Physical Aspects Maintaining personal hygiene can prove difficult when in the operational environment, and normal practices are almost impossible to execute in such conditions (4). Certainly the facilities provided in the operational environment aim to address hygiene needs (6), and every effort is made to ensure the best possible amenities are available for all personnel, but this is highly dependant on tactical, operational and strategic considerations. One aspect which may prove a challenge is elimination and must be managed well. Wardell & Czenswinski reported that females will delay urinating or defaecating due to lack of a suitable location or the standard of the facilities provided (2). The tactics women used to achieve this varied, but included reducing oral intake, both food and fluid, and taking medications to achieve a state of constipation. All of these actions can have significant impact on their physical health for example dehydration, constipation, urinary tract infections and, paradoxically, even incontinence (7). This behaviour may also be present in male personnel but no literature is available to establish such.

Reducing oral intake may result in dehydration which may not only affect the individual’s health, but could also impact on the available medical resources, stretching its capability unnecessarily (8). Urinary tract infections can occur at anytime but in the operational environment there can be more predisposing factors including poor hygiene and reduced fluid intake (9). Heat exhaustion is also a recognised consequence of dehydration particularly in tropical, sub-tropical and desert environments, and can be fatal (10). Reduced intake of fluid will also increase the potential for heat illness, and could seriously compromise the individual’s health (11). Again, not only is this going to affect the individual’s effectiveness and possibly have a direct effect on the operation, but will also impact on cost. Constipation, although initially may not appear to be a serious condition, can