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a Includes established clinics in regional offices, regional office-hospital centers, hospitals, Veterans Benefits Office, D. C., and outpatient clinic at Boston, Mass.

b Includes hospitals having no formal outpatient clinics but providing outpatient services at the request of established outpatient clinics.

e Includes outpatient servics for foreign beneficiaries and beneficiaries of other Federal Government agencies, emergency cases provided care as a humanitarian measure, and patients on rolls at VA hospitals who receive treatment in outpatient clinics.

NOTE. An "outpatient visiting" is defined as a person who receives outpatient medical services one ог more times during a given month

Chapter 24

THE NATION HONORS ITS DEAD

Deeply implanted in the hearts of Americans is a profound respect and reverence for those who have given their lives in the nation's cause. The emotion finds material expression in the beautiful national cemeteries and war memorials scattered over the United States, its outlying possessions, Europe, Africa, the Pacific islands, and the Far East. The Federal agencies having primary responsibilities in this field are the Quartermaster General of the Army and the American Battle Monuments Commission.

BURIAL OF OUR WAR DEAD

Only within the past century has any government been willing or able to assume the task of identifying, and burying in registered graves, the bodies of men dying in war. The evolution of the present system may be traced in our successive wars.

MEXICAN WAR. After the war, in 1850, Congress appropriated money for a cemetery at Mexico City "for such officers and soldiers of the United States Army as fell in battle or died in and around the said city . . ." The remains of 750 American dead were eventually exhumed from the places of their temporary burial and reinterred. Not one could be identified. However, the action created a precedent for establishing permanent military cemeteries.

CIVIL WAR. In September of 1861 the Quartermaster General was directed to supply all general and post hospitals with blank books and forms for keeping mortuary records, and to provide materials for registered headboards for soldiers' graves. In 1862 Congress took action to buy land for national military cemeteries. Many of the burial sites of major battles were converted into such national cemeteries; for example, at Sharpsburg, Gettysburg, and Vicksburg. Commanding generals were made responsible for establishing burial grounds

near battlefields, registered headboards to be placed over the graves bearing the names of the deceased, if practicable. A crude form of identification tag came into use in the winter campaign of 1863 south of the Rapidan River in Virginia.

The program of collecting the war dead and reinterring them in national cemeteries was initiated soon after the Confederate surrender at Appomattox, under the supervision of the Quartermaster General. His annual report for 1870 indicated that the project was virtually completed. At that time there were 73 national cemeteries, containing the remains of 299,696 Union soldiers. The total burials in these, and in private plots and post cemeteries plus bodies scheduled for reinterment. were 315,555. Of these 172,109 or 58% were positively identified; the remaining 143,446 could not be identified.

SPANISH-AMERICAN WAR. On the basis of enabling legislation and by direction of President McKinley, the Secretary of War took steps in August 1899 to provide for the marking of all military graves in Cuba. In February 1899 a Quartermaster Burial Corps composed of civilian morticians and assistants began the disinterment of remains in Cuba and Puerto Rico for shipment to the United States. On 27 April 1899

an Army transport docked at New York with 747 casketed remains. In all, 1,222 bodies were returned by 30 June 1899. Less than 14 percent were identified.

WORLD WAR I. Wartime graves registration and burial services during the 19th century had been performed largely by civilian contractors. This proved to be unsatisfactory for several reasons. Following our entrance into World War I, a Graves Registration Service was organized on 7 August 1917 under the Quartermaster General. In September of the same year Headquarters, Graves Registration Service, QMC, was established at Tours, France, with the following assigned functions: (1) deployment of units and groups along the entire line of battle, so that they might begin identifying bodies and marking graves immediately upon the beginning of hostilities in any given sector; (2) location, acquisition, and maintenance of all semipermanent and permanent military cemeteries required for American use; (3) registry of burials; (4) furtherance of the work of identification during the concentration of remains from battlefield burials to permanent cemeteries; (5) correspondence with relatives and friends of deceased soldiers, together with photography and surveys of cemeteries and graves; (6) liaison between the Government of the United States and foreign governments concerned with mortuary affairs in the theaters of operations.

The next of kin of deceased personnel were advised that unless they specifically indicated their desire to have the remains returned to the United States for final burial, interment would be in one of the permanent American military cemeteries to be established over

seas.

The names of 81,462 American fatalities for the war were furnished the Graves Registration Service. The bodies of 78,112 of these were recovered; the remaining 3,350 were declared missing or lost at sea. So effectively was the Graves Registration Service program carried out that, of the recovered dead, 76,404 or nearly 98% were positively identified. Of the identified dead, 46,459 were returned to the United States by request of next of kin, for burial

in private or national cemeteries; 624 were shipped to foreign countries; 18 were released to the Lafayette Escadrille; 42, by special request, were allowed to remain where they fell; and 29,261 were interred in our oversea military cemeteries. All unidentified dead were likewise buried in those cemeteries, with the single exception of a body which was returned to the United States and interred in Arlington National Cemetery as The Unknown Soldier.

ESTABLISHMENT OF THE AMERICAN BATTLE MONUMENTS COMMISISION. This agency was created by act of Congress in March of 1923. Initially it was charged with designing and erecting memorials and monuments in the oversea theaters of operation of our forces in World War I. By later legislation it took over, in the interwar period, the permanent oversea military cemeteries mentioned above, which had been created and until then maintained by the Army. Its responsibilities were further extended by reason of World War II. At present it is responsible for the design, construction, and maintenance of all battle monuments and memorials and for all military cemeteries installed by the United States on foreign soil. It is not responsible for military cemeteries in the continental United States or its possessions; these remain under the Army (QMG),

WORLD WAR II. Congress assigned to the Secretary of the Army the responsibility for the return of World War II dead. The purpose of the program was "to provide for the evacuation and return of the remains of certain persons who have died since 3 September 1939, and whose remains were buried in places located outside the continental limits of the United States and could not be returned to their homeland for burial due to wartime shipping restrictions." A time limit of 5 years, ending 31 December 1951, was set by Congress for completion of the work. The Army Quartermaster General was assigned the task of carrying out this program for the dead of all the Armed Services, including accredited civilians.

Next of kin were advised that, at their option, bodies would be (1)

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