opinionWar

Fixing Military Intelligence Gathering, but of the Medical Kind

Exploring the history of military preventive medicine, one thing becomes certain: Science and humankind have made significant progress in preventing casualties due to disease and injury. One outcome of this “progress” is that as warfare continues (and it will), fighters will be more disproportionately affected by battle injuries from the weapons of war and less so by the sequelae of war. This may not be as sexy as discussing the latest weapons systems or other hard force-multipliers, but Force Health Protection (the application of military preventive medicine) and medical intelligence gathering have serious impacts on military readiness and will continue to have significant impacts on victory.

Past

While historical records become more limited as one travels back in the history of the US at war, it is safe to assume that most Disease Non-Battle Injuries (DNBI) casualties were due to water/food-borne diseases (cholera, dysentery, salmonella), infectious diseases (smallpox, influenza, tuberculosis, syphilis, typhoid, wound infections), and insect-transmitted diseases (malaria, dengue, yellow fever, encephalitis). Each came with a heavy toll on the fighting effectiveness of affected units.

Take malaria, for example. During the American Civil War, between 1861-1865 the disease accounted for more than 1.3 million episodes of illness and some 10,000 deaths.  It has been estimated that 50% of white soldiers and 80% of black soldiers got malaria annually. Later on during WWI, according to Bernard Brabin, military malaria surveillance statistics from all theaters of the war indicate that at least 1.5 million soldiers were infected, with a case fatality rate up to 5%. During WWII, roughly 60,000 US troops died in Africa and the South Pacific from malaria. In Vietnam, malaria caused more casualties during the war than battle injuries and reduced the combat strength of some units by half.  Over 40,000 cases of malaria were reported in US Army troops between 1965 and 1970.

In contrast to the past, the present state of preventive medicine and Force Health Protection looks much better. During the years 2004-2013, with