Medical officers must understand the interplay between environmental conditions and the status of a population’s health if they are to preserve their unit’s combat effectiveness. In every war for which statistics have been recorded, military forces have lost more personnel to infectious/communicable disease and nonbattle injury (DNBI) than to direct combat with opposing forces.

Environmental health safeguards are the instruments to preserve combat effectiveness by limiting DNBIs. Critical elements to a unit’s health include: assurance of potable water and safe food; proper management of wastes and human excreta; and prevention of heat and cold injuries. Preventive medicine personnel (environmental health officers, preventive medicine technicians, or senior medical department representatives) assigned to the support element of the Marine Expeditionary Force (MEF) are responsible to ensure these safeguards are in place. However, medical officers are often called on to brief operational commanders on these and other preventive medicine topics. The following are general responsibilities that the medical department has for field sanitation:

Potable water supply

Medical department representatives (MDRs) shall advise their commanding officer on water quality issues, assist engineers in selecting water sources, identify potential health hazards within the potable water system, conduct routine halogen and bacteriological examinations of water supplies, and recommend water treatment methods.

Food service sanitation

In the field, all factors which normally contribute to foodborne illness outbreaks such as improper storage and holding temperatures, inadequate protection of food from contamination, and poor food handler personal hygiene, are exacerbated. The MDR has the following responsibilities:

• inspect food service facilities routinely

• inspect food to ensure it's fit for human consumption and received from an approved source

• maintain sanitary surveillance of storage, preparation, and serving of food, and the disposal of food wastes

• ensure food service spaces, equipment, and utensils are cleaned and sanitized properly

• examine military food service personnel for disease or unclean habits that could result in foodborne illness

• provide food service sanitation training

Waste management

All types of waste are generated each day in the field. If they are not disposed of properly, the camp will quickly become an ideal breeding area for flies, rats, and other vermin. Diseases such as dysentery, typhoid, cholera, dengue, and plague could compromise the integrity of the unit. To combat this problem, MDRs provide technical assistance in the fabrication, location, and maintenance of field waste-disposal facilities. They also inspect these facilities before their initial use to ensure their proper construction and location, and then reinspect on a daily basis.

Heat and cold injuries are a major threat to field operations, but are preventable through sound leadership and planning. Refer to the Cold Injury / Heat Injury chapter of this manual.

1. NAVMED P-5010, Manual of Naval Preventive Medicine Chapter 9 ,"Preventive Medicine for Ground Forces, " for detailed guidance regarding environmental health issues in the field.

2. US Army Field Manual FM 21-10, "Field Hygiene and Sanitation." Your preventive medicine representatives should have these in their library.