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May 18, 2004

Afflicted with Boils

When it comes to disabling American soldiers, Iraqi sand flies are far more effective than the Iraqi insurgents are.

They bring with them "Baghdad Boil," a nasty disease, more properly known as cutaneous leishmaniasis. They go about their ghastly business of extracting a blood meal and laying its eggs in human skin. In the previous 12 months there have been over 650 cases of the disease. Poor planning, imprudent regulations and military incompetence mean the Boil will be worse this summer than it otherwise should.

There are no FDA-approved vaccines or medications available to prevent leishmaniasis. The only way to control the disease is by attacking its hosts, the sand flies. Spot use of DDT would dramatically reduce the number of cases, but there's a US government ban on the chemical, even though spot use is a technique light years away from the widespread spraying of DDT described by Rachel Carson in Silent Spring. Even without DDT, measures that could be taken weren't.

Although the inability to use DDT is annoying, the entomologists' largest frustration is that in some instances requests for insecticides last summer went unanswered for many months. The results were immediate. "We started seeing soldiers basically eaten alive, 1,000 bites a night in a handful of cases," said one military medic. It is incredibly hot in the desert in the summer and most soldiers sleep in shorts and nothing else, with their tent flaps wide open to keep the air flowing.

This isn't just a failure in pre-war planning for the post-war period. It's a failure in post-war logistical planning as well, not on the same level but similar to the German failure to equip its soldiers with winter coats during the 1941 invasion of Russia.

Once it was realized that US forces in Iraq were going to be larger and stay longer than originally planned, some process should have been started to supply that larger number of soldiers with the equipment needed for the environment around them--not only insecticide and AC tents, but body armor, the shortage of which was an issue last fall.

But this may not be the military's fault in the strictest of senses. A great deal of the logistics once handled internally has been outsourced to private firms, under the assumption that this practice is both more efficient and cheaper than handling logistics internally would be. Given the $20,000 expenditure per case of cutaneous leishmaniasis versus the cost of a can of insect repellent , this would seem to not be so, at least in the limited circumstances described in the article.

Yet the shortage of protective measures for the Baghdad Boil is remarkably similar to the earlier body armor controversy. One might argue that while one instance is easily explained away, two such are evidence of an incipient pattern. Should the disease keep debilitating our forces at its current rate, or if another shortage in basic equipment is detected, the logistical arrangements in Iraq might need to be re-examined.


1.) It's possible that the logistics dealing with AC tents and insect repellent are so bad because they haven't been privatized, rather than because they have. I'm unable to find information detailing that one way or another.

2.) There are over 130,000 troops in Iraq, yet there have been only 650 reported cases of leishmaniasis, giving the disease a roughly 0.48% infection rate among American troops. Given that many troops have been rotating out of the country during the past year, the true infection rate is almost certainly even lower.

Posted by Bigwig at May 18, 2004 12:37 PM | TrackBack
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