In 1891, the population of Malta and Gozo was 164,692, There were 81,062 males and 83,627 females.
The average strength of the Command was 7,697 men, exclusive of colonial troops. There were 5,054 admissions into hospital (656.6 admissions/1000 mean strength), with 50 deaths (6.49 deaths/1000). The Garrison Staff had 56 men with 16 hospital admissions and 2 deaths.
178 men returned to England as invalids; of whom 118 were discharged from the service. The average number constantly non-effective through sickness (mean daily sick), excluding the RMA, was 344.76 men (44.79/1000 mean strength). The average sick time to each soldier was 16.35 days; the average duration of each case was 24.90 days.
There were 194 officers, with 141 attacks of illness and 4 deaths. 9 officers were invalided home. Deaths among officers were from simple continued fever, valvular heart disease, aneurysm and fractured skull from a fall while playing polo.
Admissions for officers were for: continued fevers (61), of which 1 was enteric, bronchial (17), digestive disorders (20), injuries (14).
Health of the Garrison
Fever accounted for 891 admissions into hospital with 28 deaths. Admissions were for:
97 for nervous system diseases (2 deaths)
48 for circulatory diseases (1 death)
136 for respiratory conditions (5 deaths)
559 for digestive diseases (2 deaths)
15 for urinary problems (1 death)
523 for generative disorders
311 for cutaneous diseases
191 for rheumatism (2 deaths)
248 for primary syphilis
168 for secondary syphilis
532 for gonorrhoea
24 for phthisis (6 deaths)
680 for accidents (1 death drowning)
24 for alcoholism (1 delirium tremens)
5 for parasitic diseases (all taenia solium)
54 for debility
There were 3 admissions for eruptive fevers (1 scarlet fever, 2 cowpox), 48 for enteric fever (19 deaths), 30 admissions for dysentery (1 death) and 19 for malarial fevers (1 death), of which 17 were ague at Cottonera, 1 ague at Gozo and 1 remittent at Forrest Station Hospital. The majority were in those who had served in Cyprus.
There were 840 admissions for simple continued fever (9 deaths). The PMO attributed the increase of sickness from these fevers to the prolonged and trying summer and to the presence in the ranks of several of the regiments of a large number of weakly and immature youths who were unable to withstand the trying effect of the climate.
Medical officers believed that the nomenclature of simple continued fever encompassed more than one variety of fevers, from Simple Febricula to the prolonged and severe form called Malta Fever.
The medical officer in charge of the Station Hospital Valletta pointed out that Malta Fever differed from enteric fever. The duration of the fever was indefinite in Malta Fever but not so in enteric; no spots appeared on the skin in Malta Fever as they did in enteric; intestinal lesions were present in enteric but not in Malta Fever; the comparatively small number of deaths in Malta Fever as opposed to the high mortality in enteric fever.
The number of enteric fever in the following districts was: Cottonera (28), Valletta (11), Pembroke Camp (5), Citta Vecchia (2) and Gozo (2). There were 6 from Fort Ricasoli, 6 from Tigné Hutments, 5 from Verdala Barracks and Pembroke Camp, 3 from Fort St Angelo, 3 from Fort Manoel, 2 from Citta Vecchia. The Principal Medical Officer Surgeon General C D Madden believed that the disease was probably caused by contaminated milk which had been conveyed into barracks in dirty vessels. Moreover, the milk was often adulterated with water which had not always been fit to drink.
Brigade Surgeon T F O'Dyer pointed to the supply of water from wells in houses frequented by soldiers as a possible source of enteric fever. However, he was unable to ascertain whether soldiers who obtained their water from wells were more frequently attacked by enteric fever than those supplied with water from the aqueduct.
Two cases of gunshot wound of the chest occurred at the Pembroke rifle ranges from fragments of bullets glancing off stones; one minor gunshot wound to the arm on the ranges was by a bullet from a Morris tube.
Mtarfa Barracks – Gebel Imtarfa
In 1891, a new barracks was started at Gebel Mtarfa which was completed in 1896.
The Barrack Hospital Mtarfa was built in 1895, at the same time as the barracks. It was a small building of some 20 to 30 beds and served the soldiers in the newly built barracks.
There were 317 wives, with 153 attacks of illness and 3 deaths. Admissions were for: simple continued fevers (44/1 death), of which 1 was enteric, debility (35), digestive disorders (12), generative system disorders (13). Deaths were from tubercular disease of the lungs and diarrhoea.
There were 525 children with 199 admissions and 26 deaths. Admissions were for: chickenpox (10), simple continued fever (36/3 deaths), debility (21/2 deaths), bronchitis (37/3 deaths), diarrhoea (38/11 deaths). Child deaths were from convulsions (2), enteritis (2), tubercular disease (1), scrofula (1), premature birth (1), teething (1 death).
The PMO expressed the need for a dieted hospital for women and children