By the end of April six field hospitals and one Marine evacuation hospital, with a total bed capacity of 3,000, were in operation. At the end of the campaign on 21 June available hospital beds for combat casualties had increased to only 3,929, in addition to 500 convalescent beds and 1,802 garrison beds. The small number of beds was chiefly responsible for the policy, applied in the first six weeks of the campaign, of immediately evacuating casualties to the Marianas. As a result of this policy many so-called "white" casualties, that is, casualties requiring two weeks or less of hospitalization, were evacuated from the island and lost to their units for considerable periods of time. On 16 May, in an attempt to stop this wholesale evacuation of a valuable source of trained replacements, Tenth Army instructed the hospitals to hold "white" cases to the limit of their capacity. Both corps tried to stem the losses by establishing convalescent camps—XXIV Corps on 6 May and III Amphibious Corps on 29 May. These camps alleviated conditions but hospital facilities continued to be strained after each of the great offensives. On 26 and 27 May all evacuation from Okinawa was suspended: the heavy rains made the airfields unusable, and no hospital ships were available for surface evacuation. The hospital bed situation was critical until air evacuation was resumed on 28 May. A total of 30,848 patients, or almost 80 percent of all battle casualties, was evacuated from Okinawa by 30 June—about half by air and half by ship.
Neuropsychiatric or "combat fatigue" cases, were probably greater in number and severity in the Okinawa campaign than in any other Pacific operation. Such cases resulted primarily from the length and bitterness of the fighting, together with heavy hostile artillery and mortar fire. The influx of from three to four thousand cases crowded the field hospitals and resulted in needless evacuations from the island. Treatment was instituted as far forward as possible in the hope of making it more effective as well as of retarding the flow to hospitals. Rest camps for neuropsychiatric cases were established by divisions in addition to the corps installations. On 25 April Tenth Army opened one field hospital to handle only such cases. Early treatment produced good results. About half of the cases were finally treated in divisional installations; the other half, comprising the more serious cases, were treated in the field hospitals. About 80 percent of the latter were returned to duty in ten days, but half of these had to be reassigned to noncombat duties.
Fears that Okinawa was a disease-ridden island where the health of American troops would be gravely menaced proved unfounded. Surveys made in April revealed no schistosomiasis or scrub typhus and very little malaria; about 30 percent of the natives, however, were found to be infected with filariasis. Institution of sanitation control measures, such as DDT spraying from the air at 7- to 20-day intervals and the attachment of disease control units to combat organizations, helped, together with the general favorable climatic conditions, to prevent large-scale outbreaks of communicable diseases on the island. As a result the net disease rate for the troops on Okinawa was very low.
One of the most puzzling questions confronting the planners of the Okinawa operation had been the probable attitude of the civilian population. It was very soon apparent that the behavior of the Okinawans would pose no problems. In the first place, only the less aggressive elements of the populace remained, for the Japanese Army had conscripted almost all males between the ages of fifteen and forty-five. Many of those who came into the lines were in the category of displaced persons before the invasion began, having moved northward from Naha and Shuri some time before. Others had been made homeless as the fighting passed through their villages. Casualties among civilians had been surprisingly light, most of them having sought the protection of the caves, and some, including whole families, having taken refuge in deep wells.
The initial landings brought no instances on Okinawa of mass suicide of civilians as there had been on the Kerama Islands, although some, particularly of the older inhabitants, had believed the Japanese terror propaganda and were panic-stricken when taken into American custody. While there appeared to be only a few cases of communicable diseases and little malaria, most civilians, living in overcrowded and unsanitary caves, were infested with lice and fleas.
A frugal and industrious people, with a low standard of living and little education, the Okinawans docilely made the best of the disaster which had overtaken them. With resignation they allowed themselves to be removed from their homes and their belongings to the special camp areas which soon supplanted the initial stockades as places of detention.{484} The principal areas chosen initially for civilian occupation were Ishikawa and the Katchin Peninsula in the north, and Koza, Shimabuku, and Awase in the south. Military Government supplied the minimum necessities of existence—food, water, clothing, shelter, medical care, and sanitation. Food stores sufficient to take care of civilian needs for from two to four weeks were discovered; additional quantities were available in the fields. Growing crops were harvested on a communal basis under American direction. Horses, cows, pigs, goats, and poultry, running wild after eluding the invading troops, were rounded up and turned over to the civilian camps.