21 April 1944
ANNEX "N" TO OPERATION PLAN NO. 2-44	Serial 00144
MEDICAL PLAN

1. Task

The Western Naval Task Force will supply medical service for all its component parts. This consists of medical service to all attached and embarked forces between the ports of embarkation and the high-water mark on the far-shore landing beaches. Included is (a) Joint Medical Service by Army and Navy to all personnel in the Beach Area and (b) seaward evacuation and medical service afloat from the far-shore landing beaches to the near-shore ports and/or bases.

2. Responsibilities

1. Near-shore

1. NAVY

1. The delivery of casualties to designated near-shore ports or hards at which special holding units will be provided by the Army. In the event that urgent necessity requires the landing of casualties at other than designated ports or hards, the Navy will be responsible for timely warning to the Army in order that casualties may be received and property exchanged without delay.
2. Providing the Army with information of existing Naval medical installations, in appropriate areas, that may be utilized in connection with casualty evacuation.

2. ARMY

1. The establishment and maintenance of such holding medical units in the immediate vicinity of ports and hards to which converted casualty-bearing LSTs and other casualty carrying ships have been designated to return, as may be required for the reception of casualties evacuated by ship.
2. For unloading all ships and craft at specified docks and hards.
3. The provision of such additional medical supplies and equipment in the immediate vicinity of designated near-shore ports and hards as may be necessary to effect prompt property exchange with returning LSTs and to meet emergency requirements arising in connection with shore to shore evacuation.
4. The provision of small emergency medical units at all hards used by returning U.S. craft to meet the needs of the few casualties who are evacuated by other than ships, or to other than designated hards.

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5. The necessary liaison with the Navy required for the reception of casualties without delay on the near-shore.

2. Far-shore

1. NAVY

1. The prompt exchange of medical property at the far-shore, in order to deplete far-shore stock of medical equipment and supplies. This will be effected in accordance with the agreement of the U.S. Navy, First U.S. Army and SOS.
2. The far-shore to ship evacuation of casualties in cases where DUKWs cannot be used for that purpose.
3. Medical service to personnel of the Ferry Service, Mulberry organizations, Advanced bases, Coasters, etc., will be NORMAL except where special provisions are required.

2. ARMY

1. Medical service to all personnel landward of the high-water mark on landing beaches.
2. The necessary liaison with the Navy Medical section of the Shore Party required for the evacuation of casualties from the beach.
3. The provision of sufficient DUKWs (especially allocated to the medical department when military situation permits), for evacuation of casualties from the beaches to the ships.
4. The loading of DUKWs, craft and boats, used to transport casualties from shore to ship; and the loading of motor vehicles when motor transport is used to deliver casualties to beached craft.
5. The transportation by DUKWs of casualties from shore to ship, and the transportation by the most suitable motor vehicles available in cases where motor transport may be used to deliver casualties to beached craft.
6. The provision of sufficient motor transportation facilities for necessary lateral movement of casualties in the vicinity of beaches.

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3. Afloat

1. Transports.

APs, APAs will provide:

1. Medical service to their own and embarked personnel.
2. Casualty evacuation facilities to the limits of their capacities.

2. Landing ships and craft will provide:

1. Medical service to their own and embarked personnel.
2. LSTs will provide the major casualty lift from the far to near shore.

3. Combat ships, Auxiliary ships and craft will provide:

1. Medical service to their own personnel. If overtaxed, they will evacuate to LSTs.

4. Hospital ships or carriers and Ambulance ships (if and when available) will be used in accordance with evacuation plan.

3. Evacuation

1. The principal task of the Medical Services of the Western Naval Task Force in Operation OVERLORD is that of shore-to-shore evacuation.
2. Medical Services of the Western Naval Task Force in Operation OVERLORD is that of a middle link in the chain of evacuation. The Assault Force constitutes the far-shore link; ETOUSA plus COMNAVEU, the near-shore link.
3. Casualty estimates and available lift is used as a basis of planning.
4. Evacuation policy

1. Far-shore:
   Initially - total evacuation of ineffectives except non-transportables.
   Later - a 7, 15, 30 day and longer policy, as directed by the Army.
2. Afloat:
   See paragraph 2c above.

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5. Shore to ship phase.

Any boat used in amphibious operations, including DUKWs, may be utilized for evacuating casualties from the beach.

Specially designed ambulance boats, or boats converted for exclusive use as ambulance boats will not be available except from those ambulance ships.

All landing boats will carry sufficient first-aid material to effect emergency first-aid.

Ineffectives resulting from casualties occurring in the boats during any phase will be retained in the boats for seaward evacuation when practicable.

Boat crews of landing boats will be responsible for casualty handling and emergency first-aid in their boats.

6. Ship phase.

LSTs will provide the estimated required casualty lift. All LSTs of the Western Naval Task Force will be utilized for shore to shore casualty evacuation.

The average casualty lift per LST per trip is 150. Under exceptional circumstances, this may be exceeded. Medical material for casualties will be provided each LST initially and maintained through a system of resupply at near-shore hards.

APAs will provide casualty lift as the military situation permits.

LCI(L)s will carry ambulatory cases.

Hospital Carriers will be available after D plus 1.

Hospital Ships will be used for evacuation from major ports to the United States.

7. Casualty Estimates.

Allover casualty estimates until normal land warfare develops:

Sick and non-battle casualties - .17 of 1%.

Battle casualties:
Army: 5-8%
Navy: 4-8%
If chemical agents are used, a high percentage of casualties may be expected from this cause.

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8. General Information.

1. This plan is designed to coordinate seaward evacuation and to provide maximum available pertinent casualty information to those concerned. It is set up conforming with Force organization and will utilize facilities already provided.
2. Paragraph 3 of Annex "N" (Medical Plan) lists the broad principles of seaward casualty evacuation.
3. No reports of casualties will be forwarded to the Navy Department by units of this command. From the reports submitted to him, ComNavEu will prepare and forward all reports required by the Navy Department.
4. Special medical department representatives will be on duty at the 3 main near-shore casualty evacuation ports for the purpose of receiving casualty evacuation reports from ships. These reports will be forwarded as directed later in this ANNEX.
5. Medical Annexes of Task Forces under the Western Naval Task Force will include such additional detailed information as may be requires to accomplish the plan.

9. Casualty and Personnel Reports and records.

1. Reports will be submitted in accordance with the following tables.

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REPORT	FROM	TO	TRANSMITTED		INFORMATION REQUIRED AND PURPOSE
			METHOD	WHEN
NUMERICAL REPORT BY CASUALTY EVACUATION SHIPS. (Secret)	1-LSTs 2-LCI(L)s 3-Hospital Carriers 4-APAs 5-Other ships under Shuttle Control.	Shuttle Control	By signal or voice	Prior to departure from far shore.	1-Total wounded on board. b-Number of stretcher cases. c-Other evacuees, non-casualty* Purpose: To assist in prompt handling of casualties at the debarkation ports.
	Shuttle Control reports by individual ships for entire convoy.	Appropriate Commander in Chief, Home Command, (TURCO)	By despatch	Upon departure from far shore.
RUNNING RECORD OF BATTLE CASUALTIES (Confidential)	1-LSTs 2-LCI(L)s 3-Hospital Carriers 4-APAs 5-AKAs	1-Original: Local Navy representative at debarkation point for transmission to ComNavEu. 2-Duplicate: Local Navy representative at debarkation point for transmission to ComSerFor 122. (Ships record) 3-Triplicate: Local Army representative at debarkation point.	By Hand.	Upon return to near shore with evacuated casualties.	Instruction on form. NOTE: ORIGINAL TO COMNAVEU. Purpose: To provide a record containing pertinent information for reports, statistics and casualty handling.

*Reports indicated by asterisks are personnel reports. Their compilation is not a medical department responsibility but are included in this Annex for the convenience of commanding officers.

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REPORT	FROM	TO	TRANSMITTED		INFORMATION REQUIRED AND PURPOSE
			METHOD	WHEN
EMERGENCY PERSONNEL CASUALTY REPORT (Secret)	Any Ship	NCWTF - info Assault Force and intervening commanders.	By signal or despatch	When ship efficiency is reduced.	By number:  a-Ship's complement - dead.  b-Ship's complement - wounded. *c-Ship's complement - missing. Purpose: Personnel situation of ship when fighting effectiveness is materially reduced by casualties.
ADMINISTRATIVE BATTLE CASUALTY REPORT (Secret)	All ships returning to near-shore.	1-Local Navy representative at debarkation point for transmission to ComNavEu. 2-Local Navy representative at debarkation point for transmission to ComSerFor 122 (Ships record) 3-Local Army representative at debarkation point.	By hand	Upon arrival at near-shore.	By name and service number:  a-Ship's complement - casualties:    1-dead; 2-wounded; *3-missing. *b-Ship's complement - non-casualties transferred ashore for other reasons; indicate (1-near-shore; 2-far-shore) where directed to report.  c-Not complement: by name, service number and unit, if known:    1-dead; 2-wounded; *3-missing after receipt; *4-other evacuees sent ashore. Purpose: To provide information for administration, reporting and replacement.
	Far-shore Navy Units	1-ComNavEu 2-ComSerFor 122 3-NOIC	Via chain of command to NOIC for transmission to: 1-ComNavEu 2-ComSerFor 122	Daily	By name and service number:  a-Complement - casualties (same as a, above) *b-Complement - non-casualties (same as b, above) *c-Acquisitions, with or without orders: indicate unit to which attached, if known. Purpose: To provide information for administration, reporting and replacement.

*Reports indicated by asterisks are personnel reports. Their compilation is not a medical department responsibility but are included in this Annex for the convenience of commanding officers.

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REPORT	FROM	TO	TRANSMITTED		INFORMATION REQUIRED AND PURPOSE
			METHOD	WHEN
i. REPORT of CASUALTIES	All ships and craft	ComNavEu Info ComSerFor 122	Despatch or Mailgram	Earliest practicable time.	For USN Ship's complement:   Date   Full name (surname first)   Rank or rate and service number   Type of casualty, using following nomenclature:     "Killed in action"     "Died of wounds"     "injuries received in action"      "Missing in action" Purpose: Comply with AlNavs 13 and 162 of 1942.
ii. REPORT of CASUALTIES	All ships and craft	ComNavEu Info ComSerFor 122	Letter	Earliest practicable time.	For USN ship's complement:   Date.   Place.   Full name (surname first)   Rank or Rating and service number.   Diagnosis.     "Result of enemy action" or     "Not result of enemy action" as applicable.   Prognosis (fatal, probably fatal, serious, favorable).   Disposition (died, retained on board, transferred). Purpose: Comply with par. 3518, Manual of the Medical Department.

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2. Sips and stations shall number these reports consecutively by classes of reports.
3. Commander, Service Force 122 will furnish summarized reports when directed showing total U.S. Navy dead, wounded and missing.
4. The Commanding officers of individual ships are responsible that these reports, including both medical and non-medical personnel accounting are transmitted at the required times.

4. Geneva Conference.

1. This force will comply with such articles of the Geneva Conference as are applicable to the operation.
2. All medical personnel, male and female, both officer and enlisted including medical, dental, hospital and nurse corps will carry an appropriately marked identification card (N Nav 546) on their person at all times.
3. Medical personnel will NOT carry firearms.
4. Medical personnel shall not be assigned any military duties other than those pertaining to the Medical Department.
5. All medical personnel in combat areas will wear the Geneva Red Cross arm brassard.
6. No unit, other than a medical unit, will display the Geneva Red Cross or any symbol representing or resembling it.

5. Burials.

1. The remains of dead occurring afloat, between near and far shores, will be retained on board for burial ashore. Burials at sea will be held to the extreme minimum and will be done only when it is impracticable to retain on board for delivery ashore.
2. Remains of dead occurring in landing craft enroute between ship and beach will be taken ashore for burial and not returned to ships.
3. Remains of dead ashore (far-shore) will be placed in custody of U.S. Army Graves Registration Service or Shore Party Commander for burial.

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4. Remains of dead (near-shore) will be placed in custody of U.S. Army Graves Registration Service on the near-shore.
5. The same procedure in handling remains will apply to all personnel, i.e., by U.S. Army Graves Registration Service.
6. In burials at sea, all practical means will be taken to identify the dead. These include the use of:

Recognition by friends, descriptive sheet in health record, taking of finger prints, metal identification tags, marks in clothing, personal effects. The unidentified dead will, if possible, have prints made of all ten fingers. These prints will be forwarded with records of dead. Included on record of prints will be approximate height, weight, color of hair, marks and scars and other identifying features.

7. Personal effects (and records of dead buried at sea) of all dead in ships will be inventoried, placed in the custody of the Army Officer at Port of Debarkation receiving wounded.
8. Disposition of metal identification tags.

1. Where burial at sea:

One (1) tag with remains, the other tag with records.

2. Where remains are taken ashore for burial:

Both tags accompany records.

 

 

A. G. KIRK,
Rear Admiral, U. S. Navy,
Naval Commander Western Task Force.

 

/s/
R. T. CRAGG,
Flag Secretary.

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