20 January 1915 – Cairo Vaccination

As seen above, Australian troops have brought kangaroos with them to Egypt and Africa during their mobilization. The animals had already become a national symbol, appearing in Australia’s official seal — designed just two years before the war — and make natural mascots for men who are leaving their homes for a faraway conflict. Indeed, both Australia and New Zealand are just emerging into the world as countries, and their sons have gone to war with barely an idea of their homes as nations, so it should not surprise us that they are eager to project a unique image that might stand out within the ranks of the British Empire.

After all, the Indian troops have their characteristic looks: turbans, beards, kukri knives — all the same among a large number of men who are uniform with one another, yet different from the rest of the Imperial Army in which they fight. When men decide they should all wear the same flap of their hat up in the same jaunty style, they are not just setting a fashion rule (or a ‘uniform regulation’), they are setting themselves apart as a group.

Diseases, on the other hand, do not care about our uniforms, our languages, our nations, or our causes.

The Australian 11th Battalion poses for  group photo on the pyramid of Cheops

The Australian 11th Battalion poses for a group photo on the Great Pyramid of Giza on January 10, 1915

Captain Edward Percy Cox of the Wellington Infantry Regiment is keeping a diary as his unit drills to prepare for a possible Turkish invasion of Egypt. That diary has been transcribed as an electronic record of the Gallipoli campaign, and it shows that the WIR’s training was suspended yesterday. “Vaccination is ‘taking’ to me & I’m not too chirpy tonight,” Cox added. Today’s entry reads: “Usual routine in camp. The men resting from hard training owing to vaccination.” The men of Wellington are recovering from a typhoid shot.

Not to be confused with typhus, a disease caused by a louse-borne bacterium which is currently burning up the Serbian Army and nation, typhoid is a fever caused by a germ that lives in unsanitary water supplies and spreads through poor sanitation, flies, and dust. During Britain’s war in South Africa thirteen years ago, the typhoid vaccine was only applied voluntarily, with merely 12% of troops accepting inoculation. Public distrust of the science — and activism by British citizens who oppose mandatory vaccination as a violation of civil liberties — made the army unwilling to mandate a lifesaving vaccine.

As a result, more than eight thousand troops were sickened by typhoid fever during the Second Boer War, and one in seven of those afflicted died of the illness. Unvaccinated men died at more than twice the rate of those who were treated with the vaccine. So-called ‘enteric fevers,’ including dysentery, sickened nearly ninety thousand soldiers. So it is little wonder that when this war broke out, the British Army decided to inoculate Cox and his troops whether they liked it or not.

Left: Cox's diary entry. Right:

Left: Cox’s diary entry. Right: Almroth Wright. His vaccine may have saved more British lives than any other technology of the war

Sir Almroth Wright, the immunologist and bacteriologist who invented the British vaccine and convinces the government to produce ten million doses of it for the troops, is a man ahead of his time. Long before the discovery of antibiotics by an aide who follows in his footsteps, Wright has predicted the danger of antibiotic resistance. He emphasizes prevention of disease over cures, and regards the seemingly-random process of pure science as the best way to discover the most cures. By the end of 1915, his vaccine factory at St. Mary’s has already produced three million doses that are estimated to save the lives of between a quarter and half a million soldiers.

Before his death, he will create vaccines against enteric tuberculosis and pneumonia, too. Yet Wright’s achievements are limited by his titanic ego: he is correct that hidebound battlefield physicians are killing millions of injured men when they pour antiseptics on combat wounds, but his abrasive style turns off potential allies in the medical community, delaying the adoption of the alternative method he has developed with Sir Alexander Fleming.

Australian troops visiting the Gaza pyramids on camel-back prior to the Gallipoli landings

New Zealand troops visiting the Gaza pyramids on camel-back prior to the Gallipoli landings

The results of this decision in the British high command are entirely predictable by science. The British Army sees a vastly-reduced rate of enteric fevers during the Great War — indeed, the difference is so stark as to be undeniable. Sir Arthur Conan Doyle, the creator of Sherlock Holmes who served as a medic in the Second Boer War, wrote after that conflict that typhoid fever “had been so universal that there really seemed no other disease…If the army had all been inoculated, this would, I think, have been absolutely the healthiest war on record.”

Of course, the vaccination is not perfect. As Captain Cox is learning, it sometimes causes pain at the injection site, fever, headache, and even nausea, often putting recipients out of action for days. When it was developed at the turn of the century, there were many reputable scientific figures who still objected to the germ theory of disease. While the idea of injecting a dead bacillus into a person to stimulate their immune system into resisting the pathogen might make perfect sense to us now, it was counter-intuitive in 1900.

Nevertheless, there are very few who object to the program this time around, marking an important shift in British public opinion about vaccination. By Doyle’s definition, the Great War is that “healthiest war on record,” for it is the first time in history that Britain loses more men to enemy weapons than disease. If you have been processed into a modern army within the last hundred years, you have almost certainly experienced mandatory vaccinations. In fact, no high-tech military would dare deploy without them today, and this is why.