We all take off our shoes several times a day or at least at the end, but for our soldiers in the Gaza Strip the reality is completely different. Months of war and weeks of operational activity without ventilation of the feet give their signals.Dozens of dermatologists have treated hundreds of soldiers who suffered from severe foot infections in recent months.
The military shoe is a well-closed shoe that is adapted to field conditions and is primarily intended to protect the foot from bruises. However, the closed shoe is not ventilated at all, and the soldiers are sometimes forced to stay in the same shoe for days, and in some cases, soldiers stay in the same shoes for two weeks or more.
This creates a “microclimate” of heat and high humidity, which leads to very high amounts of bacteria and fungi to multiply and cause infections. The most common infection in many soldiers is keratolysis, in which bacteria cause the appearance of a strong offensive odor, itching, and the formation of grooves and peelings in the foot, sometimes even to the point of bleeding.
Soldiers impacted were treated with oral antibiotics and local treatment for the foot with instructions to ventilate the foot as much as possible during the operational activity.
Many soldiers were infected with nail fungus, a phenomenon that is neither dangerous nor painful but causes the nail to deform, turn yellow, and cause an aesthetic disturbance. The treatment in such a case was antifungal medication taken for 4 months, along with instructions to spread antifungal talc (fungimon) on the foot and shoe and to ventilate the feet as much as possible.
Other medical conditions soldiers face
Fighters also faced ingrown toenails, a condition that causes great pain and difficulty in continuing operational activities. In some cases, they were referred for a surgical operation to remove or lift the penetrating part, along with antibiotic treatment.
“The sealing effect of the military shoe causes excessive sweating, which leads to a very high rate of bacterial and fungal growth in the foot under combat conditions,” explains Dr. Etti Sharig, a dermatologist from the Meir Medical Center, “at the same time, the physical stress and the uncomfortable footwear also causes the nail to penetrate into the foot, and the body recognizes the nail as a foreign body that causes an inflammatory process that is very painful and may develop into an infection.”
“While in normal reality the recommendation is to keep the leg ventilated and avoid sweating, it is very challenging to treat soldiers who cannot be taken out of operational activity,” explains Dr. Sharig, “on the other hand, you can actively prevent sweating: apply antiperspirant preparations like in the armpit but to the foot, or spread Fungimon powder or fungicide which is both a powder that absorbs liquids and has an anti-fungal effect.
“Military doctors should be careful to treat the soldiers urgently at the first signs of infection, even before it spreads and causes injury to the foot, pain, and complications. The emphasis is on preventive medicine, to treat as early as possible before the inflammatory condition becomes serious.”