Reviewed by Lieutenant Colonel John Boyce RFD (Retd) Defence Reserves Association – Victoria
MALARIA is not only the greatest killer of humankind, the disease has been the relentless scourge of armies throughout history. Malaria thwarted the efforts of Alexander the Great to conquer India in the fourth century BC. Malaria frustrated the ambitions of Attila the Hun and Genghis Khan to rule all Europe in the fourth and thirteenth centuries AD; and malaria stymied Napoleon Bonaparte’s plan to conquer Syria at the end of the eighteenth century.
Malaria has also been the Australian Army’s continuing implacable foe in almost all its overseas deployments since the Army formed at Federation in 1901. The scourge of malaria has actually halted Australian military operations three times in our history: in Syria 1918, in New Guinea 1943 and in Vietnam 1968. Forces have “melted away” in illness before a commander’s eyes. Throughout our military history there has been an ongoing struggle to control the impact of this disease, using medical research and mosquito-preventive measures. However, it would also appear that lessons learnt have needed re-learning by some later generations of field commanders and their troops.
This book begins by explaining the nature of the disease, which affects over 198 million annually around the globe, actually kills half a million each year and has existed since ancient times. It then charts Australian military efforts to overcome malaria from colonial days right through to recent operations in Iraq, Afghanistan, Bougainville, Timor Leste and the Solomon Islands. In the past twenty-five years some 36,850 ADF personnel (including thousands of Reservists) have deployed without any malarial deaths and only one epidemic of malarial infections.
Author Ian Howie-Willis writes in a very clear and interesting style. He begins with an overview of the disease, its transmission and the major ways in which prevention and treatment can be attempted. After briefly considering its historical impact since ancient times, he then presents separate chapters about each Australian military period. In these he sets the general context of those military campaigns and vividly describes the extent of the malarial problems encountered, what steps were taken to deal with them and how successfully (or otherwise).
Howie-Willis is full of praise for the work of the present Australian Army Malarial Institute (AAMI) and its predecessors, describing their efforts during each campaign and also summarising their work in a separate chapter later. He suggests that their existence was not always remembered by authorities during the urgency of recent tropical deployments, until the rate of disease once more started to impact upon operations, but he acknowledges that the AAMI could have promoted itself more effectively.
The book is well-illustrated by diagrams, maps, a few key graphs (showing dramatic infection rate spikes) and many photographs of people, localities and anti-malarial activities. It is extensively-referenced and has a detailed index. The author had his work peer-reviewed and he thanks by name a wide range of medical experts and military historians for their assistance. He does not comment much about recent preventive medicine action at the local unit level, nor offer specific recommendations for future operational health planning. The book also stops short of discussing the current controversy about sideeffects from use of mefloquine in the ongoing search for drugs against changing and more drug-resistant malarial strains.
Nevertheless, this is an important book well worth any military reader’s attention, both for the historical context it establishes and for the warning it provides to commanders at all levels regarding future deployments into malarial zones.