By early 1944, the army was forced to reduce the standards still more. Only the infantry saw a slight upward revision in standards – owing to the recommendations of the Infantry Committee. Yet recruiting officers were given leeway to take in men who weighed 5 lbs below the new scale – provided they felt that the recruit could gain this weight by eating army rations for three months. In practice, recruiting officers took in men who were underweight by 10–20 lbs.17 Importantly, the drop in physical standards applied as much to the martial classes as to the newer social groups entering the army. In fact, the fall in standards of the martial classes was steeper. Since these groups remained the cutting edge of fighting formations, the India Command’s nutritional anxieties multiplied.
The declining physical standard of the recruits necessitated revisions to the army’s scale of rations. At the outbreak of war, the peacetime scale of daily rations provided by the RIASC amounted to 3,385 calories. Units could supplement this by purchasing additional rations, for which they were given a monthly allowance of Rs. 0.6 per soldier. Rampant inflation, however, rendered this pittance entirely worthless. In early 1942, the cash allowance was raised to Rs. 2 per soldier per month. In September 1942, it was further increased to Rs. 3. By this time, units were also struggling to source food from local markets.18
Physical Standards for Recruitment of Infantry
Source: B. L. Raina (ed.), Preventive Medicine (Nutrition, Malaria Control and Prevention of Diseases) (Delhi: Combined Inter-Services, Historical Section, India & Pakistan, 1961), Appendix II.
Alongside these measures, the India Command began nutritional testing of troops to arrive at a more scientific scale of rations. As elsewhere, the availability of trained personnel proved problematic. In January 1943, a nutritional section was established in the medical services directorate of GHQ India. This set-up turned out to be inadequate for conducting field surveys and advising units on nutrition. Hence, the director of the Nutrition Research Laboratories in Coonoor, Dr W. R. Aykroyd, was roped in as an honorary consultant and his team supported the efforts of the army.
Preliminary investigations in 1942 had shown that the vitamin A and C content of Indian rations was well below the generally accepted estimates of optimum requirements. A more detailed study of a pioneer engineer unit in September 1942 had not only confirmed these findings but found that the scale of rations was deficient in practically all nutrients and calories. Clearly, Indian troops were subsisting on a very narrow margin of nutritional adequacy. In January 1943, the medical services director recommended placing all Indian troops on the higher, field-service scale of rations (3,950 calories per day). British troops in India had already been upgraded to this scale in October 1942. The India Command demurred. For one thing, the RIASC was not yet ready to procure and supply to all Indian units on this scale. For another, the additional financial burden was believed to be too onerous. After six months of discussion, the India Command decided to do away with the additional cash allowance and introduce an enhanced daily scale of rations for non-operational areas.19
Reality did not match the ration scale, however. Troops deployed on the Burma frontier consumed on average about 3,550 calories per day. A study by the newly formed Indian Operational Research Section observed: ‘Compared with a 20 year old Englishman of similar weight (a low standard for a mature man is some 10 lbs heavier), the average weight of the Indian troops fell short by 14 to 23 lbs.’ The energy value of food consumed by them was almost 500 calories short of the minimum prescribed. Their food was deficient in all varieties of vitamins. There was a ‘serious shortage of meat’. Each man got 14 grams of animal protein – a third of the figure accepted as ‘the absolute minimum daily requirement’. The report grimly concluded that the ‘men cannot be expected to maintain maximal output of work on the energy available in the diet supplied’.20
And yet the India Command proved itself unable to upgrade the ration scale. Part of the reason was differences among nutritional experts on the methods of testing. Many believed that simple clinical investigation by stripping men to the waist and examining for signs of deficiency would suffice. Experts were divided over the utility of biochemical and other clinical aid in surveying troops. By 1944, however, a consensus developed on methods of survey – mainly owing to the influence of practices pioneered in the United States (by the Fatigue Laboratory at Harvard) and Britain. It was agreed that four different types of data had to be collected: nutritional measurement of ration scale; analysis of food actually consumed; medical examination of soldiers; and biochemical testing of blood and urine samples.
On this basis, studies were conducted from mid-1944 to early 1945 in two recruiting centres to ascertain the effects of army diet on the recruit’s physical condition. The sample of recruits was divided into two groups: one received only the basic ration (3,950 calories) and the other received an additional 16 fl oz of milk every day (4,250 calories). The investigations revealed that the average wartime recruit gained 5–10 lbs within four months of enlisting. Thereafter, he continued to gain weight at a slower rate. The extra milk did not make any difference in the average weight gained. A further study examined the response of recruits to meat and milk in rations. One group was placed on the basic diet. A second was given 12 oz of meat instead of the normal 2 ozs. And a third group was given 48 fl oz of fresh milk instead of any meat. The results showed that while all three diets increased the weight of the recruits, those on the meat diet gained the most and those on the milk diet the least. Analysing the detailed results, the investigators concluded that the advantage of the meat diet lay not in its greater calorific value, nor yet in the higher proportion of animal protein, but in the inherent nutritional quality of meat that seemed to stimulate the general metabolism.21
In the wake of these surveys, GHQ India decided that the daily ration scale in field service or training should provide a minimum of 4,200 calories, including 100 grams of protein. Animal protein supplied daily to the Indian soldier increased from 14 grams in 1943 to 32 in 1945. In practice, though, they got only 23–26 grams a day.22 Part of the problem was the difficulty encountered in the supply lines leading up to the Burma frontier.
Equally constraining were dietary restrictions observed by Indian troops. Muslims would not touch pork and ate only halal meat; Hindus ofter forswore beef and the meat of female animals; Sikhs took only non-halal meat; and certain groups like Jats were strictly vegetarian. Soldiers of all backgrounds regarded even certified meat with considerable suspicion.23
Culture compounded the problem in other ways too. The Indian soldiers’ methods of cooking tended to dilute the nutritional content of their diet. Vegetables were boiled in water and clarified butter (ghee) for two or more hours; rice was cooked with excessive water. The Paxton cooker provided to Indian units was typically used for storing rations or utensils – the cooks preferring to light up a traditional brick-and-mud stove, which coughed up enormous quantities of smoke as well as reducing the quality of the food.
Then there was the long-standing tradition in the Indian army – mirroring wider societal practice – of giving soldiers two meals a day: one just before noon and the other in the evening. With the enhanced ration scales, it became clear that the soldiers’ digestive systems could not cope with 2,000 calories at one go. When the Fourteenth Army sought to change this routine in 1943, there was considerable objection from the Indian units. As the senior VCO of one battalion said: ‘Hazur, aisa to hamare unit mein kabhi nahin hua’ [‘Sir, this has never happened in our unit’]. Commanding officers, too, tended to see this as ‘a shattering of old-time tradition’.24
By 1944, however, a new regime was enforced. Soldiers started their day at around 5 a.m. with sweet milky tea, supplemented with sugar-coated fried biscuits or chapattis. Between 10.30 and 11.30 a.m. they took rice or chapattis with a vegetable curry. Tea was brewed again at 2.30 p.m. And around 6 p.m. they had their main meal of the day: chapattis or rice with vegetable curry supplemented by eggs, fi
sh or meat and fruit. Efforts were made to educate troops to avoid wasting food on the plate. Copies of a booklet Food and Fitness were issued to all units to make them conscious of nutrition and health.25
A directorate of food inspection was created within GHQ India in 1944. To improve the standard of cooked food, the idea of creating an Indian army catering corps – along the lines of that of the British army – was examined but not implemented.26 The supply corps was already overwhelmed by the magnitude of its tasks. The mere management of multiple ration scales – forty-three on the last count – for Allied troops in India taxed its resources. As the official historian of the supply corps noted in dismay: ‘there were strange items such as anhydrous lanoline (wool fat issuable on medical recommendation), burghal (a kind of dal [lentil] admissible to transjordanian troops), mealie meal (in South African rations) and so on which the Indian clerk and issuer had never heard of’. Indian ration scales, too, had their own peculiarities – not least the allowance on medical advice of opium to addicts.27
Even so, the supply corps mounted a superb effort to keep up with the burgeoning demands. The army’s systems of procurement, holding and distribution were radically overhauled and modernized. In 1939, the Indian army had only one, small supply depot in Lahore. From late 1942, a series of depots linked to transportation hubs were constructed in Karachi, Benares, Bilaspur, Panagarh near Calcutta, Avadi near Madras, and Waltair near Vizag. These depots had massive storage sheds linked by an internal rail network. By 1944, their total capacity stood at 328,000 tons. The supply corps also obtained and produced dehydrated food and meat as well as other nutritional substitutes such as multivitamin tablets. A cold storage network was created from scratch to provide fresh beef to British and African soldiers. Four types of ration packs of varying bulk and calorie content were created for troops out on patrol and other operations. Methods of supplying forward forces by air were learnt, practised and perfected.28 The supply corps did not manage to fully bridge the nutritional gap, but its valiant efforts ensured that the Indian soldiers that fought the Japanese in 1944 were not the emaciated men of the earlier campaigns.
Nutrition was only one aspect of the wider problem of military health. Of equal concern was the vulnerability of Indian troops to disease. As Slim noted, ‘We had to stop men going sick, or, if they went sick, from staying sick.’29 Especially dangerous in the India–Burma theatre was malaria. In 1942, 83,000 soldiers had been admitted to hospitals in the Eastern Command with malaria; many more were not, owing to the shortage of beds.30 One of the reasons for the Arakan debacle had been the epidemic scale in which malaria had struck troops of the Eastern Army command. The Infantry Committee observed that malaria accounted for 90 per cent of the casualties in the Arakan campaign.31 What’s more, troops had lost confidence in the utility of preventive measures against malaria and were refusing to co-operate with malaria control efforts. The army began a major drive to educate the troops – using lectures, pamphlets and circulars – about the nature of the problem and methods of controlling it. Notwithstanding these efforts, it was realized that the confidence of troops in anti-malaria measures could only be restored by securing a substantial drop in malaria rates.32
The Indian Medical Service (IMS), a hybrid civil-military entity, had a considerable track record in malaria research. It was an officer of the IMS, Ronald Ross, who had first demonstrated that malaria was transmitted by mosquitoes.33 During the Second World War, however, the IMS was in grave crisis. The requirement of catering to public health as well as the military had stretched the service to breaking point. As a senior Indian doctor colourfully put it in late 1943, the IMS had ‘produced twins, both males – lusty rascals – vigorously kicking … One of them is destined to wear the Sam Browne and the other the Hippocratic Toga. But they must part company immediately and begin to lead independent lives straightaway.’34
The somnolent Malaria Institute of India was revivified in 1942, when the Rockefeller Foundation offered to donate the equipment of its malaria research unit in Coonoor. The offer was at once generous and timely. The institute accepted it with alacrity and embarked on a renewed programme of malaria research. The director of the institute, Lieutenant Colonel Gordon Covell, was appointed consultant malariologist to GHQ India. Covell travelled extensively across India, inspecting units and formations. He also travelled to Australia, New Guinea and the United States to understand their methods and medicines for combating malaria.35
In the summer of 1943, Covell outlined a series of preventive measures to be adopted by units and soldiers. First, and most important, was the selection of sites for deploying troops. ‘In a malarious country’, he wrote, ‘no site should be selected within half a mile of local habitations, unless it is the only one available.’ Second, adult mosquitoes had to be killed by spraying pyrethrum insecticide. Third, personal protection measures such as the use of mosquito nets at night, full-sleeved shirts at dawn and dusk, and anti-mosquito cream – a non-greasy version was made available – had to be regularly enforced. Fourth, small doses of mepacrine should be taken as a prophylactic drug. Covell argued that this would only work if mepacrine was classed not as a medicine but as a ration. Drawing on French and Italian campaigns in Macedonia and Abyssinia, he concluded that both personal protection and suppressive treatment could only work ‘where a very high degree of anti-malarial discipline is maintained. Experience has shown that such discipline cannot be brought to the requisite degree [of] protection unless officers commanding units are made aware that if it breaks down they are likely to be deprived of their commands.’36
As Fourteenth Army Commander, Slim took this advice seriously.
Good doctors are no use without good discipline. More than half the battle against disease is fought, not by the doctors, but by regimental officers. It is they who see that the daily dose of mepacrine is taken, that shorts are never worn, that shirts are put on and sleeves turned down before sunset.
Slim began organizing surprise checks of whole units, every man being examined. ‘If the overall result was less than 95 per cent positive I sacked the commanding officer. I only had to sack three; by then the rest had got my meaning.’37 Special anti-malaria units were created to carry out other activities such as spraying and installation of drainages. In 1944, pyrethrum insecticide was supplanted by DDT. The Malaria Institute had first received DDT towards the end of 1943. To be used against mosquitoes, DDT had to be turned into a solution in kerosene or xylene-triton. Both these solvents were hard to come by in India and expensive as well. Several experiments were conducted to find a cheap alternative. The Council of Scientific and Industrial Research suggested turpentine; GHQ India could only spare toluene. Eventually, they settled on a medium kerosene extract as a solvent. Experiments carried out on the efficacy of DDT underscored its problematic environmental effects: ‘amount [of DDT] which did not completely kill the vegetation in the area was found to be insufficient for adequate control of mosquitoes in the area’. When sprayed on water, it ‘killed a large number of small fish’. The India Command was undeterred by such considerations, though it did abandon the idea of aerial spraying of DDT within India after a few trials over Delhi.38
The cumulative effect of these measures was a steady decline in the incidence of malaria among the troops of the Fourteenth Army. Allowing for seasonal variation – mid-November to mid-March was the period when transmission of malaria was always low – the results are striking. From a high point of almost 3,300 men per day in July 1943, the numbers afflicted daily dropped to 1,700 in July 1944 and reached 370 in June 1945.
Equally important were the organizational innovations that enabled the rapid recovery of those laid low by malaria and other diseases.39 The Infantry Committee had noted that on average the men who had contracted malaria took between three and eight months to return to their units. This deprived battalions of their experienced personnel for unacceptably long periods. In consequence, the committee had recommended the creation of special medic
al organizations directly behind the front line.40 Slim sanctioned the raising of Malaria Forward Treatment Units (MFTU). These were effectively field hospitals, located a few miles behind the front and capable of treating 600 men at a time. Apart from reducing transit and treatment time, the MFTUs also discouraged men from malingering in the hope of getting away from their battalions for lengthy periods.41
Another innovation was the establishment of Corps Medical Centres – combined units that pooled all Allied medical resources to enable forward treatment of battle casualties. These centres, usually made up of MFTUs and Casualty Clearing Stations, included mobile surgical units. The latter were made possible by blood transfusion units that had been raised in 1942. At this point, blood transfusion services were scarce in India. Barring Bombay, Madras and Calcutta none of the cities and towns had a blood bank. Over the following year, the army transfusion units were equipped and trained in Calcutta and Dehra Dun. By December 1943, an elaborate transfusion service organization was operating from the base transfusion unit in Dehra Dun to field ambulances on the Assam and Arakan fronts. Despite the shortage of refrigeration, the Fourteenth Army created small blood banks at various places and prepared wet plasma. Blood donation propaganda also proceeded apace: civilian donors were awarded a badge of white metal with a bronze star of India.42 The availability of such facilities near the front lines not only helped reduce the casualty turnaround times, but also bolstered the morale of the men.
India's War Page 45
