Ted Ford had carried out malaria surveys in New Guinea before the War. To find out exactly what was happening in the field in New Guinea, Colonel Keogh posted him as Deputy Director of Hygiene and Pathology at Port Moresby, with the rank of Lieutenant Colonel. In the campaign at Milne Bay, in September 1942, relatively untrained Australian troops had achieved the first defeat of the Japanese on land; they later suffered severe casualties from malaria (quinine was ineffective as a suppressive drug against New Guinea strains of malignant tertian malaria). Early in December, Ford sought and obtained an interview with the Commander-in-Chief of the Australian Army, General (later Field-Marshal Sir) Thomas Blamey. In his quiet persuasive way, Ford convinced Blamey that, unless malaria was controlled, the army in New Guinea would be totally destroyed by the disease. Blamey acted immediately. New Routine Orders dealing with malaria, prepared by Keogh with Ford's assistance, were promulgated and enforced. To provide expert advice and dramatise the importance of malaria, three new posts of malariologist were established to supplement the work of the Assistant Directors of Hygiene. In March 1943, Ford was appointed senior malariologist, based in Port Moresby, and two other medical officers, Major J. C. English and myself, were appointed malariologists. I moved up to Port Moresby in April and initially shared an office there with Ford. In July, I moved to Buna, on the north coast, where troops were preparing for the Lae-Finschhafen campaign.
Figure 3.2. Frank Fenner at the site of the 2/2 Australian General Hospital at Hughenden a day after the cyclone
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Sir Edward (Ted) Ford
Brian Gandevia noted, and I can confirm that Ted Ford had several personal qualities rarely seen in one man: an ever-present gentleness, a great depth of kindness and understanding, a wonderful generosity and a sincere humility, and a keen sense of humour and wit, none of which precluded determination and firmness when the occasion demanded (as was evident in his conversation with General Blamey). He was a late starter in medicine, working in the Postal Department at night and doing medicine by day. Graduating in 1932 at the age of 30, he entered academic medicine by becoming a lecturer in anatomy, where he came under the charismatic influence of Frederic Wood Jones. After obtaining a Diploma of Tropical Medicine in 1938, he investigated venereal disease and malaria in New Guinea. Back in Australia, he became a lecturer in bacteriology at the Sydney School of Hygiene and Tropical Medicine (which is where I first met him in 1940; in 1947 he became Director of the School) and in 1941 he went to Palestine as commanding officer of a Mobile Bacteriological Laboratory. Back in Australia, Bill Keogh organized his transfer to New Guinea as Bill's deputy, and in 1943 he was appointed to the new post of Senior Malariologist, where, of course, I had very close relations with him (see Gandevia, 1994).
Jim English and I learned what our job was as we went along. By this time, quinine had been replaced by atebrin. Our first mission was to convince all those in charge of troops in the field, from colonels to platoon commanders, that they must ensure that all troops under their control swallowed one tablet of atebrin daily. I and all troops who did this became greenish-yellow in appearance, and some suffered from skin and neurological problems as complications (but not impotence, a rumour that was widely circulated among the troops). As malariologists, we also supervised the work of the Malaria Control Units and Entomology Research Units associated with the campaigns to which we had been allocated. As malaria came under better control, we took responsibility for the prevention of other insect-transmitted diseases, mainly dengue and scrub typhus, as well as malaria. Besides keeping in close touch with Keogh via ‘demi-official’ letters, I had frequent contact with Ian Mackerras (then Director of Entomology and later the first Director of the Queensland Institute of Medical Research) and his deputy, Francis Ratcliffe, with whom I was later to collaborate in studies of myxomatosis. I also met our equivalents in the US Army in New Guinea, Majors McGhee Harvey and Fred Bang, both professors at Johns Hopkins University, who remained good friends in my post-war days.
During this period I was instructed by Colonel Keogh to apply for the position of Director of the Institute of Medical and Veterinary Science in Adelaide, where Dr Weston Hurst had been Director during my intern days. Major R. J. Walsh, officer-in-charge of the Blood Transfusion Unit in Sydney, who later became a very good friend of mine, had received similar instructions; Keogh insisted that possible candidates for such positions who were in the services should not be overlooked. Fortunately, in terms of our subsequent careers, neither of us was appointed.
The major campaign with which I was closely associated in New Guinea was the capture of Lae and Finschhafen by the troops of Second Australian Corps, comprising the 7th and 9th Divisions, over the period September 1943 to March 1944. I wrote a long technical paper on malaria control during this campaign, which is summarized in A. S. Walker's history of medical aspects of the War (Walker, 1952). I set out below an abbreviated version of Walker’s summary:
The terrain was highly malarious; the military operations were highly successful. This campaign began with better prospects than others previously fought. Equipment was better, protective clothing was worn, mosquito repellent and atebrin were available, and mosquito control was applied at an early stage in the operations, the control units moving along with the troops Notwithstanding all this nearly 10,000 men were evacuated with malaria.
There was no question that the malaria risk was high in Lae and Finschhafen; the Japanese suffered heavily, 308 died out of 708 admitted to one of their field hospitals in the Huon Gulf area. Conditions were favourable for survival of adult mosquitoes long enough to enhance the risk of a rising infection rate. It was most important to realise that poor antimalarial discipline increased the risk of a gametocyte reservoir among the Allied troops. In Lae and Finschhafen control of adult mosquitoes was ineffective; in Lae gametocyte carriers were promptly segregated, with the result that larval control was rapid and effective, whereas in Finschhafen this segregation was ineffective and larval control was consequently slowed.
The malarial risk was high during the first month after the landing, and it was only after this that control reduced the risk. Fenner made an analysis of the capture of Lae, the capture of Finschhafen and the enemy counter-attack, with the following offensives on Sattelberg and Wareo, and the final capture of the Gusika-Wareo line. Though allowances must be made for the different nature and intensity of these actions, the sick wastage figures given in Fenner's report are most significant, as seen in the table below.
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4–17 Sep |
22 Sep–10 Dec |
3 Dec–1 Mar |
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Date and place |
Gusika to |
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|
Lae |
Finschhafen |
Saidor |
|
|
Killed & missing |
150 |
291 |
83 |
|
Wounded |
397 |
1,037 |
186 |
|
Malaria |
62 |
3,400 |
4,300 |
Walker goes on to analyse the relative importance of other factors, such as the length of service in New Guinea, the physical condition of the troops on arrival there, the severity of the fighting, and the provision of reinforcements.