Medical Guidelines to INA soldiers for Guerilla Warfare by Lt. Col. R. M. Kasliwal

(The Indian National Army, or Azad Hind Fauj, led by Subhas Chandra Bose had every working department that a modern government has. In March 1944, when INA was fighting a guerilla war against the British Forces, its Medical Officer Lt. Col. R. M. Kasliwal prepared a manual in Urdu-Hindi written in Roman Script to guide the soldiers during such warfare. We are reproducing its English Translation for our readers.)

 

MEDICAL ARRANGEMENTS DURING GUERILLA WARFARE.

As opposed to regular warfare where opposing forces face and fight each other on a front, for days, weeks or months, depending on duration of the battle, in a Guerilla warfare there is no such fixed front. The fighting forces have to operate in enemy areas which may be surrounded on all sides by the enemy. In this warfare small independent groups of soldiers work and fight against a highly organised and well equipped army with little or no fixed lines of communication. In their mobility, element of surprise and fierceness of attacks, these small bodies of troops can be compared to the organised bodies of dacoits except that their motives and their objectives are different.

These small bodies of troops are highly mobile and consequently they are lightly armed. Element of surprise is their most effective weapon. They never attack the main body of the enemy, but only attack and destroy small and isolated detachments of enemy troops away from the main enemy force. They attack the vulnerable points in the enemy lines of communications and carry out sabotage work in the enemy rear.

To be able to carry out Guerilla Warfare successfully two things are essential:

(1) A big area for the Guerillas to operate so that they can quickly retreat and take refuge in some safe place after inflicting losses on the enemy.

(2) Cooperation of the local inhabitants:-

(a) To give information of enemy activity.

(b) To give supplies if necessary and

(c) To give shelter when required.

For medical arrangements under such conditions it is obvious that  the usual stereotyped medical arrangements of the army will not do.

In ordinary warfare, efficiency of the medical arrangements depend on the following factors: –

(1) Adequate and efficient medical personnel.

(2) Adequate and regular medical supplies.

(3) Adequate and efficient arrangements for evacuation and transportation of the casualties from the front.

In a Guerilla warfare as the lines of communications cannot be maintained continuously, one or more of the above mentioned factors may be dislocated.

Prevention of the diseases and maintenance of good health of the troops is more important in the Army than merely treating the sick and wounded and always more stress should be laid on the former. This is much more true for Guerilla Warfare.

The Guerillas should be in the very best of health and be tough. Maintenance of good health of the Troops and high standard of sanitation in the unit lines should therefore be the primary concern of the M.O. of the unit.

The troops should be in such a good state of health and so well trained and hardy that they should be able to cover long marches varying from 25 to 30 miles a day without any sign of fatigue and should be prepared to fight an action with enemy if so needed at the termination of the march.

Responsibility for promotion and maintenance of good health and prevention of Diseases devolves on the Unit Comd. The M.O. is an adviser and on his expert advice the Unit Comd. takes necessary steps to ensure the good health of the troops under his command.

Many adverse situations are likely to be met with under Field Service more so in a Guerilla Warfare. There is generally an absence of peace time amenities and the troops are exposed to all kinds of climatic changes and inclement weather with the result that the vitality of the troops goes down and they become vulnerable to diseases. Sometimes the troops may have to occupy unhealthy sites due to tactical reasons and then there is more likelihood of spread of the disease. Sometimes the sanitary appliances may be destroyed and medical arrangements may be disorganised due to enemy action. The water supply may be deliberately polluted with Bacteria or Chemical poisons. Thus many difficulties are met with under Field Service conditions in Guerilla Warfare and this may affect the health of the troops immensely.

It is therefore essential that many rigorous measures have to be adopted to ensure the good health of Troops and this is best done prior to the Troops proceeding on field service area.

1. The troops should be in sound bodily health both physically and mentally.
2. They should be fully protected (ensure 100 percent.) against the chief infectious diseases prevalent in the operation area e.g. Smallpox, Enteric Group of Fevers, Cholera, Plague, Dysenteries. The protection in the last four diseases only lasts six months so the inoculation must be repeated every 6 month. Smallpox vaccination may be repeated every 1 to 2 years or whenever there is an outbreak of an epidemic.
3. The troops should be trained to undergo tough and hard life, trained in long route marches, sometimes without food and very little water and to be able to do without sleep for at least 48 hours without affecting the efficiency of work.
4. High spiritual training is essential with the result that the inconveniences met with during the course of Field Service conditions are not taken notice and troops do not unnecessarily report sick and thus cases of “Psycho-Neurosis” and “Malingering” can be curtailed to a great extent.
5. Training of the troops in general and the officers in particular in the general principles of Hygiene and how to utilize them for protection and maintenance of good health and prevention of diseases.
6. Equipment of the troops should be light and well fitting and it should not exceed 40% of the body weight. Otherwise there will be enormous loss of body energy.

Special attention to be paid to socks and their proper darning and the fitting of boots, if casualties from sore feet are to be avoided.

7. Suitable clothing against cold, rain and summer should be provided. Otherwise the troops will be put to unnecessary hardships and sickness which could be easily avoided.
8. The troops should be trained under peace conditions to pay special attention to the following points which will be rigidly enforced under field service conditions in Guerilla Warfare:-

(a) Water Arrangements: – Water must be sterilised prior to consumption. Best method is by boiling. It should be very rigidly followed. All water for drinking and cooking purposes must be boiled prior to use. Japanese call it ‘OCHA’ and it is really an excellent idea. If bleaching powder or other water sterilizing powders or tablets are available they may be made use of according to the given directions, but under no circumstances will impure water be consumed by troops.

(b) Food Arrangements:- Ensure good cooking of food. Men should supplement their diet and spend more money on eating, than on other things. In Guerilla Warfare we may have to depend for supplies on local civilian population.

Food stuffs should be kept covered and well against flies etc. protected

Food should not be consumed from unlicensed vendors. Under difficult conditions if it is not possible for the troops to cook their own food, only hot food and hot drinks like tea or coffee which is cleanly prepared may be taken from the local shops or local villagers. Fruits can also be eaten provided they are not rotten and are washed properly prior to consumption. Avoid, specially, sweetmeats, biscuits, Gur and other articles which are likely to attract flies.

(c) Use of mosquito nets for all troops in night time and Anti-Mosquito Cream for persons on guard duty should be rigidly enforced. Prophylactic Quinine to be used only under special instructions on Fd. service conditions when passing through highly malarial areas.

(d) Proper disposal of excreta specially if troops are going to encamp in a place for sometime.

According to the duration of the stay shallow trench latrines or deep trench latrines may be used. Defecation on open fields should be discouraged if troops are going to stay in that locality for any length of time.

(e) While on Field Service, people should not become careless due to repeated moves but should follow the general principles of hygiene all the time and whenever facilities are available the troops should pay attention to the personal hygiene by bathing and washing the clothes and cleaning up and mending their equipment.

(f) All necessary measures against men contracting V.D. and getting drunk should be rigidly enforced.

If the above mentioned preventive measures are strictly followed it will help a great deal in cutting the sickness due to diseases to the very minimum.

Other medical arrangements consist in rendering effective treatment to the sick and wounded and their proper disposal. The M.Os. of Guerilla Units will have to act mostly on their own initiative. There being no regular communica- tion with the base, they will work more or less independently and they will have to divise ways and means how best to give medical aid to the sick and wounded. They will take help from local civilian doctors if possible and if required. When- ever it is possible to send information to the base, they will inform the H.Q. with regard to the state of health of the troops and regarding medical supplies and other medical problems. Medical Officers will ensure good health of troops and will also see that all the necessary preventive measures both individual anti-epidemic and unit anti-epidemic measures are rigorously carried out.

 

Medical Supplies: Strictest economy will be exercised in the use of drugs and dressings. Regimental panniers and other Field Equipment authorised will be carried in full. Whenever possible attempts will be made to replenish the medical stores from base but as in most cases there is hardly any means of contact, the M.Os. will have to depend on medicines available locally from local dispensaries, private chemists and Druggists and general medical practitioners. These medicines will be purchased from the local civilians and stocks will be replenished. If possible supplies may be sent sometimes by AIR but it would be so difficult and so rare that one must not depend on this. Sometimes it may be possible to obtain medical supplies by capturing enemy supplies.

 

DISPOSAL OF THE SICK AND WOUNDED.

 

1. If it is possible to evacuate, send the serious patients to the base.
2. In vast majority of cases, evacuation will not be possible. So these patients may be carried as far as possible and then left in a safe place in the custody of some friendly local civilians, or a local hospital after disguising the cases carefully.
3. Ordinarily medical personnel may not be left behind with one or two patients but if there are many cases, a trained Nursing orderly may be left behind to look after these cases. Full instructions and sufficient stock of medicines will be left behind with the orderly or the civilian friend who may be looking after the cases. If any local civilian doctor is available and he is friendly, he may be asked to look after the cases. Instructions may however be left for these cases to join up the unit when they are fit.
4. Whenever it is possible to send a message to H.Q., it will be necessary to send full details of these cases which are being left behind with exact location of the place so that when facilities are available, arrangements may be made by H.Q. to contact these cases and if possible to evacuate them to Base Hospital.
5. If in a zone of operation, an Aerodrome is captured, it may sometimes be possible to evacuate severe cases by AIR, but then again it is going to be very rare and could hardly be depended on.

If the enemy resorts to Gas Warfare or even Bacterial Warfare to small limited localities, the M.O. will tackle the situation according to the nature of the organism or the gas used and devise ways and means to combat it successfully. Bleach ointment will be issued for treatment against mustard gas poisoning.