NCC Pediatrics Continuity Clinic Curriculum: Operational Pediatrics 2021:

Goals & Objectives •

• A walking tour of key war memorials in small groups during your continuity afternoon • Increase your understanding of the role of pediatricians and other physicians in the represented wars Enjoy the field trip and the opportunity to socialize with your peers! Pre-Meeting Preparation • Read the following pages with group assignments and additional instructions • Please bring at least one interesting fact about , World War II, the Korean War, or the Vietnam War

Conference Agenda • See attached instructions and map

Extra-Credit: • History of Military Pediatrics: Fifty Years of Training and Deploying Uniformed Pediatricians (Pediatrics, 1999)

© 20 NCC Pediatrics Residency

21 NCC Peds Operational Field Trip April 12-15, 2021 WHO/WHEN: Monday April 12th: Bencze, Bennett, Borruso, Jack, McMurray, Reside | Gilbert* Tuesday April 13th: Blackburn, Brooks, Broughton, Bumgardner, Khan, Kondiles | Gilbert* Wednesday April 14th: Chikezie-Darron, Dukes, Ledgerwood, Millen, Patel, Vick |Gilbert, Carr* Thursday April 15th: Graziose, Jiang, Packett, Park, Rowe, Zven | Gilbert, * *Stay tuned for final faculty assignments!

WHAT: • Civilian clothes authorized! • Meet at the flag pole in front of the tower at 12:50. • Metro down the Red Line to Farragut North Station. • Walk around the National Mall visiting 4 war memorials with discussion. See map of route below. • Metro back to Walter Reed along the Red Line. • Eat beforehand or bring a bagged lunch! There are also food trucks around the mall, but not directly along our walking route. • Special Cases: If you are not at Walter Reed on your designated day (i.e. away rotation), please reach out to me so that we can coordinate your transport and joining the group! • HOMEWORK: Research an interesting fact about one of the four wars (WWI, WWII, Vietnam, Korean Wars) we are discussing and be prepared to share it with the group!

WHERE:

WHY: Opportunity to gather as a small group and discuss operational medicine in the context of several historical wars, while enjoying time outside! Hopefully service specific annual operational field trips can resume next year depending on infection control measures. National Military Walk District of Columbia World War I Memorial Background: 28 July 1914 - 11 November 1918. 70 million military personnel including 60 million Europeans participated in the war. There were an estimated 9 million combatant deaths and 13 million civilian deaths. Additionally, the Spanish influenza pandemic was thought to be related to WWI and included 2.62 million deaths in Europe and 675,000 Spanish flu deaths in the US.

WWI Short Synopsis: Archduke Franz Ferdinand assassinated in Sarajevo by Gavrilo Princip (Bosnian Serb Yugoslav nationalist member of the Serbian Black Hand military society). -Hungary issued an ultimatum to Serbia on 23 July 1914 and a network of alliances go to war as a result. Triple Entente of , Russia, and Britain versus Triple Alliance of , Austria-Hungary, and . , Germany focus on defeating France in 6 weeks on the West and then pivot to face Russia before its full mobilization on the East. Allied Powers versus the . Battle of the Marne ended Germany’s Western advance into France and became a war of attrition. US neutral but important war supplier of the Allied Powers. We declared war on Germany for sinking our neutral Merchant Marine ships and for trying to incite Mexico to attack us on 6 April 1917. American Expeditionary Force ultimately included 2 million troops. Soviet Socialist Republic is created over discontent about the cost of the war and the Treaty of Brest-Litovsk ends Russia’s involvement allowing Germany to focus on the West again. With the in late 1918, Allies won back most of the territory lost. Central Powers sequentially conceded. Kaiser Wilhelm abdicated on 9 November and Germany signed an armistice on 11 November 1918 ending WWI. The Big Four imposed their terms on the defeated powers – France, Britain, US, and Italy at the 1919 Paris Peace Conference. 20 years later we have WW II.

Fun facts: What US Army Division as part of the American Expeditionary Force is recognized with helping to repel the German Offensive into Paris at the Marne River at the Second Battle of the Marne during WWI? The 3rd Infantry Division (3ID, “Rock of the Marne”).

Memorial: In 1931, the people of the District of Columbia erected the District of Columbia War Memorial on the National Mall to honor individuals from the District who had served in the U.S. Armed Forces in World War I. It stands in West Potomac Park off of Independence Avenue. Dedicated on November 11, 1931 () by President Herbert Hoover. It is the only local memorial on the National Mall. It was designed by Frederick H. Brooke, with Horace W. Peaslee, and Nathan C. Wyeth as associate architects. It is a 47-foot tall, circular, domed peristyle Doric temple. Within the cornerstone is preserved a list of 26,000 Washingtonians who served in the Great War. The largest of the country's World War I memorials was the Liberty Memorial, a 217-foot (66 m) tall tower with an artificial burning pyre atop it, located in Kansas City, Missouri. But no national WWI memorial was erected, which upset WWI veterans. After lots of legislative effort, the 2015 National Defense Authorization Act authorized the World War 1 Centennial Commission to build the memorial in Pershing Park, located at 14th Street and Pennsylvania Avenue in NW, Washington DC. In January 2016, “The Weight of Sacrifice” by Joseph Weishaar, Sabin Howard, Phoebe Lickwar, and GWWO Architects (out of Chicago, Illinois) was selected as the winning memorial. On November 9, 2017, the World War I Centennial Commission held a ceremonial groundbreaking event at Pershing Park. Sabin Howard is sculpting 38 figures for a bronze relief that is 10% larger than life-size in his studio in New Jersey. Each figure takes 600 hours of work, even with 3D-printed armatures. The design, A Soldier's Journey, shows the story of a soldier who leaves his family, sees combat and the loss of comrades, and returns to his family after receiving medical care. It is expected to be completed in fall 2023 or spring 2024.

World War II Memorial Background: 1 September 1939 - 1945. We were in a state of total war with over 100 million personnel, more than 30 countries, and economic, industrial, and scientific capabilities all factoring into the war effort, blurring the distinction between civilian and military resources. WWII was the deadliest conflict in human history resulting in 70-80 million fatalities. More civilian than military personnel were killed. Tens of millions of people died by genocide, starvation, massacres, and disease. So far with the COIVD-19 pandemic, 2.53 million deaths have occurred. Air power played a major role with strategic bombing, development of nuclear weapons, and use of the only 2 nuclear bombs used in wartime.

WWII Short Synopsis: Axis versus Allies. Begun on 1 September 1939 with Germany’s invasion of . UK and France declare war on Germany on Sept 3rd. Late 1939-early 1941, with campaigns and treaties Germany conquers much of continental Europe and forms Allies with Japan and Italy. Molotov-Ribbentrop Pact of 1939, Germany and Soviet Union partition and annex Poland, Finland, Romania, and Baltic States. North and East African campaigns begin. France falls in mid-1940. On 22 June 1941, Germany (Axis) invades Soviet Union to open the Eastern Front – the largest land theatre of war in history leads to Axis war of attrition. Japan at war with China by 1937. December 1941 Japan attacks American and British territories with near-simultaneous offensives against SE Asia and the Central Pacific (including Pearl Harbor). UK and US declare war on Japan and then Axis declare war on US. Japan captures much of Western Pacific, but we halt their advance with the Battle of Midway in 1942. Soviet Union defeats Germany and Italy in North Africa and at Stalingrad. Allies invade Sicily, Italy and Pacific offenses, force Axis to retreat on all fronts. 1944, Western Allies invade German-occupied France; Soviet Union regains its territorial losses against Germany. In 1944 and 1945, Japan forced to retreat from much of mainland Asia and we cripple their Navy with capture of Western Pacific islands. German-occupied territories are liberated, Soviet Union and Allies invade Germany with culminate with fall of (Soviet Union), suicide of Adolf Hitler, and unconditional surrender of Germany on 8 May 1945 to the Allies. Potsdam Declaration by Allies on 26 July 1945, Japan refuses surrender, and we drop atomic bombs on Hiroshima (6 Aug 1945) and Nagasaki (9 August 1945). Japan surrenders on 15 August 1945. United Nations formed, including the Security Council and we were on to the Cold War…

Fun facts: What United States Army Air Force unit was tasked with the operational deployment of nuclear weapons during WWII? The 509th Composite Group (509 CG) assigned to the 313th Bombardment Wing on Tinian (one of the Northern Mariana Islands, 100km North of Guam). What were the names of the Martin-built B-29-45-MO and B-29-36-MO that dropped “Little Boy (uranium)” and “Fat Man (plutonium)?” “B29 Enola Gay” piloted by Colonel Paul W. Tibbets, Call sign Dimples 82, dropped “Little Boy” on Hiroshima and “B29 Bockscar” piloted by Major Charles W. Sweeney (Captain Frederick C. Bock flew The Great Artiste during the mission), Call sign Dimples 77, dropped “Fat Man” on Nagasaki. What was the name of the third bomb that was previously detonated in New Mexico in a test called “Trinity”? “Gadget (plutonium)”.

Memorial: On April 29, 2004 the World War II Memorial opened to the public on the National Mall in dedication to Americans who served in the Armed Forces and as civilians during WWII. The 56, 17-foot pillars represent the U.S. states and territories (48 states of 1945, DC, the Alaska territory, Territory of Hawaii, Commonwealth of the Philippines, Puerto Rico, Guam, America Samoa, and US Virgin Islands) and a pair of 43-foot triumphal arches represent the Atlantic (Northern arch) and Pacific (Southern arch) theaters. President George W. Bush dedicated the memorial on May 29, 2004. The memorial includes two inconspicuously located “Kilroy was here” engravings. Their inclusion in the memorial acknowledges the significance of the symbol to American soldiers during WWII and how the saying represented their presence and protection wherever it was inscribed. If entered from the East, two walls picture scenes of the war experience. On left, depicts soldiers doing pre-accession physical exams, oaths of office, military gear issue. Iconic scenes with battle and burying the dead and then end with homecoming. On the right, similar but more typical of the European theatre. Some scenes are in England, prepping for Air and Sea assaults. The last scene is of a handshake between American and Russian armies when the western and eastern fronts met in Germany. The Freedom Wall is on the west side of the plaza and has 4,048 gold stars each representing 100 Americans who died in the war. The message reads “Here we mark the price of freedom.” *Clapping* The Enola Gay is one of the centerpieces at the Steven F. Udvar-Hazy Center, the annex of the Smithsonian Air and Space Museum in Chantilly, Virginia.

Korean War Veterans Memorial Background: 25 June 1950 - 27 July 1953. The Korean War was among the most destructive conflicts of the modern era, with approximately 3 million war fatalities and a larger proportional civilian toll than World War II or the Vietnam War. It incurred the destruction of virtually all of Korea's major cities, thousands of massacres by both sides, including the mass killing of tens of thousands of suspected communists by the South Korean government, and the torture and starvation of prisoners of war by the North Korean command. North Korea became among the most heavily bombed countries in history. 628,833 members of the United Nations died of which 36,574 Americans died as a direct result of the war, though total may be more like 54,246. Over 1 million UN members were wounded with 103,284 Americans wounded. 7,140 Americans were captured and 8,177 were missing.

Korean War Short Synopsis: A war between North Korea (support by China and the Soviet Union) and South Korea (supported by the United Nations, principally US). North Korea invaded South Korea on 25 June 1950. The United Nations Security Council denounced the North Korean move as an invasion, and authorized the formation of the United Nations Command and the dispatch of forces to Korea to repel it. These UN decisions were taken without participation of the Soviet Union and the People's Republic of China, both of which supported North Korea. Twenty-one countries of the United Nations eventually contributed to the UN force, with the United States providing around 90% of the military personnel. After the first two months of war, South Korean Army (ROKA) and the US forces rapidly dispatched to Korea were on the point of defeat. In September 1950, an amphibious UN counter-offensive was launched at Incheon, and cut off many KPA troops in South Korea. UN forces invaded North Korea in October 1950 and moved rapidly towards the Yalu River—the border with China. On 19 October 1950, Chinese forces of the People's Volunteer Army (PVA) crossed the Yalu and entered the war. The surprise Chinese intervention triggered a retreat of UN forces and Chinese forces were in South Korea by late December.

In these and subsequent battles, Seoul was captured four times, and communist forces were pushed back to the 38th parallel, close to where the war started. After this the front stabilized and the last two years of fighting were a war of attrition. The war in the air, however, was never a stalemate. North Korea was subject to a massive US bombing campaign. Jet fighters confronted each other in air-to-air combat for the first time in history. Soviet pilots covertly flew in defense of their communist allies.

The fighting ended on 27 July 1953 with the Korean Armistice Agreement, which created the Korean Demilitarized Zone (DMZ) to separate North and South Korea, and allowed the return of prisoners. However, no peace treaty was ever signed, and the two Koreas are technically still at war, engaged in a frozen conflict. In April 2018, the leaders of North and South Korea met at the DMZ and agreed to work toward a treaty to formally end the Korean War.

Fun facts: What US Infantry Division’s Task Force Smith was badly defeated at the Battle of Osan on 5 July 1950 because of a lack of anti-tank weapons and superior KPA forces? 25th Infantry Division. What USAF Fighter Squadron mistakenly attacked facilities in Chinese territory? 67th Fighter Squadron. What Merchant Marine ship evacuated 14,000 refugees, the largest rescue operation by a single ship from the port city of Hungnam? USS Meredith Victory. What Fleet was assigned to protect Taiwan during the Korean War? US 7th Fleet.

Memorial: Korean War Veterans Memorial was confirmed Congress on April 20, 1986. The initial design competition was won in 1986 by a team of four architects from The Pennsylvania State University, but this team withdrew as it became clear that changes would be needed to satisfy the reviewing agencies. A federal court case was filed and lost over the design changes. The eventual design was by Cooper-Lecky Architects. President George H. W. Bush conducted the groundbreaking on June 14, 1992, Flag Day. The memorial was dedicated on July 27, 1995, the 42nd anniversary of the armistice that ended the war, by President Bill Clinton and Kim Young Sam, the South Korean president.

The Mural Wall: The main memorial is in the form of a triangle intersecting a circle. Walls: 164 feet long, 8 inches thick; more than 100 tons of highly polished "Academy Black" granite from California: more than 2,500 photographic, archival images representing the land, sea, and air troops who supported those who fought in the war are sandblasted onto the wall and created by Louis Nelson. On the wall, there are 38 soldiers, 38 months, and it is also representing the 38 parallel that separated the North and South Korea.

The Column: Within the walled triangle are 19 stainless steel statues designed by Frank Gaylord and collectively called The Column. Each statue is larger than life-size, between 7’ 3” and 7’ 6” tall; each weighs nearly 1,000 lbs. The figures represent a platoon on patrol, drawn from branches of the armed forces; 14 from the U.S. Army, 3 are from the Marine Corps, one is a Navy Corpsman, and one is an Air Force Forward Air Observer. They are in full combat gear among strips of granite and juniper bushes representing rugged terrain of Korea.

United Nations Wall: To the north of the statues is the United Nations Wall, a low wall listing the 22 members of the UN that contributed troops or medical support to the Korean War effort.

Pool of Remembrance: A shallow pool 30 feet in diameter lined with black granite and surrounded by a grove of linden trees with benches. The trees are shaped to create a barrel effect, which allows the sun to reflect on the pool. Inscriptions list the numbers killed, wounded, missing in action, and held as prisoners of war (Americans and UN total). A nearby plaque is inscribed: "Our nation honors her sons and daughters who answered the call to defend a country they never knew and a people they never met." In the south side of the memorial, there are three bushes of the Rose of Sharon hibiscus, South Korea's national flower.

A further granite wall bears the simple message, inlaid in silver: "Freedom Is Not Free."

Vietnam War Memorial Background: 1 November 1955 - 30 April 1975. It is also known as the Second Indochina War and the Resistance War Against America or simply the America War which occurred in Vietnam Laos, and Cambodia. North Vietnam was supported by the Soviet Union, China, and other communist allies, whereas South Vietnam was supported by the US, S. Korea, the Philippines, Australia, Thailand, and other anti-communist allies. U.S. and South Vietnam forces relied on air superiority and overwhelming firepower to conduct search and destroy operations, involving ground forces, , and airstrikes. The U.S. also conducted a large-scale strategic bombing campaign against North Vietnam and Laos. It was considered a Cold War-era proxy was that last 19 years with direct US involvement ending in 1973. The Loatian Civil and Cambodian Civil War and fall of Saigon on 30 April 1975 ended with all 3 countries becoming communist in 1975. The war exacted an enormous human cost: estimates of the number of Vietnamese soldiers and civilians killed range from 966,000 to 3.8 million. Some 275,000–310,000 Cambodians, 20,000–62,000 Laotians, and 58,220 U.S. service members also died in the conflict, and a further 1,626 remain missing in action.

Vietnam War Short Synopsis: US assumes financial and military support for South Vietnamese state in 1954 from the French. North Vietnam is invaded by Loas in mid-1950s reinforcing supply chain to the Viet Cong. President JFK increase US advisors from 1000 to 16,000 in 1963. By 1964, 23,000 US advisors in place. US destroyer clashed with a North Vietnamese fast attack craft in the Gulf of Tonkin. US Congresses passes resolution giving Pres Lyndon Johnson authority to increase US military presence. Combat troops deployed up to 184,000. 1966, Secretary of Defense Robert McNamara with doubts of victory. Tet Offensive of 1968 showed lack of US progress and domestic US support faded. In 1969, following the election of U.S. President Richard Nixon, a policy of "Vietnamization" began, which saw the conflict fought by an expanded Army of Republic of Vietnam, with U.S. forces sidelined and increasingly demoralized by domestic opposition and reduced recruitment. U.S. ground forces had largely withdrawn by early 1972 and support was limited to air support, artillery support, advisers, and materiel shipments. South Vietnam repelled the Eastern Offense of 1972 with large mechanized Northern Vietnamese Army. The Paris Peace Accords of January 1973 saw all U.S. forces withdrawn; the Case–Church Amendment, passed by the U.S. Congress on 15 August 1973, officially ended direct U.S. military involvement. The Peace Accords were broken almost immediately, and fighting continued for two more years. Phnom Penh fell to the Khmer Rouge (Cambodia) on 17 April 1975 while the 1975 Spring Offensive saw the capture of Saigon by the PAVN (NVA) on 30 April; this marked the end of the war, and North and South Vietnam were reunified the following year.

Fun Facts: What was the name of the US destroyer involved in the Gulf of Tonkin incident? USS Maddox. What aircraft fighter-bomber aircraft was used primarily in the latter part of the Vietnam War? F-4 Phantom II. Memorial: The Vietnam Veterans Memorial honors service members of the U.S. armed forces who fought in the Vietnam War. The 2-acre site is dominated by a black granite wall engraved with the names of those service members who died as a result of the service in the war. Completed in 1982, it has been supplemented with The Three Soldiers statue and the Vietnam Women’s Memorial. Designed by Maya Lin. The memorial was dedicated on November 13, 1982, as part of a five-day ceremony that began on November 10, 1982, presided over by President Ronald Reagan, and which involved a procession of tens of thousands of Vietnam War veterans Memorial Wall: Made of two 246-foot-9-inch long polished black granite walls etched with the names of the servicemen being honored in 140 panels of horizontal rows of type. At the highest tip (the apex where they meet), they are 10.1 feet high, and they taper to a height of 8 inches at their extremities. Symbolically, this is described as a "wound that is closed and healing" and exemplifies the Land art movement of the 1960s which produced sculptures that sought to reconnect with the natural environment. The stone was quarried in Bangalore, India. The wall originally listed 57,939 names when it was dedicated in 1982; however other names have since been added and as of May 2018 there were 58,320 names, including eight women. The number of names on the wall is different than the official number of U.S. Vietnam War deaths, which is 58,220 as of May 2018. The names inscribed are not a complete list of those who are eligible for inclusion as some names were omitted at the request of families. Names Names of service members classified as "declared dead" are denoted by a diamond. The memorial contains names of individuals who had died due to circumstances other than killed in action, including murder, vehicle accidents, drowning, heart attack, animal attack, snake bites and others. Names of those whose status is unknown, which typically means "missing in action" (MIA), are denoted with a cross. When the death of one who was previously missing is confirmed, a diamond is superimposed over the cross. If the missing were to return alive, which has never occurred to date, the cross is to be circumscribed by a circle. The earliest date of eligibility for a name to be included on the memorial is November 1, 1955, which corresponds to President Eisenhower deploying the Military Assistance Advisory Group to train the Army of the Republic of Vietnam. The last date of eligibility is May 15, 1975, which corresponds to the final day of the Mayaguez incident. The names of 32 men were erroneously included in the memorial, and while those names remain on the wall, they have been removed from the databases and printed directories. The extra names resulted from a deliberate decision to err on the side of inclusiveness, with 38 questionable names being included. The Three Servicemen The Three Soldiers by Frederick Hart (1984). A short distance away from the wall is another Vietnam veteran’s memorial, a bronze statue named The Three Servicemen (sometimes called The Three Soldiers). The statue depicts three soldiers, purposefully identifiable as European American, African American, and Hispanic American. In their final arrangement, the statue and the Wall appear to interact with each other, with the soldiers looking on in solemn tribute at the names of their fallen comrades. The distance between the two allows them to interact while minimizing the effect of the addition on Lin's design. Women's Memorial The Vietnam Women's Memorial is a memorial dedicated to the women of the United States who served in the Vietnam War, most of whom were nurses. It serves as a reminder of the importance of women in the conflict. It depicts three uniformed women with a wounded soldier. In Memory memorial plaque A memorial plaque, authorized by an Act of Congress (Pub.L. 106–214 (text) (pdf)), was dedicated on November 10, 2004, at the northeast corner of the plaza surrounding the Three Soldiers statue to honor veterans who died after the war as a direct result of injuries suffered in Vietnam, but who fall outside Department of Defense guidelines. The plaque is a carved block of black granite, 3 by 2 feet (0.91 by 0.61 m), inscribed "In memory of the men and women who served in the Vietnam War and later died as a result of their service. We honor and remember their sacrifice." Ritual Visitors to the memorial may take a piece of paper and place it over a name on the wall and rub a wax crayon or graphite pencil over it as a memento of their loved ones. This is called rubbing. Visitors to the memorial began leaving sentimental items at the memorial at its opening. One story claims this practice began during construction when a Vietnam veteran threw the Purple Heart his brother received posthumously into the concrete of the memorial's foundation. Several thousand items are left at the memorial each year. The largest item left at the memorial was a sliding glass storm door with a full-size replica "tiger cage". The door was painted with a scene from Vietnam and the names of U.S. POWs and MIAs from the conflict.

Resources https://en.wikipedia.org/wiki/