Diggers at Gallipoli did not just face death or injury through battle but had their fitness sapped by an epidemic of gastro ailments caused by swarming flies.
"At its most virulent, diarrhoeal disease claimed as many men through sickness each fortnight as would be placed out of action in a general assault," says an article in the Anzac Day issue of the Medical Journal of Australia (MJA).
Failed public health measures led to the spread of the communicable diseases (CDs), said Dr Milton Lewis of the University of Sydney and the MJA's editor-in-chief, Professor Stephen Leeder.
They reviewed accounts of the summer of 1915, which showed CDs, particularly gastrointestinal ailments, took an enormous toll on the Australian and New Zealand troops.
"Flies swarmed from May until October. Latrines were built, rubbish burnt and bodies buried, but incompletely so and disease continued to spread, especially as the troops' nutritional status began to wane," they wrote.
"Those who were sick could not be easily evacuated and the troops themselves scorned this approach because of the administrative difficulty in returning to the front when well."
Dental problems - due partly to the effects of army biscuits, lice infestations and a limited diet - added to the challenges of the Anzac fighting men.
"Battle fatigue, illness and the risk of death these were the realities daily confronting the Anzacs," they said.
"We need to be clear in our understanding of the variety and depth of challenges faced by those troops 100 years ago."
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