An American Hospital in Assam

This article documents a small chapter in the cataclysmic history of the Second World War. It is an account of a hospital which brought together a large number of medical practitioners from Philadelphia, Pennsylvania to Ledo, Assam in 1943 to serve the call of America's patriotic needs at a tremendously grave period in the history of the U.S.A., Assam, India, and the world. This article sheds some light on the activities of a group of American doctors, nurses and military administrators who manned this superb hospital at Margherita, near Ledo in the north-eastern corner of Assam for more than two years, in a difficult and foreign environment.

Many of us who grew up in Assam might have read in high school history about the advances that the Japanese made against the British in the Burma-Assam border during World War II, and that finally, the Japanese were beaten back. The mission of the hospital under discussion was to be of service to the American soldiers of the Services of Supply engaged in constructing a road from Ledo, Assam to North Burma to restore land communication with China, which had been cut when the Japanese knocked out the Burma Road. American army engineers were desperately cutting this new route called the Ledo Road across the Patkai Mountains, for the armed forces, military supplies and food. They had to fight as well as bulldoze all the way, and the sick and the wounded were brought back to Margherita. The hospital also cared for Chinese soldiers who were serving as screen when the road was pushed forward.

The 20th General Hospital was formed in 1940 when the Dean of the School of Medicine at the University of Pennsylvania (Penn) was asked by the Surgeon General of the United States to organize an Army hospital unit to care for the Allied wounded in the Burma-India theater. But, the unit did not receive orders to leave for Camp Clairbone, Louisiana, until May 15, 1942. It remained there seven and a half tedious months of training for field service before moving on January 5, 1943 to Camp Anza, a staging area near Riverside, California. It finally sailed on the Monticello, a converted Italian cruise ship on the morning of January 20 and reached Bombay on March 3 after 42 days of sailing and a brief stopover in Wellington, New Zealand. The last leg of the trip by rail and boat of about 1500 miles began on March 13. The unit traveled across the heartland of India from Bombay to Dhubri, Assam by train. In Dhubri, the unit boarded a river boat and for two days steamed up the Brahmaputra. At Pandu, they boarded another train which snaked for 36 hours through the Assamese jungles, tea gardens and small towns to reach Margherita, near the Burma border in the north-eastern corner of Assam on March 22.

When the staff members of the 20th General first arrived in Margherita, there were only three small buildings with concrete floors, tin roofs and open fronts, as well as a group of bamboo huts with dirt floors and lights showing through thatched roofs. But, when the hospital was finally built fully several months later, it had transformed into a first-rate 2500-bed hospital, with 148 buildings covering one and half square miles. It became the largest hospital in the China-India-Burma theater. It also received a rating of superior---the highest possible in annual general inspections.

Approximately 110 nurses and 600 enlisted men comprised this University of Pennsylvania's hospital unit. Colonel Elias Cooley, a regular Army officer and a graduate of Philadelphia's Jefferson Medical College, was in command. Lieutenant Colonel Isidor Ravdin, Professor of Surgery at Penn and an authority on the use of blood plasma and sulfa drugs, was the head of the surgical service. Lieutenant Colonel Thomas Fitz-Hugh Jr., Clinical Professor of Medicine at Penn, headed the Medical Service. Most of the medical personnel were drawn from Penn faculty, and many of its nurses came from the Philadelphia General, Penn, Presbyterian, Episcopal and Bryn Mawr hospitals.

It was difficult for the Americans to acclimatize and perform well in a region with 120 inches of rainfall per year, humid summers and cold winters. However, with little paraphernalia and with none of the personal comforts to which they are accustomed, they were able to establish a complete hospital unit which contributed not only to the health of the Allied soldiers, but also to advancement of medical science. Beginning with a few shacks, they ended with a fully equipped modern hospital, provided with laboratories, x-ray and blood storage facilities and all other necessities of medical and surgical practice. It was filled almost from the beginning beyond its rated capacity of 1000 beds. At one time, it actually sheltered 2560 patients. During the entire period of activity, it received altogether 73,000 patients, with only a few more than 300 deaths form all cases.

The case load during the summer of 1943 was almost all medical, with either malaria or dysentry. The patients rolled in by truck loads. The unit was forced to open new wards one after another. In 1943, from June to October, there were 7236 admissions for malaria alone, 705 for bacillary or amoebic dysentry. Colonel Thomas Fitz-Hugh reported a mortality rate of 33% in the Chinese patients compared to 5% among the American.

In November 1943, the first cases of scrub typhus appeared. It was a new disease not studied before. It was analyzed intensively by Dr. (Major) Dickinson Pepper. In December, he traveled the Ledo Road to Shingbwiyang and concluded after detailed observations that it was a mite-born disease.

This disease caused high fever among the patients. To control it, Dr. Ravdin, the head of surgical service, had air conditioners flown in from Delhi. Lord Louis Mountbatten, the Supreme Allied Commander of Southeast Asia, flew to Margherita to dedicate the first air-conditioned hospital ward in the whole of India. After this, the doctors were able to keep the patients cool and were able to bring the temperatures down. The mortality rate dropped to about 1% whereas before it had ranged between 5 and 20%.

A very important concept in today's medical world---the concept of intensive care, now taken for granted, originated in the 20th General Hospital in the early 1940's. Dr. Larry Stephenson pointed this out in one of his papers.

By the autumn of 1943, all the original buildings were replaced with structures that had concrete floors and metal roofs with leaf overlay for additional insulation. Their double walls of bamboo matting, covered with burlap and mosquito netting provided ventilation and kept mosquitoes out. Everything was also screened.

After being on British field rations of canned fish, meat and tea for a few months, Dr. Ravdin started a vegetable garden which finally expanded to 36 acres. It provided the unit with fresh vegetables all the year round. The hospital also began raising pigs and a flock of geese for meat. The Christmas dinner of 1944 featured roast goose.

Since the staff at the hospital had strong academic backgrounds, the hospital became a center for weekly professional conferences attended by American, British and Indian officers from other medical installations. Some 100 important medical papers and scientific reports were produced by the 20th General Hospital, including those on scrub typhus and ophthalmology.

The 20th General Hospital was cited by many for its outstanding work. These include Lord Louis Mountbatten, General Joseph Stillwell, the Commanding Generals of the 1st and the 6th Chinese Armies, etc. The hospital won praise and personal gratitude from Lord Louis Mountbatten. Mountbatten had suffered a painful and serious injury when a low-hanging section of dead bamboo struck him in the eye, causing a hemorrhage, as he drove a jeep along a jungle trail in the North Burma front. He was flown into the hospital where Dr. (Major) Harold Scheie performed delicate treatment to save his sight. Mountbatten lay flat on his back with his eyes bandaged for five days. Afterwards, Scheie accompanied the commander to Delhi and looked after ehe injured eye during the convalescent period. Mountbatten and Dr. Scheie (who died on March 5, 1990) became life long friends. It was Mountbatten who, in August 1972, dedicated the Scheie Eye Institute in Philadephia.

General Raymond Kelser of the Army Veterinary Corps reported to the US Surgeon General Norman Kirk that ``the 20th General Hospital would be outstanding anywhere in the world and is the equal of university hospitals''.

As fighting receded from the Assam-Burma region, the Army began to withdraw officers and men needed in other fronts. The hospital closed its medical services in December, 1945, and was decommissioned on December 27.

I end this article with a song called the Twentieth General Song written by Mary Myers. It is a song which kept the American nurses in good and upbeat spirit all through their stay in Margherita.

Tune: ``Yankee Doodle''

We are from Pennsylvania.
All gathered here together,
Yes, we will work and we will play
In any kind of weather.

Chorus

Army Nurse Corps, that is we,
Army Nurse Corps, proud to be,
Anxious to do all we can
For God and home and country.

Dear Uncle Sammy called us all
Away from homes so happy;
Said, ``I need nurses for my men
Who fight Germany and Jappy.''

Now we are wearing G.I. clothes
Of O.D. cloth and hues;
We are in uniform, you bet,
From head gear down to shoes.

We're in the war for all we are worth,
For six months' post duration,
And we will win for we will give
Our best cooperation.

When this was is past history
We will go back some fine day,
To live our lives of peace and joy
In good old U.S.A.

References

1. John Hayden, Looking Back with the 20th General Hospital, Health Affairs, 1984, University of Pennsylvania, Philadelphia,
2. George Corner, Two Centuries of Medicine, 1965, J.B. Lippincott Company, Philadelphia
3. Philadelphia Record, April 27 & 28, 1943
4. The Evening Bulletin, Philadelphia, August 18, 1945
5. Philadelphia Inquirer, March 6, 1990
6. Several other unidentified newspaper cuttings and private notes

The author thanks Mrs. Nadine Landis of the Archives Department of the Hospital of the University of Pennsylvania (HUP) for providing the documents on which this article is based. He also expresses his thanks to Mrs. Cordelia Shute, Assistant to the Director of Clinical Research at HUP for telephone conversations regarding her stay in Margherita as a nurse in the intensive-care ward at the 20th General Hospital.

The photograph on top shows where the Ledo-Stilwell Road began in Ledo, Assam. The photograph was taken by Francis "Brad" Obradovich in 1945. He served in Assam with the American forces during WW-II. Oradovich, who grew up in Hoboken, New Jersey, now lives in Ohio. The photograph of Chabua was taken by Obradovich on October 26, 1945. It shows an American Military office building. The photo of a British tea planter's house in Margherita was taken by Obradovich in August 1945. The photograph of a labor unit working near tents occupied by Americans was taken by Obradovich some time in 1945.

Jugal Kalita
Written: April 1990 in Philadelphia
Published in Asomi, Assam Society of America, 1990
Posted on the Web: 8/28/98