The term Mobile Army Surgical Hospital (MASH) refers to a United States Army hospital capable of providing definitive surgery within a combat area of operations and yet mobile enough to keep up with advancing troops. The units were first established in August 1945, and were deployed during the Korean War where they proved to be highly successful. The U.S. Army decommissioned the last MASH unit on February 16, 2006.
Towards the end of World War II, the MASH concept was conceived by Michael E. DeBakey and other Army surgical consultants as the "mobile auxiliary surgical hospital". It was an improvement to the system of portable surgical hospitals, field hospitals, and general hospitals used during World War II. The portable surgical hospitals had been too light and under-equipped, while the field hospitals were not mobile enough and therefore an advancing army found that casualties needed to be transported over great distances before they could get proper treatment.
The MASH concept was designed to get experienced surgical personnel as close to the front as possible, a few miles behind the front, just outside of enemy artillery range. Important features of these MASHes they were fully equipped with their own comprehensive truck transport and would work mainly out of tents. Thus the MASHes could be packed and moved within 6 hours. They could keep up with an advancing army or quickly "bug out" in the face of an oncoming enemy threat. This made them distinct from other types of hospitals such as Evacuation Hospital and Field Hospitals--these did not have as much transport and so tended to operate from semi-permanent locations.
MASHes were Echelon II facilities, in other words, only stage 2 along the US Army's chain of casualty evacuation. Casualties were first treated at the point of injury through buddy aid, then transported to a battalion aid station (Echelon I) for emergency stabilizing treatment. From there, those needing further treatment would be sent to Echelon II, usually a division clearing station which would route those needing urgent surgery to a MASH. Critically injured personnel could also be sent directly from an aid station to a MASH. The proximity of the MASH to the fighting troops, aided by the development of heli medevac meant that a Korean War casualty could get life-saving surgery within an hour, or even a few minutes, after being wounded.
While US Army doctrine specified that each division should be supported by its own MASH, there were never enough MASH units during the Korean War. Each Corps typically had two MASH units, each of them supported several divisions. This coupled with the high volume of casualties during a battle necessitated the use of meatball surgery as opposed to conventional surgical techniques. Nonetheless the MASHes were extremely successful. During the Korean War, a seriously wounded soldier who made it to a MASH unit alive had a 97% chance of survival--a historically accurate fact mentioned in various M*A*S*H episodes.
After the Korean War, MASH units continued to serve in various conflicts including the Vietnam War. In March, 1991, the 159th MASH of the Louisiana Army National Guard operated in Iraq in support of the 3rd Armored Division during Operation Desert Storm.
In 1997, 43rd MASH (formerly the 8055th MASH), the last MASH unit in South Korea, was decommissioned. A decommissioning ceremony was held in South Korea, which was attended by several members of the cast of the M*A*S*H television series. MASH units have since been replaced by the U.S. Army's combat support hospitals.
On February 16, 2006, the last MASH in the US Army, 212th MASH, was decomissioned. Based in Miesau Ammo Depot, Germany, the 212th MASH was the first US Army hospital established in Iraq in 2003, supporting coalition forces during Operation Iraqi Freedom. It was the most decorated combat hospital in the US Army, with 28 Battle Streamers on the organizational colors. In 2005, the 212th MASH was deployed to Pakistan to support the earthquake relief operations. Thereafter the unit was stood down and its equipment donated to Pakistan.
The MASH unit made its way into popular culture through the 1968 novel M*A*S*H by Richard Hooker, the 1970 feature film based on the novel, and the long-running television series based on the movie. A 1953 film, Battle Circus, also took place at a MASH.
The limitations of film-making made it necessary for films and TV shows to depart slightly from reality. In practice MASHes during the Korean War were highly mobile. One MASH moved 19 times in seven months while another moved 33 times in one year. By contrast, the MASHs on film tended to stay put. The real-life MASHes were much larger, designed to have 60 beds and later 150 beds, and staffed by up to 15 medical officers, 17 nurses and over a hundred enlisted men (corpsmen/aidmen/medical technicians).
- Office of Medical History for the U.S. Army Surgeon General
- Booker King and Ismalil Jatoi, The mobile Army surgical hospital (MASH): a military and surgical legacy, J Natl Med Assoc. 2005 May; 97(5): 648–656.
- Apel, Otto F., MASH: An Army Surgeon in Korea, Lexington, The University Press of Kentucky, 1998
- Cowdrey, Albert E. The Medic's War, Washington D.C., Center for Military History United States Army, 1987