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Military

CHAPTER IV

Preventive Medicine for the Soldier


GENERAL:

There is no reason to fear the Haitian environment, and it should not adversely affect your morale if you are prepared for it, provided you take certain precautions to protect yourself.

Recent medical and dental exams should ensure that the soldier is in good health. Carry appropriate health and accident insurance documents and copies of any important medical records. Bring an adequate supply of all prescriptions and other medications as well as any necessary personal hygiene items, including a spare pair of eyeglasses or contact lenses if necessary.

Drink only bottled beverages (including water) preferably carbonated, or beverages made with boiled water. Do not use ice cubes or eat raw seafood, rare meat or dairy products. Eat well- cooked foods while they are still hot and fruits that can be peeled without contamination. Avoid roadside stands and street vendors. BOTTOM LINE: Eat and drink only those foods and beverages that have been approved for consumption by the command.

Swim only in well-maintained, chlorinated pools or ocean water known to be free from pollution; avoid freshwater lakes, streams and rivers. Wear clothing which reduces exposed skin and apply repellents containing DEET to remaining areas. Sleep in well-secured accommodations with bednetting as appropriate. Carry antidiarrheal medication. Reduce problems related to sun exposure by using sunglasses, wide-brimmed hats, sunscreen lotions and lip protection. Avoid petting stray animals and do not adopt animals as pets or unit mascots.

Based on operations in Somalia, soldiers that slept on the ground became ill. To help ensure that soldiers remain healthy, commanders should supply them with cots, mosquito nets, and head nets.

TOPIC: Communicable Diseases.

DISCUSSION: Communicable diseases are illnesses that can be transmitted from one person to another or from animal to person. These diseases are caused by: direct contact with infected person(s); exposure to bodily discharges; bites of animals; insects and rodents; air; food; water, and milk products. Communicable diseases can be broken down into five different categories.

They are: respiratory diseases (common cold and pneumonia), intestinal diseases (dysentery, cholera, typhoid, paratyphoid fevers), insect-borne diseases (malaria, typhus, yellow fever, dengue), sexually transmitted diseases (syphilis, gonorrhea, chancroid, AIDS), and miscellaneous diseases (tetanus, rabies, dermatophytosis, tuberculosis). Above all, PERSONAL HYGIENE is the most important factor in the prevention of communicable diseases.

LESSON(S):

* Control the source of the disease through:

  • Isolation of sick person (Quarantine).
  • Treatment.
  • Maintain a high state of personal hygiene

* Control means of transmission:

  • Properly ventilate living quarters.
  • Purify water.
  • Mess sanitation.
  • Properly dispose of body waste.
  • Control disease-carrying insects.
  • Practice good personal hygiene.

TOPIC: Respiratory Diseases.

DISCUSSION: Respiratory infections account for the highest incidence of disease in the U. S. Army. While troops are affected, the highest rates of infection occur in personnel unfamiliar with the surrounding conditions.

LESSON(S): The difficulty in the prevention and control of respiratory diseases lies in the fact that most individuals are susceptible to them. Another problem is that the people transmit the disease before they realize they are infectious. The most important control measures to prevent respiratory diseases are:

  • Separate all known cases from healthy persons.
  • Quarantine and surveillance contacts.
  • Immunize.
  • Avoid overcrowding (minimum 55 square feet of floor space in sleeping areas).
  • Personal Hygiene.

TOPIC: Personal Hygiene.

DISCUSSION: Personal hygiene is necessary for the individual to safeguard his own health and the health of others. Carelessness of one member of a unit in regard to personal hygiene may lead to disease that may incapacitate the entire unit. Leaders must check soldiers daily to ensure that they are performing their personal hygiene. Personal hygiene includes, but is not limited to, washing the face and hands, shaving, changing uniform (or at least socks and underwear), brushing teeth, and combing hair.

LESSON(S):

* Individual:

  • Understand and continually apply personal measures.
  • Seek needed medical care.
  • Do not resort to self-treatment.
* Medical:
  • Conduct instruction in personal hygiene.
  • Conduct inspections of facilities and troops.
  • Provide medical treatment.
* Commanders:
  • Provide and maintain facilities.
  • Ensure the practice of personal hygiene through inspections.
  • Deploy with adequate buckets and soap so soldiers can wash personal clothing until laundry facilities are established.
  • Deploy with Australian showers.

TOPIC: Potable Water.

DISCUSSION: Safe potable water is essential to the U. S. Army. Water that is not properly treated can transmit such diseases as typhoid and paratyphoid fevers, bacillary dysentery, cholera, poliomyelitis, and common diarrhea. In some areas, water may also be the means of transmitting infectious hepatitis, schistosomiasis, and amoebic dysentery. Lessons from Operation DESERT SHIELD and DESERT STORM showed that units should use a planning factor of at least 7 gallons of water per soldier per 24-hour period.

LESSON(S): Treat the individual water supply with one iodine tablet per quart-size canteen if the water is clear, two tablets if the water is cloudy. Let stand for 5 minutes with the cap loosened and shake to permit leakage to rinse the thread around the neck. Tighten cap, and let stand for 20 minutes. Calcium hypochlorite may be used. Add one ampule in one-half canteen cup of water, dissolve, then pour one canteen cap of the solution in the canteen, shake and let stand for 30 minutes.

WATER CONTAINERS: The best containers for small quantities of water (5 gallons) is plastic water cans. Water in plastic cans will be good up to 72 hours, compared to metal which will only be good for 24 hours. However, you should change the water in your canteen at least every 24 hours. Water in trailers, if kept in the shade, will last up to 5 days. If the temperature outside exceeds 100F, the temperature of your water must be monitored, and when it exceeds 92F, it should be changed, as bacteria will multiply. If not changed, you will end up with a case of diarrhea. Ice in containers will keep water cool. If ice is put in the water trailers, the ice in it must be removed before the trailer is moved as the floating ice may destroy the inner protection of the trailer.

TOPIC: Malaria.

DISCUSSION: Malaria is wide-spread throughout Haiti. It is a serious disease which is spread through the bite of the female anopheles mosquito. Reports from operations in Somalia indicate that antimalarial medications may be harmful to an unborn fetus. Pregnant soldiers should consult their physicians before taking the medication. Post deployment follow-up consultation and treatment are also recommended.

LESSON(S):

To protect soldiers, units should:

  • Destroy mosquitoes and the control of breeding areas, by draining standing water.
  • Screen troop areas.
  • Locate camps away from infested areas.
  • Use sprays and aerosol dispensers NSN 6840-00-253-3892 and NSN 6840-00-823-7849.
  • Ensure soldiers use netting at night.
  • Wear protective clothing.
  • Soldiers should use chemical repellents.
  • Take antimalarial medication.

TOPIC: Heat Injuries.

DISCUSSION: The most frequently encountered types of heat injury are heat exhaustion and heat cramps. Less common, but of greater significance, is heat stroke. Causes of most heat injuries are the loss of salt and water from the body and failure of the sweat mechanism with a resultant increase of body temperature (heat stroke).

Heat cramps are primarily caused by excessive loss of salt from the body. The symptom is extremely painful contraction of the voluntary muscles, especially in the abdomen.

Heat exhaustion is caused by excessive loss of water and salt from the body. The symptoms include profuse perspiration, pallid skin, low blood pressure and other manifestations of peripheral circulatory collapse. Soldiers may also complain of headache, mental confusion, drowsiness, extreme weakness, vomiting, and visual disturbances.

Heat stroke IS A MEDICAL EMERGENCY. Symptoms include extreme high body temperature, total absence of perspiration or sweating and skin which is red and hot to the touch. Also the individual is usually in a profound coma. Heat stroke is a breakdown in the body's heat regulating mechanism. Individuals who have not been acclimatized are especially prone to heat stroke.

LESSON(S):

Prevention of heat injury involves the application of measures for increasing the resistance of exposed persons and reducing the exposure as much as practicable. The following are ways to prevent heat injuries:

  • Encourage soldiers to drink water; thirst is not a good indicator of a heat injury.
  • Encourage proper salt intake - do not use salt tablets.
  • Gradually acclimatize soldiers to hot climates.
  • Maintain the best physical condition of personnel.
  • Tailor work schedules to fit the climate.
  • Protect soldiers from the environment by ensuring they wear loose clothing to permit air circulation.
  • Take frequent rest breaks- in the shade if possible.
  • Educate personnel to recognize early signs, take appropriate action, and apply effective first aid.

TOPIC: Field Sanitation.

DISCUSSION: The role of field sanitation (ref: AR 40-5, FM 21-10) is to aid the unit in protecting the health of troops. Field sanitation concerns itself with the basic responsibilities of:

  • Personal hygiene and protective measures.
  • Water supplies.
  • Mess sanitation.
  • Waste disposal.
  • Insect and rodent control.
  • Troop education.

LESSON(S):

Methods for field sanitation include the following:

  • Plan for garbage/rubbish disposal by burial or incineration.
  • Plan for liquid waste disposal. Use soakage pits, soakage trenches and evaporation beds.
  • Plan for body waste disposal. Use cat-hole latrine for marches, straddle trench for 1- to 3-day bivouac sites, deep-pit latrine for temporary camps, burn-out latrines and soakage pits for urinals.
  • Plan to take lime with you.

Latrines must be located at least 100 meters from unit messes and at least 100 meters from any water source. Garbage must be buried at least 100 feet from any water source.



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