The Army Medical Department
And the Malta Garrison
1871

The average strength of the garrison was 4,977 men, exclusive of colonial troops. There were 3,531 admissions into hospital (709 admissions/1000 mean strength), with 61 deaths (12.26 deaths/1000 mean strength), of which 5 occurred in hospital and 5 among the invalids on their passage home and at the Invalid Depôt at Netley.

The highest ratio of admissions was in the Royal Engineers, and of deaths in the Royal Artillery.

133 invalids were returned home: 79 of which were discharged at the Royal Victoria Hospital Netley. The main diseases leading to men being returned to England were: phthisis (28 men), rheumatism (19 men), respiratory disease (17 men) and digestive disorders (15 men).

The average number constantly non-effective through sickness (mean daily sick), excluding the Royal Malta Fencible Artillery, was 164 men. The ratio per 1000 mean strength constantly sick was 32.95; the average sick time to each soldier was 12.03 days; the average duration of each case was 16.93 days.

Febrile diseases accounted for 696 admissions into hospital (139.8/1000 mean strength) with 27 deaths (5.42/1000 mean strength). Admissions were for:

• 39 for nervous system diseases with 2 deaths
• 25 for circulatory diseases with 7 deaths
• 231 for respiratory conditions with 7 deaths
• 664 for digestive diseases with 6 deaths
• 196 for urinary problems with 2 deaths
• 331 for cutaneous diseases
• 256 for rheumatism
• 67 for syphilis
• 34 for phthisis with 7 deaths
• 487 for accidents with 3 deaths
• 1 homicide
• 1 execution

Syphilis was very prevalent in 1871. The PMO attributed this to the spread by abandoned women, who were most likely to have been wives of soldiers, who, due to their military status, were exempt from compulsory examinations under the provisions of the Contagious Disease Act 1861.

There were 14 admissions for paroxysmal fevers (2.8/1000 mean strength) with 1 death (0.20/1000 mean strength), 576 for continued fevers (115.7/1000) with 14 deaths (2.81/1000) and 80 for eruptive fevers (16.1/1000) with 12 deaths (2.41/1000 mean strength).

Eruptive fevers were due to smallpox which had been prevalent in the Mediterranean during the autumn of 1870 and appeared in the civil population in October. On 3 January 1871, the first case among the troops occurred in the 87th Regiment. During the epidemic four officers and nine children became infected, all of whom recovered; three women became infected one of whom died. The 48th had the highest number of cases with 24 hospital admissions and 3 deaths. The military had 66 admissions and 12 deaths; there were 10 admissions of cowpox.

The island which, from situation and climate, should have been one of the healthiest spots in the world, was not so fortunate in its sanitary condition. The population in 1871, was 123,373 and as the superficial area is but 95 square miles, the population density was equal to 1,309 persons per square mile. (England and Wales had 389 to the square mile).

The average annual rate of mortality in Malta from all causes was as high as 28.3 per 1000 in the preceding ten years. The island suffered from a severe epidemic of cholera in 1865, from smallpox between 1870 and 1873, while diphtheria was more prevalent from 1867 to 1873. These epidemics contributed to a high mortality rate. Indeed, from 1867 to 1871, the death rate in Malta and Gozo was 29 per 1000. In 1872, the rate in both islands fell to 24.3 per 1000. It fell further in 1873 to 22.4 per 1000. During June, July, and August of 1873, deaths increased so rapidly that the death-rate shot up to 49.2 per 1000 in Malta. The rate for the twelve months ending August 1874, was 34.9 per 1000.³

On 10 Apr 1871, the Officer Commanding Royal Engineers Malta wrote: The military department in Valletta and its suburbs are now, as they have always been, supplied with water from large tanks which are filled in part from the rainfall on roofs, and partly from the aqueducts. At the following establishments in Valletta and Floriana, water from the Wignacourt Aqueduct is constantly laid on to:

• Upper St Elmo Barracks
• Lower St Elmo Barracks
• Garrison Hospital
• Camerata Laundry
• St Francis Barracks
• St Francis Ravelin (married soldiers)
• Notre Dame Ravelin (married soldiers)
• Floriana Barracks

For officers' quarters and other minor buildings it is turned on whenever demanded. The troops in Cottonera are supplied in a similar way.²

The medical officer of 3rd Brigade Royal Artillery drew the attention to the sanitary improvements accomplished by the construction of a new dock at the head of the harbour, which had replaced an unhealthy marsh. In 1850, the Admiralty decided to expand the dockyard facilities at Malta.

In 1857, Dock No 1 was extended and divided into two sections. In 1864, the Admiralty took over Senglea water front at French Creek, (between Senglea and Corradino), as Dock Yard Creek, (between Vittoriosa and Senglea), could not be expanded further. The construction of the new dock was started in 1865, under Lt Col Andrew Clarke RE. It involved the demolition of large parts of the Senglea fortifications, and the removal of the Maltese Commercial shipyards from French Creek. The dock was completed in 1871. It was designated No 3 Dock, or Somerset Dock, in honour of the Duke of Somerset, First Lord of the Admiralty.

The members of the Board of Health were: HE The Governor as President, the Chief Secretary to Government, the Superintendent of Ports, the PMO IGH Paynter Joshua, the Chief Police Physician Dr Ghio, the President of the Chamber of Commerce, the Dep IG of Hospitals and Fleet RN W T Domville, and Prof S. Pisani.

Sisters of Charity arrived at Malta on 13 Oct 1870. They tended the sick at the Ospizio and the Central Hospital Floriana.