MEDICAL FIELD SERVICE SCHOOL, BROOKE ARMY MEDICAL CENTER, SAN ANTONIO, TEX.

(See justification on p. 909.)

Senator STENNIS. Excuse me, we have Senator Yarborough with us. We are glad to have you, Senator. You are a member of this subcommittee. I understand you have another pressing matter you wish to attend shortly. Do you wish to be heard on another matter before the committee?

Senator YARBOROUGH. Yes, sir.

Senator STENNIS. Army matter?

Senator YARBOROUGH. Yes, sir.

Senator STENNIS. General Shuler will turn to the item you are interested in.

Senator YARBOROUGH. I find it at page 131.

Senator STENNIS. Point out the ones you are interested in.

Senator YARBOROUGH. Page 131. The ones I am interested in, Mr. Chairman, are the Army Medical Training Center at Brooke Army Medical Center and the Army Medical Laboratory, both at Fort Sam Houston, San Antonio, Tex. These two items were denied in the House report. The amounts involved are $8,300,000 for the medical field service school and $1,300,000 for the medical laboratory.

I have been to the Brooke Army Medical Center a number of times over the past years, including the time I came to the Senate. The Center consists of a number of old frame buildings. Although this is one of the great Army medical centers, in fact one of the greatest medical centers in the world, the people have been forced to work with inadequate housing and inadequate buildings. In spite of this the work there in orthopedics, the restoration of use of limbs and in treatment of men who have lost limbs, they have done some of the outstanding work in the world.

I have been in the buildings where this orthopedic equipment is located. They are old World War I buildings, scattered along the parade ground at Fort Sam Houston. This medical center has been famed along with Walter Reed here as one of the great Army medical centers and this request is for money to build a modern field service school.

HOUSE COMMITTEE LANGUAGE

The House says the work can be done by the Navy or Air Force or some other place. I want to point out that this Center is for training field service technicians to send to field hospitals. Neither the Navy nor the Air Force have temporary, field hospitals. They treat their men in permanent facilities either aboard ship or on land. Moreover, the type of wounds received by Army personnel in the type of war we now fight is extremely different from the type received by Navy or Air Force personnel.

INJURIES INFLICTED BY GUERRILLA TACTICS

To show the difference in training, consider the weapons used by the guerrillas in South Vietnam. For example, they dig small holes in the earth about a foot wide for a man to step in. They put spikes in the bottom. If a man steps in this his feet hit those spikes and they go through his shoes.

Spikes are placed on the side so that if the soldier tries to pull his foot out he is hooked in there.

They have all these different devices. They have bamboo tied up. Since it isn't metal, it doesn't attract attention. If somebody triggers it, the bamboo cuts a man like a razor. The Brooke Medical School is training field technicians to go into these field hospitals with the latest method of treatment for these types of wounds.

Last December, when I was visiting the training camps in Okinawa and Hawaii, I was told that if a wounded man doesn't get medical attention within a few hours in the jungles, a little injury on the hand can become seriously infected. The technicians must be trained to operate in all different types of climate. In operations in Alaska during the winter entirely different types of injuries occur than are experienced in the tropics in Vietnam. You can't combine this type of training with the Navy or Air Force operation since their operations are entirely different. Furthermore the Army's needs are much bigger. More men involved in action when you get into very much of an operation.

Those buildings at Brooke have been there for years. They have served a long time. The problem is they are just spread out. They are old frame buildings, lots of them. Modern buildings are now needed for the medical school. This country is short of all kinds of medical training. If you build a school such as this for medical training, even if there is no combat, it will not go unused. I learned this, Mr. Chairman, from service on the Public Health Subcommittee of the Senate. About 4 years ago we licensed 8,000 medical doctors in this country.

MEDICAL EDUCATION DEARTH

6,300 graduates came from American medical schools. We had to bring in 1,700 from Europe and Mexico and other places to make up the rest. And that many doctors were just enough to replace those dying and retiring. One of the greatest shortages in American education is medical education.

This is one thing that won't be overdone. Every bit of medical knowledge that is obtained here is being used someplace in our society. This is one type of military training that can be used in peacetime as well as war, civilian as well as military. These won't be wasted dollars. This is not a missile program where 3 years later the scientists have a breakthrough and make obsolete what was new 3 years ago.

This will be valuable for the whole society for the life of those trained. I think this is an important item in the budget, from what I have observed at Brooke and what I have learned in 7 years on the Public Health Subcommittee.

Senator STENNIS. The House report says that at the time of the hearing the plans and designs for this facility which includes special construction features such as laboratories were only 3 percent complete.

General SHULER. Mr. Chairman, they are 25-perecnt complete now. We agree we would like to be further along. We know what we are doing sir, and we feel that 25 percent is sufficient for making an estimate for this purpose. I agree that the 3 percent was not.

Senator STENNIS. You have strengthened the record on that point. Senator YARBOROUGH. I have a telegram dated 3 days ago, stating back then it was 20 percent.

Senator STENNIS. If we stay in session for a few more months this year maybe you will have plans 100-percent complete. Do you have something more?

MEDICAL LABORATORY, FORT SAM HOUSTON, SAN ANTONIO, TEX.

(See justification on p. 910.)

Senator YARBOROUGH. In addition to the medical school which is so badly needed I want to make a plea for the medical laboratory at Fort Sam Houston which is $1.3 million. I don't see it on this page.

Senator STENNIS. What page are you addressing yourself to primarily?

Senator YARBOROUGH. Pages 131 and 119 are the pages.

Senator STENNIS. Excuse me, I was reading from the $8.3 million. That was the one for which plans were 30-percent complete at Fort Sam Houston?

Senator YARBOROUGH. One is for the medical laboratory building. The other is for the field service training school. The medical laboratory is completely planned, Mr. Chairman.

Senator STENNIS. General Shuler, do you wish to add something to what Senator Yarborough has said on this?

General SHULER. I would like to thank the Senator from my home State of Texas. I appreciate very much what he said.

The existing 4th U.S. Army Medical Laboratory facility is inadequate in nearly every respect. The 22,307 square feet of space presently used by this facility is comprised of seven different buildings which were constructed between 1917 and 1944. None of these buildings were designed for laboratory use. In addition to their being inefficient in design for laboratory use and uneconomical to operate, these buildings do not provide the space essential to effectively perform the assigned mission. Lack of a proper system for the extraction of pathogenic, toxic, and explosive aerosols and vapors generated in work areas renders the present operation hazardous to laboratory personnel. It is not economically feasible to either expand or modernize any of these currently occupied buildings. The inadequacy in space is being intensified by an increasing laboratory workload. In the past 5 years, as a national trend, the requirements for medical laboratory work in both military and civilian medical care facilities have increased 10 percent per year. During this same 5-year period, workloads at the 4th U.S. Army Medical Laboratory have increased 64 percent-an average annual increase of 13 percent. Space and facilities must recognize this growth and be planned to accommodate the projected workloads.

New missions and responsibilities have been assigned to the 4th U.S. Army Laboratory. Among these are additional responsibilities in the field of water and air pollution and in the field of industrial hygiene, particularly involving hazards connected with propellents associated with the more sophisticated weapons systems. The accomplishment of these functions requires additional space.

The experience gained with operation of the recently constructed 2d U.S. Army Medical Laboratory has confirmed that a building of similar size is required for the workload of the 4th U.S. Army Medical Laboratory.

While the detailed plans of this proposed laboratory were incomplete at the time of the committee hearings, the plans of the 2d U.S. Army Medical Laboratory are being adapted to fit the workloads and site of the 4th U.S. Army Medical Laboratory.

The cost estimate of this project is validated by the actual costs of the recently completed 2d U.S. Army Medical Laboratory.

Installation: Brooke Army Medical Center, Fort Sam Houston, Tex.

The Medical Field Service School is unique in its mission and function which is to train personnel in all aspects of the role of the Army Medical Service in support of the Army in garrison as well as in ground combat. Because of the dissimilarity of the combat roles of the three military services, the training at this school is different from the other service schools. For example, a physician comes into the Army as a trained professional. Through a short intensive training period he is trained as a military officer, having to know Army organization, modes of operation, and problems inherent in his service. He must be taught to function and practice medicine in any Army organization and under the conditions of ground warfare. The same principles and doctrine do not pertain to the other military services because their combat role is dissimilar. The physician in the Navy would be primarily concerned with a medical service aboard ship, while the Air Force physician would be concerned with a medical service of a fixed installation in the vicinity of an airfield. The Army physician is trained to establish field type hospitals, under tentage or other improvised shelter, in highly mobile as well as static situations in support of varying ground combat situations, which may be conducted in various parts of the world where there are significant and unusual environmental health hazards.

The Army Medical Field Service School must train technicians to operate in both Army fixed and field medical installations. Any combined training would result in a requirement for additional training in the role and missions of the particular service.

The Medical Field Service School is part of a large medical training complex. The complex includes Brooke General Hospital, Wilford Hall USAF Hospital, the Medical Training Center, the 4th U.S. Army Area Medical Laboratory, regional dental activity, and medical field units stationed there. For example, both Brooke General Hospital and the regional dental activity are used in connection with teaching 15 officer courses and 8 enlisted courses. To conserve talent and retain the highest caliber of instruction, in 1964, personnel from Brooke Army Medical Center delivered 228 hours of instruction at the school. This medical training complex was consolidated when the Medical Field Service School was moved to Fort Sam Houston, Tex., in 1947, after an exhaustive study which showed the many advantages in locating the school at this installation. In the mid 1950's, the Medical Training Center was moved to Fort Sam Houston, Tex., which has many advantages and effected economies and efficiencies. To move any part of the Medical Field Service School to any other installation would eliminate and break up a favorable training situation or environment that has been established. None of the other large general hospitals, which is an essential part of this training complex, has the necessary space and supporting facilities to assume this diversified training mission accomplished by the Medical Field Service School. A centralized training complex enhances the accomplishment of the mission of the Army Medical Service.

The Department of Defense, during 1964, did make a study of the training facilities of the various military departments including the Medical Field Service School. The Department of the Army was advised that the review had been finalized and that findings indicated that the existing facilities in all of the service schools were fully utilized and no specific unused capacity was available to accommodate the medical training requirements of the other services.

The design of this project has progressed through a feasibility study and concept stage and at the present time the design is 25-percent complete. The present schedule provides for award of the construction contract prior to the end of the current fiscal year. A recent cost estimate made by the architect-engineer shows the cost estimate to be reasonable and that a complete and usable building can be provided within the requested funds.

MEDICAL FIELD SERVICE SCHOOL, BROOKE ARMY MEDICAL CENTER, SAN ANTONIO, TEX.

Senator YARBOROUGH. The Veterans' Administration is having difficulty with its hospitals now because some of them are isolated from medical complexes.

Where you can get a medical complex, hospital and medical school it is much easier to attract first-rate people. The State of Texas has voted some $11 million to build a medical school to be placed in San Antonio-we will find it much easier to get top medical personnel to go into this area. The State of Texas is going to build one of its greatest medical schools simply because they will not go to an isolated place for a hospital.

This is a logical place to put this training center. The personnel there can draw on the resources of the area, the aero space medical school, the new State medical school being built there.

They all complement each other. Knowing how short we are in medical teachers as well as medical personnel are in the United States, it just would not make good educational sense to pull this school out of here and go build it some other place.

TELEGRAM OF HON. HENRY GONZALEZ, A U.S. REPRESENTATIVE FROM THE STATE OF TEXAS

I ask that this telegram from Congressman Henry Gonzalez be placed in the record.

Senator STENNIS. All right, put the telegram in the record. Thank you very much, Senator.

Senator YARBOROUGH. Thank you very much.

(The telegram of Congressman Gonzalez follows:)

Hon. RALPH YARBOROUGH,

Senate Office Building, Washington, D.C.:

SAN ANTONIO, TEX., August 6, 1965.

As I mentioned to you earlier today, the House Appropriations Committee has denied the funds for construction of a medical field service school at Brooke Army Medical Center, in the amount of $8.3 million, and for a medical laboratory at Fort Sam Houston in the amount of $1.3 million. Both of these facilities were to be used as part of the present 4th Army medical complex in Fort Sam Houston. In reply to the statements made in the committee report on page 16, let me point out the following:

First, the mission of the Army in setting up field hospitals is unique and completely different from field medical facilities used by either the Navy or the Air Force. The Navy carries its medical facilities around in ships, and the Air Force usually flys its personnel to permanent hospitals. But the Army needs to set up field hospitals in the field, of a temporary nature, and often close to the areas of combat. This was dramatically illustrated most recently in Santo Domingo in the Dominican Republic where the Army had to set up field hospitals quickly for use of our troops. The Navy ships and stateside hospitals could not be used for this purpose. The same, of course, applies in Vietnam, where field hospitals have been in use for some time. As you are aware, there is now the possibility that our need for field hospitals in this area may increase drastically. Second. For a number of years, the Army has been moving its medical facilities for education and training to Fort Sam Houston for reasons of economy and efficiency. There is now in existence a medical complex at Fort Sam Houston