ARM1.941209.076
CHILL: P!(ELItiINARY SURVEY PLANS
rrrp by Dr. Frank 1;. Berry is!;istdnt Secretary of Defense (Health and McJi cili.;
3r. A. E. Schaefes, Executive Directur intrrdepnrtaentb? Cmmittee on Nutrition for Natj.onaL JJeEunsc
Rr. LJiLlim F. Asha 3irfccor, &Lid Niltrition Survey and Sprciai Cmrsultant, XCNND
9r. William J. Oarby Special Consultairt, ICNND
LnterdcpartnentaL Om-rnittet on NutritLun for National ;)rfensn NoironaL Institutes of Healtt. Beth2sJo, ilarylxir! In February lY59 Drs. Frank 8. Berry and Arnc,ld t. Schaefer visitcd :.::i- :.::i- I.,,;,:; I.: * ti, '?he reception we received from the Chilaan /. .L. iissioti, authorities, representing the Armed Fxces, Niltimu! ,.t,ilean !>linistcr Health Service a?& the University of Chile, was beyimL! ,:f Defcnsc, airector expectation and certainly testifies TO their sincere ,>.: the Nxtional interest, cooperation md appreciation of tho future i!,~z?:.thScrvice benefits to be derived from an appraisal of the nutrittonni status, ration system of the Armed Forces, food habits, production, storage and potential of Chile. A 1161: of personnel visited is given in Appendix 1. Chilean Nutrition 'The Ninister of Defense, Senor Don Carlos x, :,., *'xy C:oordinat ing Infanta, and the hmcd Forces appointed a 'ruorking group anCtt2e to Work with the ZCNND Secretariat in preparing the survcy plans. In addition, the National iiealth Service and the University of Chile were invited to participate in the committee. A list of committee members is given in Appendix 2. hurvey Planning Three afternoon meetings were held, attended by i',Jr!fcrcnci:s :he Chilean Coordiri; :ing Committee on Nutrition; Colonel Goodwln, Chief U.S. MAG - Chile; Dr. Wil1iarn.F. Ashc, U.S. Survey Director; Dr. Villiarn J. Dnrby, ICNND Consultant and Dr. Arnold E. Schaefer, Executive DirectQr; Inter- departmental Coinmittee on Nutrition for NaFional Defense. During these :;essionS a tcntative outline of the durvfy ws:: prepared (Appendix 3). Prcliminary copi3s were distributed to the Planning Cotmiittr?c (including Colonel Goodwin). Colonel Goodwin's suggestions and assistance were axtremel? hclpful to thc prcup... Washington National Record Center Ofice of the Army Surgeon General Record Group 112 Accession #: Gq A - &\3 Box #: ZI !, ' L_.!I1 i. lx Lunistisal Planning: Thr planning r,f ttlc .~,ji':'u IJ tdd Dur-ing t rsnsyor tat ion, lucisrics, billeting arrangement 5 fc3L !stervdl Jariuaiy the team, etc. wi.11 be drafted by Colonel Goodwin Labdratory Lccation i'h- Chilean officials--Armed Forces and National liealth Service--had agreed that the nutrition laborutcr:? should be estabiished in the School of iledicine. Ihe proposed laboratory site was visited by 3rs. Ashc and Schaefer and found to be most suitable. For space available, see Appendix 4. In addition, two room5 on ground floor (now empty) wiil be available for initial storage of all U.S. laboratory equipment. One room c'm be used for assembly an11 packaging of supplies for the field operation. A University cafeteria and hospital dining roo111 are close md can be used by the laboratory personnel. This laboratory will be used primarily for all blood and urine analysis. In addition, there is the food laboratory of the School of Bromotology-- Director, Professor Or. Hermann Schmidt-Hebbel. This laboratory is well equippej and an excellent functioning unit. Dr. Schmidt has a graduate student interested in analyzing the food composite samples for trace minerals. We encouraged this type of cooperation. It was requested that, if possible, the following spacial chemical reagents be included in our lab supplies: (1) 2, 9 Dimethyl-1-10 Phenanthroline Hemihydrate (Meo- Cuproine) One gram - G. Fredrick Smith Chemical Company, Columbus, Onio. (2) Zinion - 2 grams (La i4otte Chemical Company, Daltimdre, Xaryland. (3) Dowex 1-8, 100 to 2nU mesh. 1 pound. Dr. schinidt will assist the survey by analyzing food composites and special indigenous foods for proxime.t,> analysis and the usual vitamins and minerals, He i.s nisr interested in special studies on fatty acids. For thiu purpose the following scandards were requested: (1) Linoleic Acid 99% pure 1 gram $2.50 (2) Linolenic Acid 997. pure 1 gram 5.40 (3) Arachidonic Acid 90-95X pure 1UO grams 54.>1: (Nutritional Biochemicals Corporation) these supplies to be packaged separately, pack.~gos labeltzd: Attention Dr. Schmidt. Washington National Rccord Center Oflice of the Army Surgeon General Record Group 112 Accession #: 67 A - Lf- 8\3 Box #: ->- Ai I +~kage; :.f I.&~r,:tury ,.:q~?~~pm~rtim& .;L!~~;i L ShL>,uLd bc L3hL2i ,!> E. !.'::4s: Chi;.€ I,kUX,, Zhilz c/o r.5. E1aSsssy Santiago, 01i le (:larked "Pnr htrition Survcp Tc~sT~'.j Copies of bills of ladmi'; and packaging list should be forwardad i..nn.ediately via 2i.r nail to above address. Box No. 1 to contaio dbove. Cable infor.natim. on shipment date, ETA, number of packages, wight mil cubi.c footage to Colonel GooJwin ,;kq w+&I mply via c.ible upon receipt. Electric current is 201; volts and W-cycle. Plugs - murid 2-prong type (sample obtained). Have !iiring on transformers conforir. to this it at aL1 possibiL. Transforner:j are needed. Water is' stikl requi.rcil. liave package adequato'y labeled so that this piece .?f eqilpcnt can be imr' ,accly uncratcii and installed. Urying ovens, autoclaves anu furnaces a,rc avaiiablc, do not includz. Nitrogen and carbon dioxide gas are available do not ship. Include 1 set 3f reducing valves and .:zupe assembly. If budget permits due to above savings (and reduction in shippihg cost) include 1 extra PH.nietcr (battery operated), 1 extra baiimce and standard kights, cyringcs and needles. Numbers given in Nanual to lk? reduced to 2 dozen of each. Do not ship instrunient sterilizer (electric). Stoo? sample speci;.sn bottles, forma1i.n solution - include ayproximtely 1,000 bottles. Inventory 02 laboratory cqufpiwnt available in the Nutrition Lob vas obtained, AlthouKh the glassr~nrestock is fair my excess can be used most advantageously in the food unal.ysis laboratory. They would desire media for , bactrriological assay i:€ niacin, pyridoxine and panto-. thGriatc, also standardb. Washington National Record Center OTTce of the Army Surgeon General Record Group 112 Accession #: Gq A - Lf- &\3 --- 'lectin& with iicctor Urs. Ashe and Schaefer discussed the survey p:mc '.if ilniversity and with Senor Juan w. :.>illas, Rector of the University iknn of 'ledical of Chile, and Dr. Hernan Allessandri Rodrigue, Dean of school the Medical School. Necessary arrangements for per diem of University personncl traveling with the team will be worked out in conjunction with the National Hzillth Servic,! and the Armed Forces. -rrcillary Studies The Parasitology Department of the University expressed the desire to cooperato with the survey by conducting parasitological examinations. The :4edical staff is cxtrernely interested in having blood samples analyzed for blood cholesterol. (Scnd 1,000 paper containers--stool boxes). Fscilities and trained personnel are available for serum protein fractionation if needed. Llictary Survey Dr. Riquelme was given a copy of the civilian dietary.questionnaire used in Ecuador. This will be modified for Chilean foods. The Secretariat will inforn Dr. Riquelme as to those questions which shou'ld be e 1imina ted . Conference with uS0:1 Drs. Ashc and Schaefer discussed the nutrition survey program and plans with Mr. Manning, USOM Director. He was indeed interested and offered cooperation of his staff as regards the following: (1) Handling of logistical support fund.. Fund to br transferred from ,ICA/Wnshington, specifying the purpose and usc and authorizing Survey Director and Deputy Survey Director to disburse funds. To be established as done in 'support of the Peru and Ecuador surveys. (2) Mr. Eugene Baird, Sanitarian, Acting Head Heoith Section, will serve as USOF; liaison with the nutrition survey team. Mr. Baird was of great assistance to us and will cooperate with the University of Chile representatives in preparing a bockground summary rcyorc on past nutrition studies and statistics related to health. Une problem of concern i6 the high infant mortality rate o€ 122 per l,OOO in 1958. This indicates a possible upswing in rate from 1956 when it wns 109 and in 1.ib. .. 1957, Washington National Record Center Oflice of the Army Surgeon General Record Group 112 Accession #: 67 A - 8\3 Box #: -5- (3) The agricultural group of USOi.iwil1 assist and cooperate with the team's agricultural specialist. U.S. Health Program Population-wise Chile ranks fifth ia the Latin in Chile American countries where the U.S. has cooperative health programs. it ranks fift.ii in total technical cooperation budget, third in infant death rate, seventh in crude death rate, fifth in T.B. rate and twelfth in the cooperative health budget (see enclosures). Ancillary 1,iaterial 1. Washington National Record Center Ofice of the Army Surgeon General Record Group 112 Accession #: Gq ,A - 98\3 Box #: Xr. Don Car1.0~--Viol Inianra .',:inis t er c f De Lens P i>t. CoLonGl Eifuarcio &xricip;-la Lasa t4icle to Minister of Def2n:;e .kj. i;rneral Ciscar Izurirxa Molina !.~onmandfr-in-Chirf, Chiisan Army Vkdni. Leopuldo 1onLai.ne :!akin 2orrman.i e r- i.n -Ch icf , ChiLesm Navy laj. i:enernl. Dieau. Earr.,r. Ortiz l:o~imandcr-in-Chief, Cliilcan Air Forid VAdm. imnuel Quintana Oyarzun Chief, Armed Forces. Generd Staff Brig. General Rafael Przus Casas-Cordero Chief, Chilean Army Aedical Service RAdni. Hugo Vicula ilonardcs Chief, Chilean Navy NedicaL Service Brig. General Raul -Jauregui Chief, FACH i9edical Service "apt .'Luis Nozf~lin-Barbageiota Director, N~OIEospicaL (Colonel Xarcial Baeza M. nlrector, Air Force Hospital Lt. Zomander Luis F. Iturriaga Sc. Liaison Officer Lt. Colonel Jose Bfb!n J. Chilean Air Force Lt. Dr. Arturo Larrain G. Sanitary ;,fficor, Ministry of ihfense -iiunistry of Health and Social Welfare rlr. Sotero be? Rio Gundian iklinister Gf Icterior and Public IIeaIttl Dr. Custavo Friclie Director, National Heaith Service .. Dr. Alfredo Kiqilalme B. Head, Sub-Dept. of Nutrition Lasilla 3979 Santiago .lr. Bernardo Poloni G. Head, Eood Technology Section M. P. H. Service Casiila 3979 University of Chile !Ir. Juan 5- Millas Kector ?r. Hernin Allesandri Rcdrizue Dean of i4edical School Dr. J. V. Santa Maria Professor of Nutrition, :d.edical Department Dr. Herrnann Schmidt-Hebbel Director, School of Brorotology U.S. Personnel American Embass;. Ambassodor Walter Howe, American Ambassador !.7iliiam J. Krieg, Consul General Lt. Colonel Barton Lane, Jr., U.S. Army Attache Capt: Arthur i3. Savage, U.S. Naval Attache i.t. Colonel Selner Gustaves, U.S. Air Attache -1CA :lr. Lester Planning, Director of USOH Dr. ,Eugene Baird, Sanitary Officer, Medical Division, IC> Nilitary Colonel Goodwin, Chief, Amy ilission Josz. Bzhm, 10,:4PH Cornandante de Grupo Sanidad FACH Hospital Chilean b.ir r'srce Home Phone - &80456 Artxro Larrnin Gercia, >ID Xsesor de Higiene y Nutricj-on dc1 Dcpti.. :;anid:i6 :IiLitar (crinsui~.nIlt!.: Lieutenant, Chilean Army Staff Home Phone - 34161 t'ilfredo Rique?nc, ?ID, 3PH Head, Nutrition Section, rIPH Service Phone - 32364 Julio V. Santn Xai-io Prof de Alimentacion (Escueln de Salubridad! Home address: Carlos Antunez 2092 - l'hone G062i Casilla 4122 Escuela de Salubridad correo 9 Snntiag:, U. S. ihernbers kttrnding l'lonnine. SessL\~ Colonel Walter P. Goodwin (Chief IWAG, Chile Phone - 86907 Dr. IJilliam F. Ashe Nutrition Consultant, ICNNC (Head, Dept. of Preventive dedicine, Ohio State University) 3r. William J. Darby Nutrition Consultant, 1CNNI.l (Protessor of Bioclieniistry, Vandcrbitt :I. I Address: Dept. of Biocheiiiistry Schsol of I.ledicine Nashville 5, 'Tennessee Captain Robert H. Erdrich Supply Officer USAWIIS Plione - 8hYO7 Dr. Arnold E. Schaeier Zxecutive Director, ICNND Buiiciing 164, National Institutes of tIe,ilrh Rethesda 14, >laryland Appendix 3 Outline of Nutrition Survey - Chile March 20 - June 4, 1960 20 ;,larch 1960 - Advance unit arrives from U.S.A. !,Jill cable arrival time, number and names of persons involved well in a4vance. Please arrange billets Cazrera Hotel on Military rate. Two men per room. except team director. Transport personnel and baggage airport to hotel. Laboratory equipment will be sent by air Express to Col. Goodwin, U.S. ;El. Assistance Group., Do no': unpack until our arrivd. This officer will sen7e as Nutrition Team rlilitary liaison officer from present date to completion of survey. Clr. Baird, IC/-, will act as liaison officer of that riission an4 will receive 5inds (Xr. Iiartin, Comptroller) from ICA Washington in financial suppor: of Nutrition Su2vey Team. He will also take responsi- bility for 5i.iding us a thoroughly cumgetent bilingual secretsry and support our agricultural consultan: oil his arrival. -21-21, ~srch- U.S. Teim Director (Dr. Ash&) and his Chilean counterpart, ,:omandante Jose Behm, perform, protocol vis?.%, check dl aspects of survey plans aild firm up details. Dr. Alfred0 Riquelme, under the supervision of the Leain director, will take hjor responsibili,ty for the civilian aspects of the scrvey. Laboracory group, U.S, and Chilean, unpack equipment and set up laboratory. Secretary to be on dury from tiarch 21 on. Die2etic group unpack and assemble equipment. Sei. aside clinical equipment for physicians. -,Jill need foc transportation tL$o cars with drivers all week. :Jill need truck and two soltiiers to help move laborairory epipment from storage to laboratory and help to unpack sane, pyobably 1O:OO hr3. ilonday, 21 ilarch. Chileam Army expected supply this assistance. 27 March - Remainder of U.S. Team arrives. ?'leet: and tra?\sport to Carrera Hotel. Arrange for billets. -28 "iarch - 09:00, brkfing of Tihole team, U.S. and Chilean representatives. Site to be arrenged by Dr. Behm, transportation to be supplied by Chilean group. 15:30-12:00, physicians to begin trainirig; need darkened room and 2" x 2', slide projector and screen. 10:03-12:90, nutriticn end dietetic group begin training. Smll room separeie from physicians. 1O:OO-12:00, laboratory group work on methods. 24:OO-18:OG mil',tary dietetic group begins prelimicary trairing survey in cmsll comp.n;/ mess (military) in Santiago, arrange transport. 14:33-18:00, physicisn group move to military dispenszry and begin to look at soldiers, Each exemine three men and compare findings - both brief and dstailed exams. See survey manual. Score, punch ar.d code record ards, arrange cransportation. 14:OO-18:OO laboratory groups work on methods end scandards. Run samples on themselves. Wtll need 1 car thru June 4. 14:00-1G:03 civilian dietetic group try oui questionnaire, make calculations, punch cards, code for IEX, arrange transport. .-.i; .- .-!d~ch - U'I:~~U-I~::J~,ptrysicia~~s grocy do complete survey 011 25 ~,,eti, Smtiagc zir lorce unit, each physician exauines all men. Punch and cod: caras. Comphre findings, recall Inen to check differences of opinion. Vrm Lliod and urine sa-pies on 10 Inen and send to laboratory. Iteview lantern si ides where needed. 14:OO-18:00, repeat procedure on 25 additional wen fro2 same mit and smooth out technique. Also do ECG on 10 who have Lab specinens. OY:OO-1Ec:OO iniiitary dietetic group continue survey begun on 25 iiarch. 0S:JO-18:OO conilfnue qucstionnaire and start one or two home dietary surveys. i)Y:UO - laboratory group run specimens from clinicai suirwy. __-30 harch - 09:00-12:00 clinixl group LOO men air force group, Santiago. >Ii. Bridgforth to finalize piincl:inp and coding of records. 9:00 hrs. nilitsr, rliotcric group finish up ir:itiaL survey, make calculations and punch and cod2 reccmds. keview and elininate all errors. i4ove equipment to army giess frn!n which 300 men' army group is to be drawn on April 1 (see below). Perforlr 3-day survey 12:OO Narch 30 thru i2:OO April 2 on said mess. 09:GO ci.viLim ,iietctic group, continue lime surveys and use of questionnaires, in Santizgi area. 31 :!arch - 09:Oi!-lO:OO entlrc briefing on findings to date. 13:30-12:UG LOO !?an survey of Army group. 14:30-18:OO LOO person survey of civilian group selected at random in Santiago. IIi April - tJ!I:OC, 390 man survey, Army unit, Santiago. Advance unit (2 den; leaves for Punta Arenas by commercial airline. -2 All - 05:OO-1O:OO team briefing, Orders for travel. Distribute completed total survey pian. Team Director needs car throughout all of this wek 1. -:j - Field unit (20-2i persons), fly to Punta Arenas. I; April - ' Survey 350 men as follows: 100 army, 200 navy, 50 air hrcr?. 'ii!itary dietetic group start 3-day survey on navy mess. Civil group start j-day home survey. --5 and 6 April - 300 person civilian survey each day (total 603). ---7 AprIl - Go to Coyhaique. E April - 350 person civilian survey. Dietary questionnairf only. 2 April - (1/2 day) 150 man army group survey. Military diatetic group survey 1 day mess beginning 6 April. .? -__.I tsril__ - Go to Puerto Vontt - ChiLoe area. -i 1 Asil - Puerto >?oritt 275 ciilitary survey as hl~ows: k;sy 75, Navy L!K: .'sir ?!,rce 190, total 275. Three-day diztary survey on Air Force ness. -j- .-;L> I-' m:, 14 (1/2) April - I~laChilo- - civilim surveys as to!I*\rs: jW, 30V and 153. i 1/2 day Jietary survey. i5-tb April - Hcliday. FisLing on !dke. Pvssib1.y Hotel Ensenada. ;i .lpril - GO tcl c:sorno. lil April - Survuy as follows: 15i) Amiy (1 day ,1186s survey), 3lJd civilians-- qucstionnairc only. llovc to ValJivFa. 19 April - Survcy 2s fc?Lows: 100 ;i-my, JJ~Iiivllidns. 5amc as 1.3 April. c~ndietary. -ILLJ Apil- - bc. tu Csncepcion. LL April .. Survcy as isllows: IQJ Army, 231) Navy. >tart dietary survey, navy mess, L 112 ,.inys. 22 Hprii - 359 Tnan survey, navy. 23 April - 30ci person survey, civilian. _-2': April - Return to Siintiag,?. L5 April - Holiday for terllii. 26, 27, 28, 2Y, 39 (1/2) April - Civilian survey hntiago as follows: 300 - 300 - 300 - 300 and code data 1/2 day 30 April. Both dietetic team nnd all clinician:; work on this project. 30 lab samples per day plus some ynoled sapples to be arranged by Director. -12 - GCI to Valparaiso. -- .J Anv - Survey 300 navy. 2-day navy mess survey begins. ; "lay - Survey 300 navy. -_c 4 ,lay - Survey 2U0 army, 10.) air force (Quintcro group to be transported tg Army exain site). 5 :-fay - Survey 300 civilians _& - Survey 300 civilians __-7 ,iiiy (J!2) - Finish up data cards, etc., on civiliak surv-ys. -tjluy - i-love to Quillota 9 'iay - Holiday Washington National Record Center Ollice of the Army Surgeon General Record Group 112 Accession #: 67 A 9b\3 Box #: -4- 10 and 11 May - Surveys as follows: 200 army (2 day mess survey), 400 civilians (300 each day). 12 May - Move to La jerena 13 and 14 (1/2) May - Survey 450 civilians. Dietary questionnaire only. - Move to Antofagasta 16, 17 and 18 hay - Surveys as follows: 300 air force, 100 army, 50 navy, 450 civilians. Three-day mess survey, air r'orce. Three-day civilian dietary survey, 19 May - Move to Calama 20 May - Survey 100 army anti 250 civilians. One day army mess survey. Civilian dietary questionnaire only. Move this day or the next to Iquique, which ever is most convenient. 21 and 22 May - Holidqy in Iquique. 23, 24. 25 May - Surveys as ?allows: Army 100) Navy 1OC) one day Air Force 200) Three-day man survey, air Zorce civilian 600 (2 days) and three-tiay civilian dietary survey. 26 May. - Undecideti. ?ither go to Arica for one-day 300 man survey, army, or return to Santiago. To be decided by Chilean military group. I recommend that it be done, then return to Santiago 29 May. Totals of surveys: Army 2200, Navy 1650, Air For@ 775, Civilian 5500. 30 May - June 3: lrite preliminary report. 4 June - U.S. Team departs for home. In addition, Dr. Riquelme will try to arrange to get several thousand measurements of infants anti children covering all 13 health districts. re nee6 height, weight, age, sex and ethnic origin on each child. This to be accomplished in April or biay but all data to be at team laboratory office by 20 May 1S60. Personnel of team as planned at present an2 subject to some final adjustment in March, is as follows: Washington National Record Center Oflice of the Army Surgeon General Record Group 112 Accession #: 67 A tf &\3 Box #: r5- C1 in icians United States Chile Ashe Behm, Air Force McDowell Larrain (1/2 time), Army Mueller Riquelme (1/2 time), Health Service Voris (Ilrs., i.1.D.) V. Andres Vergara Wicks, Navy Garcia (Health Service) Gayan (University ) ? Santa viaria (University) Dietary and Nutrition Officers United States Chile Pavcek Larrain (1/2 time) Voris Riquelme (1/2 time) Luis Feo. Iturciaga Sc. Kiss Nievas (Health Service) Miss ifarin $1 Miss Gonzalez I, Miss Duran iJ Miss Munoz (University) Dentist Dentist - Health Service or Armed Forces Photographer Health Service Agriculture Consultant Food Technologist - Poloni (National Health Service) Statistician (2 weelrs) (Health Service or U. of Chile) Laboratory Dr. Carl Baumann - Laboratory Director One Army Chemist Dr. Johnson One Navy Chemist Dr. Aurand Three University Shemists Two Technicians * See Nutrition Survey ilanual for additional details. Field technician help, two typists and typewriters, 4 men for height and weight data, one assistant to laboratory man, etc., to be supplied by local units at sites of surveys. Nilliam P. Ashe, M.D. Team irirector Santiago, Chile, January 6, 1960 *One travels with team. LABORATORIO DEL CENTRO COORDINADOR 2 SUPaZ'RIICIE APROLIMADA DEL LABORATORIO 1: 40m 2 SUPER?ICIZ APROXIIUDA DEL LABORATORIO 2 : 38,30 m 2 SUPZR?ICIE APROXIMADA DZL LABORATORIO 3 : 10,SO m 2 SUPERTICI? APROXIMADA DEL LABORATORIO 4 : 13,lO m 2 SIJPPRPICIZ APROXIMADA OFICINA : 16,62 m 2 SUP?RFICIE APROXI-MDA SAM BALANZAS : 7,25 m 2 SUPERPIC1 ? APRQXIMADA LAVADERO : 5,62 m SUPERPICIT APROXIMADA PIZA CAMPANA : 20 m2 Superiicie total aproximada : 190 m' SUPERYICIE D3 LOS MZSONES: PEESON 1 : 4,125 m2 MfSON 2 : 4,125 m 2 PiSSObJ8S PIEZA CAIQANA: 2 MESON 3 : 4,125 m2 1,60 m MESON 4 : 4,125 m 2 i,5a m2 2 2 Ei3SOM 5 : 3,90 m 2,25 m 2 TOTAL : 20.30 m Washington National Record Center Ofice of the Army Surgeon General Record Group 112 Accession #: 67 A - Lf b\3 Box #: