One soldier died from disease during the 1991 Gulf War. Another one died during the 2003 campaign (compared to 14,000 during World War II and 930 in Vietnam). Eliminating disease as the major cause of death during campaigns was one of the major military advances during the 20th century. Dealing likewise with driving accidents only began in earnest during the 1990s. During the 1991 Gulf War, 235 troops died in accidents (half of them driving accidents), compared to 157 in combat. The reasons for this were several. Part of it was lack of sufficient training in driving at night and cross country. But the major reason was what became known as "sleep discipline." Commanders did not insure that troops operating round the clock were able to received sufficient sleep. This has long been a danger, and the "sleepy driver" problem was noted during World War II. From that came generations of NCOs admonishing their troops to take a nap every opportunity this got. This worked for the more resourceful troops, but by 1991 it was obvious that a more determined approach was needed. Thus arose the development of the "sleep plan." Officers and NCOs were instructed to keep an eye on how much sleep their troops were getting, especially those that had to drive long distances. It's not that the troops needed much encouragement to get some sleep when they were exhausted, but by establishing places where they could do it (the back of a moving truck would do it), you had fewer sleepy drivers. Setting up a "sleep tent" for drivers or troops coming off a long period of duty made a difference. Even before the 1991 war, it became clear from the U.S. Army's many realistic NTC (National Training Centers) exercises that lack of sleep hurt the ability of units to operate. The more obvious cases of commanders occasionally dropping from lack of sleep (after trying to stay alert for 48 hours or so to run their units) was accompanied by many tank and vehicle drivers dozing off and causing accidents. These particular reform efforts paid off in 2003, for every three combat deaths, there was only one death from accidents.