by Jon E. Lewis
To service the Land Rovers and Unimogs, the SAS organized a supply column (“E Squadron”) which formed a temporary workshop deep inside Iraq. Everywhere the SAS teams went they caused mayhem, and not only to the Scuds. Saddam (courtesy of the time when the West regarded him as a friend) had an advanced communications network, consisting of buried fibre optic cables. The weak point in the system was that the signal needed to be boosted at above-ground relay stations. A team from 22 SAS blew up seven of these stations alongside the highway from Baghdad to Amman. When the SAS Land Rovers returned to Saudi Arabia at the end of the war, they had covered an average of 1,500 miles and spent between 36 and 42 days behind the lines. The front wings of the Land Rovers were decorated with scores of silhouettes of “kills”, including mobil Scuds and communications towers.
The SAS had also provided valuable advice to US Special Forces, operating in a “Scud Box” north of the Regiment’s. It is a measure of the success of the SAS that General Norman Schwarzkopf, the “enemy” of special forces, praised the Regiment’s “totally outstanding performance” in the Gulf. No less than 39 awards and honours for bravery and meritorious service were given to the Regiment for its part in Operation Granby, the Gulf War.
There was of course, a price to be paid for the Regiment’s achievement. In addition to the three SAS soldiers from Bravo Two Zero who were killed, Trooper David Denbury from A Squadron was killed on 21 February during the ambush of a Scud convoy in North West Iraq. A sapper attached to the regiment was also killed in action.
Chapter 7
HEALTH AND MEDICAL SKILLS
AVOIDABLE HEALTH RISKS
Personal hygiene and concern for your immediate camping or training environment are important. It is also advisable to avoid substances which actively increase the probability of ill health, and harm the body, such as alcohol, tobacco and drugs. All these substances are addictive, and once you’ve started it’s very hard to stop. The degree of addiction can vary, but anyone can become hooked.
SMOKING
For many years smoking has been known to be harmful even the tobacco companies acknowledge this. The addictive element is the nicotine. The major harmful effects are caused by other substances such as tars and carbon monoxide that are produced by burning tobacco.
Smoking mainly attacks the lungs and heart. Lung cancer, heart attacks and bronchitis are all linked to smoking.
Lung cancer
The commonest form of lung cancer normally occurs only in smokers. This does not mean that all smokers will get lung cancer; the great majority will not. What it does mean is that non-smokers will almost certainly not suffer from the disease.
Heart disease
The largest single preventable cause of early death is coronary heart disease. Smokers have a very much higher chance of heart attacks, often leading to death, than do non-smokers; this is particularly so in men in their early 40s and even young male smokers probably run a greater risk than non smokers. Again not every smoker will have a heart attack, and not every heart attack victim is a smoker. It is, however absolutely clear that smokers run a very much higher risk of serious heart trouble than non-smokers. The sooner a smoker stops smoking the better his chances, the longer he leaves it, the greater the risk of permanent damage.
ALCOHOL
Alcohol has fewer addictive qualities than nicotine and in moderation, has relatively few ill effects. It is, however, a poison. It has a depressant effect on the brain, but at first appears to be stimulating because the first thing it depresses are your inhibitions, making you more lively and talkative.
As the dose increases, so does the depressant effect. It is less easy to control personal behaviour, so fighting becomes more likely and the control of machinery is more difficult. One of the biggest problems is that it is almost impossible for an intoxicated person to realise and accept that their driving ability has been seriously impaired.
The poisonous effect of alcohol becomes more obvious the larger the amount taken. A blood level of about 400mg/100ml is often fatal in itself. The after effects are proportional to the amount consumed. Hangovers are due to a variety of factors – a combination of the toxins acting on the brain, dehydration from the diuretic properties of alcohol and a low blood sugar level. The liver is an organ which is especially sensitive to the effects of alcohol, because it is where the alcohol is broken down and detoxified. Long term alcohol intake can lead to permanent liver damage, known as cirrhosis of the liver.
Drinking moderately is not normally a health risk, but there are circumstances when it should obviously be avoided. Any time you need to keep a clear head, such as walking or climbing in the mountains, your life and the lives of others could depend on your having absolute control, unclouded by alcohol.
DRUGS
There are a wide variety of controlled drugs ranging from the relatively innocuous cannabis to the potentially lethal heroin and cocaine. There are claims that cannabis is less harmful and addictive than tobacco, but there is no doubt that it clouds the judgement, which is particularly dangerous in a combat situation or training exercise when errors of judgement could be fatal.
Once you start experimenting it can be difficult to resist the temptation to move on and try harder and more dangerous drugs that are being pushed by the same dealers.
Heroin and cocaine are much more addictive than cannabis or alcohol. You can get hooked the first time you try it. Say no. Once you are hooked, it is extremely difficult to get off. Your health will rapidly be destroyed. In addition to the effects of the drug itself, injecting with dirty needles can give you infections, septicaemia, hepatitis and AIDS.
Some trials have been done, mainly in America, on drugs that have a stimulant effect. It was thought that such drugs might help soldiers to perform more effectively in battle but the results were so unpredictable with soldiers attacking their friends and so on that these ideas have been totally abandoned.
SEXUALLY TRANSMITTED DISEASES
Staying healthy will enable you to perform much better in combat, on exercise or in sport. Sexually transmitted diseases, like many others, can all be avoided; they will not occur unless you have had sexual contact. But advice to refrain from sex is easier to give than to take, so make sure that you know something about sexually transmitted diseases and how to minimize the risks.
VENEREAL DISEASE
Venereal disease (VD) is a legal definition relating to various sexually transmitted diseases. This is now an outdated term and has been replaced by “Sexually Transmitted Disease” (STD). Among the most important of these diseases are syphilis, gonorrhoea and non-specific urethritis.
Syphilis
Syphilis is much less common than it used to be, and can be treated with penicillin, but remains a potentially serious disease. It can be transmitted to a baby in the womb, but again this congenital syphilis is now very rare. Acquired syphilis passes through three stages, primary, secondary and tertiary syphilis. The secondary stage occurs within a few months of the primary stage but many years may go by before the tertiary stage appears.
A sign of primary syphilis is a painless ulcer about 1 cm across which shows up about a month after infection. In men it is usually on the penis, in women it can occur on the genitalia but is often deeper inside and so may not be noticed. More rarely, it may occur on the lips or in the mouth. Even if it’s not treated the lesion will seem to heal but that doesn’t mean all is well. A few months later, secondary syphilis occurs.
Secondary syphilis is characterized by a skin rash of varying appearance, plus a sore throat, a slight temperature and swollen lymph nodes. In the mouth there are painless, slimy grayish ulcers. Again these may seem to clear up, but the disease reappears years later as tertiary syphilis.
The tertiary disease is accompanied by the localized swellings that may break down into ulcers. They may occur anywhere in the body, on the surface or deep within. The disease may affect the brain or the circulatory system leading to mental breakdown, insanity or fatal i
llness.
Gonorrhoea
This again causes differing symptoms in men and women. In men, within about three to ten days of infection there is a slight burning sensation on passing urine, which is soon followed by a yellowish discharge from the end of the penis. If treatment is not given the infection may spread deeper, causing pain and a fever. There may be swelling of the lymph nodes in the groin, sometimes including the testicles.
In women, passing urine may be painful and frequent and there may be a vaginal discharge. Often however, the infection may be deeper in the genital tract, and will not be noticed.
The usual treatment is with penicillin, but there is increasing resistance by the infecting organism, so other drugs may have to be used.
Non-specific urethritis (NSU)
This is now much commoner than syphilis and gonorrhoea. It can be caused by a variety of organisms and occurs mainly in young men. The symptoms are similar to those of gonorrhoea, the passing of urine may be frequent and painful and there may be a discharge from the penis. The disease can show up anything from a few days to two or three months after infection. Treatment depends on the causative organism.
AIDS
Acquired Immune Deficiency Syndrome (AIDS) was first recognized in 1981. It is a disease affecting the body’s immune system, which means that the body cannot combat certain illnesses, including infections and some cancers. People with AIDS die of these infections and cancers, not of AIDS itself.
When AIDS was first recognized the cause was not known, but it was found to occur particularly in homosexual men. Since then it has been found in drug abusers, those who have had blood transfusions with infected blood or blood products (such as haemophiliacs), and more recently in those who have had heterosexual relationships.
In the USA and UK the disease is still one primarily of homosexuals and drug abusers. In some parts of the world however, males and females are equally affected, particularly in some countries of Africa, where the disease is widespread.
AIDS can follow infection by a virus known as HIV. This virus affects one type of white blood cell. HIV infection is NOT the same as AIDS; AIDS is an illness that results from HIV infection. Not all those affected with HIV will develop AIDS, and the average time between HIV infection and the development of AIDS is five to seven years or even longer. So far about half those affected with HIV have developed AIDS. It is not known whether everyone with HIV infection will develop the disease; the probability is that at least a proportion of HIV carriers will not.
Even if a person does not have AIDS but only HIV infection, they can still infect someone else. HIV is transmitted from person to person either by sexual intercourse, or by transmission of blood. It is not transmitted by shaking hands, by kissing or by any normal social relationships, so there is no danger in working or going to school with someone who is HIV infected.
Infection through sexual intercourse is much commoner in male homosexual relationships and this is the commonest means of transmission in the USA and the UK. But the experience in Africa indicates that we can expect an increase in transmission through normal heterosexual intercourse, which means that both men and women can be affected.
Drug abusers are susceptible to HIV infection if they inject themselves with needles used by others, because small amounts of blood will be present in the needle and syringe from the previous user. Remember that many prostitutes are intravenous drug abusers and may therefore pass on HIV infection through their sexual activities.
All blood and blood products used in the UK and USA are now screened for HIV infection and there is no chance of catching the infection through blood transfusion. Unfortunately this is not necessarily the case in other parts of the world.
HIV infection itself causes no symptoms. Infected people appear quite well and neither they nor anyone else will know if they are infected. Blood tests can be carried out to find out if people are affected, but there is no other way of telling, so an infected person can infect someone else without either of them knowing anything about it. The other great problem with HIV infection is that there is no cure, and it does not look as if one will be available for quite some time, if ever. Nor can anyone tell who will go on to develop full-blown AIDS and who will not, so prevention is all-important.
Prevention
Avoid high risk groups; avoid homosexual intercourse, and intercourse with partners of homosexuals; avoid drug abusers and their partners; avoid prostitutes. Also, avoid the enthusiastic amateur. Again, the more partners you have, the higher the risk. A steady couple who only have intercourse with each other will not become infected.
The second preventative measure is the use of condoms. Even if other contraceptive measures are being taken, a sheath should still be worn if you are indulging in casual sex. Both partners should insist on the man wearing one, and both should be prepared. Condoms are now openly available. You should not feel embarrassed about buying them, even if you are, this is better than having to worry about AIDS. But remember; a condom reduces the chance of infection, but is not 100 per cent effective.
FIELD SANITATION
In war, the number of casualties due to enemy action has always been exceeded by the number caused by illness, and similar problems often arise on expeditions and military exercises. Very often this is due to bad hygiene leading to stomach upsets and diarrhoea.
You can avoid illness by taking proper preventive measures. You must be fit to start with, maintain personal hygiene and change into clean clothes as often as possible. Pay attention to food and water, and dispose of waste carefully.
GENERAL HEALTH
Before setting out on any form of expedition or training you must be in good general health; if you are suffering from flu or a stomach upset, for example, these are likely to get worse. Also if you are suffering from or just recovering from an infectious disease you may get worse yourself and will almost certainly pass it on to others.
Make sure your teeth and gums are in good condition. Many a soldier on operations or training has had to be evacuated because of dental trouble.
Personal hygiene
1 Keep as clean as possible, paying particular attention to your feet, these must be washed daily and dusted with powder.
2 Clean your teeth regularly.
URINAL
Piss tube (should discharge into the pit about 60cm down) Side view of a gravel pit with piss tubes drawn in. This sort of pit allows urine to drain quickly into the earth rather than create a foulsmelling swamp in camp. Place some obvious marker on the spot so you can find it at night.
3 Continue to shave every day, even though it’s easier not to bother. But avoid after-shave, not just for practical reasons but because it will dry on your skin and make it sore.
4 Change into clean clothes as often as possible, and change your socks every day. Natural fibres such as wool and cotton will breath and allow sweat to evaporate. If you are out for any length of time you will have to wash your clothes; you can buy travellers clothes-washing liquid in a tube, which will work in cold water.
WATER
In Britain and the USA you can drink tap water, but this is not necessarily the case in the rest of the world. Even in Europe, although most indoor taps are safe, those in farmyards may not be.
Never assume that river or stream water is safe, even if it looks clear. Any water that you cannot be sure about must be purified by boiling or by adding water purification tablets. These will be on issue or you can buy them from camping shops.
All water that is used for drinking and cooking should be treated. It is not necessary to purify water for washing, but avoid it if it’s obviously polluted.
The lazyman boiler is an elegantly simple solution to an age-old problem. You start heating a tank of water, go away while the fire does its stuff and come back to find some lazy bastard has used up all the water. By constructing your boiler as shown anyone wanting water must pour in an equal amount of fresh water.
HEALTH IN COLD CONDITIONS
Working in a cold climate can cause major health problems. The physical effects of cold cause real difficulties, but in addition the loss of morale caused by the cold can in itself lead to further trouble. Problems with the cold are not confined to the Arctic or mountain regions. They also happen in relatively mild climates, especially when associated with wetness. Exposure causes a substantial number of casualties and even some deaths on exercises in the UK.
Dry cold
Dry cold is typical of Arctic regions and is characterized by very low temperatures and often biting winds. The temperature may be down to −30°C or even lower.
Shallow trench latrines are one way of dealing with the approximately 350 kg of faeces produced every day by an infantry battalion. This assumes the troops are eating the 24-hour ration pack, which tends to bung you up. If fresh food was available then the quantity would increase.
The five or 6 metre deep, water filled medieval style pit works fine until some idiot pours disinfectant in, killing the bacteria that make the pit work.
Wet cold
Wet cold occurs in more temperate regions where the ice and snow melts, and there may be rain. The temperature is rarely as cold as in Arctic areas for more than occasional short periods.
COLD ILLNESSES:
Hypothermia
Hypothermia simply means sub-normal body temperature. It is often called exposure when it happens outside and hypothermia when it affects old people indoors, but it is the same thing.
