The census of 1861 placed the civil population of Malta at 118,596 and that of Gozo at 15,459. The average annual deaths from fevers during 1859, 1860, 1861 was 123. The mortality from fevers during the same period was 9 per 1000 of the population.
The average strength of the garrison was 6,185, exclusive of colonial troops. All the regiments in the command were affected by ophthalmia, an inflammation of the eye, which in severe cases caused blindness from corneal ulceration.
During the year, there were 4,775 admissions into hospital (772/1000 mean strength), with 69 deaths (11.15/1000 mean strength), of which 54 occurred in hospital, 5 out of hospital and 10 among the invalids on their passage home and at the Invalid Depôt at Fort Pitt.
The average number constantly sick was 301 men. The ratio per 1000 mean strength constantly sick was 48.67; the average sick time to each soldier was 17.67 days; the average duration of each case was 23.01 days. 57 invalids were returned to the Invalid Depôt at Fort Pitt, Chatham for discharge. No men were returned home for change of climate after fever, following the opening of the sanatorium at Citta Vecchia.
Miasmatic diseases from infections accounted for 2,162 admissions into hospital (349.5/1000 mean strength) with 26 deaths (4.20/1000 mean strength). Admissions were for:
79 admissions for parasitic conditions
59 for tubercular diseases with 20 deaths
182 admissions for respiratory conditions with 5 deaths
222 admissions for digestive diseases with 3 deaths
95 admissions for nervous system diseases with 2 deaths
29 admissions for circulatory diseases with 4 deaths
9 admissions for urinary problems with 2 deaths
632 admissions for venereal diseases
453 admissions for accidents with 10 deaths
15 soldiers were admitted to hospital after receiving corporal punishment. One soldier was shot by sentence of a Court Martial. Two of the accidental deaths were from drowning, two by fracture and one by concussion of the brain. Two deaths occurred in the Army Hospital Corps and one in a trained army school master.
There were 11 admissions for paroxysmal fevers (1.8/1000 mean strength), 876 for continued fevers (141.6/1000) with 21 deaths (3.39/1000), 211 for dysentery and diarrhoea (34.1/1000) with 2 deaths (0.32/1000), 598 for ophthalmia (96.7/1000), and 358 for Rheumatism (57.9/1000). Continued fevers were very common from June to September. There were 24 admissions for eruptive fevers predominantly small pox which was epidemic among the civil population with 2 deaths in the RA and RE.
Continued Fever Mortality
Continued Fever admissions and deaths (1861)
Admissions and deaths from Continued fevers in 1861. The figures are expressed per 1000 of mean strength.
Camp of Musketry
The Governor, Gaspard Le Marchant described the Camp of Musketry at St George's Bay as a Gypsy Bivouac. During the winter months, Pembroke Barracks was occupied by detachments of 800 to 1000 troops who underwent their annual training in musketry. The troops lived in common, circular, six men tents pitched on barren rock, and exposed to the full force of chill and wind. They slept on boards on the ground. Gales ripped their tents and extinguished their cooking fires. The hospital consisted of a number of marquee and a small hut containing 10 beds.
Overcrowding in unhygienic barracks was recognised as a cause of fever. Funds became available to replace the former Hospital of Knights of St John in Valletta with a new hospital at Floriana. Gaspard Le Marchant, however, decided that the men would be better served with a new barracks for 1000 men and 35 officers erected near St George's Coastal Tower overlooking St George's Bay, and modification of Spinola Palace St Julian's Bay as a hospital for the camp. Accordingly, work commenced in June 1860 and the barracks was completed in 1861.
The barracks for nearly 1300 soldiers was named Pembroke Camp, in honour of the Rt Hon Sidney Herbert, Secretary of State for War and second son of the Earl of Pembroke. It was situated four miles from Valletta, and ranged in six block buildings looking south east and north west, four composed of fourteen rooms, and two of seven. Each room held 14 men with 600 cubic feet of space per individual. In front of each block was a verandah supported on pillars and arches. In addition to latrines, a urinal was also placed in a corner of each room, replacing the old night tub. In addition to the stone barracks, six large commodious huts were erected for 50 men with each men having 470 cubic feet of space. The barracks had a spacious mess and quarters for 30 officers and huts for 16 officers.
Barrack Improvement Commission
In 1861, the Barrack and Hospital Improvement Commission was directed by Lord Herbert and by Sir G Cornwall Lewis MP, Secretaries of State for War, to report on the sanitary condition of garrison towns in Malta, with special reference to causes of fever among the troops. The Mediterranean Stations were inspected between Sept and Nov 1861.
The report by Capt Douglas Galton RE and Dr J Sutherland pointed out the deficiencies arising from having barracks located within insanitary towns and cities. They proposed a number of improvements pertaining to drainage, water, ventilation and sewage disposal.
The ventilation of Floriana Barracks was defective. The drainage of the Civil Hospital located above it passed through its area, while foul air rose from the Ospizio or poor house, situated below it. Fever prevailed. Reporting on the barracks Surgeon Adams Andrew Leith 1st/22nd remarked:
I fear this barrack will fall short of ever becoming a healthy quarter for troops. It can scarcely be expected that a building originally constructed as naval storehouses, should have anything in common with habitation for the health and comfort of 450 men. The height and length of the rooms are out of all proportions to their breadth in so much that with 46 men, although the regulated space is 600 cubic feet per man, the superficial is so small that there is little more than 13 inches between each bed
Medical Department 1861
In 1861, the Army Medical Department was reduced in strength. All those medical gentlemen who had obtained commissions in 1861 were relegated to half-pay. The examination for admission to the Army Medical Services which was due to take place in Aug 1861 was not held. Consequently, the Director General Army Medical Services (DGAMS), decided to enroll 20 of the already serving assistant surgeons at the Army Medical School, Chatham. The majority of these had already completed seven to eight years service and found it very difficult to return to school following time spent on regimental duties.
Through the Royal Warrant of 1861, surgeons who were promoted on, or after 28 March 1861, were to rank as Majors. In March 1861, the Secretary of State for War sanctioned an increase of Staff Assistant Surgeons for duty at rifle practice. Only Staff Assistant Surgeons arriving at Malta where employed on this duty.
In 1861, Deputy Inspector General of Naval Hospitals and Mediterranean Fleet A Armstrong submitted a strong representation to the Commander-in-Chief Vice Admiral Sir W Martin, to introduce police supervision and the medical examinations of prostitutes. Armstrong, who had taken command of the Naval Hospital Malta in 1859, was concerned about the high incidence of venereal disease in the fleet.
In his letter to the Times dated 2 March 1864, he congratulated himself for persuading the Council of Government to enact the necessary legislation. Armstrong proclaimed that after the enactment of the Sanitary Law in June 1861, the evil was at once arrested, and from that time and over a period embracing upwards of two and a half years, there had been not been a single case of the disease received into the Naval Hospital that had been contracted at Malta, embracing a period of upwards of two years and a half, and, as far as I could learn, the disease had then no existence in the island.
In 1861, Jane Shaw Stewart became the first Superintendent of Female Nursing Services at Woolwich with a staff of six nurses. In 1863, Stewart was also appointed Superintendent General of Female Nurses at the Queen Victoria Hospital Netley, but resigned in 1868 following disagreements with the medical staff.