War Surgery and Medicine
The food problem in the Middle East and Italy was rather more a supply problem than a medical one. The basic rations had nearly all to be imported and distributed, and in the early months of 1942, following Japan's southward drive, a crisis threatened and urgent measures had to be adopted in the Middle East to expand existing sources and create new local ones. Fortunately, fresh vegetables and fruit, and sometimes eggs and meat, were more or less readily available to supplement dry rations at all times except in active campaigns in the desert. On such occasions the prolonged use of battle rations was often unavoidable, especially when troops became isolated or when lines of communication were seriously interfered with. Medical anxiety arose when troops were retained for some time on a battle ration designed for one week only. The need for mobility, freedom for fighting, the least bulk and weight in transport for non-perishable readily-prepared foods on the one hand, clashed with the need to provide high calorific, palatable, sustaining and refreshing meals.
By 1942 the problem was more generally appreciated. The ‘battle ration’ used, for example, by the Eighth Army in its attack at El Alamein had a caloric value of 3100 and, besides the basic items of biscuits and pressed meat, included cheese, jam, tinned milk, vegetables, and fish, and the ingredients for tea. The extremely efficient follow-up of supplies behind the advance, however, saved the troops from any long spells on the ‘battle ration’. The limit of ten days laid down was never exceeded. Operational rations in the Middle East showed the value of such items as dried fruits, ground nuts, boiled sweets, chocolate, and tinned fish. These items are palatable for troops living strenuous, exciting lives for a few days; they are of high caloric value, and easily carried. No cooking is required. Ingredients for a hot drink, tea in the case of British troops, should always be included in scales such as these. The mobile bakery was a valuable asset to the Division.page 725
In all routine ration scales, special care was taken to ensure adequate vitamin values. Food deficiency diseases did not occur.
Continuous training and propaganda were necessary to ensure that all units were provided with good cooks and proper company cooking arrangements, and that they developed a sense of cookhouse hygiene and sanitation. Care had to be taken to safeguard foodstuffs in transport to depots and thence to units. Fresh supplies suffer rapid deterioration in the field, and this was intensified in the conditions of heat, dust, and flies typical of a Middle East summer. The supply authorities built up a system of clean, efficient depots, and units, by education, were brought to a high standard in methods of collecting food from depots, transporting it forward, and storing it in unit areas. Food containers were improvised to carry and store fresh meat, vegetables, cereals, etc. The policy for divisional units in the line was to provide a cooked breakfast and a cooked evening meal. This was done by moving the company cookhouse as far forward as possible, and packing up by man-pack in individual haversacks a hot breakfast and a hot evening meal, usually before first light and after last light. The troops were thus assured of two good hot meals a day. This applied even to troops in Cassino. The Americans there had no cooked meals in the line. From time to time strong medical recommendations were made in regard to the preservation of vitamins in the storage and preparation of food supplies and to cleanliness in handling food.