by Peter Brune
They lived in squalor in the cities: say they lived in Singapore or Kuala Lumpur, they’d live in the worst part of town wherever it happened to be. And they’d use the drains in those days in Singapore as latrines as well—they’d just walk out of their, whatever hovel they lived in, and squat over the drain. Of course the drain was usually about six foot deep . . . so the drains were stinking, and they were living beside them . . . that was parts of Singapore, parts of Singapore weren’t so bad. But parts of just about every city, or even every village, or Kampongs as they called them, had that sort of person in it . . .
And then taking the people out of those places, and bringing them up into the jungle with their families and putting them to work . . . was the most inhumane thing you could possibly imagine. And of course they had no way of resisting it, they went [died] because they had to go . . .60
Rod Beattie, the Commonwealth War Graves Commission Manager for Thailand, has estimated that 75 000 Malay coolies worked on the Railway and that 42 000 of them perished (56 per cent); and that 90 000 Burmese worked and 40 000 died (44 per cent).61 Private Wal Williams:
Never saw them much, only when the poor bastards were working on the line . . . you’d go into a camp that they’d been in and oh, Jesus! It was shockin’ . . . crap everywhere, bodies under the bloody huts, and you’d have to clean all this up before you’d even occupied it and bury them all . . . the huts are all falling to bloody pieces, the attap’s rotted away . . .62
By early 1943, the tide of the Pacific War had continued to turn against the Japanese: their final defeat in Papua New Guinea had occurred on 23 January; they had suffered a major reverse during the Battle of the Bismarck Sea (2–4 March); and they had been comprehensively defeated at Guadalcanal. The Imperial Japanese Army now ordered that the completion date for the Railway was to be August 1943—the timetable was thus advanced by four months. (In the event, the Railway was finally joined on 17 October 1943.) This period of time was to be aptly referred to as the Speedo period. In May 1943, the complete death rate on the Railway soared to around 600; in June and July to about 1400; and with the deadline basically reached in August, the death rate reached its peak at around 1600. And the tragic consequence of this period was that the high death rate continued through to January 1944, well after the completion of the Railway.63
Green, Ramsay and Black Forces started the Speedo phase at the 75 Kilo Camp (Meiloe) and then moved to the 105 Kilo Camp. By mid-June 1943, the main ‘A’ Force camps were stationed just forward of the 75 Kilo Camp, and at the 105 and 108, except for the Rail laying Number 1 Mobile Force. There were four distinct ‘battles’ in progress during this time. The first was working during the monsoon. Wal Williams:
See the monsoonal period mate! Rain . . . I’ve never seen rain like it in my bloody life! . . . up there round about the 75 or the 105, [Kilo Camps] you could stand outside mate, and the rain hit ya, and it’d be like being under a needle shower, it’d hurt ya! And if you’d had a cake of soap, you could’ve stood out their and lathered up and had a bloody shower! It’d rain for 72 hours non-stop! . . .
Well, you’d be standin’ there . . . say in the middle of the day, or maybe the evening bloody meal, it’d be raining like buggery and the bucket of rice would be swimming in water . . . you were starving mate! When you’re starving you eat anything! You’re always wet, you never get dry, your bloody gear would rot, and you worked in it. You’d pick up a shovel full of mud and put it in a bloody basket and lump it up a bloody embankment and tip it out and come back . . . they didn’t give a stuff . . . we woke up to that early in the piece down at bloody Mergui when we jacked up when it was raining, and they put on a bloody blue and belted bloody Christ out of us . . .64
The second battle was between the Japanese engineers and guards. As the pressure to finish the Railway increased, the demands placed upon the latter by the former to furnish full quotas of POWs to work became relentless. In turn, the Japanese guards beat, bullied and cajoled all and sundry in the ‘hospital’ huts until the numbers were produced. The men of the Number 1 Mobile Force laid the rail until the day’s distance was done—24 hours’ continuous work if required. If a spike was bent while being hammered, and the effort slowed because of it, the engineer ‘bounded along muttering or screaming abuse, and laid about him with his heavy metre stick’.65
When you interview survivors of the Thai–Burma Railway, regardless of which force or battalion in which they served, one man will invariably be recalled with genuine respect and indeed affection by all. And terms such as ‘dedication’, ‘selflessness’, and ‘compassion’ will be universally applied to them. Among the many, those few were considered great Australians. These men were the force and battalion doctors. One of them would later describe the Japanese treatment of POWs as ‘deliberate neglect, deprivation, starvation, denial of drugs, denial of all equipment, and denial of facilities’.66 In an effort to overcome these seemingly insurmountable obstacles, the doctors on the Railway employed sheer determination, improvisation and efficiency to their care of literally hundreds of patients. And all of this was enacted on a daily basis. Their devotion is an inspiring chapter in the Australian story.
When ‘A’ Force was created its medical component was drawn mainly from officers of the 2/4th CCS. Lieutenant-Colonel Hamilton was the Senior Medical Officer. Under him were Majors Hobbs, Fisher, Chalmers, Krantz and Captains Le Gay Brereton, Higgin and White. In addition to these officers were the three battalion RMOs: Captains Cumming, Richards and Anderson. When Green’s Number 3 Battalion was landed at Victoria Point, Captains Higgin and White were assigned to it as the medical officers. Cumming landed at Mergui with Ramsay Battalion and Richards was Kerr’s (and later Lieutenant-Colonel Anderson’s) RMO.
It will be recalled that when Lieutenant-Colonel Ramsay and his Number 1 Battalion were landed at Mergui, 500 British troops were also landed and came under his command. The doctor accompanying them was an Australian who was destined to become one of the legends of the Railway: Lieutenant-Colonel Albert ‘Bertie’ Coates. Captain Rowley Richards: ‘Now Bertie Coates was, in my view, the most outstanding medical officer and man on the Railway. He was a man who was full of initiative . . .’67
Coates was born into a poor family at Ballarat on 28 January 1895 and had left school at eleven years of age. After starting work as a butcher’s apprentice, and then indentured to a bookbinder, he had put himself through night lessons and passed his junior examination with distinctions in all five subjects. Coates had then decided to study medicine and despite his studies being interrupted by his service in the Great War, he came home and yet again worked night shifts—at the Postmaster General’s Department—and graduated with first class honours in all subjects.
After a distinguished prewar career as a surgeon, he joined the Second AIF and was posted as a lieutenant-colonel to the 2/10th AGH at Malacca, Malaya. It was here, a full year before the outbreak of the war, that the initiative referred to by Captain Richards first materialised. Not only did Coates spend valuable time at Malacca studying all he could about tropical medicine, which had understandably been a minor part of his studies in Melbourne, but, with remarkable foresight, he realised that the day could come when Australian nurses could be evacuated from Malaya and Singapore. He therefore initiated nursing training—particularly surgical training—for orderlies. This was to prove invaluable in Changi and on the Thai–Burma Railway.
Just prior to the fall of Singapore, Coates was ordered to leave by ship for Java. The convoy left on 13 February 1942, but was bombed and Coates found himself in Tembilahan, Sumatra, where he immediately began work operating on British casualties. He declined a number of opportunities to escape from Sumatra and after arriving at Padang on 28 February, he was captured three weeks later. In May 1942, he was sent to Burma as the RMO for Williams Force.
Albert Coates’s prewar surgical experience made him an invaluable medical resource on the Railway, but his personal qualities won him the trust and ad
miration of the diverse cross-section of humanity found in any army formation. In short, Coates had a magnificent ‘bedside manner’ and the common touch. ‘Weary’ Dunlop recalled that Coates’s ‘short, upright figure with a ghost of a swagger, a Burma cheroot clamped in his mouth, and his staccato flow of kindly, earthly wisdom’ was to become ‘the object of hero worship and inspiration’.68 Whilst working at the 30 Kilo Camp hospital, Coates was to utter words which were to resonate across the Burmese section of the Railway:
The route home is inscribed in the bottom of every man’s dixie. Every time it is filled with rice, eat it. If you vomit it up again, eat some more; even if it comes up again some good will remain. If you get a bad egg, eat it no matter how bad it may appear. An egg is only bad when the stomach will not hold it.69
The biggest killer on the Railway was amoebic dysentery, characterised by the growth of ulcers in the colon caused by the amoeba parasite, which produced the symptoms of inflammation of the intestine: diarrhoea and stools with blood and mucus. This condition in turn caused severe pain and dehydration. The standard treatment was the drug emetine hydrochloride. As our Railway story unfolds, we shall witness some extraordinary efforts to procure this life-saving drug. Two ‘A’ Force doctors, Chalmers and Cumming, had but a paltry initial supply of it, and, in contrast to other forces, the administration of ‘A’ Force had little or no means of procuring it on the black market. At Tavoy Coates ‘performed the first ileostomy of the prison camps for this condition, with complete success, and this life saving measure was repeated in other places on a number of other patients’.70 The procedure involved an operation which exposed the small intestine, allowed it to be drained, and thereby removed the amoeba.
When working at the 55 Kilo hospital camp Coates, still recovering from a bout of tropical typhus, was initially carried around on a stretcher to see his patients. It was during this period that he worked with a Dutch chemist, Captain Van Boxtal, who was able to make emetine from an extract of a plant called ipecacuanha, which although produced in very limited quantities, also proved priceless in the fight against dysentery.71 Van Boxtal also distilled water from a primitive still which was used to make eye drops; he made tinea paint from sulphur and slaked lime; spinal anaesthetics were made ‘by the careful evaporation and dilution of Japanese novocaine’, and he ‘experimented carefully with cocaine . . .’.72 During Coates’s time at the 55 Kilo Hospital his patient numbers grew to 1000 and peaked at 1800. As the demands upon both him and his staff increased, so further improvisation and initiative became the hallmark of their response. A limited number of beds for those most in need were made from bamboo and rice sacks, every available rag and piece of mosquito netting was painstakingly hoarded and used for bandages and dressings, artificial limbs were made from the ever available bamboo, and an unceasing effort was made to construct, refine and employ instruments to replace those pilfered along ‘A’ Force’s journey to Burma. And in late 1943 at the 55 Kilo Camp Coates was able, with the rare support of a Japanese doctor, to engage in modest black market purchases of meat as a vital supplement to his critically ill patients’ watery ‘stews’.
Coates would later describe a typical day as ‘segregating the sick from the very sick . . . curetting seventy or eighty ulcers during the morning . . . and, in the afternoon, proceeding to amputate nine or ten legs’.73 The daily ‘curetting’ and the ‘amputating nine or ten legs’ was the never-ending fight against the scourge of tropical ulcers. Such ulcers spread with great speed and once they had penetrated the connective tissue in the leg, and had entered muscles, tendons and the lining around the bones, the severe scraping and cutting involved led to horrible scarring at best, and often to amputations and death. The patient’s greatest chance of surviving an operation occurred when the amputation occurred below the knee. Coates performed such procedures under a bamboo shelter with only one knife, two pairs of artery forceps and a saw which he was required to share with the camp carpenters and butchers. Private Wal Williams:
. . . my ulcers were small, I mean they start off bloody small . . . I used to go to a, like a backwater off the river, like a little tributary running in . . . and I used to put my legs in the bloody water, and these little fish . . . used to come along and pick all the bloody crap out of it. It hurt, it used to hurt like buggery . . . and you’ve got a clean wound . . . what they did, when they had to scrape those bloody things with a spoon . . . that’s when Coates and them [a doctor or an orderly], would have to come along and oh Jesus that must have been painful . . . these blokes, ulcers from the knee down to the bloody ankle, all exposed, and it’s all got pus . . . he’d have to scrape that shit out every day. And the blokes would be screaming their bloody heads off. And the stench! The ulcer ward! Christ! You could smell it a hundred bloody yards away! It’d make you want to chunder! . . .74
Coates was also an inspiration to his colleagues. Captain Rowley Richards, RMO Anderson Force:
He was in one of the camps . . . having a bastard of a time. He’d had . . . a fever for about a month, running at a very high temperature. Very crook. And I’d just finished the cholera epidemic and I was on my way down through to the 30 kilo where the hospital was at Retpu, and we called in to see him. I was uncharacteristically pessimistic and despondent, having been pretty bloody sick myself. As a result of Tom Hamilton and Varley coming out to our camp Nagatomo decided that there were four of us who’d been working on the camps as distinct from the hospital group, who deserved some sort of recognition . . . And the outcome was that there were four of us; a Dutchman, Krantz, I can’t think of who the other one was, and myself, and we were sent back to the 30 kilo hospital for a period, to give us a break. On the way back, we called in, saw Coates, and as I say, I was feeling a bit buggered at the time, and I said, ‘You know, this is all just a waste of time, we’ll never see cholera, we’ll never see dysentery if we get back.’ And Bertie Coates said to me, ‘You have learnt something that very few doctors ever learn, and that is to know when a man is sick!’ And I thought, ‘Shit! How petty can you be!’ When I came home, I knew what he meant . . . having that sixth sense to know when a bloke’s sick.75
Lieutenant-Colonel Albert ‘Bertie’ Coates would recall after the war that his time on the Railway constituted the best work of his career. He could not have been referring to the frustrating obstacles placed in his path, nor to the many tragic and Japanese-imposed deaths he witnessed, but more to the improvisation in procedures, the design and construction of equipment against all conceivable odds, and surely, to the undeniable fact that here was a doctor’s devotion to duty in its purest form—against all the odds.
The surgeons in ‘A’ Force—and for that matter in all subsequent forces along the Railway—were faced with large numbers of men requiring operations, and with the equally daunting care of the critically ill and dying. The RMO at a battalion or force camp bore an extremely lonely, isolated and onerous job in dealing with a multitude of ailments, and of having to determine who should go to work on a daily basis, and of having to argue with aggressive Japanese and Korean guards who demanded that the engineers’ work quotas be filled.
The first quality one notices about a number of the battalion RMOs on the Railway is their extreme youth. Captain Rowley Richards was born in Sydney on 8 June 1916; he graduated in medicine from University in 1939; had served as the 2/15th Field Regiment’s RMO through its campaigning on the Malay Peninsula and on Singapore Island; and, after all this, would ‘celebrate’ his 27th birthday in June 1943 with Anderson Force on the Railway. The notion that a 27-year-old doctor might be placed in a position of being responsible for the health of a force of 1000 men under the conditions described would seem no small challenge. As our Railway journey unfolds, we shall encounter other RMOs of equal youth and working under equally daunting circumstances.
The major problem encountered by Railway RMOs was the fact that the men suffered from a number of ailments which seemed to operate in a regular pattern or cycle. Captain Rowle
y Richards:
The thing I often talk about on the Railway was what I called the killer cycle. Our men in Anderson Force, over the period we were in Burma and down into Thailand, from May ’42 to December ’43, the men averaged 1.7 attacks of malaria per month. As soon as they had an attack of malaria their dysentery was stirred up; that would be followed by a flare-up of beriberi; and then as they were recovering from all that, they’d be sent out to work, and they’d get another attack of malaria. And you’d get this cycle that would just go on and on.76
Malaria, dysentery, beriberi, back to work and malaria again. The issue was, how to treat each, how to break the cycle, and how to avoid any one—or more—conditions being the cause of death. The heartbreaking reality of this ‘killer cycle’ was the fact that no surgeon or RMO had the means to break the cycle—it could only be broken by death. If a POW was lucky, therefore, the cycle went ‘on and on and on’.
Malaria on the Railway was universal and its treatment was a calculated game of ‘cat and mouse’. Captain Rowley Richards:
. . . from time to time, we did get quinine, the Japs supplied us with quinine. But then, the number of attacks that we were having in malaria, required a lot more quinine than we were receiving, so that meant that we had to make the decision—do you give a few people full courses or do you give them reduced courses, or what do you do? The playing God thing. We could’ve chosen, perhaps, to select a few people and give them a full dosage, but that would have been not acceptable, to me anyway. We were very much on the concept established by Anderson, that we all had the same in terms of rations, accommodation, and everything else—whether we were officers or troops.77
Richards last sentence is very significant to our story. To it might have been added ‘drugs and dosages of medicines’. We will discover that such egalitarian distribution of rations, the quality of accommodation, and most of all, the administration of drugs differed widely according to the battalion and force in question.