Extracts from a two page note probably written in November 1942.

The fact that many people have been reported sick with bacillary dysentery immediately after eating coconut leads to the problem of how the infection is conveyed to the nut.

The possibilities which have been advanced:

(1) The bacillus, being water bourne, is conveyed via the roots & trunk via the sap which in the tropics rises rapidly up the tree. The fact that sap is conveyed upwards by osmosis and thus is most likely to prohibit the passage of the bacillus, appears to be ruled out as minerals are conveyed by this process.  The chief objection to the argument is that no sap would enter the nut when the latter is ripe as the vascular bundles are then severed.

(2) The bacillus is carried by the pollinating insects to the stigma of the flower & eventually finds its way into the  embryo by the same way as the pollen.  This seems even more unlikely particularly as the bacillus would need to live many weeks while the nut is in the process of developing before it could hope to come into contact with a human being.

(3) The nut when opened is contaminated with the dysentery bacillus, for example by dirty hands or houseflies.  This would seem to be the most likely explanation but it does not account for the fact that cases have occurred among people who have eaten only small portions of the nut, & immediately after the latter has been opened, so as to more or less exclude indirect contamination.

(4) There is no contamination of the nut at all.  All that happens is that the copra sets up an irritation of the bowel causing a form of enteritis.  Most people in the tropics harbour the dysentery bacillus in their intestines even when they are healthy but the latter are prevented from developing & setting up symptoms owing to the overpowering effects of the body’s antibodies….  But when enteritis is set up the germs find a medium in which to grow with the result that the usual dysentery symptoms are produced.  This would seem to be the correct explanation, particularly as dysentery patients treated and discharged as cured from hospital often have a relapse as soon as they are put on the coarse POW diet of practically rice bust (sic) after previously receiving a considerable proportion of European food.  In this case it was the enteritis set up by the change in diet; the dysentery bacillus could not have been present in the rice since this had already been boiled and in any case it would, if contaminated, have affected the entire personnel eating it.

Book B, 87-88

Diphtheria precautions

February 26, 2010

The following guidelines at Roberts Hospital speak for themselves but also to the conditions.  Cigarette stubs were a precious commodity.  I’m not sure who would have been smoking cigars.

Precautions to be taken against Diphtheria epidemic

(1) Cancel all entertainments & lectures
(2) Beds to be spaced so as to give sufficient headroom (sleep head to foot if necessary)
(3) The picking up of cigarette & cigar buts for reuse is prohibited
(4) All sore throats, however trivial, are to be reported
(5) Patients to be isolated
(6) Staff to be isolated from other personnel
(7) Staff to wear nose & mouth guards (made of gauze) when working in wards
(8) Patients to wear nose & mouth guards when being moved in vicinity of non infected persons
(9) All drinking containers to be sterilized in boiling water

Book B, p.56

Squelch that bug!

February 13, 2010

Bed bugs were a constant irritant at Changi and my father never stopped making careful observations of them. In a subsequent notebook, he drafted a short account titled “Squelch that Bug!”which just shows how bad things must have been.  In my memory at least, he would never have harmed an insect, other than of course to pop it in a tube for posterity.

After the war he continued to work on his bed bug notes and started to write a paper based on them, as can be seen from the illustration.  As far as I can tell, however, he never finished it.

But always there is the fascination with detail, as can be seen from this short extract from Book B.

It appears that certain nights are more prone to attack by these insects. They prefer warm, still nights. They do not venture forth in cool, draughty nights such as which often precede a storm. (This is not always correct as they were biting continuously one night which was cool and draughty.) Some say that they appear to favour dark rather than moonlit nights, but this does not account for the fact that one night they were biting continuously throughout the night & the following night they were practically absent. One thing is clear, that is that on the the biting nights everybody in the room is affected; it is not an isolated colony restricted to a single bed. Hence the phenomenon cannot be accounted for by the fact that a new batch of eggs has been hatched.

Book B, 25

That my father devoted nineteen pages to the treatment of dysentery within a couple of weeks of arriving at Changi gives some indication of the incidence of the disease and the challenge facing the improvised hospital.  The pages illustrated below indicates the treatment for “very weak” patients as including colonic lavage, Kaolin, glucose saline, Virol and arrowroot or custard along with Bovril which was obviously still available.
Still, providing treatment in such conditions was only part of the challenge.  Flies were a ubiquious problem, for example, and patients were expected to do their part in eradicating or at least reducing them.

The general practice at Roberts during these early weeks and months included the following:

Precautions against the spread of the disease may be summarized by (1) the elimination of flies (2) personal hygiene.  In more detail these precautions include:

(1) The killing of all flies in the ward and sanitary annex.  This is done chiefly by swatting: many of the patients can help in this respect.  Fly papers, both hanging & placed on the ground, are also used but these are more of a nuisance than anything else.  Swatting should be carried out all day on & around the beds. The fly papers are more or less permanent & when full are replaced by new ones.

(2) The protection of all food from flies. All feeding jars, mugs, cups and utensils are covered after use with squares of gauze.  Bulk foods are stored in fly-proof cupboards, preferably with well ventilated gauze front & for sides.

(3) The protection of all excreta from flies.  All bedpans & urine jars, vomit bowls, spittoons etc. must be emptied immediately after use & rinsed out with cresol solution.

Book A, 56-57

Roberts Hospital

November 7, 2009

But back to Changi.

It was only in 1941 that the British military installation on the promontory was completed.  In fifteen years, as H.A. Probert describes it in his History of Changi, “a piece of virgin jungle had been transformed into one of the most modern and best equipped military bases in the world.”  Given the lack of air defense in Singapore, he continues, it was also essentially obsolete.

Roberts Barracks became the hospital for the prison camp.  Formerly housing the Royal Artillery it had to absorb sick and wounded prisoners from across the island, including those from Alexandra Hospital which the Japanese had commandeered.  Given the bombardment it had taken during the invasion it was in no condition to do so.  Water supplies, sewerage systems, buildings and roads had been severely damaged.  This is how my father put it in a note written towards the end of the war.  “To such a camp, with all of its essential services disorganized, the whole of the ‘white’ patients of the Malaya and Singapore garrisons, complete with their medical & associated personnel & multifarious supplies, converged.  It is hardly surprising therefore that for some days chaos reigned, with its accompaniment of hardships, pestilence & death.”

The Australian artist Murray Griffin completed a painting of Roberts Hospital while he was a prisoner at Changi.  Visit the Australian Memorial web site to view the image: http://www.awm.gov.au/exhibitions/sharedexperience/AWMART24491.asp.

My father was posted to Roberts precisely two weeks after the fall of Singapore.  if he had not found the rest of the Royal Army Medical Corps (RAMC) before the invasion, presumably he did now.  I have no idea what his duties were at Roberts; he never talked about them, nor do his notes make any reference to them.  Yet he writes a good deal about the kinds of diseases that always threatened to overwhelm the hospital — well, did overwhelm it — particularly, dysentery, malaria, beri beri, dhobi itch and pallegra.  When he himself became a patient at Roberts on at least two extended occasions, he wrote about that too.

Anti malarial drains

June 13, 2009


Latrines, incinerators, Otway pits and anti-malarial drains; besides food and disease, these were the main notebook topics (and presumably preoccupations) during the first few weeks and months at Changi. Such was the prevailing necessity. But the notes also reflected my father’s interest and training. He had developed a passion for natural history as a teenager and had already published a few notes in the The Entomologist’s Monthly Magazine and elsewhere. As far as I can tell, his drawing skills were largely self taught though he had done a number of technical illustrations for the Bulletin of Entomological Research while working at Farnham House Laboratory. He had also qualified as a sanitary inspector before the war and had been trained to do anti-malarial work with the RAMC.  In any case, he returned to the topics again and again in his notes.

In later life, the fascination with drains became almost obsessive. We moved house several times when I was a child and in almost every instance it wasn’t long before my father was excavating a patchwork of ditches in the garden. So deep were these that when digging them he would sometimes disappear completely from view save for the occasional shovel-full of earth tossed into the air.

There weren’t many mosquitoes in our part of Devon but then of course that wasn’t the point. The reasons for the obsessiveness lay elsewhere.

Given the climate and conditions, flies were both a general nuisance and major health threat. Every effort was made to stamp them out, including the literal; at Roberts Hospital doctors, orderlies and even patients had their fly-swatting quotas. Here is a diagram of an early fly-trap for an Otway pit constructed with a metal funnel “such as a petrol funnel with the stem sawn off” and a wooden box with a hole in the bottom to take the funnel.

The trap is fitted on top of the Otway Pit which merely consists of a large hole dug into the ground and covered with a fly proof board with two openings: one to take the fly trap, the second to receive an oil drum to act as a filter.”

Book C, 112-113

There were many other contraptions of this sort. One of them is described more for “its novelty than any efficiency derived from the device.”

“The trap merely consists of a series of lemonade or similar white glass bottles inserted by their necks into holes made to receive them in the vertical timber forming the superstructure of these two improvisations.* Every morning two men visit the traps equipped with two containers, one filled with disinfectant, the other being intended to receive the results of the previous day’s captures. Both containers are provided with handles which are slung over a pole which is carried jointly by the two men. each bottle is visited in turn and half-filled with the disinfectant. The flies are attracted to the light & enter the bottles. Here they fly about trying to escape & eventually get drowned in the disinfectant.

* Otway Pit and Deep Trench Latrine

Book, C 182-183