Page 122 - JSOM Winter 2022

FIGURE 4 Self-retaining ileostomy tube made by Private Gordon patients, or for the irrigation of tropical ulcers. In Taiwan, pa-
Vaughan, Royal Army Medical Corps, Chungkai Hospital camp, tients with dysentery were treated with a rice water diet and
Thailand, 1944. (Copyright courtesy M. Vaughan / Liverpool School ground charcoal. Warm tea enemas were sometimes used to
of Tropical Medicine.)
help to relieve symptoms of dysentery-related tenesmus. In
camps in both Singapore and Taiwan, chronic diarrhea was re-
lieved by a homemade kaolin suspension derived from locally
20
sourced China clay. Kaolin was widely used at the time to
relieve diarrheal symptoms.

Organization
Most larger camps organized workshops for the production
of medical equipment and supplies. These made use of the cit-
izen’s army referred to previously, with its wide variety of ci-
vilian skills and expertise, such as scientists, carpenters, metal
workers, glaziers, and plumbers. An example of the effective-
ness of this system is shown in a report by G. W. Chapman, the
“Camp Scientist” at the Nakom Paton Camp in Thailand.
26
Despite Chapman having Master and Doctorate degrees in sci-
ence, he held the lowest army rank of Private. Nevertheless, he
As previously noted, anesthesia was problematic because of led a team of 10 POWs with varying skills and often of higher
drug shortages. Local anesthetic issues in particular were rank than his own. During the last year of captivity (1944–45),
frequently supported by supplies from Japanese guards who the group made distillation equipment that produced 100 gal-
wished to use POW dental services because their own facilities lons per month of distilled water and 12 gallons per month
were frequently poor. These anesthetics, commonly dental No- of surgical alcohol (from rice and natural yeasts). The group
vocain, could be stored and used for spinal anesthesia. Forceps also manufactured surgical catgut sutures from the peritoneal
were adapted from scissors, and needles made from hardened membranes of yaks or cows and vitamin supplements from
copper wire or bamboo; homemade suction pumps and trac- yeast culture.
tion beds used wire from telegraph poles and bicycle spokes.
At Chungkai, a dental chair made from bamboo featured a Disease Prevention
tilted backrest, adjustable leather headrest, and an instrument A variety of disease-preventive measures were widely adopted.
tray. Where the water supply was likely to be contaminated (for ex-
ample, in areas with cholera), all drinking water was first boiled.
Psychological Support Latrines were carefully constructed to minimize cross-infection,
Another vital aspect of survival in captivity was distraction often with lids to reduce contact with flies, as mentioned. These
from the ordeals of captivity. Strategies included creating li- were also frequently rotated, with an active latrine filled in af-
braries, giving lectures, and constructing chapels and altars ter a few days and a fresh one then used. One particularly in-
in jungle clearings, as well as a range of entertainments, all teresting approach to dysentery prevention was initiated by Lt
of which provided relief. Theatricals, organized in huts or Col Philip Toosey, Commanding Officer at Tamarkan Camp in
outdoors for audiences large and small, occupied many and Thailand. The goal was massive fly reduction, with each POW
greatly boosted morale. The range and scope of artistic talent (armed with homemade swats made from bamboo, wire and
was extraordinary—from musicals and acting to scriptwriting, leather strips) required to produce 50 dead flies before sup-
27
designing and making sets and costumes, and promoting the per. The project was successful, dysentery cases were reduced,
shows—and for many performers and audiences, these proved and the method was widely adopted by other camps. Some ex-
to be invaluable. tended the idea to “rat catching sorties” because rat fleas can
transmit typhus. 28
Drugs
Inventive approaches were perhaps most difficult with regard Conclusions
to drugs, and generally, prisoners relied on Japanese supplies,
although in many POW camps clandestine purchases and smug- In this paper, we have demonstrated the remarkable innova-
gling from local traders occurred—perhaps most notably on tive responses to the medical crisis in Far East imprisonment
the Thai-Burma Railway, where an aid clandestine aid network during the Second World War utilizing the civilian skills and
known as the “V Organisation” supported supplies, often in- expertise of many POWs. Such innovation has been demon-
25
cluding vital drugs. Internal production of vitamin supplements strated particularly by the work of men such as Audus, the
by yeast culture has been mentioned. One remarkable instance botanist and yeast producer; Vaughan, the craftsman and in-
of inventive drug manufacture concerned the work of Christof- ventor; van Boxtel, the synthesizer of emetine; and Chapman,
fel van Boxtel, a Dutch POW medical orderly in Thailand who the camp scientist. There were many more such individuals,
held a PhD degree in science. From ipecacuanha plants, he was and all made a huge contribution to POW medicine. They were
able to produce workable doses of emetine, a drug vital for supported by a military structure that maintained systems of
the treatment of amoebic dysentery and always in particularly command and discipline in the most difficult of circumstances.
short supply. 18
A particular debt is also owed both to the artists who pic-
A crude saline solution was created from rock salt added to torially recorded these events and to those who kept diaries
distilled water (making an approximate 0.9% solution) for in- and reports with details of the medical support provided.
travenous use in cases of dehydrated dysentery or for cholera All were produced and kept hidden at great personal risk of

120 | JSOM Volume 22, Edition 4 / Winter 2022