OPERATION OF MANZANAR WAR RELOCATION CENTER MARCH-DECEMBER, 1942 (contined)
MANZANAR CAMP OPERATIONS DURING 1942 (continued)
Under the WCCA. Under the WCCA, insufficient clinical facilities, personnel shortages, inadequate space, and procurement difficulties limited medical care at Manzanar.  Several days after the first evacuees entered Manzanar in March 1942, the first "hospital" was opened in a barrack in Block 7. The original medical personnel were evacuees, consisting of one doctor, one dentist, and one registered nurse, all of whom had volunteered to evacuate to Manzanar. Dr. James M. Goto, a graduate of the University of Southern California and a former physician at the Los Angeles County Hospital, was the chief medical officer in the camp. Later in March, another doctor, a registered nurse, and two student nurses joined the embryonic camp medical staff. No Caucasian doctors or nurses joined the staff until October 1.
Two rooms in the "hospital barrack" were equipped for use, one serving as a first-aid station and operating room and the other containing five cots for in-patients. One refrigerator, one operating table, several tables for instruments, and five cots comprised the hospital equipment. Running water and sterilization facilities were not available at the time.
The U.S. Public Health Service provided a limited supply of drugs, instruments, and needed equipment to Manzanar. A doctor representing that agency spent two days at Manzanar at the time of the hospital opening, providing valuable assistance to the medical staff.
During March 1942 nine in-patients were hospitalized, and 251 cases were examined in the out-patient department. Of the cases treated in the hospital, two were for gastro-intestinal upsets and the remainder for upper respiratory ailments. This low number of hospital cases was a remarkable development "considering the lack of sanitary measures" in the camp. Medical services were rendered despite extremely cold weather and inadequate heat. From the beginning, emphasis was placed on the idea that preventive care was synonymous with clinical care. Within weeks of the camp's opening, various types of public health clinics were held each morning. The medical staff initiated instructions for sanitary inspectors, and a regular schedule of camp inspection and reporting was developed. During the first month of the camp's operation, the medical staff administered 14,750 typhoid inoculations and 6,968 small pox vaccinations to the incoming evacuees. A dental clinic was established under the guidance of an evacuee dentist working solely with the equipment he had brought with him.
Ground was broken for a new 250-bed hospital during late April. During that month, the medical staff increased by one doctor, two registered nurses, and four student nurses.
Meanwhile, on April 13, the hospital moved from its temporary location into larger quarters in a 100-foot x 20-foot barrack in Block 7 which had been partitioned into a pharmacy, laboratory, kitchen, and operating. X-ray, sterilizing, linen, utility, record rooms, as well as space for a ten-bed hospital unit. This building was equipped with running water. The U. S. Public Health Service provided the equipment for the ten-bed unit, including instruments, X-ray equipment, and an autoclave sterilizer.
Four more standard barracks adjacent to this unit were acquired for hospital use in April to accommodate contagious disease patients. Running water was not available then, nor at a later date, in this new addition to the hospital.
As the medical staff increased, physicians and nurses were stationed at the entrance to the center to screen the new arrivals for communicable diseases. Those requiring hospitalization were admitted immediately in an effort to prevent epidemics from spreading through the camp population.
Through the month of April, the total out-patient load was 954. Numerous cases of acute simple conjunctivitis caused by dust storms were treated. The total in-patient load was 75, consisting mostly of communicable diseases and upper respiratory cases. The number of surgical patients totaled 11. One repair of a ruptured Achilles tendon and two appendectomies were performed before April 13, when the hospital was moved to its more adequate accommodations.
In May, the camp's medical staff increased with the arrival of two doctors, three dentists, and one registered nurse. With the exception of the lay hospital administrator, the entire hospital staff was composed of evacuee personnel.
During May, the medical staff administered 558 dental treatments, 16 surgical operations, and eight baby deliveries. There were 70 hospitalized cases for communicable diseases, including measles, chickenpox, whooping cough, and mumps. The out-patient department handled 2,300 cases that month. One case (hospitalized on March 22) ended in death from "hypertension with decompensation."
Other activities conducted by the medical staff during May included examination of 146 food handlers, 99 well-baby conferences, and 45 prenatal examinations. Nutrition aides were selected to develop instructions for those working in mess halls.
On June 1, when the WRA took over administrative control of Manzanar, the improvised and primitive hospital facilities in the camp were deplorable.  On some of the hospital beds there were no mattresses, "straw ticking being used." In the nursery which housed five babies, there was "one bassinet, a common cardboard box and three wooden cribs built by Japanese workmen in the center from discarded building materials from the new hospital construction." There were only 12 urinals for the hospital patients. There was a shortage of pitchers, and "tin cans were used in several instances to supply drinking water to the patients." Nurses were forced to go outside and use an open spigot to wash their hands between patients. Water from wash basins used in bathing or caring for hospital patients was disposed "of on the open ground around the barracks, creating a possible source for the spread of infection in Manzanar's blowing dust." No telephones had been installed in the hospital.
Although the supply of drugs and medicines was considered to be adequate, the operating table, lighting, and surgical equipment were unsatisfactory. Despite the inadequate equipment in the hospital, however, "operations of a delicate nature" had been "successfully performed, including fourteen appendectomies and the removal of a cancer of the cecum, all without a fatality." Sterilizing equipment was "new and wholly adequate, and one ward had an air conditioning unit donated by Manchester Boddy, the Los Angeles newspaper publisher. The floors of the hospital buildings "were of bare boards, uncovered, but clean by dint of constant scrubbing." Hospital laundry was sent to a private establishment in Bishop. Deliveries were made twice weekly, sometimes resulting "in a shortage of hospital linen." The hospital did not have its own kitchen facilities "for the preparation of special foods and diets for the patients."
Under the WRA. In June another nurse, and in July another doctor, joined the Manzanar medical staff, bringing the camp's total professional evacuee personnel to six physicians, four dentists, six registered nurses, and six student nurses. A large shipment of medical equipment and supplies was received in June from the Quartermaster Depot in St. Louis. By the end of June, the medical services rendered to the camp population since its opening in March, included the following list:
On July 22, the new 250-bed hospital, which had been under construction since late April, was officially opened. The hospital continued to be operated with an exclusively professional evacuee staff. The Hospital Administrator, a member of the appointed personnel, was nominally the head of the hospital, but he was neither medically trained nor experienced in hospital management. He also served as a liaison officer between the hospital staff and the camp administrators.
Under the WRA organization, the Health Section was placed in the Community Services Division and divided into public health and hospital units. Each of these units duplicated various efforts, services, and supplies. In addition, a rift occurred between the staffs of the two units. The organization failed to function smoothly because of personnel friction and lack of coordination. Thus, a newly-appointed Caucasian Chief Medical Officer and his staff, along with the head of the Medical Section from Washington, arrived at Manzanar in October to investigate the hospital and public health operations in the camp. Their examination was followed by a reorganization of the hospital personnel and their responsibilities. The Health Section became a single operating entity in which all personnel from physicians down were rotated through both the hospital and public health services. The greatest aid to unity came when the physicians, "who distrusted public health on the ground that it offered an entry for socialized medicine," began to realize that proper preventive measures reduced the number of emergency calls.
The new organization provided for general supervision of all medical services under a Principal Medical Officer who consulted with his unit heads before making important decisions regarding their units. He had general supervision of the health program and overall responsibility for application of WRA health policies. Most responsibility for medical services were delegated to the Chief Nurse, who supervised all nursing services and personnel, and the Hospital Administrator, who oversaw operation of the hospital and related services, such as warehouse, clerical, telephone, laundry, mess, janitorial, and ambulance. Physicians performed all medical services expected of a general practitioner, while dentists made examinations, cleaning, fillings, extractions, and dentures. The sanitarian was responsible for checking the purity of the water supply, sewage disposal, garbage and trash removal, and sanitary conditions in the mess halls, latrines, and camp in general. The pharmacist rilled prescriptions, and a dietician supervised the preparation of and serving of meals at the hospital and the diet mess hall. Laboratory and x-ray technicians performed their respective jobs. The health section also had a medical social worker who interviewed patients as to their social welfare needs, and assisted the Welfare Section in the adjustment of evacuees in relation to their health problems.
Last Updated: 01-Jan-2002