This article is an introduction to hygiene and sanitation for families, small groups, and communities.
During early wars, dysentery was by far the cause of most of the combat ineffectiveness in the field. It can debilitate armies. Second to dysentery, were trench foot and frostbite.
Sanitation begins with personal hygiene, and is important regardless of group size. Individual habits contribute to the health of others. We do not need to be spreading disease among ourselves and becoming sick and inffective. The broader issue of sanitation must be addressed and practiced at the group level.
Having lived in austere conditions for years, I’ve experienced many of the medical issues that soldiers in the field experience. As a quasi-military operation, survivalist groups can apply what the military already knows. For those who have lived as infantry, theirs is hard-earned wisdom for those who have not lived it, and even for those who have. Once the conveniences of modern life are gone (i.e. washing machines, flushing toilets, and hot water) the uninitiated will experience a new set of sanitation and hygiene issues that will contribute to health problems when living in prolong austere conditions. These extreme circumstances will in general, degrade one’s immune system, making us vulnerable to other diseases as well. As modern conveniences go away, the once-common diseases return. These diseases of the Third World will flourish, and take us by surprise.
The odds that we could see history repeat itself with plagues, pestilence, and famine are high. Our immune systems are not adapted for primitive environments, but for relatively sanitary modern life. Given a lack of antibiotics, and other medicine, we would never be more vulnerable. The best way to deal with it is to follow the procedure and wisdom of an army in the field, and maintain a good level of sanitation. It all starts with personal hygiene. The individual must be responsible to carry out basic hygiene practices on a routine basis, otherwise all could be subject to disease. However, individual practices are not a substitute for good sanitation procedures, such as keeping latrines clean and fly-free, and providing clean water to a larger group of persons.
Cholera will be among the worst of waterborne diseases. Along with Giardia, these would cause outbreaks of dysentry. This is a type of gastroenteritis that results in bloody diarrhea. Other symptoms may include fever, a sensation of incomplete defecation, and abdominal pain. Dysentry without modern medicine is deadly and has been able to render large portions of armies combat ineffective. Historically, dysentery has been the largest cause of non-combat fatalities.
There are many other diseases to be concerned with such as antibiotic-resistant TB, Hepatitis, STDs, and a variety of others. Then there are trench foot, frostbite, and minor injuries that become serious due to infection. Separately, and certainly combined, these issues have caused a significant portion of noncombat injuries. So egregious the result, yet so simple is the prevention! For example, in Sweden, it is was once a court-martial offense to allow one’s self to become combat ineffective due to frostbite. In a WROL world, in order to survive, every member of our group needs to be as healthy and productive as possible.
Good sanitation practices are essentially preventive medicine. Its importance cannot be over-emphasized. While sanitation should be the medic’s responsibility, we might not have the organization and training afforded by military experience. It is our responsibility to learn, and take charge of this issue ourselves.
Public domain U.S. military manuals and training circulars on sanitation are excellent guides. Whether your group is larger or smaller, it would be good to have someone doing the job of monitoring and ensuring that the basics are in place and that maintenance is performed.
Here are a couple of examples:
As a subset of sanitation, efforts in general personal hygiene is the responsibility of the individual. Therefore, they need to know in advance what to look for, and how to manage issues that impact their health and performance.
The following is a list of products for personal hygiene. It is comprised of items used and recommended by combat infantry in the field. This list is not intended to be comprehensive, but as food for thought, and useful if one can obtain certain items. The items point to the common issues that arise, yet issues such as cellulitis and fungus require preventive measures. Daily washing of all the ‘dirty parts’, teeth, pits, groin area, and feet, is necessary.
Clean and dry socks, blister management, and other means of keeping the feet healthy and pain-free can not be over-emphasized. Everything we do depends on our ability to get around. Even a mechanized Army lives on its feet. I am personally aware of these issues, only because of my ‘bad’ feet that cause severe pain when standing for a long period of time. Even though I might lead a patrol, I am disqualified as a result of my ‘bad’ feet. I would be a liability instead of a team leader. A team leader must be more fit than the rest of the team. Any unaddressed issues, in general, will affect the team or workgroup.
Products for Individual Hygiene and Health:
- Small and large chamois
- Norwex brand body scrub mitt
- Anbesol or Orakel (for tooth pain)
- Tec-Nu (poison ivy, sumac)
- Fels-Naphtha (poison ivy, sumac)
- Tinactin powder
- Permethrin, (lice wash)
- Fine tooth comb (lice)
- Baby wipes
- Hand sanitizer
- Cough drops
- Eye drop antibiotics
- Bleach (for making foot wash)
- Sevin dust
- Tincture of benzoin (foot blisters),
- Unscented Ivory soap (perfumed products can be smelled by the enemy)
- Imodium AD
- Mole Skin
Basic and Inexpensive Methods of Water Disinfection
There are some basic and inexpensive methods of water disinfection using filtration, boiling, and chemicals.
Typical household 3% bleach is becoming more expensive. It also quickly loses its potency on the shelf. Pool Shock (calcium hypochlorite) is an inexpensive source of powdered bleach that is difficult to store because it is highly corrosive. But it can be used to treat water sources, and be a general disinfectant at a 10% solution in the kitchen or clinic. In a much lighter concentration, it can even be used with a wound dressing. Either sodium hypochlorite or calcium hypochlorite can be used to create Dakin Solution — a 0.5% solution.
Water filters, and the ability to boil large amounts of water over an open fire or wood stove, can be used for sanitation and drinking. These are not just good options to have, but essential tools for large groups.
If the water is particularly nasty, nothing sanitizes water better than boiling it. Even the most refined filters we normally can buy will not filter out viruses. If there could be a dead animal in a water source or if there is known to be a communicable disease in the area, hen boiling it is the only option.
Chemical treatment means require very small suspended particle sizes to be effective after a 45-minute wait. The risk is that larger particulates might encapsulate a contagion and the wait time necessary before consumption, and should therefore be extended, or more chemical used if the water is very cold. Temperature does affect the speed of the chemical reaction. A method to ensure consistent and reliable chemical treatment should standardize the condition of the water to remove the guesswork. Therefore, pre-filtering in several ways is necessary. The most simple method is with five layers of cotton T-shirt material if the water is muddy and full of other debris. If the water is still cloudy after pre-filtering then wait twice as long, or several hours if cold, when treating it with a chemical of any kind.
Additional filtration to reduce cloudiness improved the overall water quality and risk of miscalculation when chemical means are used. The ability to boil large quantities of cloudy water negates the risks associated with processing the same dirty water with filtration, or by chemical means, or both.
Refined Methods of Water Filtration and Treatment
The Black Berkey filter is expensive and their service life is greatly shortened when subjected to filtering cloudy water. Other brands of ceramic filters that cost less might be a good choice. Some of these filter out smaller particles (0.5 micron), reducing cloudiness better than does the black in color Berkey filter (0.9 microns). Some of these other brand ceramic filters are slower in water motion, and thus require a longer filtration time. Though slower to produce filtered water, they could be less expensive, and if more filter elements can be purchased and used simultaneously, and hence filtration time could be shortened. The Black Berkey is a faster filter as it filters to only to 0.9 microns, just small enough to filter out the cysts of protozoa, and amoeba that cause Cholera and Giardia dysentery.
To extend the service life of ceramic filters that claim ratings in only ideal conditions, or as a part of a process that ends with chemical treatment, use a polyproplyene 1 micron (best) or common 5 micron sediment filter. These are a standard sediment filters that are 10 inches long, intended to be used as a element in a whole house filtering system. These can be used to clarify water before chemical treatment, thereby reducing the amount of chemical needed.
A low-cost field expedient method of utilizing these filters without the need for pressurized water or filter housing, is to use a 6-gallon bucket, a 12-inch length of All-Thread stock (3/8-inch or 1/2-inch in diameter) with two nuts and a 2 inch in diameter fender washer. Drill a small hole in the center of the bottom of the bucket, place the filter element over the hole, and run the All-Thread through the center hole of the filter, and secure it in place with the fender washer on the top of the filter element. This allows us to gravity-feed the water into a container located directly below.
Typical 3% household bleach such as Chlorox only retains its full potency for about 12 months. Calcium hypochlorite is cheap, and it is good to have lots of it. The military manuals recommend and provide instruction on how to dilute 70% calcium hypochlorite. A one-pound can sterilize a huge amount of water, perhaps as much as 10,000 gallons, or only 5,000 gallons if the water is cloudy. Soap will also be in limited supply, so chlorine can be a good option to be used on food preparation surfaces, to personal hygiene, and to shocking contaminated wells providing a small community with potable water. At a 10 percent solution, is all that is needed for all surfaces if for decontamination in a clinic, or sick room setting. It is multipurpose.
Boiling water for drinking, and providing large amounts of hot water is useful no matter the size of the group. Boiling laundry, a practice not appreciated in modern times, precludes the use of soap, and chemicals. This can be used to clean clothes with minimal amounts of soap, or even no soap, to sanitize eating utensils, surfaces, and water for bathing. Boiling wound dressing material and nitril, or other ‘rubber’ gloves in a pressure cooker at 15lbs for 45 minutes will sterilize this material. The same technique using only two inches of water at the bottom and elevating surgical instruments above the water, will sterilize them much like an autoclave would.
For an in-depth look at the topic of sanitation, military manuals are invaluable. What is covered here will hopefully serve as an introduction. There is more to be learned. Living off-grid in austere conditions for many years has helped me appreciate the issues in general. The topics and particular techniques covered, used in conjunction where they are appropriate. Thus, we can conserve limited resources, i.e. soap. By shrewd management of finite resources, instead of using soap or bleach, we can boil underclothes and socks. These items are then thoroughly sanitized, and not degraded by chlorine. In this example, we conserve soap for handwashing, and spare the chlorine for sterilizing water, or for cleaning food preparation surfaces for the processing of meat, or some other critical task, that is best handled with a chlorine solution. The result of wise management of key resources will help to ensure that all the benefits of good sanitation are realized in a prolonged, austere setting.