The types and numbers of medical units of the U.S. Armed Forces sent to the Dominican Republic to participate in the Inter-American Peace Forces restoration of peaceful order there in 1965 and their assignments after arrival were determined as much by humanitarian and public relations considerations as by the basic mission of the Medical Service--to maintain the fighting strength.

Mass-scale medical aid to the civilian populace was not called for in standing contingency plans for the Dominican Republic before the government of that country was overturned on 24 April 1965. At the time of the uprising, however, the American Embassy reported heavy civilian casualties and requested above-normal Army medical support. The Army responded immediately by sending heavy support for the 82d Airborne Division from outside the Division, but as things worked out, the Division's own medical units were the ones which provided most aid to Dominican civilians.

Normal medical support within the 82d Airborne Division, in addition to battalion aid stations, and so forth, called for a company from the 307th Medical Battalion (of the Division) to accompany each combat brigade as it was committed to operations. To add flexibility, enhance the medical support, and make it self-sufficient, the field hospital was to be augmented by surgical teams and transportation and other paramedical units.

Planners from the Office of The Surgeon General, the Continental Army Command, and the XVIII Airborne Corps, when faced with the Dominican operation, put the following medical and paramedical units on the troop list to support the Division:

The 2d Surgical Hospital of Fort Bragg and the 50th Clearing Company of Fort Benning were listed in follow-on status. The Fort Bragg units other than those from the Division were part of the 55th Medical Group, 5th Logistical Command (later the 12th Support Brigade), Third U.S. Army. Professional personnel to staff the units on the troop list were designated by the Office of The Surgeon General and came from points throughout the United States.

According to plan, the 82d Division's own medical units accompanied the combat brigades. First medical units on the scene from the Division, beginning on 29 April, were battalion aid stations of the 1st Battalion, 505th Infantry and 1st Battalion, 508th Infantry, as well as Company D of the 307th Medical Battalion. Also among the first medical units to arrive in the Dominican Republic was an orthopedic surgical team (139th Medical Detachment [KB] of Valley Forge General Hospital) which was slated to be attached to the 15th Field Hospital. As the

combat commitment was escalated to division size by increments, the rest of the medical support organic to the Division was flown to the island.⁶

Reports by the U.S. Embassy and other sources at the scene when the revolt began painted a picture of bloody fighting and many wounded civilians in the streets of Santo Domingo. It was not known at that time that the civilian casualty rate had been greatly exaggerated, so the Washington administration directed Fort Bragg, through the Commander in Chief, U.S. Army Forces, Atlantic, to speed the entire 15th Field Hospital (400-bed) and two platoons of the 584th Ambulance Company from Fort Bragg to the Dominican Republic to perform civil aid. The medical units were injected into the airstream between combat units, and the first increments began arriving at San Isidro during the early morning darkness of 1 May. This resulted in "some chagrin on the part of the [82d] Division commander who had not requested any change in the [original] plan and who was less than pleased as aircraft after aircraft⁷ arrived and discharged a steady stream of red crosses instead of the combat troops expected."⁸ LTG Palmer, however, was well aware of the situation, since his headquarters was arriving in the same priority as the medical units.

This priority notwithstanding, it was several days before the hospital medics could find many Dominican casualties to treat.

Accompanying the field hospital and the ambulances was a general surgical team, the 53d from William Beaumont General Hospital. Also on 1 May, the Air Force set up a casualty staging detachment at San Isidro which subsequently administered the evacuation of all casualties from the island except for some Navy and Marine personnel who were processed through their own medical facilities and sent out to ships.

The XVIII Airborne Corps Surgeon, MAJ Foster C. McCaleb, Jr., MC (later promoted to LTC during the operation) and his small staff also landed at San Isidro on 2 May. Three days later the 345th Medical Detachment (Supply) and the first shipment (62,000 pounds) of many shipments of civil relief supplies arrived by air. The following day, 6 May, the 54th Medical

Detachment (Helicopter Ambulance) from Fort Benning moved five UH-1B air ambulances (fig. 1) ashore from the aircraft carrier USS Boxer. During the same time the 714th Preventive Medicine Detachment of Fort Bragg (two control sections, one sanitary engineer, and one entomologist of the 714th Preventive Medicine Unit) and the 69th Veterinary Food Inspection Detachment of Fort Bragg also came to the island. By that time the medical situation in Santo Domingo had been reevaluated, and the shipment of the 2d Surgical Hospital (Fort Bragg), the 232d Medical Detachment (KA) (Fort Sam Houston), and the 50th Clearing Company (Fort Benning) was canceled.

On 30 April, when the first Army troops landed, there were few organizational problems among Medical Service personnel. Technically, a naval officer was Task Force Surgeon, but the 82d Airborne Division, being the only Army unit on the ground, and MAJ Quitman W. Jones, MC, Division Surgeon and Commanding Officer, 307th Medical Battalion, were really more or less left in charge of the immediate situation, while still complying with orders from higher authority. The only non-division medical unit on the island was the surgical team from Valley Forge General Hospital which had arrived before its parent, the 15th Field Hospital. The surgical team was attached to Company D, 307th Medical Battalion, for operations until the 15th Field Hospital reached the Dominican Republic.

The next day, 1 May, the 15th Field Hospital, with LTC William L. Richardson, MC, in command, began to arrive by increments and to set up for business (fig. 2). The field hospital was then attached to the 82d Airborne Division. The 15th and its attached support units were part of the 55th Medical Group at Fort Bragg but the group headquarters was not assigned to the operation. The Group commanding officer, COL Peter S. Scoles, MC, did visit his medical units in the Dominican Republic in an advisory capacity, however.

On 3 May, the day after the XVIII Airborne Corps Surgeon, MAJ McCaleb, arrived in Santo Domingo, he assumed control of the 15th Field Hospital, and its allied units from the 82d Airborne Division. On 4 May, the 5th Logistical Command became operational on the island and took operational control of the 15th Field Hospital. The Logistical Command, in turn, was under the Corps for tactical command. Within a few more days USFORDOMREP was established, and MAJ McCaleb became the USFORDOMREP Surgeon as well as Surgeon of U.S. Army Forces, DOMREP.

Meanwhile, the individual companies of the 307th Medical Battalion were attached to the combat brigades they supported until 5 May, when they reverted to Medical Battalion control.

Thus, during the first few days of the operation, command and technical supervision lines were repeatedly shifting, but as the work at hand was more important than the lines on an organization chart, this was of little consequence. After USFORDOMREP was established, parallel command and technical lines ran down from Force Headquarters (staffed by Corps personnel) through the Division on one side and the Logistical Command on the other, and things were less confused. Organizational problems tended to be magnified only later when there was little work to be done.

On 11 June, the 15th Field Hospital and the other medical and paramedical units under the 5th Logistical Command were redesignated as U.S. Forces Medical Center, COMDOMREP (appendix A) and later became known as the Inter-American Peace Force (IAPF) Medical Center (fig.3). Even with the IAPF title, however, the medical complex owed its basic allegiance to the U.S. headquarters, although the latter was theoretically below the IAPF level (chart 1).

On 4 June, CPT Francis A. Sunseri, MC, a Special Forces officer who had been serving with the 42d Civil Affairs Company, became the first Inter-American Peace Force Surgeon and served in that position until December. The IAPF Surgeon acted as liaison between the Latin American and U.S. Army medical services. CPT Sunseri, a preventive medicine specialist, also devoted much time to advising the Latin American Brigade on sanitation and preventive medicine.

As the months passed, redeployments to the continental United States affected the medical organization in DOMREP somewhat. Even before the end of May, some personnel of the 15th Field Hospital were being redeployed, and by the first week in July, two of the three hospital units of the 15th were back at Fort Bragg. The small 139th Medical Detachment (Orthopedic Surgical) was sent back to Valley Forge piecemeal during the first two weeks of June, except for MAJ Horace E. Watson, MC, who stayed on as commanding officer of the 15th Field Hospital from 14 June until 3 July. The individual members of the 53d Medical Detachment (General Surgical) also returned to the States during the first two weeks of June. The ambulance unit's contingent in

DOMREP was reduced to one platoon by 28 June, and the air ambulance detachment's commitment in DOMREP was reduced considerably before the end of the year.

In the 82d Airborne Division, the organic aid stations were redeployed with their parent units as the overall commitment in DOMREP was reduced. Company D of the 307th Medical Battalion returned to Fort Bragg on 23 July and Company B on 14 November. At the end of the year, the Division's medical service in DOMREP consisted of five aid stations and Company C of the Medical Battalion.

A major organizational change for medical support units took place on 10 December with the establishment of USFORDOMREP as a separate command. The one hospital unit of the 15th Field Hospital, the ambulance platoon, supply detachment, air ambulance detachment, and preventive medicine detachment in DOMREP were all officially returned to CONUS, but most of their personnel and equipment stayed in the Dominican Republic and became part of the newly activated 42d Field Hospital⁹ (chart 2). At the same time, the 69th Medical Detachment (Veterinary Food Inspection) was attached to the 12th Support Brigade. The 274th Medical Detachment (Dispensary), newly arrived from Fort Knox, Ky., was attached to the 42d Field Hospital and had the responsibility of providing primary support to IAPF Headquarters, USFORDOMREP Headquarters, and related units.