We must be prepared to meet malaria by training as strict and earnest as that against enemy troopsField Marshal Viscount Sir Archibald Wavell
Commander in Chief of British Forces in Burma, 1943
Help us remember the forgotten history of those who served in the Far East
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What measures did the Fourteenth Army take against sickness?
The first line of defence was prevention and troops were asked to take a number fo measures to protect themselves.
Measures used to try prevent disease and sickness
- Draining pools of standing water
- Spraying of adult insects with insecticide
- Water sterilisation.
- Mosquito repellents; creams and oil of citronella
- Mosquito nets
- Hammocks – raised off ground reduced bites from ticks and mites carrying typhus
- Long trousers
- Arm-covering gauntlets
- Sufficient supply of anti-malarial drugs (doses taken regularly for set time period)
The most popular anti-malarial drug of choice up until the 1940s. Derived from the bark of the cinchona tree. The majority of the world’s quinine was supplied by the Dutch, but the German occupation of the Netherlands, and the Japanese occupation of the Philippines and Indonesia meant the Allies had drastically reduced supplies. This put pressure on developing synthetic alternatives.
An alternative to quinine, extremely effective if taken regularly as prescribed. It was a suppressant and treated the individual once they had been infected by the parasite. Rumours abounded that the drug caused impotence and other side effects meant it was not popular. A yellow pill, it also gave the men a yellow hue.
How effective were the prevention methods?
In practical terms, it was difficult to employ full prevention measures when the army was in retreat, under siege or advancing through jungle. Not all kit was carried or used regularly by the men.
The monsoon season (May to October) was problematic. Increasing the mosquito population, cases of Malaria peaked during and just after the rainy season.
Misinformation was a significant issue as men were reluctant to take medication as they feared rumoured side-effects.
Bad morale was also a problem. Contracting an illness meant evacuation away from the frontline. Until the men actually caught malaria, for many wishing to be removed, they actively did not use the correct precautions.
The Fourteenth Army was hampered with shortages. For example, not all men had mosquito nets or necessary medical equipment or drugs. There was also a significant shortage of doctors.
Even if kit was available, the combined weight of hammocks and mosquito nets was 7lbs and men were unwilling to carry the extra weight.
In practical terms, mosquito veils impaired vision and were therefore unpopular.
And it was difficult to exit hammocks in an emergency, therefore these were reserved for the injured and seriously ill.
Reducing the sickness rate
In 1942, the sickness casualty rate was unsustainable. General Slim, head of the Fourteenth Army identified four measures to dramatically reduce sickness amongst his men.
Application of latest medical research for prevention and treatment
Mepacrine – the anti-malarial drug issued to the British and Indian armies was proven to be the most effective, provided it was taken correctly. Slim insisted unit commanders ensured troops took the correct dosage. To demonstrate how serious the issue was he sacked three officers who failed to comply.
Education was another important factor – convincing the men the drug would not cause impotence etc. Stronger emphasis on hygiene and sanitation during jungle warfare training.
Anti-Malaria Units surveyed proposed camping grounds, spreading oil on breeding grounds and spraying camps and surroundings with insecticide.
Improve treatment of troops at front – instead of evacuation to India
Malaria Forward Treatment Units (MFTUs) were field hospitals based a few miles from the front line. Each unit could treat 600 people at a time. By administering drugs within 24 hours of an attack a soldier could return to fighting within several weeks, rather
Evacuation by air of serious casualties to free space in front area
Allied air supremacy over Burma aided evacuation along with provision of American air ambulances. Air evacuation was problematic in rainy season.
Retreating in face of a remarkable Japanese advance had a big negative impact on morale of the Fourteenth Army.
The British invested in the welfare and entertainment of the men in the Far East. Working to improve rations, provide entertainment through performers (ENSA performances) and availability of radio programmes etc.