Page 32 - JSOM Winter 2018

Guerrilla Hospital Design and Lessons Learned

Warner D. Farr, MD

ABSTRACT
The author discusses the lessons that can be learned from TABLE 1 Aims and Functions of Special Forces Guerrilla Medical
older sources when engaging in guerilla warfare medicine and Support
surgery. 1. Conserve manpower and improve morale.
2. Deny information to the enemy.
Keywords: guerilla warfare medicine; guerilla warfare surgery 3. Gather medical intelligence.
4. Improve relations with civilian population.
5. Provide medical treatment and evacuation.
Introduction 6. Provide/manufacture medical equipment and supplies.
With the renewed interest in guerilla warfare medicine and 7. Provide hospitalization and convalescent care.
surgery, especially as they apply to future missions conducted 8. Return recuperated patients to duty.
in denied areas without our usual air superiority and with 9. Evaluate the medical area.
lengthy holding times and even more lengthy evacuation, it is 10. Establish a preventive medicine program that includes
useful to review the doctrine and literature contained in sev- immunizations, rodent eradication, sanitation, and nutrition.
eral old but still useful publications.
counterparts. Second, the incidence of disease and sickness is
often higher in guerrilla forces than in comparable conven-
These include the older Special Forces field manuals, such as
FM 31-21. The best for guerrilla warfare being the 1951 and tional units.
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1961 editions. Some editions of these and some other helpful
manuals are available on the Internet, including the original Area Medical Support System
Special Forces Medical Specialist Handbook published in Jan- The area medical support system is based primarily on local
uary 1969 by US Army John F. Kennedy Center for Military facilities supplemented by guerrilla sponsor–provided medical
Assistance, and the first ST 31-91B U S Army Special Forces supplies. The medical system in the operational area features
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Medical Handbook. This article is a combination of text and organized guerrilla medical units and auxiliary medical facil-
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ideas from those publications, combined with published per- ities to aid individual patients and small groups of casualties.
sonal narratives of actual physician participants in guerrilla The guerrilla medical units are located in the guerrilla base
warfare, most of whom were surgeons on forward surgical areas and are staffed by guerrilla medical detachments. The
teams whom the Office of Strategic Services inserted to sup- auxiliary facility is a location in which one or a few patients
port guerrillas as the guerrilla force size increased. 4,5 can be held in a convalescent status and cared for by civilians
and auxiliary medical facilities sympathetic to the cause.

Guerilla Medical Service Structure, Function
Size, and Functions
Guerrilla medical detachment
The guerilla medical service structure, size, and functions are Regardless of the varying size of guerrilla units, the medical
set by a guerrilla area command medical requirements docu- detachments retain essentially the same structure and func-
ment made specifically for each mission. There are no hard and tions. Their duties are to maintain a high state of health in
fast rules concerning medical support. Medical support (Table the command, to render efficient treatment and evacuation of
1) needs to be as simple or as complicated as the mission dic- casualties, and to insure the earliest possible return to duty
tates for mission accomplishment. The success or failure of the of those who are sick or injured. The detachment may also
medical service will depend on the skill and ingenuity of the provide treatment and drugs to auxiliary and underground el-
individual Special Forces medic and her or his support of the ements of the resistance.
Special Forces detachment commander. The area command
medical requirements may vary widely between operational The organization of the medical detachment consists essentially
areas, but they usually differ from a conventional medical of three sections: (1) The aid station, charged with the imme-
command in two main respects. First, due to the nature of diate care and evacuation of casualties and with in-route care;
guerrilla operations, the number of battle casualties normally (2) the guerrilla hospital, which performs definitive treatments
is lower in guerrilla units than in their conventional infantry of casualties and coordinates medical resupply and training;
Correspondence to wfarr@lecom.edu
COL (Ret) Farr is at the Lake Erie College of Osteopathic Medicine in Bradenton, FL.

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