In 1914-15 alone, two successive Haitian Presidents were assassinated in a matter of months.  When the third, President Viulbrun Guillaume Sam was attacked and killed by an angry mob after ordering the execution of his own political enemies, 2,500 United States Marines were dispatched to restore order.

Under the command of Major Smedley Darlington Butler who had served in the Vera Cruz Campaign the preceding year, the Marines trained local militia, built roads and railways, and tried to restore order in Haiti.  On September 18, 1915 the leading rebel bandit faction, called the Cacos, fired on a Marine patrol.  One month later a similar ambush was made on a patrol of forty-four mounted Marines led by Captain William Upshur.  Among Upshur's men was Sergeant Major Dan Daly who had earned a Medal of Honor during the Boxer Rebellion.  During the valiant stand of that Marine Patrol, Daly became the first Marine to earn a second Medal of Honor.  Captain Upshur and one of his lieutenant's also received Medals of Honor.

Following these attacks, the Marine patrols became more offensive in an effort to destroy the Cacos ability to create war and terrorize the people of Haiti.  By mid-November those guerillas who had not been killed or captured, were driven back to Fort Riviere, where Major Butler led three Marine companies in an assault on November 17.  During the action, Butler became the second Marine to earn a second Medal of Honor.  Two other Marines also earned Medals of Honor that day. 

Haiti continued to experience a limited turmoil for years, but the Marine presence helped to stabilize much of the country.  Not until four years later would a leader emerge to help Cacos rebuild enough to mount a major campaign of terror.  When that happened, two more Marines earned Medals of Honor for capturing Charlemagne Peralte and again crushing the Cacos.

In between these two actions in Haiti, trouble was brewing on the east side of the island in the Dominican Republic.  Battles with similar rebel guerilla forces earned three Marines Medals of Honor in the summer of fall of 1916.

In Central America Augusto Sandino established his own anti-American rebel force called the Sandinistas in efforts to force United States troops out of the region.  On July 16, 1927 he attacked U.S. Marines at Ocotal.  Several years of fighting followed and there were numerous engagements, including a bloody two-day battle from January 6-8, 1928.  Despite continuing combat with the rebel insurgents, 1Lt Christian Schilt repeatedly flew his biplane into the village of Quilali to resupply the besieged Marines and rescue 18 wounded, earning a Medal of Honor.
Four years later during one of the last engagements before the U.S. Marines departed Nicaragua on January 2, 1933, Marine Corporal Donald Truesdell earned the thirteenth and last Medal of Honor in the Caribbean police actions of the U.S. Marines.

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