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The British colony in the Mediterranean is of crucial strategic importance to the Allied North African campaign and has been under almost constant attack from Italian and German aircraft since June 1940.
But the island's real ordeal began four months ago when Adolf Hitler ordered it should be "neutralised" in preparation for a German invasion.
Since then the Luftwaffe has carried out hundreds of air raids on Malta, at one point averaging seven a day.
In his message to the island's governor, King George VI said: "To honour her brave people I award the George Cross to the Island Fortress of Malta, to bear witness to a heroism and a devotion that will long be famous in history."
Malta is the first British Commonwealth country to receive the bravery award - second only in ranking to the Victoria Cross - which is normally only awarded to individuals.
The island's governor, Lieutenant-General Sir William Dobbie accepted the award saying: "By God's help Malta will not weaken but will endure until victory is won."
Reports from Malta say the heavy aerial bombardment is continuing.
Three raiding Messerschmitts are said to have been shot down and four more damaged in yesterday's raids.
Casualty figures for last month suggest 231 civilians were killed and 281 seriously injured. Nearly 300 suffered other lesser injuries.
The Germans have concentrated their attacks on the island's harbour and aerodrome and the nearby towns and villages.
Figures for the period from 24 March to 12 April show 1,869 tons of bombs were dropped on the Grand Harbour and 162 hours were spent under air raid alerts with much of that time underground.
Shelters have been carved out of the soft limestone rock on which the island is built. At first the Government opened up and enlarged the catacombs used by the early Christians in Malta as burial places. Since then corridors have been dug and families have carved their own rooms to take cover.
The Times correspondent writing from Malta said: "The Messerschmitts try to spread terror by machine-gunning over the land; but if their aim is to cow the population, they may as well give up the attempt."
From 1 January to 24 July 1942 there was only one 24-hour period when no bombs fell on Malta.
The population spent so much time in their underground shelters that health standards declined, malnutrition spread and scabies was rife.
Food was running desperately short. Malta depended on the convoy ships for supplies but many of the boats sent to the island between August 1940 and August 1942, were sunk and others damaged.
In May 1942 the Germans prematurely declared Malta had been "neutralised". The Luftwaffe were diverted to other areas of the war.
In the brief lull which followed 61 RAF Spitfires arrived on the island together with other reinforcements.
The Germans launched another all-out offensive to take the island in October 1942 but failed.
From November 1942 conditions began to steadily improve as supplies began to get through. When the Axis forces capitulated in North Africa in May 1943 the siege of Malta was finally lifted.
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