Malaria in World War II

Conditions in the South Pacific Theater during World War II were harsh — thick jungle, high temperatures, heavy rainfall, swamps, excessive mud, and mountainous terrain made life difficult enough for Soldiers.  But the environment was perfect for mosquitos.  Disease, especially malaria, was rampant among the troops.  Although dysentery and beriberi took their toll, malaria was by far the most devastating disease, causing more casualties than the enemy.  In many cases throughout the campaigns malaria played a significant role in determining the outcome of battle.

The primary carrier of malaria was the species Anopheles minimus flavirostris, sometimes nicknamed “Ann” by the Soldiers.  This type of mosquito thrived in the Pacific island regions, doing best in regions with swiftly-flowing, clear, shaded water.  Despite the long dry season on the Pacific Islands, there was sufficient water in the streams and rivers to maintain breeding grounds for the mosquitos year-round.  Prior to the outbreak of the war, the Army had learned to use preventative measures such as mosquito nets, careful selection of base sites, and regular quinine or Atabrine treatments.  Implementing these measures under wartime conditions often proved difficult.

The first problem to arise was a matter of supply.  Initial estimates of the need for anti-malaria drugs and supplies were nearly 100% lower than actual demand.  The logistical nightmare of supplying an Army half a world away meant that even when the necessary supplies were delivered, they had to be used sparingly.    To make matters worse, medical officers with expertise and training in tropical diseases were few and far between.  Coupled with supply problems, the problem of malaria threatened to slip out of control.

To give an indication of the severity of malaria and the impact it could have on the battlefield, estimates from the Philippines in 1942 indicate that roughly 24,000 out of the 75,000 American and Filipino defenders were suffering from malaria at the time of the invasion.  Given that the Japanese invasion force included only 57,000 troops, the loss of an entire division’s worth of Soldiers was significant.  The situation was so severe that the commander of the Commanding Office of General Hospital 2 wrote to his superiors saying:

“If the malaria situation is not brought under control, the efficiency of the whole Army will be greatly impaired; in fact it will be unable to perform its combat functions. It is my candid and conservative opinion that if we do not secure a sufficient supply of quinine for our troops from front to rear that all other supplies we may get, with the exception of rations, will be of little or no value.”

Between 60 and 65 percent of Soldiers serving in the South Pacific reported having malaria at some point.  Reports indicate that some enlisted men would refuse to take the anti-malaria drug Atabrine because continual use turned the skin a sallow yellow color.  Atabrine was only partially effective to begin with, and Soldiers who stopped use were virtually unprotected.

Treatment of the disease usually involved an increased does of Atabrine, or Quinine if it was available, coupled with bed rest.  For patients already suffering from dysentery and malnutrition, massive doses of Atabrine often had negative side-effects such as chills and increased fevers.

The only silver lining to the malaria problem was that the Japanese suffered just as much, if not more, than the Americans.  Estimates suggest that at times some Japanese units were 90% combat ineffective due to a combination of malaria and dysentery.  Fresh American troops, not yet infected, were most effective when used against Japanese forces that had been in the field for months; and the lack of medical provisioning led to even higher casualties among the Japanese.

Malaria had a significant impact on the operations and battles of the South Pacific.  Many of the campaigns were hastened by the miserable situations that the Soldiers operated in—poor health weakened Soldiers and drained their moral.  Malaria and other tropical ailments such as ringworm, fungal infections, dysentery, and beriberi were nearly ubiquitous among the men serving in jungle environments.  Combat presents enough challenges without the added problems endemic to the Tropics.  Soldiers who persevered under these conditions have every right to be proud of their service.

Further Reading

Gillespie, James O. Army Medical Department, Office of Medical History. “Malaria and the Defense of Bataan.”   <http://history.amedd.army.mil/booksdocs/wwii/Malaria/chapterIX.htm>

Sharpe, George. Brothers Beyond Blood: A Battalion Surgeon in the South Pacific. Austin: Diamond Books, 1989.

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