War Surgery and Medicine
Appendix — 2 NZEF (IP) Administrative Order — MALARIA
Appendix
2 NZEF (IP) Administrative Order
MALARIA
MEASURES FOR PREVENTION AND CONTROL
1. CONTROL OF MALARIA
Successful conduct of operations in the South Pacific Area depends to no small degree on prevention of casualties from malaria. Control of malaria is a military, rather than a medical problem. The responsibility for malaria control rests on the CO of every unit and every individual soldier. Malaria can be controlled by the application of proven control measures under strict military discipline. These measures are set out in the succeeding paragraphs of this order. They will be strictly enforced.
2. TRAINING
(a) |
Instruction on the nature of malaria, its effects on military operations, and the methods of control will be made an integral part of the training of all arms. Regular instruction in this respect will be arranged by COs. |
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(b) |
Attention is directed to the following publications:
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(c) |
COs of all units will ensure that an anti-mosquito squad on the scale of one NCO and 4 ORs per infantry Bn or equivalent, or a proportionate number for smaller units, is detailed and trained in anti-malarial work. Their primary function is destruction of mosquitoes within unit lines, and they should not be diverted to other duties which will in any way interfere with this work. As the work is technical, men of some education should be selected as far as possible, and it is particularly important that the NCO should be both energetic and intelligent. These squads are trained by the Malaria Control Unit, the OC of which arranges courses of lectures and field demonstrations for them. In addition, it is most desirable that the squads should be attached to the Malaria Control Unit for a further period when convenient, in order to gain practical experience in the field. Each squad should be supplied with a knapsack sprayer, oil for spraying, and a pick and shovel. The duties of the squads, under the direction of the Regimental Medical Officer are:
The results of the anti-mosquito work will be regularly examined by a checker from the Malaria Control Unit, who will advise on details and report any defects to the unit Regimental Medical Officer. |
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(d) |
In addition to the unit anti-mosquito squads who will be solely page 545 engaged in anti-mosquito work, the CO of each infantry company or equivalent formation will appoint for part time duties an NCO and two men. This Coy Squad will assist the Unit Squad in the execution of adequate anti-mosquito measures within its own Coy area. |
3. PERSONAL PROTECTION AGAINST MALARIA IN MALARIOUS AREAS
The CO of each unit in a malarious area will ensure that—
(a) |
From½ hour before sunset till½ hour after sunrise every member, except when protected by a mosquito net, wears slacks, boots, anklets, web gaiters, SD, or puttees and long-sleeved shirt or jacket with sleeves rolled down. |
(b) |
Every member has a container of insect repellent lotion and that the repellent is applied to exposed skin surfaces, as described in para 7 of this order. |
(c) |
Every member has a mosquito net, and that it is kept in good repair. |
(d) |
Every member sleeps under a mosquito net and that inspections are made nightly to insure that they are properly used. |
(e) |
All occupied quarters, tents, or bivouacs are closed and sprayed with mosquito spray. SMO of area will issue appropriate instructions for methods of spraying to be used locally. |
(f) |
Camps and bivouac areas are sited as far away as possible from obvious mosquito breeding areas and well away from native villages and habitations. |
(g) |
The vicinity of all villages and habitations used by local people are placed out of bounds between sunset and sunrise and that local inhabitants are kept out of camp areas during that time. |
(h) |
Every member takes atebrin tablets as directed. |
4. ATEBRIN: USES AND ADMINISTRATION
(a) |
Atebrin tablets are provided to maintain all ranks in good health by suppressing development of symptoms in those who are, or who have been, exposed to risk of malarial infection. |
(b) |
Continued administration of atebrin in the dosages ordered has no harmful effects. Atebrin is a yellow dye, and a yellow tinge appears in the skin of a proportion of individuals who take it regularly. This yellow skin coloration is of no significance and will disappear when consumption of the drug ceases. |
(c) |
Tablets will be taken after a meal, preferably the evening meal. Each tablet will be swallowed whole and followed by a drink of water. |
(d) |
The CO of the unit is responsible for the administration of atebrin to every officer, NCO, and man in his unit. Atebrin will, whenever possible, be given on parade by roster under supervision of an officer. Strict supervision is necessary to guard against failure to swallow the tablets. |
5. ANTI-MALARIAL MEASURES PREPARATORY TO PROCEEDING TO A MALARIOUS AREA
(a) |
The CO of a Unit will ensure that, prior to embarkation, the Unit has been issued with the following articles:
Items (i), (ii), and (iii) will be a personal issue to the member prior to embarkation. Items (iv) and (v) or suitable equivalents will be taken with unit stores on the transport. |
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(b) |
On embarkation, every member will take one tablet of atebrin (0.1 gram) daily for six days in each week until disembarkation. On disembarkation, the dosage will become that in force in the area of disembarkation. |
6. ATEBRIN: SUPPLY
(a) |
Medical Units will requisition, through the usual medical channels, for atebrin which is to be used in the standard course or maintenance course of treatment of cases of malaria. |
(b) |
Atebrin tablets (0.1 gram) for suppressive treatment will be distributed by NZ ASC. |
(c) |
Supplies will be drawn by NZ ASC from Advanced Depots of Medical Stores or from Medical Unit responsible for drawing medical supplies. |
7. INSECT REPELLENT LOTION
(a) |
Supplies of insect repellent lotion, which is harmless, non-greasy, non-staining, and effective against mites which carry scrub typhus as well as against mosquitoes, will be distributed by NZ ASC. |
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(b) |
Its regular use, when combined with other essential measures of personal protection and with suppressive drug (atebrin) treatment, should greatly reduce the incidence of malaria. Each man should be supplied with one 2 oz. bottle and the allowance is one such bottle per man each month. |
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(c) |
COs will ensure that insect repellent lotion is made a personal issue to all members of the unit. |
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(d) |
Instructions for use:
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(e) |
A few drops are shaken on to the palm and, after rubbing the hands together, smeared over all exposed portions of the face, neck, and arms to give a thin uniform covering. Do not apply to mouth or vicinity of eyes. Reapply when insects again begin alighting on the skin, using about one half of the amount originally applied. |
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(f) |
While liberal use of insect repellent lotion is to be encouraged, wastage should be carefully avoided; and, wherever possible, empty bottles are to be returned to NZ ASC. |
8. ORDERS FOR ANTI-MALARIAL DRILL
For the purpose of preserving the health of all troops and for the prevention of malaria within the force, the following orders will be obeyed by all personnel immediately upon entering a malarious area or so soon before entering a malarious area as may be ordered:
(a) |
At all times from half an hour before sunset until half an hour after sunrise, except when protected by a mosquito net, all personnel will wear slacks, boots, anklets, web gaiters or puttees and long-sleeved shirt or jacket with the sleeves rolled down. |
(b) |
Insect repellent lotion will be applied as described in para 7, sub-para (d) and (e) of this order. |
(c) |
Mosquito nets will be kept in good repair at all times. |
(d) |
All personnel will sleep only under mosquito nets. |
(e) |
Atebrin tablets will be taken as directed. Each tablet will be swallowed whole and followed by a drink of water. |
9. BREACHES OF ORDERS
The whole of the foregoing should be explained by officers to their men on frequent occasions. Para 7, sub-para (d) and (e) and para 8 will be read to all troops on parades at such intervals as will ensure that all troops are familiar with their provision. Breach of the instructions contained in these paras will be regarded as a serious breach of discipline. An appropriate penalty for a first offence might be forfeiture of gross pay for a period of say 10 days.