military hygiene and sanitation essay

Perspective
Open access
Published: 07 April 2020

Fit to fight – from military hygiene to wellbeing in the British Army

Martin C. M. Bricknell 1 &
Colonel David A. Ross 2

Military Medical Research volume 7 , Article number: 18 ( 2020 ) Cite this article

10k Accesses

15 Altmetric

Metrics details

This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from ‘hygiene’ through to ‘wellbeing’. It starts by considering the health of the army in the mid-nineteenth century and the emergence of military hygiene as a professional subject. It continues by looking at advances in military hygiene in the two world wars. Hygiene was replaced by the term ‘health’ in the 1950s as the collective noun used by professionals working in this field. This unity split when the professions of occupational medicine and public health established separate faculties and training pathways. However, the health issues for the armed forces remain fundamentally unchanged. Going forward, the term ‘wellbeing’ is helping to refresh the close relationships between executives, their medical advisers and those within the population of health professions charged with keeping the British Army healthy. The core theme is the collaborations between civil society, executive leadership and medical services in maximizing the health of the military population from recruitment through to life as a veteran.

This paper reviews the evolution of the conceptual framework for sustaining the health of the British Army as an occupational group from the introduction of military ‘hygiene’ in the middle of the nineteenth century to that of ‘wellbeing’ in the early twenty-first century. This evolution is based on the story of the British Army. However, this does not mean that a similar story is less important in either the Royal Navy or the Royal Air Force. Indeed, since the establishment of a tri-service Surgeon General in 1990, this narrative has become framed around the health of armed forces personnel. This description of the evolution of thinking about the health of a defined population mirrors the evolution of the thinking and language used for global health, especially from a ‘hygienic’ approach to protecting the health of a population, through to the improvement of health by social and political interventions alongside the improvement of health services [ 1 ].

The historical journey starts with the emergence of the speciality of military hygiene and its influence on the public health movement in the United Kingdom. Next, the current study will consider the public health innovations that arose from strategic concern over the quality of the nations’ manpower for the army prior to World War I. Experiences in World War I and World War II led to the emergence of ‘health’ as an attribute for military capability based on a holistic perspective of the performance of soldiers within a physical and social environment. This holistic view of ‘army health’ lasted until the early 1970s, when civilian industrial medicine and social medicine became separate medical specialities of occupational medicine and community medicine (and later of public health). This separation split the professional training of specialist army health doctors into either occupational medicine or public health. Since the 1990s, medical services have become more Joint and Defence in their orientation. The health of the armed forces continues to be of strategic importance, and the current paper will close by discussing the emergence of thinking about ‘health and wellbeing’ for armed forces personnel and veterans through collaborations across the government, between the armed services and within healthcare professions. The core theme of the current study is the collaboration between civil society, executive leadership and medical services in maximizing the health of the military population from recruitment through to life as a veteran.

Military health and hygiene in the nineteenth century

The story of the ravages of disease experienced by the British Army during the Crimean War (1853–1856) and the role of Florence Nightingale to bring this experience to the attention of the British government and the public is widely recognized. Less well known is the impact of disease on the army in garrisons both abroad and in England. In 1858, a Royal Commission led by Sidney Herbert (Secretary of State for War and a close friend of Florence Nightingale) published a report on the health of the army. This report showed that the mortality of soldiers stationed in England was 17.5 / 1000 people-year, which was substantially greater than the mortality rate of the general adult male population at 9.2 / 1000 people-year [ 2 ]. Even more surprising, the mortality of the army when garrisoned in England was nearly one-third greater than that of the army when it was stationed at Sevastopol, Crimea, in 1856 (at 12.5 / 1000 people-year). It was demonstrated through statistical analysis that substantial savings in army manpower could be attained by improving the health of the army through better hygiene, better army hospitals and better-trained army doctors. The report made wide-ranging recommendations for the improvement in the organization and management of the Army Medical Services, army hospitals, and the education of army medical officers in military medicine and hygiene. This report made the health of soldiers into a political and executive issue rather than solely a medical issue.

Edmund Parkes - the first professor of military hygiene

There was a substantial reform of the Army Medical Services over the course of the second half of the nineteenth century. This reform included the creation of the Army Medical School in 1860 at Fort Pitt in Chatham (which became the Royal Army Medical College, Millbank, in 1907). The school was endowed with three professors: one of clinical and military medicine, one of clinical and military surgery, and one of sanitary science and military hygiene. The appointment of Edmund Parkes as the first Professor of Military Hygiene became one of the most important innovations in the education of military medical personnel. Parkes joined the army at the age of 22 and served for 3 years before establishing himself in private practice in London and University College. In 1855, he was sent to Turkey and established a military hospital at Renkoi based on a prefabricated structure that was designed and manufactured by Isambard Kingdom Brunel [ 3 ].

After his appointment, Parkes wrote the Manual of Practical Hygiene that had influence across the public health movement in the UK and overseas [ 4 ]. The manual’s preface highlighted the altered position of the army medical officer because of changes to the Queen’s Hospital regulations in 1859 [ 5 ]. ‘Previously, the Army Surgeon had been entrusted officially merely with the care of the sick…..(now) he is ordered to advise commanding officers in all matters affecting the health of troops, whether as regards garrisons, stations, camps and barracks, or diet, clothing, drill, duties or exercises’ . This is the epitome of occupational medicine. In the introduction, Parkes defines hygiene as the ‘..art of preserving health; that is, of obtaining the most perfect action of body and mind during as long a period as is consistent with the laws of life. In other words, it aims at rendering growth more perfect, decay less rapid, life more vigorous, death more remote’ . This is the epitome of public health.

The introduction continues by stating that ‘..in many cases, the employer of labour finds that, by proper sanitary care of his men, he reaps at once an advantage in better and more zealous work, in fewer interruptions from ill-health so that his apparent outlay is more than compensated. This is shown in the strongest light by the Army. The State employs a large number of men, whom it places under its own social and sanitary conditions. It removes from them much of the self-control with regard to hygienic rules which other men possess and is therefore bound by every principle of honest and fair contract to see that these men are in no way injured by its system. But more than this: it is as much bound by its self-interest. It has been proved over and over again that nothing is so costly in all ways as disease and nothing is so remunerative as is the outlay which augments health, and in doing so, augments the amount and value of the work done’ . These three quotes provide enduring social and economic arguments for protecting the health of soldiers in the army and show the interrelationship between the modern clinical specialities of occupational medicine and public health in advising on the health of army personnel.

This focus on military hygiene reduced all-cause admissions to hospitals per thousand strength from 1060 in the 1870s to 1020 in the 1880s, 850 in the 1890s, and 500 in the first decade of the twentieth century [ 6 ]. By the time of his death in 1876, Parkes had established the importance of hygiene within the military and of the contribution of military hygiene experts within the wider public sector alongside the civilian Medical Officers of Health in towns and cities. Teaching military hygiene now had equal status to military medicine and surgery.

The health of the public and its impact on the health of the Army

The army faced many challenges during the Boer War in South Africa (1899–1902) both in trauma care and preventive medicine. However, the requirement to mobilize the manpower of Great Britain for the war also exposed the very poor standards of health amongst the civilian male population. This resulted in very high rates of rejection for military service. Such was the concern that Parliament set up a Committee on Physical Deterioration ‘to determine, with the aid of such counsel as the medical profession are able to give; the steps that should be taken to furnish the Government and the Nation at large with periodical data for an accurate comparative estimate of the health and physique of the people; to determine generally the causes of such physical deterioration as does exist in certain classes; and to point out the means by which it can be most effectually diminished’ [ 7 ]. This report made 53 recommendations, many of which are recognizable as public health and industrial health improvements that persist today. These recommendations included a national anthropometric survey of the population; the medical examination of school children, factory workers and coal miners; the training of mothers in the domestic economy (which became Health Visiting); and health education and sport as part of the school curriculum. The army continued with the progress of sanitary reform after the Boer War. In 1904, training in basic hygiene was added to the curriculum for officer training, and the Army School of Sanitation was established in 1906. There was considerable technical progress in subjects such as water purification, the ‘hygiene of the march’ and immunization against infectious disease [ 8 ]. Institutional knowledge was codified as the Manual of Elementary Military Hygiene, published by the War Office in 1912 [ 9 ]. Thus, by the beginning of World War I, the public health movement had unified the importance of both the health of the population to be recruited into the army and the maintenance of the health of soldiers once in the army.

World War I – hygiene at scale

The substantial role played by military hygiene in keeping the mobilized armed forces fit for military operations during World War I was summarized in 1924 by Colonel Anderson, who was a professor of hygiene at the Royal Army Medical College [ 10 ]. This experience led to a greater understanding of infectious diseases such as typhus, relapsing fever, cerebrospinal fever, and influenza and the prevention of these diseases by setting standards for accommodation, sanitation and cleanliness. These standards also included the education and training of individual soldiers in ‘sanitary habits’ [ 11 ]. Many aspects of military hygiene were transferred to civil society. The work to define the food and energy requirements for soldiers on the march was used by the Food (War) Committee of the Royal Society to determine the rationing requirements for the civil population. The requirement for preserved military rations led to the development of pasteurization and canned food. The subject of medical topography, which we would now call travel health, emerged from the requirement to analyse the potential impact of endemic medical disease on military forces. Finally, the Chemical Warfare Medical Committee, under the chairmanship of the first Director of Military Hygiene, Colonel Sir William Horrocks, supervised the development of protective equipment and medical treatments for gas warfare, which could be considered a very specific branch of industrial hygiene. This momentum was maintained during the inter-war years through the creation of an Army Hygiene Directorate in 1919 and an Army Hygiene Advisory Committee comprised of military and civilian experts. In 1922, a hygiene specialist was appointed to the staff of the Army School of Physical Training to carry out research and advise on the physiology of exercise [ 12 ]. This knowledge was consolidated through the publication of the Manual of Army Hygiene and Sanitation in 1934 [ 13 ].

In his presidential address of 1922 to the Navy, Army and Air Force groups of the civilian Society of Medical Officers of Health, Major General Sir William Macpherson [ 14 ] summarized military hygiene as ‘the maintenance of physical fitness, physical training, the hygiene ‘of the march’, the relationship between food and energy and camp sanitation ’. He also highlighted other subjects in military hygiene that have equal importance in civilian life, such as the prevention of epidemics and the preservation of health in communities living in close contact with one another. Major-General Beveridge [ 15 ], in his presidential address to the same body a year later, compared military hygiene and public health as follows: ‘Public health, as applied to the civil community, is concerned with the individual during the whole period of life, but in the fighting services it is chiefly concerned, for all practical purposes with selected personnel during a certain period of life’ . This close relationship between the practice of hygiene in the army and civilian practice by members of the Society of Medical Officers of Health continued through the twentieth century as the professional body evolved into the Faculty of Community Medicine in 1973.

World War II – hygiene to health

In World War II, military hygiene continued to be critically important in ensuring the health of the army both in the UK and in operations across the world, notably extending from physical health to mental and social health. There were advances in the application of science to hygiene, for example, the introduction of chemoprophylaxis against malaria, the use of dichloro-diphenyl-trichloroethane (DDT) as an insecticide, and the use of penicillin in the control of sexually transmitted disease [ 16 ]. Lessons from the contribution of hygiene to winning the campaign in the Middle East were incorporated into the preparation of the 21st Army Group to fight in Northern Europe. Field Marshall Montgomery is quoted as saying that ‘the men of 21 Army Group were fully immunised and fully trained; their morale was at its highest; they were well clothed and well fed; they were fighting in a climate to which the average British soldier is well accustomed; hygiene, both personal and unit, was exceptionally good; welfare services were well organised. The exhilarating effect of success also played a role in reducing rates of sickness’ [ 17 ].

The opening section of the chapter on the Army Medical Services in the volume of Principal Medical Lessons of the Second World War describes how the concept of the nature of health was enlarged to encompass much more than just the physical functioning of the single individual. ‘ It came to be recognised that disharmony between the individual and the conditions and circumstances that obtained within the community was the cause of much ill-health and so the search for causation became extended from the physical to the social environment of individuals and groups’ [ 18 ]. This social perspective on health was also strongly championed by General Sir Ronald Forbes Adam, the Adjutant-General (head of personnel for the British Army), alongside medical services. He directed the development of aptitude selection based on psychological tests and physical tests and introduced the concept of the demobilized soldier as a returning citizen member of the nation. The experience of preventive medicine in World War II also re-emphasized the responsibilities of commanders to ensure that the recommendations of their medical advisers were implemented alongside the developments in hygiene measures by the Army Medical Services [ 19 ].

Army Health – 1950s - organization

In addition to the widening of the outlook in the attainment of physical and mental health in the British Army, it was also felt that the term ‘hygiene’ had become restricted to the field of sanitation rather than the earlier broad ‘health’ perspective. Therefore, in 1950, the Directorate of Army Hygiene became the Directorate of Army Health [ 20 ] within the Army Medical Directorate of the War Office. The Army Health Advisory Committee (comprising leading civilian authorities on public health, malariology, physiology, nutrition, and statistics) continued to provide external advice. The directorate was responsible for leading the Army Health Organisation [ 21 ]. Senior staff officers were graded as specialists in Army Health with civilian public health qualifications. The majority also attained a Diploma in Tropical Medicine and Hygiene that was jointly taught by the Royal Army Medical College and the London School of Hygiene and Tropical Medicine. Postgraduate education for medical officers in Army Health was delivered through the Army Health Department of the Royal Army Medical College, and non-professional training was provided by the Army School of Health to members of the Royal Army Medical Corps (RAMC), non-RAMC officers and other ranks. King’s Regulations and Army Council Instructions continued to place the primary responsibility for the health of the army upon the chain of command. Senior leaders of medical services framed this as the welding together of the traditional art of man-management and the modern scientific methods of disease control into the so-called ‘health discipline’ [ 22 ].

Organizing health education was one of the primary tasks of specialists in Army Health. To aid them in this task, new films dealing with personal and communal hygiene were released in 1950, and Mobile Health Training Teams were set up. A great deal of thought was given to the various educational techniques involved. A new pamphlet was produced to help the individual soldier, Your Health and You [ 23 ]. The lessons of World War II were incorporated into the Handbook of Army Health [ 24 ] for non-specialists and into the Manual of Army Health for specialists [ 25 ]. The importance and interdisciplinary nature of Army Health continued to be championed during the 1960s. In an article in the Journal of the Royal Army Medical Corps , Colonel Lewis (Professor of Army Health) stated that ‘to select military personnel in accordance with high physical and mental standards, to subject them to long and expensive training, and then to dissipate a large portion of this human treasure in non-productive man-hours wasted through preventable ill-health is uneconomical, to say the least; and, when manpower resources are limited the issue is nationally vital (…) the successful practice of Army Health calls for team-work in which everyone in the Army, irrespective of regiment, corps, trade; grade, mode of employment and rank has a part to play’ [ 26 ]. These observations echo the social and economic arguments about military hygiene made by Parkes almost a century earlier.

Army Health separation into Public Health and Occupational Medicine in the 1970s

This integrated Army Health Organisation continued until the late 1970s, when postgraduate professional training for medical officers in the RAMC was formally structured into general practice, hospital specialities and a new grouping, namely, Army Community and Occupational Medicine (ACOM). Doctors in this third stream were required to qualify for Membership of the Faculty of Community Medicine or Occupational Medicine [ 27 ]. ACOM changed to Army Public Health and Occupational Medicine (APHOM) when the Faculty of Community Medicine was renamed the Faculty of Public Health in 1989 [ 28 ]. Slowly, the professional training routes for Army Health doctors split, despite the considerable overlap of their roles as preventive medicine or health specialists [ 29 ]. Consultants in each speciality were quite public in their views of the differences in their professional knowledge [ 30 ]. The postgraduate medical training route for both specialities followed the discrete civilian faculty models with a blend of military and civilian experience [ 31 ]. This led to the demise of the dual-speciality education course at the Royal Army Medical College and the competition to label the previous health posts as either public health or occupational medicine [ 32 ]. An Army Health research capability was created by the formation of the Army Personnel Research Establishment in 1965 [ 33 ]. This developed into the Army Occupational Health Research Unit in the 1980s that was manned by occupational physicians. It was disestablished when QuinetiQ was formed from the Defence Evaluation and Research Agency in 2001 with its military manpower being incorporated into the Army Health Unit in the Army Medical Directorate in the early 2000s.

Occupational medicine in the military has become a more clinical speciality, as army general practitioners and hospital specialists have become less closely associated with army personnel in their workplace [ 34 ]. This has also led to the creation of military occupational health (OH) nurses in a model that partially mirrors civilian practice. Public health has become a central staff function, with posts in the Joint Medical Group and the service commands [ 35 ]. This separation of medical specialties has also distanced the environmental health care from a ‘military health’ identity. Indeed, a review of occupational health in the armed forces published in 2009 did not mention the relationship between occupational health and the specialities of public health or environmental health [ 36 ]. Thus, the unifying identity of ‘Army Health’ became disaggregated during the 1980s into the early 2000s as the individual professions aligned to their separate identities in the civilian sector.

Current issues in military health and wellbeing across the military life course

Many issues in military health remain the same as those of the nineteenth century, though the context has changed (and deaths in the barracks are very rare!). The 2017 Francois Report of a review of recruiting for the armed forces stated, ‘At present, over 90% of individuals who are failed when attempting to join the Armed Forces do so on medical grounds [ 37 ] ’. This has raised concerns about the physical and mental health of the recruitable population and the thresholds at which those with a pre-existing medical condition are excluded. At the other end of military service, the rate of medical discharge in the armed forces attracts attention because the two primary causes, musculoskeletal injury and mental ill health, are perceived to be preventable. Mental health in the armed forces and the veteran community has had particular political and media prominence, with the House of Commons Defence Committee conducting an inquiry into mental health in the armed forces and veterans from 2017 to 2019 [ 38 ]. Preventive medicine continues to be scrutinized, with legal cases pending on the anti-malarial Mefloquine, Q fever, non-freezing cold injury and noise-induced hearing loss.

The integration of professional knowledge from all health specialities to promote health and prevent disease for the military population has been re-emphasized over the last decade. The Defence Medical Services Top Structures review in 2008/2009 introduced a life-course approach to force health protection and the preparation of armed forces personnel for military operations. This starts at the stage of recruitment from the civil population through to understanding the long-term health effects of military service amongst Veterans and takes place on a ‘continuum of care’ [ 39 ]. The three services of the Royal Navy, the British Army and the Royal Air Force continue to promote wellbeing and healthy living through education during entry training and periodic mandatory additional training. Briefings on keeping healthy are included within pre-deployment training for military operations. There are active research programmes on physical fitness, diet, mental health and other dimensions of health in the military.

The military medical services remain empowered as advisers on health to the executives, with structural collaboration between the personnel and the medical function. In the evolution from ‘hygiene’ to ‘health’, the term ‘wellbeing’ has become preferable to that of ‘health’ to further emphasize the contribution of all other stakeholders in supporting armed forces personnel to maximize their physical, mental and social potential. The Defence Mental Health and Wellbeing Strategy, launched in 2017, described the role of the Defence Health and Wellbeing Board to bring coherence across Defence [ 40 ]. There are subordinate groups with the responsibility for lifestyles, injury prevention, preventive health and mental health. This shift is also occurring within civilian occupational medicine [ 41 ] and other military medical services [ 42 ]. In the army, the Director of Personnel for the Army is supported by a Senior Health Advisor (Army) as the most senior medical services officer. The Head of the Royal Navy Medical Service is the medical adviser to the Navy Board, and the Head of the Royal Air Force Medical Services is also the medical adviser to the Air Force Board [ 43 ]. Outside the Ministry of Defence, the National Health Service (NHS) Long-term Plan seeks to give people more control over their own health and to invest in more NHS prevention services [ 44 ]. The plan also includes a specific section on NHS services for armed forces personnel and veterans. The UK government has recently established an Office for Veterans Affairs to coordinate activities and existing funding to ensure that ex-service people get access to medical treatment, training and housing to meet their unique health needs [ 45 ].

Conclusions

This paper has described the enduring importance of physical, mental and social health and wellbeing amongst army personnel as a key enabler of military capability. Although the language has changed (from ‘hygiene to ‘health’ and then to ‘wellbeing’), the core issues regarding the health of the British Army remain. The scourge of infectious disease in garrison in the 1800s has been addressed by improvements in housing, sanitation and wider public health measures such that mortality in the army population is no longer an issue. However, the quality of the health of the civilian population for entry into the army remains a concern, although the modern issue is obesity and poor physical conditioning rather than malnutrition. Non-medical, military leaders continue to emphasize the promotion and maximization of health for serving military personnel to support the personnel component of military capability. The current subject areas of lifestyles, injury prevention, preventive health and mental health are similar to those listed by Parkes in the late nineteenth century. The media and the wider public maintain an interest in how government services meet the health needs of the armed forces and military veterans. There has been a recent refreshing of the close relationship between military health and wider civilian public and occupational health. This paper has also demonstrated the requirement for a cadre of military health professionals with a combination of public health, occupational health and environmental health competencies who can provide technical advice that informs policies, procedures and practices in the promotion and protection of the health of the military population. This paper has focused on experiences in the UK, especially those of the British Army. It would be interesting to compare these results with other nations’ military medical experiences.

Availability of data and materials

Not applicable.

Abbreviations

Army Community and Occupational Medicine

Army Public Health and Occupational Medicine

National Health Service

Occupational health

Royal Army Medical Corps

Bashford A. Global biopolitics and the history of world health. Hist Hum Sci. 2006;19:67–88.

Article Google Scholar

Commissioners R. Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded: with evidence and appendix. Br Foreign Med Chir Rev. 1858;21(42):424–43.

Google Scholar

Rosen G, Edmund A. Parkes in the development of hygiene. J R Army Med Corps. 1976;122(4):187–91.

Gordon JL. Department of Army Health. J R Army Med Corps. 1961;107:23–30.

CAS PubMed Google Scholar

Parkes EA. A manual of practical hygiene. London: J. & A. Churchill; 1864.

Melville CH. Military hygiene and sanitation: a retrospect. J R Army Med Corps. 1927;48(1):24–37.

Great Britain War Office. Report of the inter-departmental committee on physical deterioration. London: HM Stationery Office; 1904.

Thompson SV. Fearsome enemy (1); a history of sanitation in the British Army 1899-1914. J R Army Med Corps. 1998;144(3):166–71.

Article CAS Google Scholar

Great Britain War Office. Manual of elementary military hygiene. London: HM Stationery Office; 1912.

Anderson JA. The recent trend of military hygiene. J R Army Med Corps. 1924;43:27–42.

Daukes SH. The teaching of Army hygiene as an aid to military efficiency. J R Army Med Corps. 1920;35(1):10–24.

Henderson PH. Some milestones of achievements in army hygiene and a few suggestions for future progress. J R Army Med Corps. 1935;64(1):1–16.

Great Britain War Office. Army manual of hygiene and sanitation. London: HM Stationery Office; 1934.

Macpherson WG. The influence of military service on hygiene. J R Army Med Corps. 1923;40(3):161–76.

Beveridge WWO. A brief review of the progress of military hygiene since the war. J R Army Med Corps. 1924;42(3):187–205.

Campbell DJ. Venereal diseases in the armed forces overseas-2. Br J Vener Dis. 1946;22(4):158–68.

CAS PubMed PubMed Central Google Scholar

Hunter M. Hygiene problems of the campaign in North West Europe-1944-45: a review. J R Army Med Corps. 1947;88:1–21.

MacNalty AS, Mellor WF. Medical services in war: the principal medical lessons of the second world war; based on the official medical histories of the United Kingdom, Canada, Australia, New Zealand and India. London: HM Stationery Office; 1968.

Richmond AE. Fifty years of hygiene in the British Army. J R Army Med Corps. 1948;90(6):233–46.

Editorial. Army health. J R Army Med Corps 1950;94(6):279–280.

Scott RW. The British Army health organization. J R Army Med Corps. 1951;97:172–6.

Cantlie N. Health discipline. J R Army Med Corps. 1950;94:316–20.

Great Britain War Office. Your health and you. London: HM Stationery Office; 1950.

Great Britain War Office. Handbook of Army health. London: HM Stationery Office; 1950.

Great Britain War Office. Manual of Army health. London: HM Stationery Office; 1959.

Lewis MM. Army health training and practice. J R Army Med Corps. 1966;112(1):78–84.

Editorial. A new speciality. J R Army Med Corps. 1979;125:57.

Warren MD. The creation of the Faculty of Community Medicine (now the Faculty of Public Health Medicine) of the Royal Colleges of physicians of the United Kingdom. J Public Health Med. 1997;19(1):93–105.

Finnegan TP. Wither diplomatosis! — whither APHOM? J R Army Med Corps. 1993;139:87.

Wade AJ. Diploma in the sports medicine for doctors only. J R Army Med Corps. 1994;140:99–101.

Macmillan AHM. A career in public health medicine. J R Army Med Corps. 2002;148:172–5.

Braithwaite M, Cooper N. Part 1-occupational medicine & army aviation medicine. The doctors who assess groups as well as individuals. J R Army Med Corps. 2001;147(2):210–4.

Finnegan TP. In search of health - the RAMC contribution to APRE. J R Army Med Corps. 1995;141(3):125–6.

Owen J. Occupational health development in the army. J R Army Med Corps. 2001;147(3):264–7.

Ross DA, Pudney RL, Macmillan AM. A public health in the defence medical services. J R Army Med Corps. 2008;154(4):265–7.

Braithwaite M, Nicholson G, Thornton R, Jones D, Simpson R, McLoughin D, et al. Armed forces occupational health—a review. Occup Med. 2009;59(8):528–38.

Francois M. Filling the ranks. Report presented to the prime minister. 2017; https://www.markfrancois.com/filling-ranks . .

House of Commons Defence Committee. Mental health and the Armed Forces, part two: the provision of care. London: House of Commons; 2019.

Ross DA. Preventive medicine in the 21st century - a population challenge. J R Army Med Corps. 2012;158(2):77–8.

Ministry of Defence. Defence people mental health and wellbeing strategy 2017–2022. London: Ministry of Defence; 2017.

Napier J. The future of occupational health – building wellbeing into organisational life. Society of Occupational Medicine. 2019; https://www.som.org.uk/sites/som.org.uk/files/The_Future_of_OH_building_wellbeing_into_organisational_life.pdf . .

Dorrance KA, Robbins DA, Kimsey L, LaRochelle JS, Durning S. Toward a national conversation on health: disruptive intervention and the transformation from health care to health. Mil Med. 2018;183(Suppl 3):193–7.

DMS. Defence Medical Services. https://www.gov.uk/government/groups/defence-medical-services .Accessed 1 Jul 2019.

NHS. NHS Long Term Plan. Department of Health. Available at: https://www.longtermplan.nhs.uk/ . Accessed 1 Jul 2019.

Cabinet Office. Government kickstarts Office for Veterans’ Affairs with £5m funding. https://www.gov.uk/government/news/government-kickstarts-office-for-veterans-affairs-with-5m-funding . .

Download references

Acknowledgements

Author information, authors and affiliations.

Health and Military Medicine, Conflict and Health Research Group, School of Security Studies, King’s College London, Strand Campus, London, WC2R 2LS, UK

Martin C. M. Bricknell

Parkes Professor of Preventive Medicine, Robertson House, Camberley, GU15 4NA, UK

Colonel David A. Ross

You can also search for this author in PubMed Google Scholar

Contributions

MB was the primary author. DR provided a comprehensive review and significant additional material. All authors read and approved the final manuscript.

Authors’ information

Lt. Gen. (Rtd.) Professor Martin CM Bricknell retired from the post of Surgeon General of the UK Defence Medical Services in April 2019. He is trained in public health, occupational medicine and general practice and has extensive operational experience.

Colonel David A Ross is the Defence Consultant Adviser in Public Health in the UK Defence Medical Services and holds the Parkes Professorship in Preventive Medicine.

Corresponding author

Correspondence to Martin C. M. Bricknell .

Ethics declarations

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare that they have no competing interests.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Bricknell, M.C.M., Ross, C.D.A. Fit to fight – from military hygiene to wellbeing in the British Army. Military Med Res 7 , 18 (2020). https://doi.org/10.1186/s40779-020-00248-6

Download citation

Received : 17 September 2019

Accepted : 31 March 2020

Published : 07 April 2020

DOI : https://doi.org/10.1186/s40779-020-00248-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Public health
Occupational medicine

Military Medical Research

ISSN: 2054-9369

Submission enquiries: Access here and click Contact Us
General enquiries: [email protected]

Fit to fight – from military hygiene to wellbeing in the British Army

December 2020
Military Medical Research 7(1)

King's College London
This person is not on ResearchGate, or hasn't claimed this research yet.

Discover the world's research

25+ million members
160+ million publication pages
2.3+ billion citations
Guang-Dong Liu
Hai-Ming Wang
Yun-Dai Chen
Thomas Falconer Hall
MCM Bricknell

Beverly P Bergman

Jill P. Pell
Kevin A Dorrance
Dennis A Robbins

T. P. Finnegan
George Rosen
M. M. Lewis
PUBLIC HEALTH
Major-General William Macpherson

M BEVERIDGE

Proc Roy Soc Med
P H Henderson
J A Anderson
Recruit researchers
Join for free
Login Email Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password? Keep me logged in Log in or Continue with Google Welcome back! Please log in. Email · Hint Tip: Most researchers use their institutional email address as their ResearchGate login Password Forgot password? Keep me logged in Log in or Continue with Google No account? Sign up

Log in using your username and password

Search More Search for this keyword Advanced search
Latest content
Current issue
For authors
BMJ Journals

Statistics from Altmetric.com

Request permissions.

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

This is a PDF-only article. The first page of the PDF of this article appears above.

Read the full text or download the PDF:

Personal Hygiene in the Military

The topic of personal hygiene is one of the most controversial yet crucial topics that applies to all and sundry. It encompasses the basic cleanliness routines of hand and body wash, cleanliness of clothes, footwear and other personal effects that surround an individual such beddings and towels. It is expected that each and every individual regardless of age, sex, profession, social class and culture lives in a hygienic manner not only for their sake but also for that of the people around them.

If this sample essay on "Personal Hygiene in the Military" doesn’t help, our writers will!

Military personnel play quite an important role in the defense and protection of their jurisdictions and most of the time put their lives on the line in service of their respective nations. It is important to note that most of these military officers are deployed in areas with harsh conditions hence making it very difficult for them to maintain a high standard of hygiene as compared to when they stay in their normal non-deployment residential areas.

Some of the common deployment zones are extreme and usually include very cold alpine conditions, very hot desert areas, those with no water supply and regions that are unfavorable to basic cleanliness such as taking regular showers, maintaining a regular change of clothes and keeping sleeping quarters clean. In some harsh weather, unexpected rainfall can soak soldier encampments while in other scenarios the soldiers may even be living in defensive bunkers which make it difficult for them to carry out practices such as regular washing of garment cloths and body parts and proper drying techniques. The result is that most soldier garrisons have unfavorable stench with the soldiers characteristically exhibiting poor personal hygiene. Congestion is also a key factor that contributes to poor personal hygiene as soldiers in overcrowded facilities are likely to be infected with communicable respiratory, alimentary and dermatologic diseases.

Basic hygiene practices involve the proper drying of moist surfaces since they might attract bacterial and fungal infections. The main reason behind this is that most microbes reproduce in moist environments hence spreading infections. Military personnel are advised to properly wash and dry specific body parts due to their susceptible nature. Emphasis lies on: genital areas, feet, between thighs, armpits and between the buttocks. Talcum powder is advisable for use in places where wetness is a problem such as between the thighs and under the breast in females. Loose fitted clothing should thus be worn so as to ensure adequate ventilation. Nylon and silk undergarments should not be worn in humid environments (Headquarters, Department of The Army and Commandant, Marine Corps, 41).

Casualty rates are also reduced by proper personal hygiene among soldiers in combat regions. Most warfare zones have poor sanitation conditions hence high probability of mortality when a soldier is wounded during battle. It is a common occurrence that medical supplies are limited in nature due to the strained capability to deliver and replenish used medical supplies. As such, wounded soldiers may develop septic wounds that are easily contaminated if they do not maintain proper personal hygiene. Normally, it is common practice to take regular showers and change beddings, bandages and clothes all in a bid to ensure fast recovery and save the lives of wounded soldiers.

Studies have shown that poor personal hygiene usually results in psychological disorders as the individual is not able to focus and pay keen attention to the military mission at hand (Weyant ,9-10). An individual in such an unclean environment is easily distracted by the events going on in the environment and cannot act in pinpoint precision required of soldiers on a mission. The result is that the soldiers have a high probability of making mistakes that are very costly in terms of both human life and property. The individual thus risks their own life and that of their military unit when they cannot function at peak concentration hence putting other soldiers at risk of death.

In some instances, a soldier with poor personal hygiene is likely to be easily irritable and hence little provocation can degenerate into a violent confrontation with their colleagues. The ensuing bad blood usually manifests as arguments, brawls and even fights among soldiers who are on the same team and are tasked with accomplishing a planned mission. Such negativity hinders cohesion among soldiers and this impairs teamwork and their ability to achieve success in their planned objectives.

A military unit is likely to isolate a soldier whom they deem unhygienic and sideline such an individual making them feel not listened to and not part of the team. Therefore, it is expected that such an individual does not feel part of the close knit military unit and the stigma drives them to become loners who cannot interact properly with other team members.

From this standpoint, it is critical that soldiers maintain clean surroundings and sanitation of items that they use in their day to day lives. One cannot overlook the importance of personal hygiene on the saving of soldiers lives from contaminable wounds and equally important on cohesion within their military teams and units.

Works Cited

BIBLIOGRAPHY Headquarters ,Department Of The Army And Commandant, Marine Corps . Field Hygiene And Sanitation. Washington, DC: United States Army, 2000. Electronic.

Weyant, R. "Interventions based on psychological principles improve adherence to oral hygiene instructions." J Evid Based Dent Pract. (2009): 9-10. Web.

If you are the original author of this essay and no longer wish to have it published on the SuperbGrade website, please click below to request its removal:

Improving a Battalion
Status of Airline Partnerships and Viability of Strategic Alliances
Trends in the Airline Industry Partnerships
Requirements Gathering and Elicitation of DC-1
The Role of the Federal Aviation Administration in Fulfilling the Requirements of the ICAO

Submit your request

Sorry, but it's not possible to copy the text due to security reasons.

Would you like to get this essay by email?

Sorry, you can’t copy this text :(

Enter your email to get this essay sample.

Don’t print this from here

Enter your email and we'll send you a properly formatted printable version of this essay right away.

How about making it original at only $7.00/page

Let us edit it for you at only $7.00 to make it 100% original!

We’re fighting to restore access to 500,000+ books in court this week. Join us!

Internet Archive Audio

This Just In
Grateful Dead
Old Time Radio
78 RPMs and Cylinder Recordings
Audio Books & Poetry
Computers, Technology and Science
Music, Arts & Culture
News & Public Affairs
Spirituality & Religion
Radio News Archive

Flickr Commons
Occupy Wall Street Flickr
NASA Images
Solar System Collection
Ames Research Center

All Software
Old School Emulation
MS-DOS Games
Historical Software
Classic PC Games
Software Library
Kodi Archive and Support File
Vintage Software
CD-ROM Software
CD-ROM Software Library
Software Sites
Tucows Software Library
Shareware CD-ROMs
Software Capsules Compilation
CD-ROM Images
ZX Spectrum
DOOM Level CD

Smithsonian Libraries
FEDLINK (US)
Lincoln Collection
American Libraries
Canadian Libraries
Universal Library
Project Gutenberg
Children's Library
Biodiversity Heritage Library
Books by Language
Additional Collections

Prelinger Archives
Democracy Now!
Occupy Wall Street
TV NSA Clip Library
Animation & Cartoons
Arts & Music
Computers & Technology
Cultural & Academic Films
Ephemeral Films
Sports Videos
Videogame Videos
Youth Media

Search the history of over 866 billion web pages on the Internet.

Mobile Apps

Wayback Machine (iOS)
Wayback Machine (Android)

Browser Extensions

Archive-it subscription.

Explore the Collections
Build Collections

Save Page Now

Capture a web page as it appears now for use as a trusted citation in the future.

Please enter a valid web address

Donate Donate icon An illustration of a heart shape

A textbook of military hygiene and sanitation

Bookreader item preview, share or embed this item, flag this item for.

Graphic Violence
Explicit Sexual Content
Hate Speech
Misinformation/Disinformation
Marketing/Phishing/Advertising
Misleading/Inaccurate/Missing Metadata

NO COPYRIGHT PAGE

plus-circle Add Review comment Reviews

Download options.

For users with print-disabilities

IN COLLECTIONS

Uploaded by [email protected] on March 23, 2017

Fit to fight – from military hygiene to wellbeing in the British Army

Martin c. m. bricknell.

1 Health and Military Medicine, Conflict and Health Research Group, School of Security Studies, King’s College London, Strand Campus, London, WC2R 2LS UK

Colonel David A. Ross

2 Parkes Professor of Preventive Medicine, Robertson House, Camberley, GU15 4NA UK

Associated Data

Not applicable.

Military health and hygiene in the nineteenth century

Edmund Parkes - the first professor of military hygiene

The health of the public and its impact on the health of the Army

World War I – hygiene at scale

World War II – hygiene to health

Army Health – 1950s - organization

Army Health separation into Public Health and Occupational Medicine in the 1970s

Current issues in military health and wellbeing across the military life course

Conclusions

Acknowledgements

Abbreviations.

ACOM	Army Community and Occupational Medicine
APHOM	Army Public Health and Occupational Medicine
NHS	National Health Service
OH	Occupational health
RAMC	Royal Army Medical Corps

Authors’ contributions

MB was the primary author. DR provided a comprehensive review and significant additional material. All authors read and approved the final manuscript.

Authors’ information

Colonel David A Ross is the Defence Consultant Adviser in Public Health in the UK Defence Medical Services and holds the Parkes Professorship in Preventive Medicine.

Availability of data and materials

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare that they have no competing interests.

Contributor Information

Martin C. M. Bricknell, Email: [email protected] .

Colonel David A. Ross, Email: ku.tenretnitb@forPsekraP .

24/7 writing help on your phone

To install StudyMoose App tap and then “Add to Home Screen”

Personal Hygiene in the Army

Save to my list

Remove from my list

Personal Hygiene in the Army. (2016, May 24). Retrieved from https://studymoose.com/personal-hygiene-in-the-army-essay

"Personal Hygiene in the Army." StudyMoose , 24 May 2016, https://studymoose.com/personal-hygiene-in-the-army-essay

StudyMoose. (2016). Personal Hygiene in the Army . [Online]. Available at: https://studymoose.com/personal-hygiene-in-the-army-essay [Accessed: 11 Jul. 2024]

"Personal Hygiene in the Army." StudyMoose, May 24, 2016. Accessed July 11, 2024. https://studymoose.com/personal-hygiene-in-the-army-essay

"Personal Hygiene in the Army," StudyMoose , 24-May-2016. [Online]. Available: https://studymoose.com/personal-hygiene-in-the-army-essay. [Accessed: 11-Jul-2024]

StudyMoose. (2016). Personal Hygiene in the Army . [Online]. Available at: https://studymoose.com/personal-hygiene-in-the-army-essay [Accessed: 11-Jul-2024]

Personal Hygiene Pages: 4 (1092 words)
Personal Hygiene and Sanitation Pages: 7 (1867 words)
Maintain Personal Hygiene Pages: 3 (800 words)
Personal Hygiene: Why it is important Pages: 7 (1875 words)
Personal Care, Hygiene, and Grooming Pages: 13 (3604 words)
Story Of An Army Man: Desire To Be An Army Officer Pages: 7 (1926 words)
Hygiene and Cleanliness Pages: 11 (3293 words)
Principles of Supporting an Individual to Maintain Hygiene Pages: 5 (1478 words)
Hygiene and Hand Washing Pages: 8 (2211 words)
The Sanitation and Hygiene of Street Food Vendors Pages: 20 (5924 words)

👋 Hi! I’m your smart assistant Amy!

Don’t know where to start? Type your requirements and I’ll connect you to an academic expert within 3 minutes.

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

We're Hiring!
Help Center

Sanitation, Health and Hygiene during World War 1

This paper analyses the crisis and the condition of public health, sanitation and hygiene in four countries of the World War 1, including UK, USA, Ottoman Empire and Germany.

Related Papers

Melanie S Tanielian

Elina Gugliuzzo

The aim of this paper is to understand the sanitary policies adopted by the Ottoman Empire during the recurring outbreaks of plague in a comparative perspective. When the Black Death first arrived, Constantinople was still part of the Byzantine empire and the Ottomans were a small Anatolian group. This was followed by three phases of plague activity from the time the Ottoman’s conquered Constantinople, renaming it Istanbul.

Javier Abellán

We still don’t have a truly European history of modern water supply and sanitation services. The existing literature on this topic can be characterized by a national or local scope. We try to offer a descriptive account of the key developments in water supply and sanitation services in nineteenth- and twentieth-century Europe following a transnational approach. Four periods are identified. Between 1800 and 1830, urbanization set the perfect environment for the spread of contagious diseases. In 1830-1850, contemporaries began to give importance to an appropriate water management system due to the spread of cholera. In the period ranging from 1850 to 1870 the first large infrastructures were built, but they only reached the affluent districts of large cities. From the 1870s onwards, the public sector took a leading role and extended the access to water and sanitation services to the whole population.

Daniel Gallardo-Albarran

Clean water provision is considered crucial towards eradicating water-borne diseases. However, the benefits of piped water are limited in the absence of efficient systems of waste disposal due to recontamination or the exposure of citizens to excrement. In this article, I analyse the historical experience of German cities and estimate the impact of water supply and sewerage systems on mortality. The results show that waterworks lowered mortality, although to a lower extent than suggested previously. I observe a much stronger effect of sanitary interventions in cities that also established sewerage systems. Together they explain 19 percent of the overall mortality decline during this period. Three pieces of evidence show that the limited effects of waterworks is related to illnesses spread via faecal-oral transmission mechanisms. First, sanitary infrastructures account for a quarter of the decline in infant mortality, which is largely affected by water-borne ailments. Second, I find a large effect for enteric-related illnesses, while deaths from etiologies with a different pathological basis are not affected. Finally, the estimated effect is related exclusively to the sanitary interventions because mortality only declines significantly after their completion, and not before.

Hygiea Internationalis An Interdisciplinary Journal for the History of Public Health

Nermin Ersoy

Benoit Pouget

American Journal of Public Health

Lisa Haushofer

World War II created a large group of persecuted, homeless or stateless people who came to be united under the term “displaced persons” (DPs). The United Nations Relief and Rehabilitation Administration (UNRRA) was charged with the care of these individuals in various camps in Germany, although the military governments of the respective zones of occupation had ultimate authority over them. Among the various public health efforts directed toward DPs was a campaign against venereal disease during which compulsory examinations were particularly stressed by the military governments. The controversy resulting from this campaign opens a new window on the complex context of an international organization working under the roof of a national authority to achieve common—or differing—public health goals.

Public Health

Robert Atenstaedt

Background: The aim of this study, which evaluated historical data, was to delineate the probable impacts of infectious diseases on human populations under extraordinary circumstances. The second goal was to disclose the mortality rates for infectious diseases in the absence of antibiotics. Methods: The Third Ottoman Army records at the Turkish General Staff Military History and Strategic Study Directorate were studied retrospectively for the period between March 1915 and February 1916. Results: For the Third Ottoman Army, the number of infection-related deaths over the single-year period was 23,601. Malaria, relapsing fever and dysentery were the most common infections. In that pre-antibiotic era, the highest mortality rates were seen for cholera (80%), pulmonary tuberculosis (58%) and typhoid fever (51%). However, typhus had the maximum share in soldier deaths (6053 soldiers). The rate of vector-borne infections peaked in the summer of 1915, while the frequency of respiratory tract infections was highest in the colder months. In contrast, gastrointestinal tract infections appeared to maintain a steady state throughout the year. Conclusions: If the wartime data for 1915 are accepted to provide a model for extraordinary circumstances in the 21 st century, vector-borne, respiratory tract and gastrointestinal infections can be accepted as the challenging issues with signifi cant mortality.

Theodorou Vassiliki

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

RELATED PAPERS

Theodorou Vassiliki , Despina Karakatsani

Anna Mazanik

PLoS Medicine

Claudia Stein

Maggie Black , Ben Fawcett

Dynamis Acta Hispanica Ad Medicinae Scientiarumque Historiam Illustrandam

Despina Karakatsani

Paramita: Historical Studies Journal

Kiki Maulana Affandi

Ronald Waldman

Hakan Ertin

Acta medico-historica adriatica : AMHA

Ana Alebić-Juretić

American Journal of Infection Control

Philippe Hartemann

Dave Hamlin

Eugenia Tognotti

Enrique Barreiro

Historical Journal

Valeska Huber

Acta historica universitatis Klaipedensis

Aistis Zalnora

Nuran Yıldırım

International Journal of Community Medicine and Public Health

Valentine Belfiglio

Water History

Constantin Ardeleanu

Ahmet C. Başustaoğlu, Sadık Emre Karakuş; "The fight against typhus in the Ottoman Army during WWI." Microbiology Australia 35.3 (2014): 148-152.

Sadık Emre Karakuş

Nihon ishigaku zasshi. [Journal of Japanese history of medicine]

Christopher Aldous

Clarissa Brocklehurst

Christian Promitzer

Christopher S Rose

International Journal of Middle East Studies

Jennifer L Derr

GAZA / HYGIENE SUPPLIES SHORTAGE

You need to first accept the terms and conditions before download.

Subject to the Terms of usage of UNifeed , UNifeed materials are available free of charge for news purposes only. UNifeed materials may not be sold or redistributed to third parties without the prior written consent of the UN or the UN entity which is source of the UNifeed material. All users of UNifeed materials must provide due credit to the United Nations or any UN entity source(s) in their use and broadcast of UNifeed materials.

Type	Language	Format	Size
Video	Original	HD NTSC	627797.00	Download
Video	Original	HD PAL	627609.00	Download
Video	Original	SD PAL	627830.00	Download

STORY: GAZA / HYGIENE SUPPLIES SHORTAGE TRT: 4:28 SOURCE: UN NEWS RESTRICTIONS: NONE LANGUAGE: ARABIC / NATS

DATELINE: 06 JULY 2024, AL-RASHID STREET, WEST OF DEIR AL-BALAH CITY, CENTRAL GAZA STRIP

1. Various shots, tents where displaced people stay 2. Various shots, Al-Taluli family washing clothes 3. SOUNDBITE (Arabic) Muhammad Al-Talouli, displaced person from East Al-Bureij Camp, Central Gaza Strip: “We suffer from lack of cleaning supplies. There is no soap, detergent or anything. I mean, the price of soap, even if it is available in the Gaza Strip, we cannot buy it. The price of the scented soap is 25 shekels. I don't have 25 shekels to buy soap, and I don't have 25 shekels to buy laundry detergent. They say that the crossing is closed. We ask people outside to open the crossing and bring us the things we need, including soap, cleaning supplies and other things.”

4. SOUNDBITE (Arabic) Sabah Al-Talouli, Al-Talouli’s wife: “We have absolutely nothing. I swear to God, I don't have money to buy food, let alone buy a bottle of shampoo or soap. It's a very bad situation. I have lice in my hair due to lack of soap. I am an adult woman, I have never had lice, but due to lack of soap I have lice. Has this ever happened, my brother. An adult woman brushes her hair and lice come out of it. Why? Due to the lack of necessary supplies, no one takes care of us.”

5. Various shots, market in the city of Deir al-Balah

6. SOUNDBITE (Arabic) Ayham Bashir, a resident of the city of Al-Balah:

“The lack of personal hygiene is apparent on the bodies of all the people in all governorates of Gaza, because there are no cleaning supplies or soap. There is nothing. You find nothing to wash your hands.” 7. Various shots, market in the city of Deir al-Balah 8. SOUNDBITE (Arabic) Nasser Al-Kurdi, displaced from Al-Bureij Camp, Central Gaza Strip: “Even the soap we bathe with does not exist, the shampoo does not exist. Epidemics and diseases have spread among people and among children. A very terrible thing. It is all a small area. The whole of Gaza does not accommodate 2.5 million people. Imagine when they confine the residents to Deir El-Balah and Khan Younis and place two million people in this area. The person who sneezes in Deir El-Balah could be heard in Khan Yunis. Diseases spread at a very fast rate. When you go to the pharmacy to get medicine, they tell you that there is an alternative that may or may not work for you.” 9. Various shots, Al-Sayed working at his cleaning supplies store 10. SOUNDBITE (Arabic) Kenan Al-Sayed, Owner of a Cleaning Supplies Store: “The entry of the dyes has also stopped. We are using food dyes instead of the original dyes for liquid soap. In addition, many things have been interrupted, so we have found an alternative for them. With the closure of the crossings, the entry of supplies to us has stopped.” 11. Various shots, Al-Sayed working at his cleaning supplies store

Due to the lack of clean water and personal hygiene materials, infectious diseases are spreading amongst displaced people in Gaza.

The Al-Taluli family are displaced from East Al-Bureij Camp to the west of Deir al-Balah in the middle of the Gaza Strip.

Muhammad Al-Talouli said, “We suffer from lack of cleaning supplies. There is no soap, detergent or anything. I mean, the price of soap, even if it is available in the Gaza Strip, we cannot buy it. The price of the scented soap is 25 shekels. I don't have 25 shekels to buy soap, and I don't have 25 shekels to buy laundry detergent. They say that the crossing is closed. We ask people outside to open the crossing and bring us the things we need, including soap, cleaning supplies and other things.”

Sabah, Al-Talouli’s wife said, “We have absolutely nothing. I swear to God, I don't have money to buy food, let alone buy a bottle of shampoo or soap. It's a very bad situation.”

Sabah added, "I have lice infested in my head due to the lack of soap."

In the main market of the city of Deir al-Balah, people cannot find any types of cleaning materials available.

Aiham Basheer, a resident of the city of Deir Al-Balah, said that he searched the market to buy cleaning supplies and did not find anything.

He said, “The lack of personal hygiene is apparent on the bodies of all the people in all governorates of Gaza, because there are no cleaning supplies or soap. There is nothing. You find nothing to wash your hands.”

Nasser Al-Kurdi, displaced from Al-Bureij Camp, said, “Epidemics and diseases have spread among people and among children. A very terrible thing. It is all a small area. The whole of Gaza does not accommodate 2.5 million people. Imagine when they confine the residents to Deir El-Balah and Khan Younis and place two million people in this area. The person who sneezes in Deir El-Balah could be heard in Khan Yunis. Diseases spread at a very fast rate. When you go to the pharmacy to get medicine, they tell you that there is an alternative that may or may not work for you.”

In the same market, Kenan Al-Sayed works on manufacturing alternative and primitive cleaning materials to overcome the problem of the shortage of cleaning materials.

He said, “The entry of the dyes has also stopped. We are using food dyes instead of the original dyes for liquid soap. In addition, many things have been interrupted, so we have found an alternative for them. With the closure of the crossings, the entry of supplies to us has stopped.”

GAZA / HUMANITARIAN CRISIS

UN / GAZA UPDATE

UNICEF / GAZA CHILDREN WATER ACCESS

UN / GAZA HUMANITARIAN

WHO / GAZA FOOD UTILIZATION

WHO / GAZA AL NASSER HOSPITAL

WHO / GAZA MEDICAL SUPPLIES

WHO / GAZA KHAN YOUNIS HOSPITAL

WHO / GAZA RAFAH DISPLACEMENT

Download PDF
Share X Facebook Email LinkedIn
Permissions

A Text-Book of Military Hygiene and Sanitation.

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

The author is professor of military hygiene in the United States Military Academy, West Point. As a guide to the layman who takes service in a medical corps the book may be considered as meeting the requirements. It throws in for good measure a chapter on alcohol and narcotics which cannot harm and may do good. The physician who accepts army work should know what the book contains in order that he may be able to correlate his work to the best advantage with that of other officers.

A Text-Book of Military Hygiene and Sanitation. JAMA. 1914;LXIII(25):2253. doi:10.1001/jama.1914.02570250083040

Manage citations:

Artificial Intelligence Resource Center

Cardiology in JAMA : Read the Latest

Browse and subscribe to JAMA Network podcasts!

Others Also Liked

Select your interests.

Customize your JAMA Network experience by selecting one or more topics from the list below.

Academic Medicine
Acid Base, Electrolytes, Fluids
Allergy and Clinical Immunology
American Indian or Alaska Natives
Anesthesiology
Anticoagulation
Art and Images in Psychiatry
Artificial Intelligence
Assisted Reproduction
Bleeding and Transfusion
Caring for the Critically Ill Patient
Challenges in Clinical Electrocardiography
Climate and Health
Climate Change
Clinical Challenge
Clinical Decision Support
Clinical Implications of Basic Neuroscience
Clinical Pharmacy and Pharmacology
Complementary and Alternative Medicine
Consensus Statements
Coronavirus (COVID-19)
Critical Care Medicine
Cultural Competency
Dental Medicine
Dermatology
Diabetes and Endocrinology
Diagnostic Test Interpretation
Drug Development
Electronic Health Records
Emergency Medicine
End of Life, Hospice, Palliative Care
Environmental Health
Equity, Diversity, and Inclusion
Facial Plastic Surgery
Gastroenterology and Hepatology
Genetics and Genomics
Genomics and Precision Health
Global Health
Guide to Statistics and Methods
Hair Disorders
Health Care Delivery Models
Health Care Economics, Insurance, Payment
Health Care Quality
Health Care Reform
Health Care Safety
Health Care Workforce
Health Disparities
Health Inequities
Health Policy
Health Systems Science
History of Medicine
Hypertension
Images in Neurology
Implementation Science
Infectious Diseases
Innovations in Health Care Delivery
JAMA Infographic
Law and Medicine
Leading Change
Less is More
LGBTQIA Medicine
Lifestyle Behaviors
Medical Coding
Medical Devices and Equipment
Medical Education
Medical Education and Training
Medical Journals and Publishing
Mobile Health and Telemedicine
Narrative Medicine
Neuroscience and Psychiatry
Notable Notes
Nutrition, Obesity, Exercise
Obstetrics and Gynecology
Occupational Health
Ophthalmology
Orthopedics
Otolaryngology
Pain Medicine
Palliative Care
Pathology and Laboratory Medicine
Patient Care
Patient Information
Performance Improvement
Performance Measures
Perioperative Care and Consultation
Pharmacoeconomics
Pharmacoepidemiology
Pharmacogenetics
Pharmacy and Clinical Pharmacology
Physical Medicine and Rehabilitation
Physical Therapy
Physician Leadership
Population Health
Primary Care
Professional Well-being
Professionalism
Psychiatry and Behavioral Health
Public Health
Pulmonary Medicine
Regulatory Agencies
Reproductive Health
Research, Methods, Statistics
Resuscitation
Rheumatology
Risk Management
Scientific Discovery and the Future of Medicine
Shared Decision Making and Communication
Sleep Medicine
Sports Medicine
Stem Cell Transplantation
Substance Use and Addiction Medicine
Surgical Innovation
Surgical Pearls
Teachable Moment
Technology and Finance
The Art of JAMA
The Arts and Medicine
The Rational Clinical Examination
Tobacco and e-Cigarettes
Translational Medicine
Trauma and Injury
Treatment Adherence
Ultrasonography
Users' Guide to the Medical Literature
Vaccination
Venous Thromboembolism
Veterans Health
Women's Health
Workflow and Process
Wound Care, Infection, Healing
Register for email alerts with links to free full-text articles
Access PDFs of free articles
Manage your interests
Save searches and receive search alerts

Schools ‘bombed-out’ in latest Gaza escalation, says UNRWA chief

A bombed-out school provides some shelter to a family in Khan Younis, Gaza.

Facebook Twitter Print Email

Amid reports of intensified heavy shelling in north, central and southern Gaza, the head of the UN agency for Palestine refugees, UNRWA, confirmed on Wednesday that schools-turned-shelters have been “bombed-out” as a result of the latest escalation.

“ Four schools hit in the last four days. Since the war began, two thirds of UNRWA schools in Gaza have been hit, some were bombed out, many severely damaged,” said Philippe Lazzarini, in a post on X.

In a statement posted on Tuesday, the Israeli military said it had been targeting “terrorist infrastructure and terrorist operatives” in Gaza City.

On Tuesday, at least 25 people were killed after an Israeli strike near a school building sheltering displaced Gazans in eastern Khan Younis, southern Gaza, according to the enclave’s health authorities.

On Saturday, another strike left at least 16 dead at an UNRWA school in Nuseirat, central Gaza, followed a day later by a hit on a school in Gaza City that was reportedly sheltering hundreds of people.

Further Israeli strikes on Monday were reported on or near an UNRWA school in Nuseirat, UNRWA Director of Communications Juliette Touma told UN News .

No safe place

“This is becoming commonplace; only in the past four days we've seen four schools come under attack,” she said. Every time a school is hit “dozens of people pay the price.”

The UN agency – the largest humanitarian operator in Gaza - closed all of its schools when war erupted on 7 October in response to Hamas-led attacks on multiple targets in southern Israel that left some 1,250 dead and more than 250 taken hostage.

“We've turned the vast majority of them into shelters and at some point we had one million people staying in our schools,” Ms. Touma explained, adding that of the casualties from the latest school strikes, “many” were women and children.

Since the war began, more than half of UNRWA’s facilities - the vast majority of them schools - have been hit.

“Some were completely bombed out and are out of commission”, Ms. Touma continued, adding that since the war began, at least 600,000 children have seen their schools close.

Lost generation

“In the case of UNRWA most of them were used as shelters, but what this means is that if this war continues, we are on the verge of losing a whole generation of children,” she continued.

“The longer children stay out of school, the more difficult it is for them to catch up on education losses; the higher the risk that they fall prey to exploitation, including child labour, child marriage, but also recruitment into armed groups, and recruitment into the fighting. So it is for the sake of those children that we must have a ceasefire”.

In response to allegations that the schools were being used by Hamas fighters or affiliates, the UNRWA official insisted that no UN facility should be used for military purposes, before reiterating repeated calls by the Commissioner-General for “independent inquiries and investigations into all these very serious claims”.

“Civilian infrastructure, including schools, including shelters, including other facilities like health, clinics, or hospitals, must be protected at all times, including in times of conflict,” Ms. Touma insisted.

Rising toll

In a related development, the UN sexual reproduction agency, UNFPA , warned that the humanitarian situation in Gaza continues to worsen, with “severe suffering” now the norm.

Citing Gazan health authorities, UNFPA said that nearly 38,000 Palestinians have now been killed and more than 87,000 injured , with food, shelter, health and livelihood resources all “critically low”.

Across the enclave some 1.9 million people remain forcibly uprooted by the conflict – often repeatedly - and evacuation orders issued by the Israeli military.

Gazans live in “tents, overcrowded shelters, or on the streets without basic necessities”, the UN agency said, pointing to widespread feelings of hopelessness by people “with little prospect of returning home or ending the conflict”.

Lifesaving supplies blocked

“Severe obstacles” in ensuring that humanitarian aid can reach those who need it continue to hamper the relief operation, the UNFPA situation update noted, listing “crossing point closures and bureaucratic hurdles impeding life-saving assistance”.

Problems associated with the breakdown in law and order in Gaza has also increased theft and violence, endangering humanitarian workers and their operations, according to the UN agency.

In addition, doctors continue to report rising numbers of preterm and low-birth-weight babies, “indicators of severe malnutrition exacerbated by stress and fear among pregnant women” UNFPA said, while also highlighting the high risk of gender-based violence (GBV) faced by women and adolescent girls, “particularly those displaced, widowed, or unaccompanied”.

Aid successes

Despite the challenges, UNFPA has distributed essential sexual reproductive health and GBV services in Gaza and the West Bank.

The UN agency and partners have also established two maternal health units for emergency births, provided menstrual hygiene products to thousands of women and girls and supported mobile medical points and deployed sexual and reproductive health teams to shelters.

Donate to the humanitarian response in Gaza

IMAGES

Personal Hygiene in the Army Free Essay Example
Text-Book of Military Hygiene and Sanitation by Frank R. Keefer
Books & Manuals US WWI Elementary Military Hygiene & Sanitation Manual
13-HYGIENE-AND-SANITATION.docx
MILITARY-HYGIENE-AND-SANITATION-ACTIVITY.docx
A text-book of military hygiene and sanitation : Keefer, Frank R., b

VIDEO

CBRN-övningen RECCEX 2012
Essay on Importance of Hygiene
How Marines Maintain Hygiene During Cold Weather Operations
All Military Women Cheat/ Women With Bad Hygiene/ Don't Take Women Serious in the Military
Qusai's story from Gaza
Florence Nightingale & Modern Nursing #awareness #history #crimea #hospital #humanity #usa #facts

COMMENTS

Personal hygiene among military personnel: developing and testing a
Good personal hygiene (PH) behavior is recommended to prevent contagious diseases, and members of military forces may be at high risk for contracting contagious diseases. The aim of this study was to develop and test a new questionnaire on PH for soldiers.Participants ...
Fit to fight
This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from 'hygiene' through to 'wellbeing'. It starts by considering the health of the army in the mid-nineteenth century and the emergence of military hygiene as a professional subject. It continues by looking at advances in military hygiene in the two world ...
PDF Field Hygiene: Intersection of Training, Readiness, Leadership and
Field hygiene for the most part is an individual Soldier responsibility. Not to be conflated with field sanitation or handwashing before chow, field hygiene often occurs as the fourth priority of work. However, it frequently consists of hoping to have time to brush your teeth and shaving with uncomfortably cold water - primarily so the command sergeant major does not find you unshaven in the ...
PDF MCRP 4-11.1D Field Hygiene and Sanitation
Permitting poor personal hygiene or sanitation practices by food handlers. Example: Not washing hands after using the latrine; improperly washing and sanitizing all cooking utensils.
from military hygiene to wellbeing in the British Army
This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from 'hygiene' through to 'wellbeing'. It starts by considering ...
PDF FIELD HYGIENE AND SANITATION
The material presented in this publication reflects enduring practices of field hygiene, sanitation, and preventive medicine measures. Implementation of these techniques and procedures enable commanders to preserve the health of their Soldiers in order for them to accomplish the units' mission.
Military Hygiene and Sanitation : a Retrospect, by Colonel C. H
Military Hygiene and Sanitation : a Retrospect, by Colonel C. H. MELVILLE, C.M.G., M.B., late R.A. Med. Corps, lately Professor of Hygiene, R.A. Med. College.
Military Hygiene
This article is taken from the material tween hygiene and sanitation in military life.
Field Hygiene and Sanitation
Field hygiene and sanitation are two facets of military medicine that seek to ensure reduction of casualties through avoidance of non-combat related health issues among military personnel, particularly in the prevention of disease. As such, it encompasses prevention of communicable diseases; promotes personal hygiene; ensures adequate field water supply; supervises food sanitation; administers ...
Military Hygiene and Sanitation: A Retrospect
This is a PDF-only article. The first page of the PDF of this article appears above.
Military Hygiene and Sanitation.
The author then takes up the topics in the logical order, beginning with sanitary organizations, and the recruit, physical training, marching, food, the ration, water-supply, ventilation, disposal of waste matters, clothing, equipment, prevention of infectious diseases, and disinfection, and closes with a short chapter on sanitation of the ...
A Text-book of Military Hygiene and Sanitation
military, hygiene, alcohol, disease, dntzerlbygoogk, disposal, physical, sanitary, men, military hygiene, physical training, preventable diseases, typhoid fever, personal hygiene, olive drab, google sanitation, public health, field service, venereal diseases
PDF Microsoft Word
One study in a military population decreased lost-duty time due to acute respiratory infections with an effective hand hygiene program.
A text-book of military hygiene and sanitation
Evidence reported by judyjordan for item textbookofmilita00keefrich on August 8, 2007: visible notice of copyright; stated date is 1914. 305 p. 21 cm
Personal Hygiene in the Military Free Essay ...
Basic hygiene practices involve the proper drying of moist surfaces since they might attract bacterial and fungal infections. The main reason behind this is that most microbes reproduce in moist environments hence spreading infections. Military personnel are advised to properly wash and dry specific body parts due to their susceptible nature.
A textbook of military hygiene and sanitation
A textbook of military hygiene and sanitation 305 pages : 21 cm
Sanitation and Hygiene in The Great War
The following lecture on Sanitation and Hygiene is taken from the book, "Military Organisation and Administration" published by Major G. R. N. Collins, 4th. Battn. Canadians Instructor, Canadian Military School, in 1918. Major Collins was incapacitated from general service in the field and was appointed to the Canadian Military School where he gave lectures to several thousands of Officers of ...
Fit to fight
This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from 'hygiene' through to 'wellbeing'. It starts by considering the health of the army in the mid-nineteenth century and the emergence of military hygiene as a professional subject.
Personal Hygiene in the Army Free Essay Example
As with all aspects of military sanitation, commanding officers were responsible for enforcement of the provisions concerning personal hygiene. The Medical Department was to conduct inspections and recommend appropriate action to correct deficiencies.
Sanitation, Health and Hygiene during World War 1
This paper analyses the crisis and the condition of public health, sanitation and hygiene in four countries of the World War 1, including UK, USA, Ottoman Empire and Germany.
13-HYGIENE-AND-SANITATION.docx
ROTC MS 1: MILITARY KNOWLEDGE MODULE HYGIENE AND SANITATION OBJECTIVES: At the end of this module, you will be able to: 1. Understand the rules of personal hygiene; 2. Understand the rules of cleanliness and sanitation which soldiers should follow to keep and maintain camps; 3. Understand the methods of waste disposal; 4. Understand the Eight (8) Water Contaminants and How to Stop them; and 5 ...
Microsoft Word
99 One study One study in in a a military military population population decreased decreased lost-duty lost-duty time time due due to to acute acute respiratory respiratory infections infections with with an an effective effective hand hand hygiene hygiene program. program.
GAZA / HYGIENE SUPPLIES SHORTAGE
Due to the lack of clean water and personal hygiene materials, infectious diseases are spreading amongst displaced people in Gaza. UN NEWS
A Text-Book of Military Hygiene and Sanitation.
The author is professor of military hygiene in the United States Military Academy, West Point. As a guide to the layman who takes service in a medical corps the book may be considered as meeting the requirements. It throws in for good measure a chapter on alcohol and narcotics which cannot harm and...
Schools 'bombed-out' in latest Gaza escalation, says UNRWA chief
"Four schools hit in the last four days. Since the war began, two thirds of UNRWA schools in Gaza have been hit, some were bombed out, many severely damaged," said Philippe Lazzarini, in a post on X.. In a statement posted on Tuesday, the Israeli military said it had been targeting "terrorist infrastructure and terrorist operatives" in Gaza City.

Fit to fight – from military hygiene to wellbeing in the British Army

Military health and hygiene in the nineteenth century

Edmund Parkes - the first professor of military hygiene

The health of the public and its impact on the health of the Army

World War I – hygiene at scale

World War II – hygiene to health

Army Health – 1950s - organization

Army Health separation into Public Health and Occupational Medicine in the 1970s

Current issues in military health and wellbeing across the military life course

Conclusions

Availability of data and materials

Abbreviations

Acknowledgements

Contributions

Authors’ information

Corresponding author

Ethics declarations

Rights and permissions

About this article

Share this article

Military Medical Research

Fit to fight – from military hygiene to wellbeing in the British Army

Log in using your username and password

You are here

Statistics from Altmetric.com

Read the full text or download the PDF:

Personal Hygiene in the Military

Don’t print this from here

Internet Archive Audio

Mobile Apps

Browser Extensions

Save Page Now

A textbook of military hygiene and sanitation

plus-circle Add Review comment Reviews

IN COLLECTIONS

SIMILAR ITEMS (based on metadata)

Fit to fight – from military hygiene to wellbeing in the British Army

Colonel David A. Ross

Associated Data

Military health and hygiene in the nineteenth century

Edmund Parkes - the first professor of military hygiene

The health of the public and its impact on the health of the Army

World War I – hygiene at scale

World War II – hygiene to health

Army Health – 1950s - organization

Army Health separation into Public Health and Occupational Medicine in the 1970s

Current issues in military health and wellbeing across the military life course

Conclusions

Acknowledgements

Authors’ contributions

Authors’ information

Availability of data and materials

Contributor Information

Personal Hygiene in the Army

Sanitation, Health and Hygiene during World War 1

Related Papers

RELATED PAPERS

RELATED TOPICS

GAZA / HYGIENE SUPPLIES SHORTAGE

Related Content

GAZA / HUMANITARIAN CRISIS

UN / GAZA UPDATE

UNICEF / GAZA CHILDREN WATER ACCESS

UN / GAZA HUMANITARIAN

WHO / GAZA FOOD UTILIZATION

WHO / GAZA AL NASSER HOSPITAL

WHO / GAZA MEDICAL SUPPLIES

WHO / GAZA KHAN YOUNIS HOSPITAL

WHO / GAZA RAFAH DISPLACEMENT

A Text-Book of Military Hygiene and Sanitation.

Manage citations:

Others Also Liked

Schools ‘bombed-out’ in latest Gaza escalation, says UNRWA chief

No safe place

Lost generation

Rising toll

Lifesaving supplies blocked

Aid successes

Donate to the humanitarian response in Gaza

IMAGES