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New Zealand Medical Services in Middle East and Italy

Infectious Diseases

Infectious Diseases

Malaria was highly endemic in Syria. With many rivers and numerous swamps lying between the Lebanon and Anti-Lebanon ranges, and especially with the melting snows and swollen rivers following the severe winter, the stage was set for a high malarial incidence among New Zealand troops unless energetic measures page 324 were taken to combat the disease. To meet the situation a complete anti-malaria organisation was set up within the Division.

At the outset arrangements were made to determine the areas where malaria was most marked and to combat the danger by field operations as well as by taking full personal precautions. The spleen rate in the different villages and areas was determined and highly infected areas put out of bounds. The spleen rate varied from 4 to 92 per cent in the different villages, and a very extensive investigation was made of the whole of the area of Syria in contact with the Army. General Freyberg circulated an instruction to the Division stressing the supreme importance of precautions against the disease. Mosquito nets and repellent creams and sprays were distributed to the troops. Veils and gloves were issued to night sentries. The unbecoming ‘Bombay bloomers’ were issued, with instructions to lengthen them into slacks at sunset.

Captain J. M. Staveley was placed in charge of divisional malaria control and sent on a course to No. 2 Malaria Field Laboratory, Beirut. Two anti-malaria control units of one officer, one sergeant, and five other ranks were formed within the Division, and members from each unit also attended the Malaria Field Laboratory for training. Ten anti-malaria sections, with a civilian staff of one foreman and twenty-three labourers, worked under the supervision of, first, 4 Field Hygiene Section, and later of 4 and 6 NZ AMCUs at Baalbek and Aleppo respectively. They drained swamps and sprayed potential mosquito breeding grounds. In addition, unit squads, consisting of an NCO and three men, worked under the control of each RMO.

As a result of these measures malaria in the New Zealand Division was kept within moderate limits. A high proportion of the cases occurred in two battalions stationed on the Turkish border, beyond which no malaria control was exercised. Fortunately, the Division left Syria before the malaria season was at its peak. In June, the first month of the season, there were only sixty-two cases reported, mostly BT infection. More cases developed later in the Western Desert from infection arising in Syria, bringing the total Syrian cases to 261, from which 27 per cent of relapses was reported.

Owing to the high incidence of venereal disease in Syria, it was deemed wise to establish controlled brothels. Two were opened in Aleppo and two in Baalbek, under the control of DAPM NZ Division, and PA treatment centres were established in each brothel by 6 and 4 Field Ambulances in the respective towns. Arrangements were made for the examination by medical officers of prostitutes by ‘snap’ inspections every second day, cervical and urethral smears were examined weekly, and blood tests carried out monthly. The page 325 field ambulances co-operated with DAPM NZ Division in the questioning of VD patients regarding the source of infection and the tracking down of infected prostitutes. This strict supervision was singularly effective and resulted in a remarkably low incidence of venereal disease among New Zealand troops in Syria. Most of the few cases which did occur followed infection contracted from prostitutes in Beirut and Damascus.

Sandfly fever was present to a moderate degree. There were a small number of cases of dysentery and diarrhoea and a few cases of infective hepatitis and measles. The small number of relapsing fever cases investigated at the CCS were treated successfully with injections of NAB. Typhoid and paratyphoid fevers were endemic in Aleppo but only one case was reported in the Division.

Diseases reported in the Division in Syria were:

April May June
Diarrhoea 17 50 116
Dysentery 15 39 68
Sandfly fever 1 88 214
Malaria 2 17 62
Venereal disease 9 8 4