Page 26 - JSOM Fall 2023

Yugoslav Guerrilla Hospital Design Features
and Operation in World War II

M. Tyler Colesar, MD *; Jay B. Baker, MD 2
1

ABSTRACT
In the most austere combat conditions, Yugoslav guerillas of Dr Djordje Dragic. 1,2,5 These sources describe the strategies
World War II (WWII) demonstrated an innovative and effec- used to operate and sustain austere, long-term hospitals in
tive hospitalization system that saved countless lives. Yugoslav hostile territory. Dr Lindsay Rogers was a New Zealand sur-
Partisans faced extreme medical and logistical challenges that geon and the first surgeon to be covertly deployed to Yugo-
spurred innovation while waging a guerrilla war against the slavia. He worked in secret hospital networks treating injured
Nazis. Partisans used concealed hospitals ranging between 25 Partisans, downed Allied pilots, and wounded civilians in
to 215 beds throughout the country with wards that were of- various locations in the Balkans including Dalmatia, Croatia,
ten subterranean. Concealment and secrecy prevented discov- and Bosnia. After returning to Italy to acquire more supplies
ery of many wards, which prototypically contained two bunk for his mission, he returned to the battle zone by parachuting
levels and held 30 patients in a 3.5 × 10.5-meter space that in- into Slovenia with two assistants to continue the mission. Dr
cluded storage and ventilation. Backup storage and treatment Dafoe was a Canadian surgeon who served with Dr Rogers in
facilities provided critical redundancy. Intra-theater evacuation North Africa and later followed his example and parachuted
relied on pack animals and litter bearers while partisans relied into Yugoslavia. In Yugoslavia, he treated a variety of casu-
on Allied fixed wing aircraft for inter-theater evacuation. alties and directed the construction of a hospital ward made
of parachutes and wood, for which the book Parachute Ward
Keywords: Yugoslavia; warfare; hospital design and construc- is named.
tion; military personnel; military health; military medicine;
war-related injuries; armed conflicts; World War II Dr Dragic served as a surgeon in the Partisan forces and wrote
extensively on the structure, tenets, and design of the Partisan
guerrilla medical system. Dr Dragic worked briefly with Dr
Dafoe to treat casualties in the 38th Division, and they contin-
Introduction
ued to correspond after the war. Additional primary sources
2
On April 6, 1941, Axis forces invaded Yugoslavia and quickly describing the guerilla hospital network include the writings
subdued Yugoslav forces. The Yugoslav Partisans soon of Dr Gojko Nikolis, the first head of the Partisan Medical
emerged as a robust and credible fighting force led by Josip Corps, and Josip Tito, leader of the Partisans.
Tito and were able to mount a successful guerrilla resistance
with material and personnel assistance from the Allied pow- This article adds to the knowledge of guerilla hospital opera-
ers. The rugged and mountainous terrain made Yugoslavia tions previously described by Dr Warner “Rocky” Farr in his
1
ideal for mounting a guerrilla defense. To the west, the Adriatic 2017 monograph, The Death of the Golden Hour and the Re-
Sea provided access to the Mediterranean and enjoyed moder- turn of the Future Guerilla Hospital, among other sources.
6–8
ate weather. The northern portion of the country bordered the It reviews and summarizes detailed information from previ-
eastern edge of the Alps, resulting in tall peaks, deep gorges, ously unreported sources regarding guerilla hospital design,
and vast forests. operations, and logistics that provide additional understand-
ing and detail about the successful conduct of unconventional
Yugoslav military and civilian casualties sustained during the warfare medicine.
conflict were estimated at upwards of 1 million. Medical
2,3
infrastructure and supply were limited because of German Hospital Design
occupation, who would often resort to torture to extract infor-
mation from Partisans and civilians to locate hidden hospitals. Principles for organizing hospitals implemented by Major
These hostile conditions forced the Partisans to protect their General and Partisan physician Gojko Nikolis included dis-
wounded with the utmost secrecy. 4 persing casualties when possible, use of triage and clearing
centers before transport to a remote hospital, and use of hid-
The WWII Yugoslav medical system has been described in den backup facilities. In unoccupied friendly territory, open
9
multiple firsthand accounts including in Guerilla Surgeon by (public) hospitals were often located in schools, cooperatives,
Dr Lindsay Rogers, The Parachute Ward featuring Dr Colin hotels, and similar structures. Secret hospitals located behind
1
Dafoe, and Partisan Hospitals in Yugoslavia 1941–1945 by enemy lines were more likely to have purpose-built structures
*Correspondence to michael.t.colesar.mil@army.mil
2
1 CPT M. Tyler Colesar is an emergency physician with 2nd Brigade, 11th Airborne Division in Anchorage, Alaska. COL Jay B. Baker is an
emergency physician currently serving with the Joint Trauma System in San Antonio, Texas.
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