in the timeline for the 24th Field Hospital in Luzon:
January 9, 1945 – the 24th Field Hospital lands at Lingayen Gulf, Luzon, Philippine Islands.
January 11, 1945 – the organization sets up for operation and receives its first patients.
January 16, 1945 – Paragraph 12, General Order # 9, Headquarters Sixth United States Army, APO 442, dated January 27, 1945, confirms transfer of the 24th Field Hospital from XIV Army Corps to Sixth Army.
January 20, 1945 – the Hospital closes for receipt of patients and transfers all remaining sick and wounded to the 7th Evacuation Hospital.
January 30, 1945 – the 24th Field Hospital closes its present site for operations and transfers all its patients to the 21st Evacuation Hospital.
May 28, 1945 – following receipt of new movement orders, the organization sets up at a new site further inland.
July 1, 1945 – General Orders issued by Headquarters, Sixth United States Army, announce that the 24th Field Hospital will end its stay in Luzon, Philippine Islands, by July 4, 1945.
Specifically, the 24th Field set up under canvas on 11 Jan 1945 in Binmaley, “to accommodate about 400 patients”. This was:
“[…] mainly to care for Filipino civilians who had been injured from the initial air and naval bombardment, prior to the landings. During the immediate phase of operations, evacuees were taken to the 7th Evacuation Hospital, located at the Lingayen airstrip. Unfortunately, evacuation by air could not be effected immediately since the strip was not in a condition to be used, and therefore those patients were evacuated from the beach to ship.”
What had happened was that “several hundred Filipinos” had been wounded by the initial three-day bombardment of the area surrounded the landing area, that “resulted in the destruction of hospital buildings, churches, and what few medical supplies were in the hands of civilians. Hundreds of civilians were killed, injured, separated from their families, and dispersed throughout the objective area.”
We can then see these civilians being moved out of the 24th Field Hospital:
On the afternoon of 10 Jan 1945, civilian casualties were evacuated from division clearing stations to companies A and C, 264th Medical Battalion, in order to free them for possible movement inland.
During 11 and 12 January, civilian casualties were transferred to the 24th Field Hospital from Company A, 264th Medical Battalion, and to the 894th Clearing Company by Company C, 264th Medical Battalion. The 24th Field Hospital thereafter received civilian casualties in the 37th Division sector, and the 894th Clearing Company received those in the 40th Division sector, until such time as improvised civilian hospitals under PCAU control were able to assist such hospitalization responsibilities.
It was also mentioned that “Civilian physicians and nurses were hired through PCAU to assist Army personnel in the care of civilian casualties.”
We similarly learn:
The 894th Medical Clearing Company opened at Lingayen on 11 January and was not utilized as a chain in the medical service for Army personnel. It served entirely as a hospital for the care of sick and injured civilians in the 40th Division sector.
We further learn that at this time:
Evacuation by water took the seriously ill and wounded to Leyte, and when hospitals became crowded, to Biak. Hospital LSTs, medically-equipped APAs and Hospital Ships carried the wounded on slow journeys to other destinations.
What I’m trying to highlight, however imperfectly, is the network of station hospitals, field hospitals, and evacuation hospitals that criss-crossed the Pacific. Even in just this one tiny slice of war, we can see casualties from the front:
- Being evacuated by ambulance (e.g. by the 410th Medical Collecting Company)
- Being triaged and processed by Companies A and C, 264th Medical Battalion
- Being taken to 894th Medical Clearing Company at Lingayen or the 24th Field Hospital in Binmaley.
- The seriously ill and wounded were then taken by water to (already crowded hospitals) in Leyte
- When Leyte ran out of space, casualties were shipped to Biak in Western New Guinea (in modern-day Indonesia)
- Casualties were also taken onwards to further destinations by hospital ships / transports etc.
Camp Del Pilar
The 24th Field Hospital’s next phase began on 30th January 1945:
The 24th transferred all remaining patients to the 21st Evacuation Hospital and then moved on to Dau. The new hospital site was located on National Highway No. 3, approximately 2 miles north of Angeles, 7 miles south of Mabalacat, and near to Airstrip # 2, Clark Field. The site itself was a former Filipino garrison hospital named Camp del Pilar. It consisted of permanent buildings which the Japanese had taken over and utilized. Consequently they needed much repair and cleaning prior to any possible use. The main building was allocated to the Surgery Section while additional small rooms were utilized for Clinics and Administration. The theater auditorium and stage conveniently housed approximately 174 acute surgical patients. As the place was really large, three 2-story barracks were used to accommodate 250 more patients, and two thatch-roofed other buildings were converted into wards with a capacity for approximately 1500 beds, two Operating Rooms, one Mess Hall, and some Offices.
Here we can see Japanese hospital buildings (i.e. the Camp del Pilar garrison hospital) being appropriated and used by the 24th Field Hospital.
So it would seem that many of the historical components we were looking for were indeed in place in the Pacific in January 1945, though that hardly amounts to proof that everything claimed to have happened did in fact happen. But even so, it’s arguably a tolerably OK starting point. 😉
Associated Archives
Incidentally, NARA has a sizeable (1665 boxes’ worth) collection of material related to this period called “The Philippine Archives Collection”, though the matching digitization project seems to be taking a fair old while. I found one 270-page pdf describing Phase II box contents, but given that I don’t yet know what I would like to find out from these, it’s perhaps a bit early for a deep dive into these waters.