Mud and Mustard Gas, Sweat and Bugs: The 20th General Hospital

Entrance to the 20th General Hospital in India, World War II. Photo courtesy of the US Army Office of Medical History.

A critical element of any army’s strength is its ability to mobilize the resources necessary to provide first-rate medical care for Soldiers. These resources include up-to-date medical facilities staffed by exceptional doctors and nurses.  As World War I progressed, many Americans came to realize that U.S. involvement was inevitable. In 1916, the University of Pennsylvania mobilized 22 doctors, 65 nurses, 2 dentists, 1 chaplain, 153 other staff, and $36,000 in donated funds to create Base Hospital #20.  Most of the staff were students, graduates, or faculty from the University who embodied the Army’s great tradition of selfless-service.

Base hospitals were the brainchild of famed American surgeon George W. Crile, who suggested the development of civilian hospitals to Army Surgeon General William Crawford Gorgas after a tour of French military hospitals in 1915.  Base Hospitals were organized to Army standards with the assistance of the American Red Cross and America’s leading teaching hospitals, and would fall under the control of the Army in the event of war.  The Army had only to assign a compliment of enlisted personnel for unskilled and semi-skilled labor to establish 50 fully staffed and equipped hospitals.  The 20th Base Hospital would see distinguished service in World War I and World War II.  Notable individuals assigned to the 20th Base Hospital include both Emma Elizabeth Weaver and Anna Mae Hays.

Operating theater at the 20th General Hospital, Ledo, Assam, India, during World War II. Photo courtesy of the US Army Office of Medical History.

In 1917, Base Hospital # 20 received orders to deploy to Europe with the Medical Corps of the United States Army.  Once in France, Base Hospital # 20 s set up facilities in Chatel Guyon, Puy de Dome in central France about halfway between Lyon and Limoges.  The Hospital treated wounded Soldiers regardless of nationality, as revealed by Army Nurse Elizabeth Lewis’ diaries.  Although they were not at the front, the hospital staff was also exposed to many of the same hazards as the Soldiers at the front, including artillery, air raids, gas attacks, and rampant disease due to filthy conditions.  The Hospital treated thousands of Soldiers for bullet wounds, shell fragments, gas, disease, and shell shock during its deployment to the combat zone.  Two months after the Armistice in November 1918, the Hospital was relieved of its duties and shut down.

Over twenty years later, with World War II looming, the University of Pennsylvania once again organized the hospital in preparation for war.  This time, however, the staff of the 20th General Hospital would experience a completely different environment.  Stationed in Ledo, India, the 20th General Hospital staff faced enemy attack, dangerous wildlife, tropical diseases, dense jungle terrain, debilitating heat, heavy rainfall, and oppressive humidity.  The U.S. and her allies had come to Ledo to build a supply road to China to replace the Burma Road, which had been cut by the Japanese in 1942.


Army nurses and a physician at the 20th General Hospital . Notice the palm frond roof on the building. Photo courtesy of the US Army Office of Medical History.

Housed in “bashas”, indigenous structures made chiefly of bamboo, the staff conducted operations and provided care in facilities that could be generously described as primitive.  With dirt floors and palm frond roofs, the bashas were far from ideal.  The buildings had swinging doors that did not latch, and Nurse Anna Mae Hays recalls having to drive out animals, both wild and domestic, that wandered in from time to time.  Electricity was limited, and fresh water was scarce.  Heat and fatigue tested the staff’s physical limitations as they cared for Soldiers wounded in battle or suffering from dangerous diseases and infections.


The staff themselves were not immune to the threats American Soldiers faced in the tropical combat zone.  Malaria, one of the most dangerous tropical diseases of all time, sickened thousands of Soldiers, nurses, and doctors.  No one was immune, and the 20th General Hospital alone saw roughly 12,000 cases. Malarial infections spiked during the monsoon season from July to October 1943 as the wet conditions lead to an explosion of the mosquito population that spread the disease.  A lack of insecticides, mosquito netting, and window screens contributed to the outbreak, especially among night shift workers.


By the end of the war, the staff had treated almost 75,000 patients in two years in the Pacific theater, a great achievement by any standard.  But the end of the war did not mean the end of the contributions of the men and women of the 20th General Hospital, and many of the staff went on to make significant contributions to post-war medical advances.  Most notable among them is, Anna Mae Hayes, a young nurse who joined the Army out of patriotism and a sense of duty.  After the war, she would rise through the ranks to become Chief of the Army Nurse Corps and America’s first female general.  She would go on to make significant contributions to the field of Nursing, raising professional standards for Army Nurses and fighting to increase nurses input into the decision making process.  Her contributions are among the many made by the men and women of the U.S. Army’s 20th General Hospital.


Bellafaire, Judith A.  The Army Nurses Corp: A Commemoration of World War II Service.  U.S. Army Center of Military History (USAMHI).  http://www.history.army.mil/books/wwii/72-14/72-14.HTM.

“History of the 20th General Hospital in the China-Burma-India Theater during World War II.”  Volumes 1 & 2.  The Historical Unit.  U.S. Army Medical Service.  Forest Glen Section.  Walter Reed Army Medical Center, Washington, D.C., 1945.  USAMHI.

Lloyd, Mark F. “Base Hospital No. 20.”  University Archives and Records Center, University of Pennsylvania University Archives,  Feb. 1999.

“U.S. Army 20th General Hospital Collection, 1932 – 1952 (bulk 1942 – 1945).”  University of Pennsylvania University Archives and Record Center.  http://www.archives.UPenn.edu/faids/upc/upc15.html.

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