To: The DMS, EAF
Memorandum on Sanitary Organisation of East African Force.
The experience of the campaign has exhibited special difficulties in regard to sanitary control, and has shown that the ordinary organisation is not fitted to cope with the peculiar circumstances of the War in East Africa.
The special conditions may be summarised as follows:-
a) The vast extent of country occupied and controlled by the Army authorities.
b) Absence of transport facilities, rail and road, consequent difficulties in means of communication.
c) Inclusion of large areas, densely populated by natives, not actually occupied by troops, but controlled by Political Officers under GHQ.
d) Constant confusion in regard to responsible authority in areas of junction between LofC and Columns, and, during period when LofC are taking over the Column Areas.
e) Lack of sanitary training of many Medical Officers and want of appreciated of their responsibilities in this respect.
f) Lack of knowledge of sanitary duties by many combatant Officers and want of appreciation of their responsibilities in this respect.
In regard to d). This is one of the most important points and where our old organisation has completely failed. It is during the formation and growth of news posts that efficient sanitary control is most required. At this time disputes as to who is the responsible authority frequently take place, with the result that efficient control is lacking and most insanitary conditions often prevail.
It would appear evident, therefore, that a sanitary control organised on ‘watertight compartment’ lines is unlikely to be efficient, where three separate authorities are concerned in overlapping areas, the exact limitation of which are indefinite.
In considering this problem the term sanitation is being used in its wide sense, and includes the control of infectious diseases, supervision of food and water supplies, questions of clothing, housing etc, and is not limited to the comparatively small section known as Camp Sanitation.
The following outline scheme is proposed as an alternative, and would, I believe, prove much more satisfactory in practice and lead to greatly improved sanitation and reduction in sick-rate.
a) The division of the country inti Sanitary Areas. The Divisions would be made on Military and Geographic considerations.
b) A Sanitary Officer GHQ on the Staff of the DMS as Chief Sanitation Officer under whom the Sanitary Officers of the district would work.
c) Each district would be controlled by a Specialist Sanitary Officer or DADMS (San) and the Sanitary Sections in the area would be distributed under his direction.
He would be responsible to the DMS through the Chief Sanitary Officer GHQ, to report on all sanitary matters in his area; to advice CO’s and MO’s of Units, Posts, etc, in regard to sanitation generally; to enquire into all matters affecting the health of troops and followers; to see that the personnel of the Sanitary Sections were employed to the best advantage; to supervise and control outbreaks of infectious diseases with special reference to native populations.
No small or unimportant part of his duty would be to instruct the new Medical Officers in regard to tropical sanitation, care of African Natives, and their diseases. The large number of recently qualified Medical Officers who have joined the Force, who are untrained and unacquainted with tropical conditions, the hygiene of the Native or his diseases, makes it essential, I consider, that some supervision of this nature be inaugurated if the sick-rate among porters is to be reduced to a minimum.
d) An organisation such as the above would not interfere with the existing authority of AMO’s in this respect, nor relieve them of their responsibilities. It would assist them by giving them access to expert advice and criticism. As Officers working directly under the DMS they would have control of Districts not in LofC or Column areas.
e) The occupied area of GEA would appear, at present, to be best divided as follows:-
1. DODOMA AREA: Tabora to Kilossa-Dodoma-Iringa and forward with the Iringa Column
2. MOROGORO AREA: Morogoro-Mikesse-Rufiji and forward with the Nigerian Column.
3. THE KILWA AREA
4. THE LINDI AREA
5. DAR-ES-SALAAM could be controlled as at present, by a Sanitary Officer.
(Sgd) GD Maynard, Major
SAMC, DADMS (San)
To: Medical GHQ, Dar-es-Salaam,
8 August 1917