SCIENTIFIC INTELLIGENCE DIGEST

• Document Type: SPECIALCOLLECTION
• Collection: Tet Declassified
• Document Number (FOIA) /ESDN (CREST): 05647983
• Document Creation Date: January 28, 2019

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13526
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1) I R EC TO R ATE OF
SCIENCE S. ECHNO 1.0G )'
SCIENTIFIC INTELLIGENCE DIGEST
Se
� OSI-SD/68-2
February 1968
Copy NE' 47
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MEDICAL CARE AND ASSOCIATED PROBLEMS
OF THE VIET CONG� A STATUS REPORT
Liie Sciences Division
OSUCIA
SUMMARY AND CONCLUSIONS
Medical support for the Viet Cong
combat units has been carried out in
the face of almost unbelievable difficul-
ties. In spite of good planning and a well
organized system for � cbmbat medical
services, the .Viet Cong is plagued by a
lack of sufficiently trained physicians at
the various health stations, inadequate
transport methods for evacuation of the
wounded, inadequate supply of medicines
at all stations, and fatalities resulting
From infectious diseases endemic to
Vietnam. Although the Viet Cong are
efficient in evacuating the wounded from
the battlefield to the first echelon of
medical aid, their greatest deficiency
Combat. Medical Preparations
lies in the slowness of evacuation to areas
capable of providing definitive care as
evidenced by the killed to wounded ratio
of 1:1.2 to 1:1.5 from battle casualties.
As an integral part of operational
planning, the Viet Cong make prepara-
tions for placing medical facilities in
pre-located areas in support of combat
missions. Nevertheless, only 50 percent
of the wounded .can be expected to re-
ceive the necessary' medical treatment
within 24 hours after injury and estimates
.suggest that between 25 and 42 percent of
the wounded have died, most of them
enroute to medical facilities.
DISCUSSION
It is the responsibility of all Viet Cong
unit commanders and their chief medical
cadres, prior to launching a combat
operation, to organize and prepare facili-
ties to insure the timely evacuation of
the sick and wounded. The Viet Cong
emphasize this phase of medical service
to provide assurance that the wounded
will be treated and to restore the wounded
to combat status as soon as possible. In
addition, rapid evacuation would deny
precise casualty figures to the enemy
and deny to the enemy intelligence from
wounded Viet Cong. Casualties are re-
moved from the field as quickly as pos-
sible by troops or by civilian laborers
recruited for that purpose.
SID 68-2
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. The Viet. Cong make elaborate pre-
parations for medical support during
combat operations. These can be effected
rapidly when an operation involves single
small unit actions or a series of them.
In .major operations, successful medical
support is vulnerable due to larger num-
bers of wounded, enemy interdiction of
escape routes, and enemy discovery of
fixed medical facilities.
Pre-combat medical preparations are
carried out systematically as follows:
(1) Review of the situation and mis-
sion using information procured from
Chief, Rear Services Echelon;
(2) fix the missions of unit medical
sections involved, and prepare to impro-
vise to meet new contingencies
(3) review TO&E and the status of
medical support to be certain that suf-
ficient cadre is available to support the
mission. (Supplies usually come from
province or district clandestine depots);
(4) the Battalion or Regimental sur-
geon conducts terrain reconnaissance,
selects evacuation routes, and places
medical stations in concealed areas;
(5) the surgeon then forwards a
Medical Resolution to Chief, Rear Serv-
ices, Chat includes a medical prepared-
ness statement, deployment of medical
stations, and casualty estimates;
(6) all echelons of the medical serv-
ice involved in the mission are co-
ordinated and the shortcomings of pre-
vious battles are reviewed;
(7) a critique of 'medical effective-
ness follows each operation.
Evacuation and Treatment
The Viet Cong medical chain of
command has six levels ranging from
platoon (company) aid station to zone
hospital. Management of the wounded is
effected systematically. The wounded
are evacuated by any available means
to one of the concealed platoon aid sta-
tions where bleeding is controlled,
bandages are applied, and bones are
splinted. Casualties are then transported
by stretcher or other deviees to the bat-.
talion aid station which contains a first
aid cell whose Table of Organization and
Equipment (TO KE) calls for three
persons including at least one physician.
This station is usually located 400 to 2500
meters to the rear of the combat area.
Minor wounds are treated in the aid sta-
tion, and some surgery is performed. The
more seriously wounded are then eVaell-
ated to the regimental mobile surgical
unit where light wounds and shock are
treated, and where routine surgery is
performed. Post-operative care is given
here, with a maximum in-patient time of
15 days. Recuperating patients are car-
ried over jungle trails to a series of Re-
gional or District hospitals of about 10_or
more beds each. The regional hospital is
primarily a dispensary which handles not
only wounded but also the sick� both mili-
tary and local civilian. In this sense the
regional hospital performs a civil affairs
functions. The Regional hospitals are in
wooden huts hidden in the forest.
The, most severely wounded often by-.
pass the regional level and are taken to
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the provincial military hospital with ap-
proximately 50 or 60 beds which is
located usually in a remote area and well
concealed. Here, general medical and
surgical facilities exist in underground
rooms and blood transfusion can be made.
Apparently no whole blood transfusions
are available below provincial level due
to a lack of power and refrigeration
facilities. Long periods of recuperation
are handled here, and general medical
aid is often given local, civilians. The
largest hospitals are at the zone level,
containing about 100 beds or more, and
are equipped for general medical and
surgical service as are the provincial
hospitals. The only difference appears
to be size. Zone hospitals are also hidden
in the jungle and contain underground
facilities.
, The organization works well as long as
combat operations go as planned and units
are not cut off from the chain of medical
facilities. Even when all goes as planned,
however, a major weakness exists in the
time required for wounded to be "hand
carried" to the various levels of medical
facilities. According to available in-
formation, only about 50 percent of the
Viet Cong wounded can receive the neces-
sary medical treatment within 24 hours of
being hit.
Evacuation of the Dead
Evacuation of dead Viet Cong is a
priority assignment quite independent of
the evacuation and care of the wounded.
In fact, it is given even higher priority
than wounded; as a counterintelligence
,..measure. If the slain man's comrades
cannot evacuate his body, a combat team
may be made up and sent to do so for
security purposes�the possibility of
further losses not withstanding. Burying
of the dead is planned in advance of com-
bat operations and is part of the medical
pre-operational planning phase. Burying
operations are carried out by a Rear
Services Medical Station.
Wounds and Diseases
Although some data on Viet Cong/North
Vietnamese Army wounds and diseases
are available from captured enemy docu-
ments, these documents ordinarily refer
only to small, individual units, and con-
clusions drawn from them necessarily
must remain somewhat tenuous. The
overall ratio of killed in action (KIA)*
to wounded in action (WIA) has been esti-
mated at between 1:1.2 to 1:1.5; these re-
flect the rigors or evacuation by foot and
the variable quality of medical care under
clandestine conditions. A figure of 3 per-
Cent has been mentioned for deathduring
hospitalization. This may be a reflection
of the fact that many die�estimated range
from 25 to 42 percent�enroute to hos-
pitals. The average hospitalization time
for wounded is given as 24 clays. Of the
24-day survivors, perhaps as many as
60 percent return to duty in some capa-
city. Another captured document delin-
ates types of wounds as 28 percent from
ball ammunition, 69 percent from shell
and grenade fragments, and the remain-
* The KIA figure given here appears to
include those troops killed outright and
those deceased while in transport to
medical facilities. Other VC unit medical
reports have separated KlA from
"deceased during transport."
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Mg 3 percent are unspecified. Severity of
wounds according to one Viet Cong break-
down was: 1.4 percent serious (head,
spine, cnest, abdomen); 30 percent slight
(am bu lent). These figures apparently are
(riven for wounds at the time of their �e-
n
currence and do not reflect loss of life
or worsening of the condition due to de-
lays in evacuation.
Data on diseases among the Viet Cong
arc not as well developed as for wounds.
Malaria appears to be the most prevalent.
In highland areas, and in Laos and
Cambodia, the average infestation rate is
estimated at 32 to 50 percent among Viet
Gong with the peak season between April
and June, although the incidence oc-
casionally reaches 100 percent in some
NVA and Viet Cong units. Falciparum is
highest in incidence (20 falciparum to 1 of
the other forms) and US casualties from,
falciparum malaria becomes heavy
whenever Viet Cong held areas are taken
and occupied. Treatment of talc iparum
malaria by US medical units is with
quinine plus pyrimethamine (amidopyri-
midine). 'Viet Gong treatment up until
about August 1967 was by quinine and
synthetic antimaliiria Is other than pyri-
metharnine. Pyrimethamine is now used
but amounts a inadequate due to re-
supply difficulties.
Gastrointestinal diseases is the second
most important infectuous disease in
Vietnam and may infect some 30 percent
of the Viet: Cong. Thc primary epidemio-
logical factor here is inadequate sanita-
tion. ltespiratory and nutritional dis,7-
cases are next in incidence but do not
represent a major factor in disability.
Plague is always a problem in this area,
but few cases are known to have been
reported by the Viet .Cong.
Although only sporadic figures are
available for disease casualties among
the Viet Cong, it appears that diseases
may be the major cause of morbidity and
mortality among both Viet Cong and North
Vietnamese Army forces in South
Vietnam. The primary reason is that in
the South, Viet Cong control over public
health conditions is inadequate even
though well organized. The conditions
have worsened as US combat operations
have been stepped up. The necessity of
continually moving medical Facilities to
back up tactical maneuver and the re-
sulting difficulty of logistical support,
makes prophylaxis and sanitation in-
creasingly difficult to achieve. The ratio
of disease casualties to wound casualties
\vill be clearly adjusted in Favor or
wounds should NVA and Viet Cong units
commence Operations on a divisional
scale. In such a case medical facilities
of both units will be greatly overtaxed
since battle wounds generally require
longer periods of convalescence.
Supplies, and Training
All drugs used by the. Viet Gong must
be brought into South Vietnam through
existing infiltration routes, open pur-
chase in Saigon, captured from US forces,
�or procured through neutral countries.
Most of the medical supplies entering
'Viet Cong areas via infiltration routes
originate in the USSR (2.5percent); Coni-
munist China (2.5 percent), and the Corn-
munist bloc countries (3.0 pereent)-
511) 68-2
Feb 68
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approximate percentages based on cap-
tured medical supplies and PO\V inter-
rogations. These supplies are trans-
ported either directly to Hanoi and infil-
trated down the Ho Chi Minh Trail to the
south, or through Laos and Cambodia to
the Viet Cong.
Fixed medical installations have been
established throughout Viet Cong opera-
tional areas.- These installations serve
combat casualties and also perform a
perfunctory civil affairs function among
the South Vietnamese peasantry. Medical
training units, semi-permanent para-
medical schools, in which Viet Cong
medics can be trained have been estab-
lished�even in areas occupied by US
military forces.
Viet Cong medical support bases also
exist in Cambodia and in Laos. Recent
reports indicate that there are 98 clan-
destine medical facilities under control
of the Pathet Lao ranging in size from
10 to over 100 beds. Approximately 1000
personnel of which less than 5 percent
are -Ioctors staff the facilities. The
facilities provide medical care to the
Pathet Lao in and civilian per-
sonnel in operational areas not secured
by the Pathet Lao and presumably also
to elements of the Viet Cong. Certain
Viet Cong VIPs are reported to have
been treated at the French built
Calmette Hospital in Phnom Penh after
evacuation from combat areas in air-
craft owned by French plantations in
South Vietnam./
SR) 68-2
Feb 68
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