Page 29 - JSOM Fall 2023

widened passageways, and included an ambulatory convales- their wounded, which would often influence military actions.
cent ward in an old barn to serve as a decoy. If threatened, the Even General Tito noted, “. . . operations were closely linked
ambulatory patients would evacuate, and this ward would be with our wounded, who were always numerous, so that it
sacrificed to hopefully preserve the secrecy of other Mt. Rog was not possible to avoid encirclement, although the Supreme
wards. Two cabins 10 minutes away served as a reserve in the Headquarters were fully aware of the enemy’s intentions.” 16
event the hospital needed to take on more patients. Patrols
communicated enemy movements between additional cabins, The Partisan hospital system was designed to minimize losses in
the furthest of which were up to 5 hours away. An air raid the event the Germans threatened hospital safety. The general
alarm prompted rapid camouflage of all cabins and huts, and strategy was to have designated fallback wards and bunkers if
cooking with smokeless charcoal reduced the likelihood of en- the enemy encroached. The small security force protecting the
emy detection. hospital would harass and misdirect enemy forces while the
hospital was evacuated. Ambulatory patients dispersed to dis-
Hospital facility distance reduced the number of routine tant wards or temporary forest shelters with medical staff and
checkups and added burden to the medical staff. Two doctors supplies. Litter-bound patients hid in underground bunkers
oversaw the growing Mt. Rog hospital, and a surgery team pre-stocked with supplies and staffed with a nurse. Patients
would travel to each ward. Hospitals generated weekly reports would sometimes remain hidden for months at a time.
to central command, and specialized providers would visit the
facilities as needed.
Hospital Staffing
Most accounts indicate Partisan hospitals were very under-
Hospital Operations
staffed, especially during hospital evacuations. Smaller hospi-
When the British surgeons entered Yugoslavia, they encoun- tals would often only have a single nurse or physician that
tered hospitals with appalling sanitary conditions. Many were split their time between multiple hospitals. The medical skill
dirty, were overcrowded, were damp, and lacked clean water of the Partisans was highly variable. Dr Dafoe considered his
and supplies. An ironic consequence of the poor sanitary con- first assistants to be inefficient, whereas Dr Rogers remarked
ditions manifested with many wounds becoming infested with that the untrained peasant nurses in the Partisan hospitals
maggots that would clear away necrotic tissue. The first orders were comparably skilled to British nurses he worked with in
5
given by the British surgeons were to have the facilities rigor- North Africa. A 2-month course was held at the hospitals to
ously cleaned and operating rooms disinfected to the best of train local girls as nurses, with an advanced medical course in
1
their ability. At Kosta hospital, Dr Dafoe required patients to Vojvodina for exemplary nurses that was 2 to 3 months long.
be “disinfected” on arrival by shaving their heads, sanitizing Recovered patients often aided in hospital construction and
2
their clothes, and bathing them in a separate facility. It was assisted staff. Partisan hospital doctors were prized German
1
also standard practice to delouse incoming patients. 1 targets, likely because doctors knew the location of hospitals,
backup bunkers, and supply caches in the network. Extracting
Dr Dafoe recorded an average of 15 surgical cases a day, with that intelligence would have allowed the Germans to strike a
a hospital census of 150 at Kosta. Periodically, he would also fatal blow to that region’s medical system. 5
be confronted with mass casualty events requiring rapid triage
2
and redirection of some patients to other hospitals. Civilians Logistics
were often treated in Partisan hospitals because they repre-
sented an important source of support for the Partisans. Partisans supplied themselves through many different channels
to include the local population, enemy units, occupied hospi-
Maintaining secrecy was paramount and “[a]s a rule, no hos- tals, manufacturing supplies, Allied air drops, and scavenging.
1
pital knew the location of the others.” Hospital staff were During the conflict, Partisan forces believed a strong medical
carefully selected from the most loyal Partisans. To maintain system would boost military morale and prioritized adequate
secrecy, patient admissions and discharges only occurred at supplies and personnel for the medical system over line units. 17
night. Code names were used for hospitals, nearby villages,
and landmarks to minimize the odds of discovery if a patient An important source of supplies in the early stages of the war
or staff member was captured. Dry food was issued during the was the free market. The local population was generally loyal
day when necessary and cooking performed at night. Staff and and supplied a large fraction of medical supplies. Hospital
patients could not leave the hospital without permission from furniture would be obtained locally or by attached hospital
the senior officer; movement into and out of hospitals in the craftsmen. Enemy medical supplies were obtained through
1
winter was only permitted during heavy snowfall in order to capture or by smuggling supplies out of occupied zones.
conceal tracks. Treating patients out of a backpack became a Medical staff who were loyal to the resistance would assem-
1
necessity for both British surgeons while hospitals were mov- ble supply packages and often pass them to couriers to take
ing with maneuver units. 2 the packages across German lines to Partisans, usually under
5
the cover of darkness. Partisans would conduct purposeful
The close tie between troop morale and care of the wounded raids on hospitals in occupied territory. Highest priority items
necessitated direct communication between the commanders were “bandages, surgical instruments, thermometers, serums
and the medical corps. 1,14 Partisan statutes dictated that the (especially anti-tetanus vaccine), syringes, cardiac drops, an-
medical officer was a member of the staff and should be in- aleptics, narcotics, disinfectants, etc.” Medicines would only
1
formed of future operations, and that the medical officer and be used if they were found in original containers because of
commander should mutually agree on the transfer of a medical the risk of accidental or intentional mislabeling by the enemy.
unit. Medical service also had location priority when a unit ar- Dr Rogers would sometimes use half a cup of the local fruit
15
rives to a new location. The Partisans were very dedicated to brandy, named rakija, to supplement morphine for shrapnel
WWII Yugoslav Guerrilla Hospital | 27