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Sanitation in the African campaign

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Just read article in recent issue of Oxford Today (fundraising mag. of Oxford University) called "Victory and Medicine"-- contrasts extreme care taken by Brits in sanitation and health, with haphazard attitude of Germans and Italians during N. African campaign. Lots of Germans out of combat because of disease, especially among elite units; men weakened by disease, at El Alamein. Apparently, German combat officers considered such matters as sanitation beneath their dignity; the officer in charge of sanitation for the Brits observes, in a post Alamein report, that German positions were easily identifiable by the faeces strewn about them.

A suggestion for CMAK battles, then-- Axis troops' combat power should be automatically weakened by diarrhoea, etc; and various terrain mods suggest themselves.

(and I've yet to buy CMAK)

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There was something about this on QI a couple of Friday nights ago. The British Army used the experience gained in Empire building, and from the East Indian Company's troops, in realising that disaease was linked to sanitation. Hence from Napoleonic times, losses from disease were lower than many other armies.

However, I'm reading Alamein, by two blokes (can't remember), and they have just been writing about the high level of dysentry in the Eighth Army.

With this in mind, BFC should patch a v1.05 with smellovision for the correct realism.

And flies. Lots of flies.

WAV packs of soldiers thowing up in five different languages.....

Cheers

Ed

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The old "World at War" series (1970s) talked about the flies. The platoons had fly swatting contests. They would burn the heaps of flys killed. The stench of burning fly corpses was unbearable. Patch 1.05 will include a stench factor.

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The prime sanitary problem of desert warfare was jaundice and dysentery. Both Axis and Ally was affected in like scale, and both countered this with Sulfa drugs. Quick to cure, it was impossible to prevent as the bacteria present in water and carried by flies could not be defeated with contemporary medicine. Though water would be checked by special desert water units before used, the bacteria would not be discovered. DDT was used to combat flies late in the campaign, but as we know now the men did not necessarily fare well by this in the long run. Extremely contageous, there was no way (for either side) to stop spread of infection of these two diseases. Both sides simply buried fecal matter and hoped for the best. But until the end of the desert warfare, both sides suffered considerably from jaundice and dysentery.

The German army, upon advice from the Italian Colonial army as it was, reinforced the battallion medical personnel with a sanitation officer to each company (and battery). The role of this officer, who was a qualified doctor, was to continuously supervise sanitary measures and troop health, as well as issue instruction. These instructions were extremely detailed and concerned all sanitary measures from the washing of clothes and burying of excrements to the correct procedure of boiling water. And in fact forcing everyone to take a siesta.

In addition there were the divisional hygenic consultants and their bacterological labs (mot.). Assisting him was also the an additional mobile medical company (aside from the normal divisional medical units), specially equipped and trained for desert conditions.

Germans were forbidden to camp in wadis or an oasis, since both were breeding grounds for both dangerous bacteria or malaria mosquitos. However, as with the Allies (who had the same rules), military concerns assured that German (and italian) troops frequently breached this prohibition. In spite of the Atabrine tablets, malaria was a problem. This is because there are more than 100 types of malaria, most of which can still not be cured. You cannot protect yourself to this day, wash however much you like. Brits and Germans alike suffered horribly.

The British enjoyed no benefits of their longer experience of empire building. The Germans had had an African empire of their own very recently, and still had quite a number of citizens settled in Africa (still do). In addition, the italians had a wealth of experiences to share.

Northern Europeans - German or British - displayed a dropping rate of performance starting from day 1 in the desert. The Germans (like the US and French) did not believe in "breaking in" troops, and so did not allow time to acclimatise. The British did. Effects of either policy are uncertain to this day.

Both Brits and Germans believed 12 months to be maximun service time, and 6 months ideal service time, after which men should be rotated out of the theatre. Neiher side actually implemented that ideal.

Both sides intentionally tried to force enemy deployment into unsanitary regions. The defender was usually able to do this. The allies did it to the Germans at Alamein, the Axis did it to the British at Mareth. But either way, there were no regions sanitary (for Europeans) enough to prevent disease from being a problem for both sides.

The notion of German or Italian combat officers considering themselves to dignified to concern themselves with sanitation can be discarded. These were two modern armies concerned primarily with combat efficiency, quite regardless of what that entailed. Just like their opponents, they did what they deemed necessary to improve sanitary conditions, and also just like the enemy they intensely studied their foes to steal good ideas in this respect. The italians suffered some shortages in resources, making them unable to implement many of their per se good ideas.

Overall, climate terrain and weather was a bigger health problem than disease. It caused much larger amounts of temporary casualties of men.

Cheerio

Dandelion

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The sand was an aggravating factor as well. I have read many accounts that specifically mentioned it. It would get into one's clothing and shoes and cause chafing. Because of inadequate hygiene, any place where the skin was broken inevitably became infected and turned into an open, running sore if not attended to promptly, which was often impossible. Life in the desert could be quite miserable.

Michael

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Private Stan Scislowski talks about this in relation to the Italian front. There was one house that was used as a latrine by German troops before liberation by the Canadians; basically they went into the living room and crapped on the floor; there were piles of it all over, along with German magazines and newspapers.

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I once had a friend who had lived for a while in a small village in northern Italy during the 1950s. He reported that there was an old woman living there then who told him, "I was here when the Germans came through in 1917. I was here when they came though in 1943. If they come through again, I'm gonna kill myself."

Now I have a bit more insight into her motivation.

Michael

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very interesting thread guys, but the real question above, was what relation this has to the game, and should there be some sort of performance penalty.

no.

ya, sure, alot of guys were laid out from disease, festering pustules, whatever, but it has no bearing here (however interesting). the guys who are out of it, are several kilometers away, in a sick tent. the units you get, are however realatively healthy at the time, and are unlikely to keel over from dysenty in the course of the next 40 or so add minutes (however long your game is). they may tommorow, or next week, but that is irrelevent.

optionally, you could cut back the unit strength, and say start with 8 out of 12 guys per unit...if that makes you happy to believe they are sick (rather than blown away the day before).

maybe in cmxx2 we will be able to see some soiled khaki's, or steaming dung piles

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Originally posted by Macphail:

very interesting thread guys, but the real question above, was what relation this has to the game, and should there be some sort of performance penalty.

no.

Actually it should.

Dysentry (just like malaria) will affect your performance every bit as much as extreme heat or cold. That does not mean a man is excused duty because of them. Bad or insufficient gear to shelter a man from the elements is every bit as debilitating as frozen mud in the tracks. The game simulates machinery stalling because of frozen tracks etc. Just because the phenomenon does not effect mechanical stuff does not mean there should be no penalties for theses kinds of things for the infantry.

BFC will call for qualititive and quantitative data on these things of course. Trenchfoot etc causes are easier to qualify and quantify, dysentry and other related things are not. Mainly because of the "delicacy" of the issue which has left it undcumented from the annals of war.

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Isn't there a line in Aristophanes that war is "the hard one, the wet one, the one upon the legs" ? Though apparently that passage is more a reference to being incontinent in line of battle from fear rather than from disease.

I remember a former girlfriend telling me about a passage in a soldier's memoirs from the Pacific theatre in which things got so bad that he cut off the back of his pants to save time during the constant firefights.

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Originally posted by Philippe:

I remember a former girlfriend telling me about a passage in a soldier's memoirs from the Pacific theatre in which things got so bad that he cut off the back of his pants to save time during the constant firefights.

I heard this one in relation to the American soldiers in Burma. Dysentery was so rampant that with their pants cut away, when they were out on patrol all they'd have to do is take a step off the trail, squat, and let it go. That way, they could keep both hands on their rifles and their eyes on the trees.

Michael

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Originally posted by Sergei:

Sick troops can be modelled with the weakened or unfit attributes. We'll just have to hope that CMX2 will model "smell contacts"...

Yes. But which is more effective, a depleated squad or a full squad in CM ? I would imagine there were IRL squads with full complement with every member having dysentry.

The use of unfit status now in CM is a bit dodgy since it affects morale. And since soiled pants are (I imagine) commonplace in combat I doubt seeing your mates dashing for a dump, especially when you know they are dashing for a dump, does not have the same effect in morale as seeing them dashing for safety in panic.

Mind you, I have seen very few pictures of the fallen who have been killed with their pants down. Even the one(s) I have seen stated in the caption they were not killed in action.

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Originally posted by Tero:

The use of unfit status now in CM is a bit dodgy since it affects morale. And since soiled pants are (I imagine) commonplace in combat I doubt seeing your mates dashing for a dump, especially when you know they are dashing for a dump, does not have the same effect in morale as seeing them dashing for safety in panic.

Well, sick troops are probably more prone to flee in reality too. You hardly can be described as a spirited fighter when all you can think of is the functioning of your stomach and bowels.

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To Dandelion: the article is the summary of a book called "Medicine and Victory", forthcoming; it may be wrong, but I've summarised the summary of its findings-- the Brits were fastidious about hygiene ("fight the Fly Axis !" etc), and shocked by German neglect in such matters; the comment about the combat officers being too high and mighty to give a crap about crap based on interrogation of German and Italian prisoners.

The Brits were actually surprised that the Germans were so lax; they'd expected it from the Italians.

The article also has stuff on blood transfusions (Germanshad plasma but not enough blood, again neglected this aspect)-- German wounded in hospitals always shockingly pale; and, finally, penicillin.

****

A bit more than "every one poops their pants in combat", i think, is involved here.

As the Canadians say, never eat yellow snow.

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Originally posted by Sergei:

Well, sick troops are probably more prone to flee in reality too.

The guestion is are they able to flee ?

You hardly can be described as a spirited fighter when all you can think of is the functioning of your stomach and bowels.

I would imagine the Japanese had the same problems as the ANZAC's, the British and the USMC and I have never seen it mentioned they were not spirited fighters.

And as mentioned the troops deviced ways to poop while staying alert (or the other way around smile.gif ) so I think this particular aspect of the general condition of the troops did not affect the morale as much as it did their actual fighting capabilities. What would be the difference between the reload time be for a squatting man vs a prone/kneeling man ? ;)

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I think there are 2 types of CM players. (maybe more)

The boardgame generation that thinks of CM in rules and dice rolls.

The Atari to X box generation looking for something different in a RTS FPS.

Group one just wants good gameplay.

Group two wants all the toys.

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Disease can be aptly illustrated by reduced number of men in squads I think, representing absentee hospitalised cases and those with light service only. If it had been possible to make permanent a state of exhaustion, such as those available in the game, one could have illustrated whole squads hit by jaundice as well. In some phases of the campaign, disease was a crippling factor. Even though not at the levels of Burma, it deserves being illustrated IMHO.

The statistics are available from the archives, and I've seen several American military medical publications - articles and books - on the very topic, using characteristic US reader-friendly formats. Not least during the two Gulf wars. The BFC should have no problem researching at all, should they want to.

Medical information make up a good part of the German evaluation report on desert warfare as well, although not a specific medical report and not so strong on statistics.

Eg. About half the men infected with Jaundice virus (we're talking A type of course) displayed no symptoms at all. They just went around contaminating other people, until they were visibly identified as carriers (you know the excrements became...). But for those who did display symptoms performance could be reduced in varying degrees. Men were hit by nausea (possible vomiting), fever and a general - sometimes overpowering - lack of energy. Varying types of pain could be part of the parcel. All symptoms could be reduced by medication except the reduced "Leistungsfähigkeit", er, capacity or performance I guess. This could stay on for weeks or even months after recovery. Some men were thus hospitalised by jaundice, and many were allowed light service for at least a week. But most just laboured on.

Being hit by dysentery bacteria meant light fever and diarrhea. For some Europeans, notably few Italian patients (at least of those in German medical care) the diarrhea could get so severe that lifethreatening dehydration was a real risk. Either way, it will all pass in a week unless your condition is very weak. Only in extreme cases were men hospitalised, or even exempt from normal service.

Getting the Malaria organism in ones blood of course means anything from fever attacks to loss of consciousness and life. The "everythirdday shakes" typical of Malaria could be seen among both German and Italian troops (the latter including native Libyans), as well as among British POW patients.

The ordered SOP for the number two was the "spade principle". In other theatres, Germans were supposed to use the Donnerbalken, i.e. a log suspended above a ditch for collective use. This could not be done in Africa due to sanitary risks. Instead, each man had to bury his own products, thus you always brought along a spade, when doing a number two.

The British were ahead of the Germans in terms of medical science. Not only the Penicillin available to them but not the Germans (and quite a revolution in itself). The British had also found ways of synthetically producing Quinine (the supply of which was broken during the war) whereas the Germans were critically short from 1941 and onwards. Sulfa used was of better quality and far greater quantity than German stocks. And so on. German medical care at hospital level was thus not able to keep pace with the UK/US.

JTCM I read you. I hold no stakes in this debate as such, the input on German sanitary neglect and pride seem simply not to compute with my research. Nor do I understand why it could be expected that Italians be more filthy than Germans. But my interest confines itself to learning the actual procedure. We have thus far seen no coverage on the medical or otherwise sanitary organisation, resources or standards used by the British/CW armed forces. I have some myself on the US armed forces and it all seems highly similar to German procedure. But zip on the Brits. I am sincerely interested, if you can provide.

Cheerio

Dandelion

[ December 06, 2004, 11:25 AM: Message edited by: Dandelion ]

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Originally posted by Michael Emrys:

</font><blockquote>quote:</font><hr />Originally posted by Philippe:

I remember a former girlfriend telling me about a passage in a soldier's memoirs from the Pacific theatre in which things got so bad that he cut off the back of his pants to save time during the constant firefights.

I heard this one in relation to the American soldiers in Burma. Dysentery was so rampant that with their pants cut away, when they were out on patrol all they'd have to do is take a step off the trail, squat, and let it go. That way, they could keep both hands on their rifles and their eyes on the trees.

Michael </font>

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Originally posted by General Colt:

Like my mother always said:

When the conversation turns to ****

its time to QUIT.

Quite a poet that lady...

Moon, please lock this thread...

Why ? If you can discuss killing in graphic detail then you should be able to stomack discussion about bodily functions without resorting to kiddie stuff like "number one" and "number two".

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Originally posted by General Colt:

When the conversation turns to ****

its time to QUIT.

This debate revolves around disease and effects of disease on combat efficiency. And how this was handled, and how it might be illustrated in the game.

Feel free to contribute something beyond base slander of your own mother. How do you feel on the subject? Is it motivated to reduce manpower in scenarios or QBs due to disease? If so, should either side suffer more reduction than the other?

Dandelion

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