Humanitarian Relief and Assistance Missions in the 1970s 141

Chapter Seven
Humanitarian Relief and Assistance
Missions in the 1970s

I
n the post–Vietnam era, particularly in the early days of the 1970s, many
aspects of Army Nurse Corps life were less than ideal. Moreover, the war-
weary American populace was firmly opposed to supporting overseas combat
operations. Nonetheless, when the call came to participate in relief or humanitar-
ian missions, Army Nurse Corps officers responded quickly and with enthusiasm.
They made worthwhile contributions to the disaster relief operations in Nicaragua
and Guatemala and in Operations New Arrivals and New Life. They also readily
shared their expertise and acumen when asked to do so by U.S. international allies
and friends.
Just after midnight on 23 December 1972, an earthquake shook the Nicaraguan
capital city of Managua. Although the temblor measured in the moderate to seri-
ous range at 6.25 on the Richter scale, several factors intensified the effects of
the shock and created a disaster with significant destruction and casualties. The
effect of the earthquake was even more devastating because of the location of the
epicenter in a vulnerable, heavily populated downtown area; the fragile mortar-
and-tile construction of dwellings; the unfortunate timing, when most citizens
were indoors asleep; and the ensuing fire that raged unchecked for days because
of high winds and a disrupted water supply.
The Nicaraguan government immediately asked the United States to provide
some measure of medical assistance because all local hospitals in Managua were
destroyed. U.S. Southern Command responded to the call by deploying two field
hospitals—an Air Force Tactical Hospital based at MacDill Air Force Base, Flor-
ida, and 100 beds of the Army’s 21st Evacuation Hospital, garrisoned at Fort
Hood, Texas.1 General Lillian Dunlap handpicked Lieutenant Colonel Jane High
to serve as chief, Nursing Service, for the 21st Evacuation Hospital Team. The
Army Nurse Corps placed 23 Army nurses and 30 enlisted nursing staff from
Darnall Army Hospital at Fort Hood on alert. With many personnel on holiday
leave, selection of staff was complicated by concerns about reducing the fixed fa-
142 A Contemporary History of the U.S. Army Nurse Corps

cility’s staffing to a dangerous level. Nonetheless, by 1800 hours on 23 December

1972, the Corps had notified nearly all of the deploying personnel. Throughout the
night, those deploying completed necessary preparations, such as making finance
arrangements, receiving immunizations, and reviewing personnel records. Local
staff issued field clothing and equipment to the minority of Army nurses who did
not have such gear, but summer-weight fatigues—so important for comfort in the
expected hot and humid environment—were unavailable for issue. At noon on
Christmas Eve, the first of several groups of the hospital’s staff and its equipment
departed from Texas and arrived in Managua by dusk that same day. The first
three Army nurses and a number of enlisted service members then bunked down
at a staging area adjacent to the rubble of what was formerly the Managua Gen-
eral Hospital. Other cohorts of the 21st Evacuation Hospital arrived in Managua
in subsequent sorties. The original contingent arose at 0600 hours on Christmas
morning and, before eating, began erecting their tentage. By noon, the hospital
was operational and admitted its first patients, two children with meningitis and a
two-year-old postoperative nephrectomy patient. At the end of the first day, the in-
patient census numbered 35 patients. By 1 January 1973, five wards with 20 beds
each were functional. At that time, the total census averaged 49 patients per day.
Army nurses worked 12-hour shifts, either from midnight to noon or from noon
to midnight. This arrangement allowed both shifts to enjoy a few hours of sleep
in relatively cool temperatures. After a week, High wanted to close some wards
and consolidate patients so that the work shifts could be shortened. However, the
hospital commander elected to maintain the status quo, feeling that closed wards
would require posting guards to protect equipment and supplies from looters.
As the first week passed, several more Army nurses arrived in Nicaragua, in-
cluding three officers from Reynolds Army Hospital at Fort Sill, Oklahoma. At
peak, 30 Army Nurse Corps officers participated in the effort. By the beginning
of the new year, Nicaraguan doctors and nurses gradually began to replace their
American counterparts. The focus of the workload then shifted from the inpatient
to the outpatient setting, where the ambulatory workload averaged 385 patients
daily. Finally, on 5 January 1973, Health Services Command (HSC) released all
Army Nurse Corps officers from the mission and redeployed them back to their
home units in the continental United States.
The overall mission in Nicaragua was generally successful, although several
minor setbacks surfaced. For example, the x-ray facility lacked a darkroom in
which to develop film. Since the majority of patients presented with fractures,
they could only be immobilized until the film could be developed. The function-
ing of the operating room was delayed by the need to process instruments. Es-
sential surgical instruments, originally received in depot packs, came coated with
cosmoline, a petroleum jelly-like rust preventive agent. They had to be cleaned
by hand before use. The Central Material Section could not operate its autoclaves
because no 220-volt cable was available. Deficiencies in all types of supplies
were an added complication. Although aircraft efficiently delivered supplies as
planned, the medical logistic warehouse was overwhelmed, understaffed, or dis-
 Humanitarian Relief and Assistance Missions in the 1970s 143

organized and was unable to locate and deliver specific supplies and pieces of
equipment. Furthermore, the US Southern Command was unprepared to resupply
needed expendable items. Over the course of the mission, it filled only one supply
requisition and responded with “due outs” for the 10 additional typewritten pages
of requisitions.
The type of supplies also conflicted with the mission requirements. Although
there were many pediatric and obstetrics patients, planners had included no pe-
diatric or obstetrics supplies or medications in the original supply issue. The pre-
ponderance of the supplies naturally was geared instead to the demands of combat
medicine, not disaster relief. Other deficiencies included a lack of field safes to
store narcotics and valuables securely; too few military police for crowd control;
limited shower and laundry facilities; and inadequate blood supplies, vaccines,
water, fuel pods, generators, organic mess facilities, and vehicles. The minimal
care ward was unexpectedly inundated with individuals with supportive care
needs, like geriatric patients, the debilitated, the blind, and paraplegics. Caring
for these patients called for adjustments in expectations, staffing, and equipment.
Weather was equally trying. Dusty winds gusted constantly. Oppressive heat in-
tensified the state of affairs.2
Although difficulties arose in the work setting, off-duty living conditions were
correspondingly annoying. All 35 officers and enlisted women assigned to the unit
were initially billeted in a cramped general purpose medium tent and subsisted
on C-rations for the entire duration of the mission.3 Creature comforts such as
personal space and appetizing meals certainly raise morale, and their absence has
an equal and opposite reaction. Nonetheless, conditions in the field can hardly be
expected to approach the standard of living enjoyed at home.
Despite hardships, there was some good news. The first maternity case at the
hospital produced a baby girl whose parents named Christina. The news media
highlighted this human interest story and labeled the operational site “Camp
Christina, Fort Hood, South.” Excursions to the nearby Pacific coast beach for a
few staff chosen by lottery also helped to boost spirits.4
Operational conditions experienced during the disaster relief operations in Ni-
caragua seemed to ignore the imperative for adequate preparations and provi-
sions, a lesson relearned in the mid-1960s in Vietnam and once again promptly
forgotten. The success achieved by the task force deployed to Nicaragua can be
attributed in large part to the adaptability and field expedient skills of participat-
ing Army nurses and other dedicated service members and to the relatively brief
mission, just under two weeks. Sad to say, the Nicaraguan experience was a mi-
crocosm of the shortcomings of the Army Medical Department (AMEDD) and
the Army in the immediate post–Vietnam era.
A few years later, Army nurses received another call to provide assistance. In
the spring of 1975 after the fall of Vietnam, more than 100,000 South Vietnamese
fled their homes and lands in Southeast Asia, attempting to escape the threat of
marauding North Vietnamese Communists. Forced to leave their country with few
or no possessions, they sought refuge. In the spirit of humanitarianism, the U.S.
144 A Contemporary History of the U.S. Army Nurse Corps

Army nurse clinician Captain Miller provides care for a newborn Vietnamese baby during operations
New Life and New Arrivals. An Army physician stabilizes the baby’s head while a civilian nurse
shares her observations.
Photo courtesy of Army Nurse Corps Archives, Office of Medical History, Falls Church, VA.

government aided them and subsequently initiated a massive effort to resettle the
displaced Vietnamese.5
Hence, in April 1975, Operation New Life began. At that time, the Depart-
ment of Defense (DoD) established refugee reception centers at Orote Point on
the island of Guam; at Fort Chaffee, Arkansas; and later at Fort Indiantown Gap,
Pennsylvania, all supported by the Army. Ultimately, the Army processed 55 per-
cent of all the refugees at the latter two sites. The Navy maintained a similar im-
migrant station at Camp Pendleton, California; and the Air Force was responsible
for another such refugee center at Eglin Air Force Base, Florida. The center on
Guam was the initial screening point for all refugees. They then were channeled
to one of the four continental U.S. sites for more extensive services.6 Operation
New Life became Operation New Arrivals on 1 May 1975.7
Because a large percentage of the boat people were in poor health, with many
suffering from various maladies common to developing countries, DoD delegated
 Humanitarian Relief and Assistance Missions in the 1970s 145

Army nurse clinician Major Gurley holds a Vietnamese infant while discussing the child’s condition
with its attentive Vietnamese parents during operations New Life and New Arrivals. An Army physi-
cian listens to the conversation.
Photo courtesy of Army Nurse Corps Archives, Office of Medical History, Falls Church, VA.

to HSC the responsibility to provide the refugees with certain health care services
in the Army-sponsored centers. In all, about 97 Army Nurse Corps officers par-
ticipated in the overall mission, with nine officers assigned to Guam, 50 to Fort
Chaffee, and 38 to Fort Indiantown Gap.8 Several nurse clinicians (Army Nurse
Corps nurse practitioners) participated in operations New Life and New Arrivals
and provided primary care in the refugee camps. This was the first instance where
the AMEDD augmented field units with advanced practice nurses.9
The chief of the Army Nurse Corps selected Lieutenant Colonel Jeanne Hoppe
to deploy from Hawaii to serve as the chief nurse of the 1st Medical Group on
Guam. With the initial flood of refugees, Hoppe was in dire straits with too few
staff.10 To augment the nursing staff, she asked the Red Cross, local hospitals, and
the civilian population for assistance. Many volunteers responded. As a result,
Hoppe had two to three additional nurses every day, including several who were
formerly medical missionary nurses in Vietnam. Transportation initially was a
146 A Contemporary History of the U.S. Army Nurse Corps

Although assigned to the 702nd Medical Clearing Company on Orote Point, the westernmost point
on the mainland of Guam, Army Nurse Corps officer Lieutenant Colonel Jeanne Hoppe, second from
right, pauses with three medical missionary nurses. The three had formerly served in Vietnam. All of
these nurses volunteered to care for refugees during operations New Life and New Arrivals.
Photo courtesy of Army Nurse Corps Archives, Office of Medical History, Falls Church, VA.

problem, but one quickly resolved when the commander of the 1st Medical Group
made a vehicle available, allowing Hoppe to travel to supervise staff. Originally,
everyone was working 12-hour shifts. But when the flood of immigrants subsided,
eight-hour shifts with days off became the routine. Patient loads included both
outpatients and inpatients, with 90 percent of the latter being pediatric cases.11
Hoppe assigned the medical-surgical nurses to clearing companies that treated
1,800 ambulatory patients per day at the outset of the deployment and, by June
1975, treated approximately 800 to 900 patients per 24-hour period. Although
Hoppe concluded that “all the nurses . . . performed in an outstanding manner,”
she expressed some dismay with the nurses’ lack of preparation to function in a
field setting.12 She observed that “TOE [Table of Organization and Equipment]
training in CONUS ‘is inadequate’.”13 The Army mission on Guam concluded on
15 July 1975.14
HSC support at Fort Chaffee spanned from 29 April to 22 December 1975. In
all, 50 Army nurses served there under chief nurses Lieutenant Colonel Velma
J. Barkley and later Lieutenant Colonel Maurine Hill.15 The Fort Chaffee health
care facility, which was vacant for nine years, was a wood-frame World War II
 Humanitarian Relief and Assistance Missions in the 1970s 147

cantonment configuration with separate ward buildings connected by open-sided

ramps.16 The structure had been maintained in fair condition as a contingency for
future mobilizations, but it initially required extensive cleaning. Soon after the
buildings were occupied, structural and engineering problems materialized.17
When First Lieutenant Stephanie Velsmid reported in to the 47th Field Hospital,
which had deployed to Fort Chaffee, and helped to open the obstetrics ward, she
spent the “first two days . . . cleaning and scrubbing walls and floors.” Then the
exposed plumbing pipes and fixtures began to leak, and Velsmid explained that
the staff spent “half the time mopping up these little puddles. Last night the ceiling
pipes let loose and flooded the whole hallway!” As always, supplies were prob-
lematic. Although pitocin was available, ergotrate and methergine were somehow
unobtainable. Neither were medication cards available. Velsmid took to “tearing
up small pieces of paper to make med cards!”18
Meanwhile, operating room nurse Captain Diane McDermott wrote that they
desperately needed 5 percent dextrose in water in liter bags for intravenous ad-
ministration. Instead, they were “swamped” with saline, an unsatisfactory substi-
tute. McDermott vowed that “someday, sometime, I’ll look back on this mission
and smile; but I think it will be a long time from now.”19
On a more positive note, the hospital’s first delivery was a little girl weigh-
ing 7 lbs. and 1 oz. on 7 May 1975. At the baby’s birth, the father emotionally
exclaimed, “I have lost all of my possessions but now I have gained a new joy!”
Velsmid remarked that the refugees were “very kind and grateful for every little
thing we do for them. Their attitude . . . is surprisingly optimistic for people who
have lost family, most of their possessions, and their country.”20
Conditions in the upper administrative echelons were little better than those on
the ward level. As days of little irritants passed into months of ongoing hassles
with no resolution on the horizon, compounded by the stress of being away from
home in a situation where everyone had to make do with what little was available,
conflicts and personality clashes emerged. As late as August 1975, no one as-
signed to the 47th Field Hospital understood the unit’s mission. With no unifying
mission and no common goal, varied ends resulted in disparate means. The hospi-
tal commander refused to allow Lieutenant Colonel Maurine Hill, the 47th Field
Hospital’s chief nurse, to comply with guidelines passed down from the Forces
Command chief nurse. He forbade Hill to go on consultation visits to community
health nurses in the Vietnamese village or to the outlying Vietnamese dispensa-
ries. Patient care concerns and dispositions were equally difficult. One patient,
diagnosis unknown, was hospitalized, probably unnecessarily, for 80 days. Sev-
eral malaria patients were hospitalized for several weeks. A schizophrenic patient
regularly fled the ward, causing frustration for all concerned. Several patients on
the infectious ward had provisional diagnoses of tuberculosis, a dreaded disease
that few of the younger nurses had previously encountered.21
The challenges met by the five Army Community Health Nurses (ACHNs) de-
ployed to Fort Chaffee contributed significantly to the mission’s success. One
ACHN supervised American Red Cross volunteer nurses in the initial reception
148 A Contemporary History of the U.S. Army Nurse Corps

center. There both volunteers and ACHNs dispensed “advice, fluids, infant needs,
and minor analgesics.” These nurses also “identified and questioned pregnant
women, the elderly and disabled, and those who appeared ill.” In addition, the pre-
ventive medicine officer assigned one ACHN to each of three cantonment areas
where refugees were housed. These ACHNs dealt with minor medical problems,
provided care for convalescents or those with chronic illnesses, implemented case
findings by seeking those who were ill but unable to reach out for help, supported
epidemiologic investigations, and sponsored health education offerings. They
later organized and supervised minor illness clinics in each of the three living
areas and staffed the clinics with Vietnamese health professionals. The preven-
tive medicine officer assigned the fifth ACHN to the epidemiology section. In
this role, the ACHN carried out “epidemiologic surveillance and investigations.”
This effort involved “collecting and tabulating medical screening, inpatient, and
outpatient data; . . . providing follow-up for medical screening; . . . conducting
contact tracing and interviewing; and . . . investigating disease outbreaks.” The
ACHNs’ interventions yielded various positive outcomes that contributed to the
atmosphere of welcome, monitored sanitary conditions, enhanced refugees’ qual-
ity of life, provided day-to-day comforts, maintained family cohesiveness, and
prevented large-scale morbidity and mortality.22 The ACHNs’ role was key to the
mission’s success.
In retrospect, the minor, daily aggravations of deploying to the field did not
eclipse the yeoman’s service provided by those members of the AMEDD that par-
ticipated in the relief mission at Fort Chaffee. In spite of daunting circumstances
that persisted for 90 days for many deployed personnel, they provided high-quali-
ty health care for the 36,000-plus refugees who passed through the center.23
When the refugee center at Fort Chaffee, Arkansas, reached its capacity of
24,000 evacuees, DoD had to find an alternate site.24 On 22 May 1975, another
center opened its doors at Fort Indiantown Gap, Pennsylvania, and remained in
operation until 15 December 1975.25 Indiantown Gap accommodated more than
17,000 refugees in World War II era barracks painted white with green trim and
situated on 22,000 acres of gravel and grass in Pennsylvania’s Blue Mountains.26
The 42nd Field Hospital deployed from Fort Knox, Kentucky, and initially ca-
tered to the health care needs for the population at Fort Indiantown Gap. Lieuten-
ant Colonel Vera Nolfe served as the unit’s chief nurse.27 The 42nd Field Hospital
settled into the installation’s cantonment hospital building that had been moth-
balled since 1953. Here, too, preparations involved significant elbow grease. Ma-
jor Louis Tardif, a nurse anesthetist, who deployed with the 42nd Field Hospital
from Walter Reed Army Medical Center, remarked that the staff searched in stor-
age areas there and found an operating room table and cabinets that were “basic,
operational, and simple.” They scrubbed the table “down every morning, whether
we plan[ned] on using it or not.” As of 20 June, the total number of operative
cases included one appendectomy and several births.28
Lieutenant Colonel Mary Dewan was an ACHN whose home unit also was
Walter Reed Army Medical Center. On Mondays, Wednesdays, and Fridays, De-
 Humanitarian Relief and Assistance Missions in the 1970s 149

A group of Vietnamese refugees carrying their few belongings enter their assigned living quarters at
Fort Chaffee Refugee Center in Arkansas on 5 June 1975.
U.S. Army photograph released by Department of Defense, Washington, DC.

wan could be found in one of two tram te tuu dong, or mobile health clinics, set
up in an Army van. The “tailgate medicine” vans brought basic primary care to
the refugee quarters that were located a few miles from the hospital. Through
the doors of the vehicle, staff distributed over-the-counter preparations, helped
to screen patients for common maladies, and set up clinic appointments for the
refugees.29 The two mobile health clinics provided assistance for an average of
700 patients daily. Fortunately, Dewan had a competent interpreter to facilitate her
communications with her clients. For the remaining two days of the work week,
Dewan and her associate conducted home visits to patients recently discharged
from the hospital.30
Forces Command and the Office of the Surgeon General agreed on a 90-day
rotation policy for staff. However, the average overall time spent by the AMEDD
personnel on temporary duty at the camps was 71 days. The purpose of the ro-
tation policy was to mitigate personnel difficulties by replacing partial or total
units assigned to the relief mission.31 Thus, as summer ended, the 15th Combat
Support Hospital from Fort Belvoir, Virginia, replaced the 42nd Field Hospital.
150 A Contemporary History of the U.S. Army Nurse Corps

The incoming unit subsequently reduced itself to a 10-bed holding facility and
operated a community medical center for routine outpatient obstetrics, optical,
and dental appointments. When a medical officer judged that a refugee required
hospitalization, an ambulance transferred the patient to nearby institutions such
Hershey Medical Center in Hershey, Pennsylvania, or other hospitals in nearby
Baltimore, Maryland.32 As the number of expatriates decreased and requirements
for care declined, the commander refused to reduce the staff correspondingly,
perhaps fearing that another influx of immigrants might overwhelm a diminished
staff. Although nursing administrators felt that the facility was overstaffed, the
commander insisted on maintaining a one-for-one replacement system as outgo-
ing staff returned to their home units. With very little to do, 13 Army Nurse Corps
and five Medical Corps officers remained more or less idle, a state of affairs that
seemed incomprehensible to many in an era when Army Nurse Corps assets were
at an all-time low.33 Nevertheless, the 15th Combat Support Hospital stayed at
Fort Indiantown Gap until the mission closed at the end of calendar year 1975.34
Also among the tribulations of Fort Indiantown Gap was the emergence of a
large number of cases of respiratory illness. The refugees were accustomed to the
tropical climate of Southeast Asia. With impaired immune systems plus the stress
of monumental change and a lifelong exposure to war and poverty, many suc-
cumbed to infectious diseases, pneumonias being the most serious.35
In the final analysis, operations New Life and New Arrivals cost the AMEDD
much but yielded great benefit in assisting a deserving population of displaced
persons. On the debit side, financial expenditures for medical supplies, equip-
ment, and other health care costs from the massive humanitarian enterprise totaled
more than $2.5 million in 1975 dollars, excluding personnel costs.36 Effects felt in
selected HSC medical treatment facilities as a consequence of the absent person-
nel included random increases in patient appointment waiting times, cancelled
leaves for nurses, consolidated wards, and some 12-hour duty shifts for person-
nel. At Fort Campbell, Kentucky, the commander suspended activities of ACHNs
for two weeks.37 The intangible emotional losses of those that deployed and were
consequently separated from their loved ones, families, and friends must not be
ignored. These costs are not easily quantifiable but are a noteworthy feature of
any such mission.
Overall, significant advantage came from the operation. The large-scale hu-
manitarian assistance provided to the great masses of displaced Vietnamese refu-
gees who were in truly dire straits ranks first. The AMEDD also learned valuable
lessons about the conduct of these missions that had applicability to future, as yet
unanticipated, combat missions. Operations New Life and New Arrivals tested
and refined the AMEDD’s emergency operation plans and highlighted areas of
readiness that clearly needed improvement.38 Many of those mobilized, for in-
stance, were not Process for Overseas Rotation qualified. Furthermore, most of
the senior Army nurses lacked the lightweight summer fatigue uniform. Many
could not obtain these uniforms at their home stations, in which case the Academy
of Health Sciences issued the uniforms to the senior officers.39 Finally, participa-
 Humanitarian Relief and Assistance Missions in the 1970s 151

tion in this disaster relief situation undoubtedly paid substantial dividends “in the
peacetime mission of patient care through deepened and improved competencies
in nursing practice.”40
In a related effort, AMEDD personnel cared for hundreds of Southeast Asian
orphan babies at various HSC installations in April 1975. Referred to as Operation
Babylift, the humanitarian relief mission involved the air evacuation of children,
mostly orphans, from Indochina after the collapse of the South Vietnamese gov-
ernment. The state department, DoD, and various volunteer American relief agen-
cies collaborated to place these children with adoptive families within the United
States. Along the way, nurses and other personnel at military treatment facilities
cared for the infants, many of whom were suffering from a variety of illnesses,
such as conjunctivitis, otitis media, skin diseases, chicken pox, malnutrition, de-
hydration, upper respiratory infections, and pneumonia. AMEDD personnel at
Tripler Army Medical Center, Letterman Army Medical Center, Madigan Army
Medical Center, Fitzsimons Army Medical Center, and Fort Benning, Georgia,
cared for the children both in hospital settings and in centers outside hospitals
specifically set up to house the evacuees.41
Tragically, one of the Air Force air evacuation flights that transported the Viet-
namese babies crashed when taking off from Ton Son Nhut Airbase in Vietnam
in April 1975. Many of the orphans and two of the medical crew died in the ac-
cident. One of those who perished in the line of duty was an Air Force flight nurse,
Captain Mary T. Klinker. Operation Babylift concluded on 6 May 1975.42 The
short-term venture was but one of many contributions made by military nurses in
the name of good will and humanitarianism.
In this same period, the AMEDD once again answered the call to provide hu-
manitarian relief assistance to earthquake victims, this time in Guatemala. On 4
February 1976, a massive earthquake measuring 7.5 on the Richter scale struck;
its epicenter was approximately 38 miles east of Guatemala City. The state depart-
ment originated the request for foreign medical assistance, and Forces Command,
HSC, and the Office of The Surgeon General coordinated the type of support to
deploy. They opted for the 100-bed 47th Field Hospital from Fort Sill, Oklahoma,
as a suitable unit to participate in the mission, perhaps because the 47th Field
Hospital had a considerable amount of recent field experience. Six months before
the Guatemalan disaster, the 47th Field Hospital had spent four months (from
April to August 1975) at Fort Chaffee providing health care for the Southeast
Asian refugees. When the earthquake struck, the 47th Field Hospital was conduct-
ing a field exercise. HSC immediately put personnel on alert, and they mobilized
quickly. An advance team flew without delay to Guatemala and selected the hos-
pital site on a picnic grove at the edge of a mountain lake near Chimaltenango,
a small Indian village 31 miles southwest of Guatemala City. The main echelon
followed straightaway, and the 47th began operations on the evening of 6 Febru-
ary 1976.43
Most of the 26 Army Nurse Corps officers who joined the unit came from the
Fort Sill, Oklahoma, Medical Department Activity. However, HSC pulled others,
152 A Contemporary History of the U.S. Army Nurse Corps

In this photo, Captain Margaret Kulm lends a hand with a native patient who sustained crushing inju-
ries during the Guatemala earthquake of February 1976. Although she was head nurse of the 47th Field
Hospital’s pediatric ward, Kulm and all the multitalented Army Nurse Corps officers who deployed to
Guatemala assisted and provided care wherever help was needed.
Photo courtesy of Colonel Peggy Jane Newman, Great Falls, VA.

including the chief nurse, from units at Fort Sam Houston, Texas.44 Among the
nursing personnel who deployed to Guatemala were two ACHNs who worked
with the preventive medicine staff and three nurse clinicians (practitioners). Two
of the three clinicians, prepared as adult ambulatory care specialists, functioned
in the dispensary and were deemed “extremely effective.” Little demand existed
for the services of the third, an obstetrics/gynecology clinician, so she worked as
a staff nurse on the obstetrics/pediatric ward.45
The majority of casualties cared for at the tent hospital had suffered orthope-
dic injuries. About 30 percent of those treated carried a diagnosis of a fractured
pelvis.46 Other cases involved various crushing injuries, other fractures, and lac-
erations.47 A number of babies, including a set of twins, also were delivered at the
hospital.48 Captain Margaret Kulm, head nurse on the pediatric ward, noted that a
few of the newborns were premature, but all of the infants thrived. The older chil-
dren on the pediatric ward bore emotional as well as physical wounds and would
“often wake screaming from nightmares.” Frequent aftershocks also distressed
the smaller tots.49 Reassurance and comfort played a large part in the treatment
regimen of these patients.
 Humanitarian Relief and Assistance Missions in the 1970s 153

This Guatemalan couple share a quiet moment immediately after birth of their twins at the 47th Field
Hospital during the Guatemalan earthquake of February 1976. Staff observed that the period of labor
was quite precarious with the new mother lying on a flimsy field bed. The sparsely equipped hospital
also had only one isolette, so both newborns closely shared their first external accommodation.
Photo courtesy of Colonel Peggy Jane Newman, Great Falls, VA.

A number of operational snags emerged during the mission. Supply deficits

were again a major concern. Much needed items that were in insufficient quantity
or nonexistent included plaster, Ace bandages, slings, x-ray film, pediatric anes-
thesia equipment, surgical instruments, gloves, suture, urinary drainage systems,
chest tubes, intravenous fluids, needles, administration sets, and replacement light
bulbs.
The unexpected cool weather precipitated other difficulties. Before deployment,
the unit failed to issue any TA-50 equipment, and thus members of the 47th were
not protected from the elements.50 Captain Sandra Hamper recalled that no one
had anticipated cool weather, with nights as low as 28° F and afternoons lower
than 70° F, and many were uncomfortably cold.51
Public relations was among the many frustrating issues that surfaced with this
mission. The chief nurse, Lieutenant Colonel Marbeth Michael, perceived a need
for a public information officer in future deployments because many individuals
wanting to explore the hospital appeared on the scene “and occasionally they were
disrespectful.”52 The commander added that these individuals were major irritants.
They were the “curiosity-seekers and reporters . . . and Americans who turn[ed]
154 A Contemporary History of the U.S. Army Nurse Corps

up and demand[ed] to be fed because they are taxpayers.” The commander made
it a policy to furnish meals for “only those volunteers who work[ed] alongside his
men and women, such as two medical students and a Guatemalan woman who
[was] a trained nurse.”53
Cultural differences and communication problems also emerged. A throng of
family members wishing to visit hospitalized victims caused substantial strife and
misunderstanding. To deal with the crowds, hospital authorities asked Guatema-
lan soldiers to restrict entry into the hospital compound, an action that “seemed
absurd to local peasants.” An American physician who had resided and practiced
among the Indians in the neighboring villages for 14 years disclosed the natives’
view of the American presence. He explained that a number of families wished
“to take their relatives out of the Army hospital because . . . the Americans don’t
speak their language, don’t understand them and never explain anything.” This
expatriate American physician allowed that the 47th Field Hospital “was ‘do-
ing a good job’ and ‘keeping a low profile’.” Notwithstanding, he concluded that
the Army “practiced a medicine unadapted to the customs and lives of the peo-
ple it served.” Other observers summarized their viewpoints by stating that the
American contributions to the relief effort were “overstaffed, overorganized, and
slow.”54
A total of 69 officers and enlisted medics from 19 HSC organizations deployed
to Guatemala and provided disaster relief.55 The 47th Field Hospital spent a total
of 12 days in Guatemala and cared for about 700 patients, most of whom were
treated on an outpatient basis.56 Like all relief missions, it too was an amalgam of
unfortunate and worthwhile components.
Although the humanitarian assistance operations of the 1970s seemed to be
plagued by difficulties, they were—in the final accounting—significantly con-
structive. Not only did the mission provide “succor [to] countless victims of na-
ture’s wrath who might not otherwise have received help,” but they also were a
source of growth and development for the AMEDD institution and fulfillment
for those who personally furnished the relief. Army historian Gaines M. Foster
concluded:

Civilian emergencies provided more realistic experience in the care of mass casualties than most
training exercises, and participating units learned a great deal about operating in an environment that
resembled combat. Moreover, the personnel felt a sense of accomplishment that came from helping
people in need and using the skills they had worked to develop. Successful disaster relief missions, in
sum, improved technical skills while they increased morale and esprit. They thereby strengthened the
Army Medical Department as well as aided civilians.57

The Military Training Team (MTT) effort that involved sending two Army
Nurse Corps officers to Jordan was another type of foreign assistance. The Jorda-
nian government and the AMEDD jointly conceived and implemented the MTT
to educate approximately 40 senior Royal Jordanian Medical Corps nurses in the
current trends in “nursing administration, methods of instruction and hospital
management and operation.” The goal of the MTT was “to provide the Jordanian
nurses with enough ‘know-how’ so they [could] form their own cadre of teachers”
 Humanitarian Relief and Assistance Missions in the 1970s 155

Two non-English speaking members of the Guatemalan protective forces flank Army Nurse Corps
officers Major Nancy Nooney, left, and Captain Peggy Jane Newman, right, on the picnic grounds
where the 47th Field Hospital erected its tents near Chimaltenango, Guatemala, after the February
1976 earthquake. The local militia guarded the hospital compound.
Photo courtesy of Colonel Peggy Jane Newman, Great Falls, VA.

to pass on their acquired knowledge and skills.58

The Army Nurse Corps selected two officers, Colonel Marian C. Barbieri and
Major Mary Lou Spine, to participate because of their extensive backgrounds in
the education of military nurses.59 They departed from their respective home sta-
tions, Fort Dix, New Jersey, and Letterman Army Medical Center, California, on
14 November 1976 for orientation at HSC, Fort Sam Houston, Texas, from 15 to
19 November 1976.60 Then they went to Jordan, arriving in Amman on 21 No-
vember 1976.61 The two settled into their lodging, a spacious but no-frills second-
floor flat, and began their work as expeditiously as possible.62
Barbieri and Spine spent an initial assessment period observing at the Princess
Muna College of Nursing (a three-year diploma program and an 18-month practi-
cal nurse course), at the King Hussein Medical Center, at the 1st and 2nd Field
Hospitals, and at the Amman Military Hospital. After the initial assessment pro-
cess, the two U.S. Army nurses presented several iterations of a two-day lecture
156 A Contemporary History of the U.S. Army Nurse Corps

series on the basics of nursing administration and principles of teaching. This

didactic program was followed by a practicum geared to the individual needs of
the particular faculty and staff members.63 By February 1977, the two made other
significant contributions, such as assisting the Jordanians to write job descriptions
and administrative procedures and helping their hosts to restructure the existing
nursing department. They also were setting up a staff development program and
helping the college faculty to implement a new curriculum.64 As of March 1977,
Barbieri and Spine had prepared suggestions for the professional development of
members of the Royal Jordanian Nurse Corps. These recommendations included
tentative plans for Jordanian Army nurses to participate in observer training pro-
grams with selected counterparts in the U.S. Army Nurse Corps and in educa-
tional offerings such as the operating room, intensive care, and nurse clinician
courses sponsored within the United States by the U.S. Army Nurse Corps.65 By
the midpoint of the six-month temporary duty, Barbieri noted that the “feedback
we do receive is our best reward and serves as an incentive to plug ahead. Our
hope is to build a bit of self-confidence for . . . our counterparts. . . . We hope to
encourage self-reliance.”66 In April 1977, the pair “oriented the staff of one of the
Field Hospitals to the intricacies of process audit.” They noted that they “would
have preferred to do [a] retrospective audit but discovered nursing notes, if they
exist, are not made a permanent part of the chart.”67 One of the team’s final efforts
was to promote and set up a supervisory level of employees in the King Hussein
Medical Center hierarchy between the matron and the head nurses to improve
supervision and coordination in the large, widely dispersed facility. Many of the
staff were unwilling to accept this change. One new supervisor was markedly
unenthusiastic because she feared “that if the need arose for her to correct” one
of her assigned head nurses, “the disciplined person would complain to the su-
pervisor’s mother.” At first the American nurses could not fathom this Jordanian
nurse’s way of thinking. However, the supervisor’s concern was sincere. “In the
light of the very strong family influences that prevail[ed] in this culture,” Barbieri
and Spine realized that the new supervisor’s apprehension about the “possibility
of someone tattling on her to her mother” was indeed a terrifying prospect.68 The
pair ironed out many similar cultural wrinkles while they were in the Hashemite
Kingdom of Jordan.
The two Army Nurse Corps officers’ copious correspondence shows that their
days were saturated not only with professional activities, educational offerings,
and consultation, but also with various social events and extensive sightsee-
ing. Local Jordanians, the embassy staff, and other American military families
assigned to Jordan entertained Barbieri and Spine in a series of dinners, teas,
receptions, and parties. They attended the Royal Jordanian Military Academy’s
commencement ceremony and shopped in bazaars and souks, finding a variety
of native arts and crafts. They also visited the ruins of a first-century city called
Jerash, picnicked on the edge of the Dead Sea in view of the city of Jericho and
the Mount of Olives, and visited Damascus and bought tablecloths. Barbieri and
Spine realized a special dream when they toured Egypt and the Holy Land in
 Humanitarian Relief and Assistance Missions in the 1970s 157

April. In their last days in Jordan, they spent some time with Bedouin families in
their desert tents “to assess health needs of the nomadic tent dwellers.” In Febru-
ary 1977, Spine was promoted to lieutenant colonel. The Americans arranged for
the promotion ceremony to take place in the Princess Muna College of Nursing
with Jordanian Army dignitaries, college staff and students, and U.S. military at-
tachés from the embassy in attendance. Barbieri and the chief of the Royal Jor-
danian Nurse Corps pinned the silver leaves on Spine’s uniform. A reception that
followed featured “tea and sweets.”69 Barbieri and Spine took advantage of many
opportunities while serving in the Middle East, and they lived every minute of
their six-month temporary duty in Jordan to the fullest.
The duo wrote in their final communiqué that they were beset “with ambivalent
feelings.” They explained that although they were

. . . pleased to be returning to our family and friends on US soil, we were saddened to leave behind
our foster family and newly acquired friends on desert sands. In six months we became very close
with the Jordanians with whom we worked and felt that we had just reached an optimum level of pro-
ductivity where concepts and ideas were beginning to be transferred into action. This phase is always
the most satisfying but leave it we must with hopes that the seeds we planted take hold and continue
to grow.70

Six years later, the Army Nurse Corps provided additional support to the Jorda-
nian Army. From 12 February to 12 March 1983, Major Annette R. Aitcheson, an
Army nurse from the U.S. Army Institute of Surgical Research at Brooke Army
Medical Center, Texas, advised the staff of the Jordanian Army Burn Treatment
Centre. While in Amman, Jordan, Aitcheson presented lectures to Jordanian phy-
sicians and nurses on various aspects of care for “the thermally injured patient”;
demonstrated specialized equipment such as the Laminar Flow Isolator, the Clini-
tron Air Fluidized Bed, and the IVAC infusion pump; and helped the nurses to
develop policies and job descriptions. However, one of the greatest challenges for
the mission arose from the fact that the Jordanian Army Burn Treatment Centre
was not yet operational. Without actual burn patients, “the clinical application of
the didactic and theoretical data” was impossible.71
Professional and cultural conditions Aitcheson encountered in Jordan were
marked by vivid contrasts. On the one hand, some of the physical facilities were
state of the art. The Queen Alia Heart Centre, for instance, was “one of the best
equipped and clean” institutions that Aitcheson had ever seen.72 Also, the Jorda-
nians billeted Aitcheson at a four-star hotel, a first-rate establishment that served
gourmet meals, and provided her with transportation and “afforded [her] every
possible courtesy and respect.” On the other hand, there was a complete “ab-
sence of Standards of Nursing Practice.”73 Additionally, nursing documentation
was sparse to nonexistent, and nursing care plans were not used at all.74 When a
protracted snowfall happened during Aitcheson’s visit, employees failed to report
to work and staffing levels were inadequate. Those nurses already on duty were
forced to work “two to three additional shifts” to maintain coverage.75
At the conclusion of her visit, Aitcheson made several recommendations. She
proposed appropriate staffing levels, training, supplies, and equipment necessary
158 A Contemporary History of the U.S. Army Nurse Corps

for quality care in the Jordanian Army Burn Treatment Centre. She suggested that
several Jordanian Army nurses spend three months at the U.S. Army Institute of
Surgical Research to learn necessary skills for caring for critically burned pa-
tients. Finally, Aitcheson advised that a MTT consisting of a burn nurse adminis-
trator, a critical care staff nurse, and 91C licensed practical nurse revisit Jordan in
the future to evaluate the “prior training” and build on these previous educational
efforts.76
One year later, a team consisting of Aitcheson, Major Kathryn Robertson, and
Staff Sergeant Joe Constantine returned to Jordan and discovered numerous im-
provements in practice, such as the use of standard nursing care plans and evi-
dence of better nursing documentation, both of which bore witness to the moti-
vation and diligence of the Jordanian nurses. However, Aitcheson noted that “if
the nurses write too much [on their nursing notes] then the Records Department
complains and the chart must be thinned out (permanently).”
Overall objectives for this 1984 mission included striving to improve the qual-
ity of nurses notes, changing “the nurses’ attitude of patient care from a task . . .
to an holistic orientation,” implementing a “multidisciplinary approach to burn
care” involving physical therapy and social work in the patient care effort, and
developing “a diet that will meet the increased nutritional demands of the burn in-
jured patient.” However, some disappointment inevitably accompanied progress.
Aitcheson wrote:

Everyday when we think we have a good grasp of the situation, the realities of the culture and the
economic conditions rocks us on our heels. Today we had to sit down, again, and decide what it is we
can and cannot change.77

The trio of U.S. Army visitors managed some diversion and rest with a trip to
Azrat, an oasis in the nearby desert, but even that adventure was rife with chal-
lenges. They attempted to camp out with a Jordanian nurse on a cold 30º F night.
Aitcheson revealed that “like true soldiers we tried to brave the freezing tempera-
ture and howling winds as we huddled around the barbecue grill . . . in two and
three blankets.” Eventually, however, they “packed up and spent the night in the
rest house.” In the morning, the band of intrepid campers awoke to a desert dust
storm. Aitcheson philosophically remarked “so much for our first adventure.”78
Several years later Aitcheson articulated her guiding philosophy, writing:

As nurses, we each have a responsibility to assist in the growth of nursing throughout the world.
Nurses in the United States can participate in developing nursing colleagues in third world nations.
It is only through consistent and knowledgeable practices throughout the world that nursing will be
recognized as the sole authority on nursing care.79

Although challenges were many and progress was slow, long-term gains were
significant. Much credit can be attributed to the optimism of those altruistic Army
Nurse Corps officers who traveled to Jordan and shared their knowledge and ex-
pertise in spite of attendant hardships. Moreover, the Jordanian nurses’ willing-
ness to internalize the proffered advice and their enthusiastic efforts to improve
 Humanitarian Relief and Assistance Missions in the 1970s 159

their professional practice were laudable. Few, if any, other allied military nurses
were eager to endure the trauma inherent in the professional growth process.
No Army Nurse Corps officers participated in combat operations during the im-
mediate post–Vietnam War era. At that time, the prevailing state of affairs dictated
that deployments not exceed the boundaries that defined the term ‘operations oth-
er than war.’ However, the more or less peaceful operations that occurred at that
juncture exhibited many telling attributes. For example, the readiness planning
that occurred before the deployments in the 1970s was nominal and lacking in re-
finements. The deficient levels of readiness were similar to those that existed just
before the onset and during the early days of Vietnam and other prior wars. Army
nurses coped with the deficits that were one consequence of meager planning by
functioning with ingenuity and implementing field expedient strategies. In the
final analysis, the missions of that time generally were successful, furnishing the
required amenities and assistance to the populations they served. The deploy-
ments also profited those who provided the support and the Army organization as
a whole by supplying very useful, practical field experience. Finally, the deploy-
ments triggered essential development and underscored the imperative to improve
readiness planning on a regular basis. Readiness planning as an ongoing process
would be acknowledged as a prime necessity in the years to come.
160 A Contemporary History of the U.S. Army Nurse Corps

Notes

1. Raymond L. Coultrip, “Medical Aspects of US Disaster Relief Operations in Nicara-

gua,” Military Medicine 139 (December 1974): 879–83. Gaines M. Foster, The Demands
of Humanity; Army Medical Disaster Relief (Washington, DC: Center of Military History,
U.S. Army, 1983), 168–70.
2. Jane High, “Information Copy, Nursing Service, Managua, Nicaragua Disaster,”
Typewritten Document (TD), 22 January 1973; and Jane High to Madelyn Parks, Hand-
written Letter, 1 January 1973 (both in Army Nurse Corps Collection [ANCC], Office of
Medical History [OMH]).
3. The general purpose medium tent measured 32 feet long and 16 feet wide.
http://www.imsplus.com/ims66b.html (accessed 28 June 2005). Jane High, “Information
Copy, Nursing Service, Managua, Nicaragua Disaster,” TD, 22 January 1973; and Jane
High to Madelyn Parks, Handwritten Letter, 1 January 1973 (both in ANCC, OMH).
4. Ibid.
5. Department of State, Bureau of Public Affairs, Office of Media Services, “Humanitar-
ian Aid to Viet-Nam,” News Release, 15 April 1975; and Department of State, Bureau of
Public Affairs, Office of Media Services, “Indochina Refugee Resettlement,” News Re-
lease, August 1975 (both in ANCC, OMH).
6. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Washing-
ton, DC: Office of the Surgeon General, Department of the Army, 1988), 165–67. Richard
R. Taylor, “Landmarks Point to Army’s Future,” U.S. Medicine 12 (15 January 1975): 46.
Robert Shaw, “Health Services in a Disaster: Lessons from the 1975 Vietnamese Evacua-
tion,” Military Medicine 144 (May 1979): 307–11.
7. Carolyn M. Feller and Debora R. Cox, Highlights in the History of the Army Nurse
Corps, 100th Anniversary Edition (Washington, DC: U.S. Army Center of Military His-
tory, 2000), 48.
8. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 165–67. The
Army Nurse Corps After Action Report stated, “over 100 ANC officers participated in this
mission.” Virginia L. Brown, “After Action Report—Operation NEW ARRIVALS,” Type-
written Disposition Form, 26 January 1976, ANCC, OMH.
9. Richard R. Taylor, “Landmarks Point to Army’s Future,” U.S. Medicine 12 (15 Janu-
ary 1975): 41.
 Humanitarian Relief and Assistance Missions in the 1970s 161

10. As of 9 June 1975, seven Army nurses were in Guam. They included Hoppe; the
two Army Community Health Nurses, Lieutenant Colonel Anna Frederico and Captain
Mary L. Criswell, who were assigned to an epidemiology detachment, the 152nd Medical
Detachment; captains June Sekiguchi and Mary F. Faupel; and first lieutenants Ollie B.
Gray and Rebecca Atwood, who were assigned either to the 423rd or the 702nd Medical
Company (Clearing). Jean Hoppe to Edith Nuttall, Typewritten Letter (TL), 9 June 1975,
ANCC, OMH.
11. Edith Nuttall, “Nursing Activities, 1st Medical Group, Guam,” Telephone Conversa-
tion Record from dialogue with Jeanne Hoppe, 6 June 1975, ANCC, OMH.
12. The MOS (Military Occupational Specialty) for Medical-Surgical Nurse at that time
was 3438. Other MOSs in existence then were 3430, Nurse Administrator; 3431, Commu-
nity Health Nurse; 3437, Psychiatric/Mental Health Nurse; 3442, Pediatric Nurse; 3443,
Operating Room Nurse; 3445, Nurse Anesthetist; 3446, Obstetric and Gynecologic Nurse;
and 3449, Clinical Nurse, or one who “functions in first level nursing care activities.” The
specific digits had meaning as well. The first digit, 3, indicated an AMEDD MOS. The sec-
ond digit, 4, specified an ANC or AMSC officer. The final two digits identified the specialty
with the ANC. Academy of Health Sciences, U.S. Army, “Nursing in Army Hospitals,”
Study Guide 310, 102–12, November 1974, ANCC, OMH. Jean Hoppe to Edith Nuttall,
TL, 9 June 1975, ANCC, OMH.
13. Edith Nuttall, “Nursing Activities, 1st Medical Group, Guam,” Telephone Conversa-
tion Record from dialogue with Jeanne Hoppe, 6 June 1975, ANCC, OMH.
14. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 167. U.S.
Army Health Service Command, Annual Historical Review, 1 July 1975 to 30 September
1977 (Ft. Sam Houston, TX: Historical Office, HSC, 1979), 120.
15. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 166–67. Caro-
lyn M. Feller and Debora R. Cox, Highlights in the History of the Army Nurse Corps, 100th
Anniversary Edition (Washington, DC: U.S. Army Center of Military History, 2000), 48.
Edith Nuttall, “Information, 47th Field Hospital, Fort Chaffee, Arkansas,” Telephone Con-
versation Record from dialogue with Maurine Hill, 5 August 1975, ANCC, OMH.
16. Joel C. Gaydos and others, “A Preventive Medicine Team in a Refugee Relief Oper-
ation—Fort Chaffee Indochina Refugee Camp (April–July 1975),” Military Medicine 143
(May 1978): 318–21.
17. Lillian Dunlap, 33 Years of Army Nursing (Washington, DC: U.S. Army Nurse
Corps, 2001), 292. James B. Dalton, “Conditions at Fort Chaffee Refugee Camp,” TL, 12
June 1975, ANCC, OMH.
18. Stephanie Velsmid to Ward 7, Handwritten Letter, 8 May 1975, ANCC, OMH.
19. Diane McDermott to Lieutenant Colonel Carr, Handwritten Letter, 11 May 1975,
ANCC, OMH.
20. Stephanie Velsmid to Ward 7, Handwritten Letter, 8 May 1975, ANCC, OMH.
21. Edith Nuttall, “Information, 47th Field Hospital, Fort Chaffee, Arkansas,” Tele-
phone Conversation Record from dialogue with Maurine Hill, 5 August 1975, ANCC,
OMH.
22. Joel C. Gaydos and others, “A Preventive Medicine Team in a Refugee Relief Oper-
ation—Fort Chaffee Indochina Refugee Camp (April–July 1975),” Military Medicine 143
(May 1978): 318–21.
23. Department of State, Bureau of Public Affairs, Office of Media Services, “Indochina
Refugee Resettlement,” News Release, 2, August 1975, ANCC, OMH.
24. Ibid. Lillian Dunlap, 33 Years of Army Nursing (Washington, DC: U.S. Army Nurse
162 A Contemporary History of the U.S. Army Nurse Corps

Corps, 2001), 292.

25. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 167.
26. Department of State, Bureau of Public Affairs, Office of Media Services, “Indochina
Refugee Resettlement,” News Release, 2, August 1975; and Ann Butler, “Waiting for Ac-
ceptance,” Pittsburgh Press Roto (26 October 1975): n.p., Newspaper Clipping (both in
ANCC, OMH).
27. Connie L. Slewitzke, “Indian Town Gap Military Reservation,” Memorandum for
Record, 21 May 1975, ANCC, OMH.
28. Vickey Mouze, “Ft. Indiantown Gap: WRAMC Personnel Doing Their Part to Im-
prove, Restore Health of Refugees,” The Stripe (20 June 1975): 6.
29. OTC preparations are medications that can be purchased without a prescription. Cer-
tain cough and cold remedies, aspirin, and specific ointments are examples of OTC items.
30. Vickey Mouze, “Ft. Indiantown Gap: WRAMC Personnel Doing Their Part to Im-
prove, Restore Health of Refugees,” The Stripe (20 June 1975): 6.
31. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 166–67.
32. John Romer, “Refugee Work: A New Experience,” Army Times (3 December 1975):
n.p., Newspaper Clipping, ANCC, OMH.
33. Edith Nuttall, “Information from Chief Nurse, Indiantown Gap, PA,” Telephone
Conversation Record from dialogue with Dorothy Nelson, 9 October 1975, ANCC, OMH.
Lillian Dunlap, 33 Years of Army Nursing (Washington, DC: U.S. Army Nurse Corps,
2001), 293.
34. John Romer, “Refugee Work: A New Experience,” Army Times (3 December 1975):
n.p., Newspaper Clipping, ANCC, OMH.
35. Lillian Dunlap, 33 Years of Army Nursing (Washington, DC: U.S. Army Nurse
Corps, 2001), 292–93.
36. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 167.
37. Virginia L. Brown, “After Action Report—Operation NEW ARRIVALS,” Typewrit-
ten Disposition Form, 26 January 1976, ANCC, OMH.
38. Lillian Dunlap, 33 Years of Army Nursing (Washington, DC: U.S. Army Nurse
Corps, 2001), 294–95.
39. Virginia L. Brown, “After Action Report—Operation NEW ARRIVALS,” Typewrit-
ten Disposition Form, 26 January 1976, ANCC, OMH.
40. Academy of Health Sciences, U.S. Army, “Nursing in Army Hospitals,” Study Guide
310, 96, November 1974, ANCC, OMH.
41. Virginia L. Brown, “Impact Statement on Vietnam Orphans,” Typewritten Docu-
ment, 11 April 1975; “Arrival of Sea Orphan Evacuees, Fort Benning, GA,” Memorandum
for Record, 11 April 1975; Virginia L. Brown, “Information on “Operation Baby-Lift” in
CONUS,” Telephone Conversation Record from dialogue with Edith M. Nuttall, 14 April
1975; Ron Taylor, “Benning’s Babes, 171 Vietnamese Orphans Find Temporary Home,”
Newspaper Clipping from Columbus (GA) Journal-Constitution, n.p., n.d. (all in ANCC,
OMH). “Operation Babylift,” Army Times (30 April 1975): 27.
42. Mary C. Smolenski, Donald G. Smith, and James S. Nanney, A Fit, Fighting Force,
The Air Force Nursing Services Chronology (Washington, DC: Office of the Air Force
Surgeon General, 2005), 33–34.
43. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 172–74.
 Humanitarian Relief and Assistance Missions in the 1970s 163

Gaines M. Foster, The Demands of Humanity; Army Medical Disaster Relief (Washington,
DC: Center of Military History, U.S. Army, 1983), 170–71. Richard B. Taylor, “Army’s
Programs Fitted to Mission,” U.S. Medicine 13 (15 January 1977): 49. “Massive Quake
Smashes Guatemala,” Washington Star (4 February 1976): A-1. “GIs Ease Quake Victims’
Pain,” Los Angeles Herald-Examiner (20 February 1976): A-10.
44. Marbeth G. Michael, “Nursing Service After Action Report,” TL to Thomas C. Birk,
15 March 1976, ANCC, OMH. Gaines M. Foster, The Demands of Humanity; Army Medi-
cal Disaster Relief (Washington, DC: Center of Military History, U.S. Army, 1983), 171.
“HSC’s Medical People Help Field Hospital Care for Guatemala’s Earthquake Victims,”
HSC Mercury 3 (April 1976): 4–5.
45. Marbeth G. Michael, “Nursing Service After Action Report,” TL to Thomas C. Birk,
3, 15 March 1976, ANCC, OMH.
46. “Five Brooke Nurses Weather Shocks, Cold to Aid Victims,” HSC Mercury 3 (April
1976): 5.
47. “HSC’s Medical People Help Field Hospital Care for Guatemala’s Earthquake Vic-
tims,” HSC Mercury 3 (April 1976): 5. Gaines M. Foster, The Demands of Humanity; Army
Medical Disaster Relief (Washington, DC: Center of Military History, U.S. Army, 1983),
171.
48. “GIs Ease Quake Victims’ Pain,” Los Angeles Herald-Examiner (20 February 1976):
A-10.
49. “Five Brooke Nurses Weather Shocks, Cold to Aid Victims,” HSC Mercury 3 (April
1976): 5.
50. TA-50 is the field equipment issued prior to deployment. It can include any number
of objects, such as web gear, canteens, ponchos, and helmet liners, to name but a few cru-
cial items. Marbeth G. Michael, “Nursing Service After Action Report,” TL to Thomas C.
Birk, 1–3, 15 March 1976, ANCC, OMH.
51. “Five Brooke Nurses Weather Shocks, Cold to Aid Victims,” HSC Mercury 3 (April
1976): 5.
52. Marbeth G. Michael, “Nursing Service After Action Report,” TL to Thomas C. Birk,
4, 15 March 1976, ANCC, OMH.
53. “GIs Ease Quake Victims’ Pain,” Los Angeles Herald-Examiner (20 February 1976):
A-10.
54. Gaines M. Foster, The Demands of Humanity; Army Medical Disaster Relief (Wash-
ington, DC: Center of Military History, U.S. Army, 1983), 171–72.
55. Spurgeon Neel, “HSC Guatemala Earthquake Assistance,” in Department of the
Army, Headquarters, U.S. Army Health Services Command, Commander’s Notes, CG
HSC Bulletin No. 4-76 (April 1976): 1, Record Group 112, Entry 452, National Archives.
56. Report of the Surgeon General United States Army Fiscal Years 1976–1980 (Wash-
ington, DC: Office of the Surgeon General, Department of the Army, 1988), 174. Gaines
M. Foster, The Demands of Humanity; Army Medical Disaster Relief (Washington, DC:
Center of Military History, U.S. Army, 1983), 171.
57. Gaines M. Foster, The Demands of Humanity; Army Medical Disaster Relief (Wash-
ington, DC: Center of Military History, U.S. Army, 1983), 174–75.
58. U.S. Army Health Services Command, Public Affairs Office, “Army Nurses Depart
for Jordan,” News Release No. 470, 19 November 1976, ANCC, OMH.
59. Marian C. Barbieri, Interview by Susan Steinfeld and Wynona Bice-Stephens, 10,
11, 14–16, and 19–20, 12 May 1988, U.S. Army Center of Military History, Washington,
D.C., ANCC, OMH.
60. Marian C. Barbieri, “Effectiveness of Training Report (RCS CSGPO-125),” Type-
written Report, ANCC, OMH.
164 A Contemporary History of the U.S. Army Nurse Corps

61. Marian C. Barbieri, “Nursing Administration and Education MTT-JO-0025-77, In-

terim Report—20 January 1977,” Typewritten Report, ANCC, OMH.
62. Barbieri and Spine sent regular letters to Brigadier General Madelyn Parks full of
candid, humorous details chronicling their circumstances, challenges, and experiences.
Their letter dated 2 December 1976 tells of their hospitable welcome, spartan living con-
ditions in a “cold water flat,” erratic transportation provided by a chauffeur who carried
a sidearm and spoke no English, social engagements, and their initial efforts to educate.
Marian C. Barbieri and Mary Lou Spine to General Parks, TL, 2 December 1976, ANCC,
OMH.
63. Marian C. Barbieri, “Nursing Administration and Education MTT-JO-0025-77, In-
terim Report—20 January 1977,” Typewritten Report, ANCC, OMH.
64. Marian C. Barbieri and Mary Lou Spine to General Parks, TL, 2 February 1977,
ANCC, OMH.
65. Marian C. Barbieri and Mary Lou Spine to General Parks, Typewritten Letter, 7
March 1977; and Marian C. Barbieri and Mary Lou Spine to Director, Royal Medical Ser-
vices, JAF, “Suggested Plan for Further Education for Royal Jordanian Nursing Services
Personnel,” TD, 5 March 1977 (both in ANCC, OMH).
66. Marian C. Barbieri to General Parks, Handwritten Letter, 12 March 1977, ANCC,
OMH.
67. Marian C. Barbieri to General Parks, TL, 1 April 1977, ANCC, OMH.
68. Marian C. Barbieri to General Parks, TL, 10 May 1977, ANCC, OMH.
69. Marian C. Barbieri and Mary Lou Spine to General Parks, 2 December 1976; Marian
C. Barbieri and Mary Lou Spine to General Parks, 15 December 1976; Marian C. Barbieri
and Mary Lou Spine to General Parks, 20 January 1977; Marian C. Barbieri and Mary Lou
Spine to General Parks, 2 February 1977; Marion C. Barbieri to General Parks, 26 April
1977; and Marion C. Barbieri and Mary Lou Spine to General Parks, 10 May 1977 (all TLs
in ANCC, OMH).
70. Marian C. Barbieri and Mary Lou Spine to General Parks, TL, 10 May 1977, ANCC,
OMH.
71. Annette R. Aitcheson, “RCS CSGPO-125 (Effectiveness of Training of Mobile
Training Team),” TD, 5 April 1983, ANCC, OMH.
72. Annette R. Aitcheson, “Annex (Unofficial Report),” TD, n.d., ANCC, OMH.
73. Annette R. Aitcheson, “RCS CSGPO-125 (Effectiveness of Training of Mobile
Training Team),” TD, 5 April 1983, ANCC, OMH.
74. Annette R. Aitcheson to General Slewitzke, Handwritten Letter, 11 March 1984,
ANCC, OMH.
75. Annette R. Aitcheson, “Annex (Unofficial Report),” TD, n.d., ANCC, OMH.
76. Annette R. Aitcheson, “RCS CSGPO-125 (Effectiveness of Training of Mobile
Training Team),” TD, 5 April 1983, ANCC, OMH
77. Annette R. Aitcheson to General Slewitzke, Handwritten Letter, 11 March 1984,
ANCC, OMH.
78. Ibid.
79. Annette R. Aitcheson, “US Army Burn Nurse Consultant Assignment Jordan,” Medi-
cal Bulletin of the US Army, Europe 43 (September/October 1986): 45.