Summer in Thessalonica: The Malaria Epidemic of 1916

Soldiers Sunbathing Outside No. 4 Canadian General Hospital
MEDICINE DURING THE FIRST WORLD WAR: BASE HOSPITALS (Q 32802) Patients at a Canadian base hospital in Salonika lying on cots outside their huts enjoying the winter sun. Copyright: © IWM. Original Source:

In light of the present pandemic, much has been written comparing Covid-19 and the global response to the Spanish Flu of 1918-1919. However, influenza was hardly the only illness that proliferated during the Great War era. Given the unsanitary conditions of the battlefields and the high density of people along the various fronts, the First World War was as much a struggle against ill-health as it was against any nation. Malaria was amongst the more belligerent diseases, and it was present on all major fronts. Rather than a virus or a bacterial disease, malaria is a parasite. It proliferates in our red blood cells, it is transmitted by certain mosquito species, and certain strains can hide in the liver, allowing a person to go years without symptoms or to suffer malarial bouts in waves. One of the major hotspots of the Great War malarial epidemic was Greece, where as many as one-third of the half-million BEF casualties were due to the disease.

The last time we discussed the Salonika front, Sergeant Herbert Harvey Jones of the No. 5 Canadian General Hospital described life under the threat of Zeppelin raids. He will be guiding us again, through the summer of 1916. Following the raids of early spring 1916, the temperature quickly warmed and heavy showers commenced. The turn in the weather led to a precipitous increase in patients at No. 5. On May 13th, 1916, just over a week after the Zeppelin that had been harassing them was shot down, No. 5 became overwhelmed with patients, “All [our hospital beds have been] used up, & some big marquees had to be put up, to hold the extra number [of patients] over our limit.  We can hold 1040, but now we have 1165 in.” While a number of the patients were afflicted with battle wounds, far more suffered from diseases and ailments such as dysentery and malaria.

Patients at a Ward of No.5 Canadian General Hospital
Patients at a Ward of No.5 Canadian General Hospital. Major James Skitt Matthews “Patients in a ward at No. 5 Canadian General Hospital”, 1914-1918: AM54-S4-2-: CVA 371-248.07.

As the seasons turned towards summer, the heat became oppressive and the humidity made things worse. Diary entries in this period are short, often, as from the period between June 23-26, 1916, Jones simply writes, “Hot.” Breaking up the monotony of weather forecasts are descriptions of his physiological decline, as on June 19 where he follows up an entry of “Hot” with “June 19: Sick fever diarrhea.” Jones would not let his bodily deterioration keep him from his patients however, and he continued to work to the best of his ability. His fellow doctors, nurses, and orderlies suffered similarly; on June 26 he records, “Hot. Admitted 6000 patients Deaths 21. Invalided home from our Unit 24. 7 officers 5 [nurses]/sisters 12 men.” Many more hospital staff members were too ill to work but not sufficiently ill to be sent home.

Jones’ daily descent into the maelstrom of disease, infection, and filth that was the No. 5 Canadian General Hospital in this period exposed him to all manner of microscopic threats. The threat to his health increased in severity as No. 5 became more and more over-crowded. Finally, on June 30th, 1916, the long hours, terrible environmental conditions, and exposure to the sick took their toll. Jones collapsed and had to be taken to the hospital. He described his condition as, “Fever, high temperature, pains & aches all over.  Ice bags all night.  No sleep. Diarrhoea. Awful wind & lightning storm during night.” The next day Jones was diagnosed with Malaria and given (the now infamous) quinine to help deal with his symptoms. He would spend the next three weeks in the hospital under various forms of medication and a starvation diet in order to try and control the parasites that now proliferated through his bloodstream.

BEF Soldiers on the Salonika front taking their daily dose of quinine. Quinine was the only medicine available to prevent and combat malaria during the First World War. Its bitter taste was notorious, so, in the 19th century, some enterprising British officers developed a mixture of tonic water, sugar, lime, and gin to make it more palatable, creating the original gin and tonic. Ariel Varges, “British troops taking their daily dose of quinine, July 1916” in MINISTRY OF INFORMATION FIRST WORLD WAR OFFICIAL COLLECTION, 1916/07: © IWM Q 32160.

Sergeant Jones returned to treating patients towards the end of July. The weather was as unbearably hot and humid as ever and the results of that weather quickly became apparent. As he describes it, on July 26, “Still hot. British Flying Corps have arrived last 2 or 3 days from Egypt. Tried out dirigible this morning. Total admitted 8800, 37 Deaths. Lots of malaria cases now. Short of Unit 35. 9 officers. 7 n/s. 19 men and NCOs.” Jones’ characteristic preoccupation with the flying corps could only momentarily distract him from the growing malaria crisis. By 1918, around 150,000 soldiers would be struck by malaria. While quinine and rest allowed many to recover, many others, including Jones himself, would never fully expel the parasite and would suffer regular bouts of exhaustion, fever, and diarrhea.

Malaria would continue to haunt the Salonika front for the duration of the war, infecting soldiers, and civilians in the hundreds of thousands. The medical staff charged with defending against the aggressive illness would themselves suffer the ravages of the disease. Malaria drained the strength of both sides of the war and required massive efforts to effectively treat. Despite the occasional malarial relapse, Jones would continue to work for the No. 5 Canadian General Hospital, until its relocation to France in 1917. The Great War was fought not only against armies of different nations but also against a myriad of microscopic belligerents. As recent events can attest to, even though hospitals were located in the rear, they had their own battles to wage and it was only through unimaginable courage and endurance that those lines could, and can, be held.


Brabin, B.j. ( 1, 2 ). “Malaria’s Contribution to World War One – The Unexpected Adversary.” Malaria Journal 13, no. 1 (01 2014).

Landscapes of Disease: Malaria in Modern Greece. 1 edition. Budapest ; New York: Central European University Pr, 2018.

Smedman, Lisa. “Diaries Reveal Harrowing Experiences of First World War Nursing Sisters.” Vancouver Courier. Accessed May 9, 2020.

Cain Doerper is an honours history undergraduate student at Concordia University. His studies focus on European modern history

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