Hektoen International

A Journal of Medical Humanities

Malaria in defeat and victory

Richard J. E. Brown
Yorkshire, England, United Kingdom


Lab researching malaria
Lab work in progress at the Royal Navy School of Malaria and Hygiene, Ceylon (Sri Lanka), 1944. IWM Non-Commercial Licence © IWM A 28167.

A few weeks ago, in the reading room of the National Archives in London, I came across the war diary of a British medical unit of the Second World War. This particular unit, No.1 Malaria Field Laboratory, Royal Army Medical Corps, had been posted to the eastern Mediterranean in early 1941, where it was tasked with mitigating the impact of insect-borne disease on British troops. I have read a great many such war diaries over the past few years, and there is usually a soporific regularity to their contents. The life of a malaria field laboratory generally consisted of a comfortable rhythm of education, lab work, and field surveys, and this essentially orderly existence was reflected in the tedious uniformity of the unit’s paperwork. I leafed lazily through page after page, following the unit’s activities chronologically.

I had made it as far as mid-May 1941 when, very abruptly, those sheaves of painstaking malaria survey maps and closely typed reports on the optimum siting of infantry encampments gave way to something far terser. Crete had been invaded by the Germans. The British were swiftly overwhelmed. There followed a partial and disorderly evacuation. I now had in my hands a set of papers hastily assembled by a British officer in Cairo, whose task was to try to piece together, from the fragmented stories of those who had survived, precisely what had happened to No.1 Laboratory in those last few days on Crete. Through him I learned that Privates Tyson and Jones were captured by the Germans, rescued by a squad of Australians, and eventually escaped the island under heavy bombardment. I learned that Private Hunt was twice separated from his unit, was knocked unconscious by the blast of an explosion as he struggled on foot towards the coast, and awoke three days later aboard a Royal Navy ship en route to safety. And I learned that the rest of the unit, including all the officers, were last seen in the hills above the evacuation beach as the last ship sailed, their ultimate fate unknown. That, it appeared, marked the end of No.1. Malaria Field Laboratory. It had become a footnote: one of the many casualties of a bruising and unexpected defeat.

Except that I then found an additional document, showing that many weeks later the officer in Cairo had received the following laconic note from one of the missing officers:

A short note to let you know that I managed to escape from the Hun and am back in Cairo. [The others] are well and I believe on the mainland. God knows where. The story must wait till I see you.1

Quite what “the story” was, or even whether it was ultimately told, I cannot say. The archive contains no further information on the subject. No.1 Malaria Field Laboratory was re-formed in Britain in the autumn of 1941, and its new staff served, largely uneventfully, in Iraq and Bengal for the rest of the war.

I do not mention this incident because I think it was especially remarkable. In the grand scheme of things, it was not: the varied and chaotic experiences of those men can in one sense stand for many thousands more who also faced the perils of retreat, in all theaters of the war. Instead, I mention it because it highlights something that is often neglected in the history of malaria in conflict. Insofar as we think about it at all, we tend to think in terms of heroic late-war narratives about new inventions such as DDT or mepacrine saving the day for the Allies. We think a lot less about the fact that even from the outset, the Allied armed forces had devised complex strategies for the management of malaria—and that these plans proved largely ineffective. Despite its best intentions, No.1 Malaria Field Laboratory’s was unable meaningfully to protect British troops on Crete. Mercifully, the fighting there was over before malaria could have much impact one way or another, but for the Americans in the Philippines, the collapse of anti-malarial precautions greatly exacerbated casualty numbers on their bloody retreat to Bataan.2 So too for the Australians in Papua, where soldiers retreating along the brutal Kokoda trail suffered cruelly from both malaria and dysentery.3

None of this should be surprising. “No plan can survive contact with the enemy,” wrote Moltke,4 and plans for the prevention and treatment of malaria were more complex than most. Early failures of malaria prevention were certainly profoundly sobering. Nevertheless, the Allies persisted in their assumption that resilient anti-malarial protection was possible for fighting troops, and by the end of the war malaria’s threat to Allied military efficiency was mitigated by a convoluted system of techniques and technologies targeting every stage of the malaria cycle. Old and newly-discovered larvicides and insecticides were systematically deployed to rid newly-occupied areas of mosquitoes. Dedicated squads of troops sprayed large swaths of vulnerable territory, while individual soldiers were issued insecticides for personal use. (American troops generally carried a one-ounce aerosol can containing the newly-developed synthetic insecticide DDT; British troops were issued smaller sprayers based on the gas canisters fitted in soda siphons.) Increasingly efficient repellent creams were developed to deter mosquitoes from biting exposed skin: at the University of Cambridge, Sir Rickard Christophers alone tested several hundred compounds for the British Army. Troops in exposed areas were ordered to take a regular dose of mepacrine (also known as atabrine or atebrin), which large-scale testing conducted by the Australians at Cairns had proven effective not simply as a treatment but also prophylactically.5 Meanwhile, malaria forward treatment units were constructed just behind the front line, meaning that cases could be treated more swiftly and the hassle of a lengthy evacuation avoided. New and stringent forms of “malaria discipline” were introduced, with precautions strictly enforced by officers and NCOs right down to platoon and squad level, all reinforced by a concerted propaganda effort.6

By 1945 this unwieldy but effective system promised to afford the Allies a substantial military advantage over the enemy, who had not replicated any of the anti-malarial fervor outlined above. In fact, when the Australians in Papua New Guinea captured a Japanese hospital encampment, they found bottles of quinine looted from British hospitals in Singapore, still marked “property of HM Forces.”7 Yet it is probably going too far to say that malaria itself was consciously weaponized by the Allies. Malaria prevention certainly figured in Allied offensive planning—the United States landings on Morotai in the South West Pacific Theater were accompanied by aerial spraying of DDT, for example—but malaria was nevertheless always viewed as an underlying threat rather than a potential asset. The British general in charge of the Burma campaign, William Slim, flatly denied suggestions that he had sought somehow to use his troops’ apparent anti-malaria edge over the Japanese by deliberately choosing to fight through the most malarial terrain.8 The Germans, in contrast, may well have had the spread of malaria as one of their motivations for having demolished numerous dykes in their retreat north through Italy: it was certainly one of the outcomes with which the Allies had to deal, by diligently deploying all of the techniques mentioned above. What mattered most in this, and in each of the Allies’ victorious campaigns in malarial regions, was the growing resilience of their anti-malarial system. It was now appreciated that some unforeseen eventuality might render one aspect of the strategy ineffective (in one memorable instance, units of Allied troops wading ashore in Sicily noticed yellow patches swirling around them where their inadequately waterproofed packs of mepacrine tablets had begun to dissolve into the sea!) and so no one technology was relied upon exclusively. Rather, every possible means of protection was employed. In this sense, the Allies’ mastery of malaria was not so much a cause of victory, as one of its symptoms: it spoke of an army that held the initiative, and of a family of nations that—unlike their enemies—had the time, resources, and inclination to develop and deploy a host of different techniques to protect their troops.



  1. WO 177/574, The National Archives of the United Kingdom.
  2. Mary Ellen Condon-Rall, “U.S. Army Medical Preparations and the Outbreak of War: The Philippines, 1941 – 6 May 1942,” The Journal of Military History 56, no. 1 (1992).
  3. Peter Brune, A Bastard of a Place: the Australians in Papua, (Sydney: Allen & Unwin, 2004).
  4. An English paraphrase of the lengthier German: Kein Operationsplan reicht mit einiger Sicherheit über dass erste Zusammentreffen mit der feindlichen Hauptmacht hinaus.
  5. Tony Sweeney, Malaria Frontline: Australian Army Research During World War II, (Carlton, Victoria: Melbourne University Press, 2003).
  6. Mark Harrison, “Medicine and the Culture of Command: the Case of Malaria Control in the British Army during the Two World Wars,” Medical History 40, no. 4 (1996).
  7. Brune, A Bastard of a Place, 389, quoting Bill Spencer, In the Footsteps of Ghosts (Sydney: Allen & Unwin, 1999).
  8. William Slim, Defeat into Victory (London: Cassell and Company, 1956) 354.



RICHARD J.E. BROWN, PhD, is a historian of science, technology, and medicine at the University of York, England. An alumnus of King’s College London and the University of Oxford, his work focuses on the development and use of technology in twentieth century conflict. His current position as a Research Associate on the Chemical Empire project at York is funded by the Wellcome Trust.


Fall 2021  |  Sections  |  Infectious Diseases

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