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There was also a gross shortage of water on the island and most drinking water had to be shipped in, thus the prisoners were often significantly dehydrated. This and the contaminated water supplies resorted to by prisoners, caused a widespread fever (Spirochetosis) with severe boils that killed many prisoners. At Sylt there was a chronic lack of water and in the early stages of the SS camp prisoners had to wash their faces in their coffee before drinking it, or use their own urine. There was a small spring near the camp used by prisoners to relieve their thirst, but one day vomiting among the prisoners led the SS to discover an unnoticed dead body submerged into the churned-up swamp around the spring when they sought to bring things into order.

The difficulties of arranging boats (as opposed to trains) to ship-out sick prisoners, to die or be exterminated elsewhere, meant that more worked-out prisoners died on the island and with delays in shipping caused by Allied attacks meant even more prisoners died on the island than was anticipated. This also leads to speculation that there may be other undiscovered burial sites on the island, though it may well be that in reality a great many prisoners were disposed of into the sea, with the powerful tides and currents sweeping the remains well away from the island and it is an established fact that human remains disposed of at sea rapidly disappear, which is why dives on wrecks which are war-graves rarely reveal obvious human remains.

Many of the prisoners suffered from constant exposure to the elements as the island was very wet and windy with little natural shelter and the weakened prisoners had to deal with greater exposure from the elements than on the main-land.

Finally, it was almost impossible to escape from Alderney, whereas on the Nord Pas de Calais escapes were common and many escapees were helped by local farmers, resistance or French railway men. The only feasible escape plan was to stow-away on board ship and the only know successful escape occurred when a prisoner, Ted Misiewiec, managed to take the place of a deceased worker on a transport to Cherbourg.

An informative and direct comparison of reported conditions can be made directly between the related OT camps in the Pas de Calais, as well as the Emsland group of camps and those on Alderney. A pattern of beatings, starvation, robbery, over-work, in adequate medical care, especial brutalisation by certain camp personnel and outright murder, are reported. A favoured method of murder, common to all concentration camps and used at Sylt, was to force prisoners across the camp boundary with dogs and SS threats, when they would be shot. In terms of mortality, a reading of the evidence suggests that perhaps 7-10 prisoners died each week in the SS run camps, sometimes more. One SS NCO was heard to comment that between March 1943 and November 1943, 140 prisoners died in Sylt alone, which accords with this estimate.