New Zealand Medical Services in Middle East and Italy
Health of Troops
Health of Troops
With large numbers of men congregated in camps under conditions to which the majority of them are unused, there is likely to be a greater incidence of disease than normally occurs in the civil population. The DGMS (Army and Air) was insistent in his recommendations to camp authorities at the beginning of the war that the following points should be strictly observed:
Adequate air space and ventilation in sleeping quarters.
All damp and wet clothing to be changed at the earliest possible moment, and the provision of adequate drying facilities, and no wet or damp clothing to be permitted in sleeping quarters.page 26
Adequate changes of clothing to be provided.
Avoidance of undue fatigue in the early stages of training, i.e., training to be graduated.
Provision of sufficient hot and cold showers.
Diet not only wholesome and well cooked, but containing those foods which have a protective value against disease, and the food to be varied and served in a palatable manner.
Sanitary arrangements to be above suspicion.
In regard to (1), it was pointed out that it was essential that each soldier should have 600 cubic feet of air space and that the distance between the centres of adjacent beds be at least 6 ft. In the early stages of the First World War proper attention was not given to adequate ventilation and air space, and when a serious outbreak of cerebro-spinal fever occurred, a number of cases being fatal, a complete disorganisation of training resulted. Points (2), (3), and (4) were the direct responsibility of the unit commander.
The efficiency of the medical services was sternly tried in the latter part of October and during November 1939 by a severe epidemic of influenza (streptococcal respiratory catarrh) in which between 30 and 54 per cent of the strength of all units in the mobilisation camps was affected, the incidence rates in the three camps being similar. Energetic measures were taken to combat the epidemic, these consisting mainly in an insistence on the medical safeguards for the health of troops already set out. The fact that there was not a single death and only four cases of true pneumonia as a result of the infection was evidence of the success of the prophylactic and nursing measures taken. Similarly, a milder influenza epidemic in May 1940 did not assume any serious proportions.
In the early months of 1940 it was found that on some matters in connection with camp construction and arrangements neither the Army Medical Service nor the Assistant Director of Hygiene for the district was consulted. It was felt that there should have been a greater degree of consultation between the Public Works Department, the Quartermaster-General's Branch, the Army Medical Service and the Director of Hygiene.
Neither the DGMS nor the ADsMS were first consulted regarding the design of huts, latrines, and showers, and strong protests by them when they pointed out weaknesses during the actual construction work or insanitary conditions were often ignored, particularly in the Central Military District. It was fortunate that the consequences were not more serious.
To some extent this was probably a result of the concern of one particular organisation to push ahead expeditiously with its own programme. The medical interest in camp construction and arrangements from the point of view of the health of the troops and the page 27 avoidance of epidemics had to be emphatically stressed before it came to be recognised. Otherwise the valuable and extensive experience of senior medical officers in military medicine and hygiene, and the importance of its application, tended to be underrated.
On 31 October 1940 a conference was held to discuss the question of hygiene and sanitation of military camps; attending it were representatives of the Army, Health, and Public Works Departments, with the Adjutant-General as chairman. The chairman admitted that conditions in some camps were not all that could be desired, but it had to be remembered that practically all camps had been established at very short notice. The urgent nature of most of the work required quick action, and the usual procedure of preparing plans and submitting them to various officers had, in some cases, been departed from, and, instead, verbal arrangements had been made on the spot by Army and Public Works officers. The sole reason for non-consultation with specialists in hygiene and medicine was the urgent demand for construction. The delay in completing Waiouru camp had seriously upset army plans and necessitated the occupation of temporary camps where expenditure was restricted to what were considered to be essentials, and economies were effected at the expense of efficiency and proper hygiene conditions.
It was explained that the army officers concerned proposed to recommend the appointment of a full-time Deputy Director of Hygiene. It was decided that, in future, the procedure to be followed in deciding on the location of a camp would include a reconnaissance of the site and buildings by the district commanding officer, AQMG, and ADMS, the Works Officer, and District Engineer, Public Works Department. These officers would furnish a report on the site. When plans were received at Army Headquarters, the Quartermaster-General would submit them to the Director-General of Medical Services and Deputy Director of Hygiene for approval from the medical service point of view. In November 1940 the Principal Sanitary Inspector, Health Department, was appointed full-time Deputy Director of Hygiene (Army and Air), and held the appointment throughout the war. The revised arrangements worked effectively.