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When French colonial rule there came to a chaotic end in 1954 following the climactic defeat at Dien Bien Phu, the U.S. Navy helped evacuate 721 French troops and transport them back to their homes in France and North Africa. The hospital ship Haven, which had already seen action in World War II and four tours during the Korean War, was again pressed into service for the trip. One of the French soldiers died en route. As Navy nurse Anna Corcoran later recalled, "They off-loaded the body in a casket with the French flag draped over it. That was very, very emotional to watch. Of course, at that time, we didn’t know how many of our own would be going home that way from Vietnam. We couldn’t have imagined back in 1954 that 10 years later we would be involved just like the French were."
America’s long Vietnam nightmare indeed began that fateful year—1954. Shortly after Haven’s participation in "Operation Repatriation”, the Navy was again called upon to spearhead another humanitarian operation. Under the terms of the 1954 Geneva Accords, which ended the war between France and the Communist Viet Minh, the people of Vietnam could decide where they wished to settle. Few in the south chose to go north, but with the collapse of French rule, hundreds of thousands of refugees streamed south to escape the Communists. In "Operation Passage to Freedom," Navy ships evacuated to South Vietnam more than 860,000 refugees.
Passage to Freedom had a major medical component. Navy physicians and hospital corpsmen were charged with providing medical care for the refugees, many of whom were already very debilitated by their ordeal. Skin diseases, dysentery, and intestinal parasites were very common as was the highly contagious eye affliction—trachoma. As the refugees were brought to Haiphong—the port from which they would embark for South Vietnam—the Navy set up temporary camps for them complete with tents, potable water, food, and medical care. Preventive medicine teams worked diligently to control the rodent and insect population, spray for malarial mosquitoes, and purify water. Men, women, and children were vaccinated, deloused, and treated for their illnesses. When they boarded transports and LSTs for the journey south, Navy medical personnel accompanied them, dressing their wounds and handling fractures, fevers, and delivering an average of four babies per trip.
In the late winter of 1963, Navy physicians and nurses began arriving in Saigon. By that fall, they began setting up what became known as Station Hospital Saigon. It was a five-story concrete building which at that time served as the only Navy hospital receiving American combat casualties directly from the field. The 100-bed hospital was established to meet the need for an inpatient facility in the southern portion of South Vietnam. The need was precipitated by an increase in the number of casualties in the Mekong River Delta area, and the distance involved in flying patients from there to the only existing American hospital at the time—the 100-bed Army field hospital in Nha Trang, 200 miles north of Saigon. In addition, increased terrorist activity in Saigon itself supported the need for a hospital in or near the capital city.
Despite the American low profile, Viet Cong terrorists were already very active, exploding bombs not only in the Central Market, but in bars and theaters frequented by American service personnel. On Christmas Eve, 1964, a Viet Cong agent parked a bomb-laden car in the underground garage of the Brink BOQ. It detonated less than an hour later with devastating results. There were a number of killed and wounded. Four Navy nurses were among the latter and became the only Navy nurses to be awarded the Purple Heart during the Vietnam War.
In the summer of 1964, an incident in the Gulf of Tonkin had already turned the festering conflict in Southeast Asia into a full-blown war. On August 2nd, USS Maddox was on what was termed a routine patrol in international waters when three North Vietnamese torpedo boats commenced a high speed torpedo run on the destroyer. What resulted was the so-called “Gulf of Tonkin Resolution” passed by Congress on August 7th. This resolution gave the president the power “to take all necessary measures to repel any armed attack against the forces of the United States and to prevent further aggression.” Escalation of the war in Vietnam was now assured.
If the Communist insurgency was to be kept at bay and finally defeated, “winning the hearts and minds” of the South Vietnamese people increasingly became the goal of U.S. aid. Because medical care of any kind was a luxury few Vietnamese in the impoverished countryside could afford, medical aid programs became a high priority. A series of programs co-sponsored by the Department of State, the U.S. Agency for International Development (USAID), and the Department of Defense staffed what became Military Provincial Health Assistance Program teams or MILPHAP. The Department of Defense was to provide military personnel to staff these teams. By the spring of 1969, the Navy fielded seven MILPHAP teams which operated in many of South Vietnam’s provinces. The goal was to practice medicine in South Vietnamese civilian hospitals alongside their Vietnamese counterparts.
The Navy and the other services also began what were called civic action or “people to people” programs whose primary aim was to enable the Vietnamese to help themselves. These programs also embraced English and technical training classes and on-the-job instruction. They also provided medical and dental assistance.
The Medical Civil Action Program (MEDCAP) was, in fact, one of the first civic action programs to be implemented. MEDCAP was intended to provide emergency care for civilian casualties and refugees in combat areas, offer sick call and limited dispensary care in populated areas not yet secure, and give professional medical assistance in secure areas and local hospitals.
With escalation of the war, the first U.S. combat troops arrived in Vietnam in March 1965 to defend the Danang airfield. These were the Marines of the 3rd Marine Division. Soon Marines were also deployed to Chu Lai, about 50 miles south of Danang to protect the airstrip, and also to Phu Bai, about 40 miles north, near the city of Hué, to defend another airfield there. With a force of 3,500 troops, medical support became a high priority. The 3rd Medical Battalion provided that support.
The 3rd Medical Battalion had a collecting and clearing company for each of the infantry regiments and one at the division headquarters. The collecting and clearing company was intended to be mobile so it could move within the infantry regiment to which it was attached. Because the war in Vietnam was essentially a “frontless” conflict with little movement, the collecting and clearing companies were in fixed locations. These companies traditionally were not designed as definitive treatment facilities but were the only companies then available to assign to Danang, Chu Lai, and Phu Bai, where airfields needed protection. Despite their limitations at the outset, within a few short months, these collecting and clearing companies had become real hospitals. Charlie Company organized at Danang, Bravo at Chu Lai, and Alpha at Phu Bai. Before long Delta Company was also operational.
The policy developed for treating casualties at the medical companies was this: After being admitted, a patient received treatment. If he could recover from disease or wounds in 120 days and return to duty, he was kept in theater. If additional care was required, he was shipped back to the United States.
As troop buildups continued and the war became more violent and widespread throughout South Vietnam, Navy medical personnel had plenty of business. The types and severity of the injuries were those typically inflicted by the weapons of war—mines, high velocity small arms, artillery, grenades, mortars, rockets, and booby traps. In time, the medical battalions were very well staffed and equipped to handle the large influx of casualties. Well trained and skilled surgeons, anesthesiologists, orthopedists, and oral surgeons, many hailing from some of the finest medical schools and hospitals back in the U.S. were able to perform definitive surgery. Many of the mine-inflicted injuries required vascular repairs, and skilled surgeons saved many limbs from amputation.
The very first care-giver a wounded Marine would see in the field was his “doc,” the ubiquitous Navy hospital corpsmen. Vietnam era corpsmen were very special to the Marines they served. He was the man they protected because they knew he was there to take care of them. “Doc” had the skills to save their lives if they were hit. As in other wars, corpsmen were trained to accomplish the four basic resuscitative techniques: Stop the Bleeding. Clear the airway. Protect the wound. Treat and prevent shock. To accomplish this, the corpsman’s Unit 1 medical kit typically contained battle dressings and other bandages, morphine syrettes, a wire splint, atropine, adhesive tape, scissors, casualty tags, iodine, Bacitracin ointment, aspirin, and sometimes a small surgical kit containing a forceps and scalpel blades.
The Vietnam corpsman had to practice his brand of medicine in a particularly hostile environment. The extreme heat and humidity and the necessity of living in the field for long periods meant that disease and injury were constant companions. During the summer, heat exhaustion and heat stroke were common. COL Michael Holladay, a former Marine Corps platoon commander who served up near the DMZ (Demilitarized Zone), recalled: “We had only the clothes we were wearing, which were the old green jungle utilities. We spent so much time in the bush that your clothing stayed wet damn near all the time. Because we went through the old tiger grass, which had a razor edge on it, the crotch of the utilities wore out. A lot of Marines had groin infections and boils. The corpsman spent much of the time trying to deal with some of the health issues that came up with men who were constantly living in a muddy, wet environment.” That constant wetness also contributed to foot problems and jungle rot. Leeches were common; occasionally a corpsman was called upon to render first aid to a snakebite victim or two. The awarding of four Medals of Honor to Navy hospital corpsmen in Vietnam, two posthumously, is testimony to their valor.
Unlike Korea where Navy nurses were relegated to duty aboard hospital ships or in naval hospitals far from the front, in Vietnam nurses served at Station Hospital Saigon, were part of MILPHAP teams working in Vietnamese civilian hospitals, aboard the two hospital ships—Sanc-tuary and Repose—and at the Naval Support Activity (NSA) hospital in Danang.
By the summer of 1966 there was a functioning hospital at Danang with a highly skilled staff and a range of specialties not seen anywhere else in Vietnam except on the two hospital ships. In addition to general and orthopedic surgeons, NSA Danang had the luxury of urologists, neurosurgeons, and even plastic surgeons. And even though frozen blood technology was still experimental at the time, NSA Danang maintained a blood bank with a frozen blood capability. Units donated, processed, and frozen in the States, were shipped to NSA where they were thawed, processed, and used when required.
By 1967, two hospital ships augmented the Medical Department’s assets in theater. USS Repose had been recommissioned in the fall of 1965 and arrived on station off Chu Lai in February of the following year. Sanctuary had arrived in Vietnam in April 1967. Both vessels were once part of the World War II Navy hospital ship fleet and all were of the Haven class built near the end of that conflict. The brand of medicine practiced aboard these vessels was as state of the art as any practiced at the finest hospitals back in the U.S. But, most importantly, both ships had helicopter landing decks, allowing for patients to arrive aboard ship, some within an hour of having been injured. In addition, their mobility allowed them to cruise off the Vietnamese coast and render aid in areas where combat operations were underway.
Although helicopters had been used extensively during the Korean War, it was in Vietnam where the helicopter came into its own. In a country of few roads, little infrastructure, and a topography of jungle, highlands, and delta, helicopters were required to provide troop transport and airlift supplies. The omnipresent UH-1 “Hueys,” employed so effectively to airlift Marines, soldiers, or ARVN (Army of the Republic of Vietnam) troops, doubled as ambulances, evacuating the wounded from where they had been injured to medical company hospitals, NSA Danang, or to the hospital ships. RADM Almon Wilson, who commanded Charlie Med shortly after it was established, recalled how the system worked: “When helicopters landed, they were on the ground in less than 20 seconds. We had people always available to take patients from the helicopters. Standard procedure was for somebody to take the stretcher under an arm and rush out to the helicopter with another stretcher bearer, get the patient out of the helicopter, put the fresh stretcher in, and move the patient into the shock and resuscitation area. The helicopter could then leave, and this was a matter of 20 seconds if just one patient was involved.”
During the Vietnam War, 771 American military personnel became prisoners of war, most of them aviators. In 1973, 658 were returned to U.S. military control; 113 died in captivity. The POWs who were freed had many physical and psychological issues to be resolved. Navy orthopedists confronted the aftermath of torture and maltreatment—broken bones that had not mended properly, and the ravages of osteo-arthritis that sometimes resulted. Treatment for these conditions is ongoing in some former POWs over 30 years later.
When the war ended in 1975 with a Communist victory, Navy medical personnel suddenly had a new constituency—Vietnamese refugees fleeing their homeland. After Navy ships picked up these refugees at sea, they were brought to special refugee camps set up for their relief in Guam and back in the States. There, medical personnel provided medical care until the refugees could be resettled into a new life. The story of Navy medicine in Southeast Asia had come full circle. In 1954, who could have imagined that just over 20 years later, “Operation Passage to Freedom” would be repeated.