A Fighting Chance: Disease, Public Health, and the Military, Part 2

*the following blog post was written by 2013 Margaret Angus Research Fellow Robert Engen    

Two of the most remarkable stories in military medical history happened in the exact same place: Walcheren, a strip of land that sits like a cork in the mouth of the Scheldt River running through the Netherlands and Belgium. Walcheren is in the province of Zeeland, much of which has been reclaimed from the sea over the centuries through ambitious irrigation dykes and drainage projects, so part of it sits below sea level. It is known for being swampy, prone to flooding, and, historically, very unhealthy.[1] In 1809, during the Napoleonic Wars, Walcheren was the initial landing site of a major British expedition bent on capturing Antwerp; in 1944, Walcheren was defended to the death by the armies of Nazi Germany, trying to prevent the Allies from using Antwerp’s port to bring in supplies.

Figure 1: The Scheldt Estuary, ©Google Maps 2013. Walcheren is the knob at the end of the peninsula stretching out into the Scheldt. Its capital is Middelburg, and its largest port is Flushing.
Figure 1: The Scheldt Estuary, ©Google Maps 2013. Walcheren is the knob at the end of the peninsula stretching out into the Scheldt. Its capital is Middelburg, and its largest port is Flushing.

The two military campaigns for control of the River Scheldt took place on the exact same ground, at the same time of year, and in similarly unhygienic conditions, 135 years apart. But the outcomes of the 1809 The Walcheren Expedition and the 1944 Scheldt Campaign could not have been more different – and the difference was entirely medical.

In August 1809 the British expeditionary force, attempting to seize Antwerp, one of Napoleon Bonaparte’s most important ports in Europe, deployed 40,000 soldiers and a substantial naval squadron to the Dutch island of Walcheren. They quickly captured Walcheren and the neighbouring islands, and besieged the French forces holed up in Flushing.[2]

Things were going well for the British when, seemingly out of nowhere, infectious disease struck. Until late August 1809 the expedition had been quite healthy, but within a week thousands of soldiers were falling ill and dying from what physicians began to call “Walcheren Fever.” By the last day of August there were 3,400 British soldiers listed as sick, and the number exploded upwards from there. At its worst, in the middle of October, there were almost 10,000 sick soldiers still on Walcheren, not including those already evacuated home to England. By that point 60% of the force had become casualties of the disease, which caused several different types of fever, intense back and head pain, swelling, rash, myalgia, hepatomegaly, and splenomegaly.[3] Today, forensic historians and physicians believe that “Walcheren Fever” was a combination of malaria, typhus, typhoid and paratyphoid fevers, and dysentery.[4]  Conditions on Walcheren were unspeakable, and exacerbated the situation. The expedition was short on doctors, the flooded fields spread filth, manure, and dampness everywhere, there was an acute lack of effective medicines, and major hospitals had to be set up in buildings half-destroyed from shelling.[5]

The expedition was abandoned and Walcheren slowly evacuated, but “Walcheren Fever” remained, and in February 1810 there were still 12,000 soldiers from the expedition reported as sick in hospitals in Britain. 4,000 enlisted men and 60 officers died of the disease, and many of those who survived took years to fully recover.[6] The Walcheren Expedition was a disastrous failure. It indirectly brought down the British government and caused a public furor during the parliamentary inquiry.

Figure 2: "The Winding up of the Medical Report of the Walcheren Expedition," 1810, by Thomas Rowlandson. The caricature blames the failure of the Walcheren Expedition on the incompetence and gross mismanagement of the top army medical board officers.
Figure 2: “The Winding up of the Medical Report of the Walcheren Expedition,” 1810, by Thomas Rowlandson. The caricature blames the failure of the Walcheren Expedition on the incompetence and gross mismanagement of the top army medical board officers.

One hundred and thirty five years later, the Scheldt Estuary was being fought over again. In October 1944, the Canadian Army was attempting to wrest control of the ScheldtRiver and Walcheren from Nazi Germany. The Scheldt Campaign saw the Canadians fighting through the flooded Zeeland province, battling worse conditions than the British had faced in 1809. It took almost a month and a half of intense combat through flooded fields and across dykes and polders, before Walcheren was seized and the Germans were defeated.

What about “Walcheren Fever”? Conditions in the Scheldt in 1944 were just as putrid and unhygienic as they had been in 1809, perhaps even worse, and diseases like malaria, typhus and dysentery were still very real threats to soldiers’ health. Thousands of Canadian and Allied soldiers had become casualties to malaria in 1943 and 1944.[7] If disease was going to cripple the Allied war effort anywhere, historical irony would ensure it would be on Walcheren.

Given how “Walcheren Fever” had destroyed the 1809 expedition, infectious disease played an almost negligible role in the 1944 Scheldt campaign. Throughout the month of October 1944 the rate of hospitalization for sickness in the First Canadian army was less than one in every hundred.[8] During the weeks of fighting in the Scheldt and for Walcheren, there were only 66 cases of malaria, total, in an army of almost 200,000 men. There were a handful of cases of confirmed dysentery, two cases of typhoid or paratyphoid fevers, and no cases whatsoever of typhus.[9] There were many other diseases, and on any given week there were between 1,000 and 1,700 Canadian and Allied soldiers out sick with a variety of complaints, but there were no serious epidemics or outbreaks of infectious disease. During the entire month of October 1944 there was only one soldier in the First Canadian Army who was reported to have died of illness while in hospital during the entire Scheldt Campaign.

The two military campaigns for Walcheren could not have been more medically different. But the successes of 1944 did not come about because the diseases that had destroyed the 1809 expedition had been cured or eradicated. Infectious disease was still a real danger in 1944, and had any serious number of Allied soldiers become disease casualties, the entire campaign, which already balanced on a knife’s edge, might have failed. The vast reduction in disease casualties came about, as we shall explore in my next blog post, because of the rigorous implementation of public health practices by the Canadian Army.

Figure 3: Allied soldiers landing at Flushing, Walcheren, November 1944. Photograph BU 244, Imperial War Museum, public domain.
Figure 3: Allied soldiers landing at Flushing, Walcheren, November 1944. Photograph BU 244, Imperial War Museum, public domain.

Robert Engen is pursing his PhD in military history at Queen’s University. He also teaches at Queen’s and writes extensively about Canadian military history.


[1] Dirk Marc de Waard, “Luctor et Emergo: The Impact of the Second World War on Zeeland” (Wilfrid Laurier University: MA Thesis, 1983), 2.

[2] J.W. Fortescue, A History of the British Army, Volume VII: 1809-1810 (London: Macmillan, 1912), 79.

[3] John Lynch, “The Lessons of Walcheren Fever, 1809,” Military Medicine 174, no. 3 (March 2009), 318.

[4] Ibid., 318.

[5] Martin Howard, “Walcheren 1809: A Medical Catastrophe,” British Medical Journal 319 (18-25 December 1999),1643.

[6] UK Parliamentary Papers 1810 (14(2)) Military – Supplementary – A – No. 26, 1; Robert M. Fiebel, “What Happened at Walcheren: the Primary Medical Sources,” Bulletin of the History of Medicine 42, no. 1 (Jan/Feb 1968), 64.

[7] William R. Feasby, Official History of the Canadian Medical Services Vol. 1: Organization and Campaigns (Ottawa: Edmond Cloutier, 1956), 146-8.

[8] Health of the Troops – First Cdn Army, reports by Brigadier C.P. Fenwick, DDMS, First Cdn Army, LAC RG 24, vol.12565, 11/AEF HYG REPORTS/2.

[9] Weekly Summaries of Sick, Injured & Dead (by disease and formation), LAC RG 24, vol. 12565, 11/AEF HYG REPORTS/2.

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