This Power Point is part of an Enlisted Advancement Program training series for US Navy Corpsman rating provided by Naval Medical Center Portsmouth Virginia Naval Medical Center Portsmouth is a military treatment facility serving active duty service members, their dependents and retirees in the Hampton Roads community of southeastern Virginia and northeastern North Carolina.

1. NAVMED P-5010 CHAPTER 9
PREVENTIVE MEDICINE FOR
GROUND FORCES
Presented By:
HM1(SW) Marlene Rivera

2. WATER SUPPLY SANITATION IN THE
FIELD
 Engineers are responsible for providing
sufficient potable water for the population
to be served.
 The medical department advises the
commanding officer on water quality
issues.
 Daily Water Requirements:
 Navy 24.6 gallons per man per day
 Marines 19.7 gallons per man per day

3. WATER SUPPLY SANITATION
IN THE FIELD
 Equipment Used to Purify Water (2):
• ROWPU (reverse osmosis
water purification unit)
• the most common field
purification system in use.
• versatile unit will produce
potable water from contaminated
sources including fresh,
brackish, or sea water.
• Erdalator
• Transportable quick-response water
purification system capable of
aerating, clarifying, filtering and
disinfecting contaminated water

4. WATER SUPPLY SANITATION IN THE
FIELD
 Chlorination
 is the most common method of disinfecting
potable water
• Sufficient chlorine is added to the water to achieve
the desired free available chlorine (FAC) residual
after a 30 minute contact time.

5. WATER SUPPLY SANITATION IN THE
FIELD
 Chlorination is available in several forms:
 Calcium hypochlorite, 65-70% (HTH)
• This is the preferred agent
 Sodium hypochlorite (5%) or (10%)
• This is a liquid solution (household bleach) and
may be used in lieu of HTH.
 Chlorine gas (in compressed gas cylinders)
• This is the most common form used by municipal
water treatment plants.

6. WATER SUPPLY SANITATION IN THE
FIELD
 Required Chlorine Residuals:
 Public water supply systems of questionable quality
• 5.0 parts per million (ppm) FAC after a 30 minute contact time and
maintain at a minimum of 2.0 ppm FAC throughout distribution
system.
 Engineering water points
• 5.0 ppm FAC at the standpipe or fill-hose.
 Water tankers, trailers, bladders and cans
• Maintain between 5.0 ppm and 2.0 ppm FAC when filled at an
approved engineering water point. Maintain at 5.0 ppm FAC when
used as a “source” for a distribution (piping) system.
 Distribution (piping) system
• Maintain 5.0 ppm FAC at the source and 2.0 ppm FAC at the spigot.
 Lyster bags and canteens
• Maintain at 2.0 ppm FAC when filling from an approved water
source. Chlorinate to 5.0 ppm FAC initially and maintain at 2.0 ppm
FAC when filling from an unapproved or raw water source.

7. SUPERCHLORINATION
 This process is used to disinfect water
containers and distribution systems initially
(before they are used) or when they have
become contaminated. Used for contaminated
water.
 Chlorinate water to 100 ppm for 4 hours
 Should be labeled “POISON DO NOT DRINK”
during this process
 After 4 hours the FAC must be 50 ppm or
above.

8. CANTEENS
 Add 2 iodine tablets to each
full canteen (double for 2 QT
canteens)
• Tincture of Iodine 2% may
be used in place of tablets.
5 drops per 1 QT/10 drops
if cloudy.
 Place lid on loosely and wait 5
minutes then shake vigorously
allowing leakage around the
cap.
 Tighten and wait addt’l 30
minutes.

9. 5 Gallon Water Cans
 Dissolve 40 Iodine
tablets.
 Place lid on loosely
and wait 5 minutes
then shake vigorously
allowing leakage
around the cap.
 Tighten and wait
addt’l 30 minutes.

10. Testing Requirements
 FAC (Free Available Chlorine) Testing
 Determine the FAC residual of all water
supplies at least daily
 Bacteriological Testing
 Field water supplies must be tested
bacteriologically at least weekly following the
procedures provided in Chapter 6 of this
manual
* Recorded in Medical Department Water Log. *

11. FOOD SERVICE IN THE FIELD
 In the field, all the factors which normally contribute to
foodborne illness outbreaks, such as improper storage
and holding temperatures, inadequate protection of food
from contamination, and poor food handler personal
hygiene, are exacerbated.
 All food should be inspected by the Food Safety Officer

12. Storage/Preparation of Food
 Temperature readings must be taken/logged 3 times
daily (during each meal period)
 Field reefers: maint at or below 40 deg F
 Freezers: maint at or below 0 deg F
 Chopping or grinding of meat in the field is prohibited
 Frozen foods thawed under refrigeration. Maybe thawed
at room temp not to exceed 80 deg F.
 Ice scoops washed & sanitized daily.
 “Four Hour Time Rule”
 Potentially hazardous food kept b/t 40 and 140 deg F
 Keep hot foods hot and cold foods cold

13. FOOD SERVICE IN THE FIELD
 A field dishwashing unit can be set up by using five (5) metal GI cans
 (1) First GI can is for collecting garbage.
 (2) Second GI can is for prewash and will contain a hot detergent
solution and a brush.
 (3) Third GI can is for washing and will contain a hot detergent solution
and a brush.
 (4) Fourth GI can is for rinsing and will contain clean hot water held at
a rolling boil.
 (5) Fifth can is for the final sanitizing rinse and will contain clean hot
water held at a rolling boil (212 deg F).

14. MRE’s/T-Rations
 MRE’s have a shelf
life of 48 months
 Can use for 21 days
 T-Rations provide 36
servings. The tray
packs are hermetically-
sealed half-size steam
table containers in
which up to 36 servings
of food, depending on
product

15. Waste Disposal in the Field
 4 Types of Waste
1. Human Waste
2. Liquid Waste
- Bathing and liquid kitchen wastes
3. Garbage
- Peelings, slicings, etc from field
service operations
4. Rubbish
- Boxes, cans, paper, plastic

16. WASTE DISPOSAL METHODS
 Location for latrines
 100 feet from the nearest natural
water source
 100 yards from food service
areas
 50 feet from berthing areas

17. Human Wastes (feces and urine): Disposal
 Cat Hole
• When troops are on the march
• It is dug 8 to 12 inches in diameter
and 6 to 12 inches deep and is covered
and packed down after use
 Straddle trench
• temporary bivouacs (1 to 3 days)
• 4 ft long, 1 ft wide, 2.5 ft deep
• Serves 25 people
The devices for disposing of human wastes in the field vary with the tactical
situation, soil conditions, water table, weather conditions, availability of
materials, and local environmental regulations

18. Human Wastes (feces and urine)
 Deep Pit Latrine
• 4 holes (seats), 8 ft L x 2 ½ ft W
• One, 4 seat, DPL/50 ppl
 Bored Hole Latrine
• 8 per 100 ppl
• 18 in diameter hole bored to a
Depth of 15-20 ft
• Seldom used

19. Human Wastes (feces and urine)
 Mound Latrines
• indicated when higher
ground water levels or
rock formations prevent
the digging of a deep pit

20. Waste Disposal
 Urine soakage pit
• Most effective in sandy
soils
• Six tubes made by
PVC piping 1x36”
• One pipe for every 20
men

21. Waste Disposal
 Urine Trough
• 10 ft long “U” or “V”
shaped trough is made
of sheet metal or wood
• 1 trough per 100 men

22. Waste Disposal
 Burn-Barrel Latrine
• Contains 2-4 seats on half a 55 gallon drum.
• Will be primed with 3 gallons of diesel fuel and
gasoline, 4 parts to 1.
• After burning, bury ashes at least 12”.

23. Waste Disposal
 Urinoils
• These permanent type latrines are very sanitary and less
odorous than other urine disposal methods.
 Chemical toilets
• Chemical Toilet Requirements
 # of Personnel # of Chemical Toilets
 1 to 15 1
 16 to 35 2
 36 to 55 3
 56 to 80 4
 61 to 110 5
 111 to 150 6
 Over 150 Add 1 toilet for each additional
40 persons.

24. Disposal of Liquid Waste
 In the field, bathing and liquid field mess
wastes are disposed of in the soil by
means of either a soakage pit or soakage
trench.
 Soakage pit
 4 feet square, 4 feet deep
and filled with a suitable
contact medium.
 Will service a field mess
serving 200 people or less

25. Disposal of Liquid Waste
 Soakage trenches
 used when the groundwater level or a rock formation
prevents the use of a soakage pit
 Evaporation beds
 constructed to allow 3 square feet of evaporation area
per person, per day, for field mess wastes and 2
square feet per person, per day, for bathing wastes.

26. Disposal of Liquid Waste
 Grease traps
 Filter grease trap
• 55 gallon drum with top
removed and bottom
perforated
• Covered with burlap
• Filled 2/3 full with 3 layers of
material (crushed rock on the
bottom, layered with sand,
ash, charcoal or straw)
 Baffle grease trap
• most effective device
for removing grease

27. Garbage Disposal
 Garbage is disposed of by burial or incineration
 Burial (must be at least 100 feet away from any natural water
source and 100 yds from the field mess)
 When troops are on the march or in camps for less than
one week garbage is disposed of by burial in pits or
trenches
 Pits
• Pits are preferred for overnight halts
• 4 foot square pit that is 4 feet deep and will service 100 people for
one day
 Continuous trench
• used for stays of 2 days or more
• trench is dug 2 feet wide, 4 feet deep and long enough to
accommodate the next day’s garbage
 Incineration
• garbage disposal method often used in camps that will be used for
1 week or more

28. Garbage Disposal: Incineration
 Incline plane incinerators
 Handle garbage –
entire battalion
 Barrel incinerator
 Made from 55 gallon
drum by cutting out
both ends

29. HEAT INJURIES
 Types of Heat Injuries
 Heat cramps
 Heat syncope
 Heat exhaustion
 Heatstroke
• IS A MEDICAL EMERGENCY!

30. Prevention of Heat Injuries
 Acclimatization - 3 weeks is optimal
 Adequate water intake
 Salt Intake
 Proper clothing (field uniforms
should not be starched)
 Careful WBGT monitoring

31. WBGT Monitoring
 <80 white flag
 80-84.9 green flag
 85-87.9 yellow flag
 88-89.9 red flag
 90> black flag
Wet Bulb, Globe Temperature (WBGT)
Index most effective means of assessing the
effect of heat stress on the human body

32. COLD INJURIES
 Types of Cold Injuries
 Immersion syndrome
• Occur in little as 24 hrs; water temp below 50 deg F
 Frostbite
 Hypothermia
 Snow burn/snow blindness

33. DISEASE CONTROL
 Prevention is the key to a successful disease control
program and may mean the difference between
success or failure of the mission
 Disease occurrence requires a “Chain of
Transmission” consisting of four links:
1. Reservoir
2. Means of transmission
3. Portal of entry
4. Susceptible host
Reservoir
Means of
transmission
Portal of
entry
Susceptible
host

34. DISEASE CONTROL
 Diseases of Military Importance
 Intestinal diseases
 Diseases of the respiratory tract
 Vector-borne diseases
 Parasitic Diseases
 Zoonotic Diseases (Diseases transmitted from animals)
 Sexually Transmitted Diseases

35. Any Questions?