New Zealand Medical Services in Middle East and Italy
Appendix B — Health Precautions Issued by HQ 2 NZEF in Egypt, 1940
Health Precautions Issued by HQ 2 NZEF in Egypt, 1940
Before entering messrooms for any meals, all ranks will disinfect hands in cresol solution, in special basins provided.
All messing utensils must be washed in clean soapy water and then boiled in special apparatus provided. To prevent rusting of tin plates, a level teaspoon of washing soda should be put into the tub at each boiling. All dishes and cutlery must be stored in messrooms in fly-proof containers. Unused portions of sugar, butter, jam, etc., must be stored in fly-proof receptacles promptly after meals.
Medical Fitness for Employment: No one will be employed in the cookhouse, or in the handling of food, who has suffered from enteric fever, dysentery, typhoid, or cholera, or who is suffering from, or is under treatment page 93 for venereal disease. Regular medical inspection of personnel handling food will be carried out by Unit Medical Officers.
Cooks' Clothing: Each cook and man employed handling food will be provided with at least three sets of washable white uniforms. These should always be worn when at work, kept as clean as possible, and changed when dirty.
Cleanliness of Hands: A hand basin, soap, and a nailbrush will always be available for the use of cooks. There will also be provided a basin of cresol solution for the frequent disinfection of the hands.
Clothing: No personal clothing or private property of men employed in cookhouses will be kept there. A proper place is provided for hanging jackets, hats, etc., at entrance to cookhouses.
Smoking in Cookhouses: Smoking in cookhouses is forbidden.
No personnel will sleep in mess kitchens or storerooms.
Only efficient and conscientious men must be employed as cooks and mess orderlies. The latter should be inspected by RMOs before going on duty, should remain on duty for seven days, and be relieved in relays.
Cleanliness of Pots and Pans: Pots and pans will be cleaned and dried immediately after use.
General Cleanliness of the Cookhouses and Utensils: The cookhouses, sinks, chopping blocks, cutting-up boards, pastry slabs, mincing machines, knives, forks, spoons, and other utensils will be kept as clean as possible when in use and will be thoroughly cleaned after the last meal of the day. All utensils when not in use will be kept in places allotted to them and will be available for inspection at any time. No accumulation of old rags, tins, etc., will be allowed in drawers or elsewhere in the cookhouses.
Care and Preparation of Food: Only food which is in the process of cooking will be kept in the cookhouse. Food for the current day's use only should be kept in the preparation rooms, and must be protected from flies.
All meat and other perishable foodstuffs must be consumed within twenty-four hours of issue. An exception is made in the case of meat treated in brine tubs, but in this case it must be eaten within twenty-four hours of cooking.
Tinned goods should be opened immediately prior to consumption. Tins should be closely inspected prior to opening.
Preparation of Vegetables: Vegetables will not be prepared in the same sink in which pots and pans are cleaned.
Food Scraps: Food scraps, vegetable peelings, etc., will not be thrown on the floor but deposited in a covered refuse bin provided for the purpose. In order to prevent used tea leaves being processed for incorporation in tea to be marketed, units will ensure that used tea leaves are burnt in their own fires.
Refuse Swill Bins: The contractor will completely empty the bins and clean them to the bottom daily: in the case of swill bins, they are to be emptied three times a day after meals. The bins should be scrubbed if necessary and the surroundings kept clean. The lids of bins will be kept closed.
In order that a special effort may be made to combat this disease it is thought that more interest may be taken and better results obtained if all officers, warrant officers, NCOs, and men understood how this disease is carried from one person to another, and the methods taken to prevent its spread.
It is impossible to get dysentery except through eating or drinking something contaminated by dysentery germs. In plain words it means that a person who gets dysentery has swallowed food or drink which has been defiled from a “latrine”. Hence the necessity for disinfecting the hands after using latrines.
It is most strongly emphasised that the idea that anyone coming to Egypt must get “Gippy tummy” is absolutely wrong. In many cases so-called “Gippy tummy” is mild dysentery and will not occur if the proper precautions are followed.
It is obvious, therefore, that it is a disease that can be prevented by good sanitation. The infection of dysentery is usually carried out as follows (the precautions to be taken being shown under each heading):
Contamination of Body by Dirty Hands, Flies, etc.: Only purchase food from clean sources. Avoid unlicensed hawkers. Protect food from flies and dust. See that the mess orderlies wash their hands. Do not eat any food that appears in the least way tainted. Disinfect your hands after using the latrines and before meals.
Contaminated Water, Milk, Minerals: If in the least doubt boil the water. Tea is a good safe drink. Always boil fresh milk and keep all drinks protected from flies and dust. Only use minerals from recognised Army sources. Ice is almost invariably contaminated in transport and should not be put in drink.…
Uncooked Vegetables, Salads, Fruits: In no circumstances eat uncooked green vegetables (lettuces, etc.) and onions. Eat only hard skinned fruit (except red melons) with a sound skin. Dip in boiling water for thirty seconds, or soak for one hour in “pink” solution (permanganate of potash), the strength being such that the bottom of the container cannot be seen through the solution. After soaking, rinse in tap water. Tomatoes, dates, and figs may be bought if their skin is unbroken and they are treated in a similar manner. No fruit, vegetable, or other food is to be purchased from hawkers, who are forbidden to enter the camp precincts. Egyptian cheese is stated to be unsafe. Avoid overripe fruit. Grapes must not be eaten.
Melons are safe to eat provided they are bought from a thoroughly reliable source (of which one is the Nile Cold Storage and Ice Coy.). The best type of melon is the “Chilean Black”, followed by the ordinary water melon. Melons should bear the Government stamp.
It must be emphasised that the above does not authorise the indiscriminate purchase of melons from any source.
Do not leave any refuse about to attract or allow flies to form breeding places. See that lids fit all dust-bins and keep the bins covered. page 95 See that all latrines especially those used by natives, are fly-proof. Personal investigation of this matter will cause some surprises. Protect all food from flies. Use fly-swatters and fly papers to kill the odd fly that may get into the house or barrack room.
Flies cause a spread of many diseases—not only diarrhoea and dysentery, but also cholera and typhoid fever, and diseases of the eye.
Units are responsible for the prevention of the breeding, and for the destruction of flies, within their own area.
The prevention of fly-breeding is mainly a matter of the efficient fly-proofing of latrines, and the storage of all refuse in fly-proof receptacles and the satisfactory disposal of same.
The best fly poison is a solution of formalin and sugar, placed in saucers, with a piece of bread in the middle for the fly to settle on. This solution will be prepared in bulk under the supervision of the Medical Officer in charge of the nearest medical inspection room or RAP, and issued to units as required. The solution is non-poisonous to human beings and animals. To be really successful it must be of a definite strength, and no fluid should be available with which the fly can satisfy his thirst apart from this solution.
All offices, messrooms, etc., should have some form of fly-trap.
The most efficient and easily constructed fly-trap is made by mixing together resin and castor oil, and whilst still hot, painting the mixture on sheets of tin or hoop iron or stiff wires (old telegraph wires, the wires used for binding bales of hay, etc.). These wires should have a hook at one end to hang from, and a piece of paper or cork at the bottom to prevent drips. These are hung on beams, etc. When covered with flies the wires and tins can be cleaned by burning, and then used again.
Units will arrange with the officer in medical charge of troops for instruction of their sanitary personnel in the use of sprays, preparation of castor oil and resin mixtures, and the best method of using formalin solution.
As the contamination of food is the principal danger of these parts, all food must be stored in fly-proof safes and protected from flies. It is most important to place in food safes food which is not cooked, such as bread, biscuits, cheese, jam, and sugar, and it is also necessary to provide similar receptacles for eating and drinking utensils. Fly-proof conditions should exist where food is stored, etc., prepared and consumed. It is realised that this is not fully possible, but it is the ideal to aim at.
Units must ensure that fly-proof safes are available, if necessary constructing them from scrap material obtained from the Garrison Engineer.
Everything should be done to prevent flies breeding and to reduce the fly pest. A plague of flies has a big bearing on health. Quartermasters should draw scale supplies of sprays, fly-tox, resin, oil, and swatters, etc. Every effort must be made to prevent flies from breeding and to keep all areas free of any material likely to encourage these pests.
All latrines must be boxed in. The seat and bucket type is not satisfactory.
Sanitary Police will be posted by units at all latrines from reveille to sunset:
Receptacles for disinfecting hands must not be inside latrines, but should be placed at least 30 feet from the centre of the latrine, and as near as possible to the normal route between tents and latrine. (For small latrines this distance could be reduced.) These stands should be whitewashed to facilitate location at night. The solution should be changed daily.
It will be found that hands dry very quickly in the air after immersion in the disinfectant, and no sort of discomfort is experienced.
Latrine seats must be scrubbed daily with soap and water and twice weekly with cresol solution. Buckets are cleaned by conservancy contractor after emptying. After cleaning, buckets should be wiped with pan-ol, and a trace left in the bottom. Pan-ol should be drawn from Unit QM.
The attention of all ranks is directed to the necessity of using sawdust freely in latrine pans and avoiding excess of urine in the pans by using the special urine buckets whenever possible. These measures facilitate incineration and contribute to the maintenance of a healthy camp.
In view of the prevalence of sandfly fever in this area, the following notes are published as regards certain preventive measures:
Conservancy services are carried out by a civilian contractor with native labour, and the standard of the work they render is in direct proportion to the standard desired by the unit concerned. Sanitary officers and their personnel will greatly assist in the satisfactory carrying out of the service by closely supervising the work, insisting upon punctual and regular clearing of receptacles, verifying that all refuse is properly buried (when this means of disposal is used), or properly burnt (when incinerators are provided).
The principal points of Conservancy Contract are given below for guidance:
Careful attention to the above points from the outset will help to create and maintain a satisfactory service upon which the health and comfort of all concerned depends.
Disinfectants, sump oil, fuel, etc., are obtainable.…
heat exhaustion and cramps
This condition is in a great measure due to salt loss owing to sweating. This can be prevented by supplying the following drink:
earthenware jars used for drinking water (zeers)