X
In July, 1944, comparable figures were as follows:-
Nature of deficiency
Vitamin A deficiency
Vitamin B1 deficiency-wet
central nerve blinding
Minor degrees of B1, B2, C, calcium and salt
deficiency
-dry
+
Vitamin B2-pellagra type.
Total new cases
Total old cases
108
No. of individual cases
25
30
43
56
13
9 176 718
The ration had a caloric value of rather less than 1,600 and was made up of :--
protein, 37-53 gms.; fat, 22.75 gms.; carbohydrate, 300 gms.; vitamin A, 6,910 i.u. ; vitamin Br, roo; vitamin B2, 58; ascorbic acid, 0-64 mgs.; calcium, 0.317 gms.; iron, 0-0115 gms.; phosphorus, 0·0576 gms.
In July, 1945, the recorded figures were as follows:—
Nature of deficiency
Vitamin A deficiency
Vitamin B1 deficiency-wet
-dry
Vitamin B2 deficiency-pellagra type
-central nerve blindness
Minor degrees of B1, B2, C, calcium and salt
deficiency
Total new cases
Total old cases
No. of individual cases
37
23
9
34
12
9 124 911
The dietetic value of the ration showed some deterioration on that of the previous year. PA. S. SELWYN-CLARKE, D.M.S.
APPENDIX II
An Account by the Deputy Director of Medical Services of the Organisation of
the Medical Services in Stanley Internment Camp
January, 1942—August, 1945
For ease of description, the Medical organisation may be set out under the following headings:-
(a) STAFF
(a) Staff.
(b) Hospital and Sanatorium.
(c) District Clinics.
(d) Special Clinics.
(e) Drugs.
Equipment.
Miscellaneous activities,
It was fortunate that among the 2,500 individuals who were interned at Stanley, there were no less than forty doctors, two dentists, a distinguished biologist, six pharmacists, one hundred trained nurses including contingents of the Q.A.R.N.N.S. and the Q.A.I.M.N.S.. six masseuses and a host of auxiliary nurses. These professional men and women consisted of Government servants, members of the staff of the Hong Kong University, private practitioners and the staffs of private and mission hospitals, All these individuals pooled their talents and resources, and worked as a harmonious whole for the benefit and welfare of the entire community.
In the absence of the Director of Medical Services, who was not interned, but later imprisoned, the Deputy Director of Medical Services was appointed Camp Medical Officer by the Representative of Internees. Very soon after internment the medical organisation was established on a firm and co-operative foundation.
(b) HOSPITAL
A three-storied building, formerly used for accommodating single Indian warders, was transformed into a very efficient, though poorly equipped hospital. This building over- looked Tweed Bay, and hence was named Tweed Bay Hospital. On the top floor in
21
109
dormitories, there was accommodation for fifty members of the nursing staff, living under very crowded conditions; four wards made up the first floor; three wards, offices, operating theatre, kitchen, pantry, dispensary, etc., were situated on the ground floor. The hospital seventy-four beds (thirty-seven for females, and thirty-seven for males). These beds were usually filled to capacity. The turn-over was rapid, patients having to be discharged early to make room for more acute cases. The number of new admissions for a month varied between ninety and one hundred and fifty. Disorders of the alimentary tract, including bacillary dysentery, accounted for most of the admissions.
Operations were performed regularly, even after the electricity had been cut off, and lighting was limited to the amount of daylight that could be reflected into the wound by means of a reflector.
The induction of anaesthesia often presented a serious problem owing to the shortage of chloroform and ether. Whenever feasible, spinal anaesthesia was the method of selection.
A Board, known as the Surgical Board, was appointed by the Representative of Internees. It consisted of four members--the Camp Medical Officer as Chairman, and three senior surgeons.
The functions of this Board were to control surgical activities in the operating theatre. This was made necessary owing to the limited stock of dressings, gloves, catgut and general anaesthetics, etc., etc.
SANATORIUM
to 14.
By 1943, the number of cases of open pulmonary tuberculosis had increased from seven A small building, known as the Leprosarium (it was here that in peace time cases of Leprosy among prisoners in Stanley Gaol were, isolated) was cleared of its occupants and transformed into a sanatorium for the treatment of cases of pulmonary tuberculosis. The single large ward was divided by a wooden partition, thus separating the sexes-(ten males on one side and four females on the other). This transference of tubercular infected patients from Tweed Bay Hospital to the Sanatorium proved a great success and incidentally provided more accommodation for other cases at Tweed Bay Hospital.
Treatment was handicapped by the absence of radiography---but this did not prevent collapse therapy being regularly carried out. The only other treatment that could be given to these unfortunate sufferers was regular doses of shark's liver oil, soya bean milk, peanut butter or margarine, according to available stocks held by the Camp Supplies Officer and the International Welfare Committee. Albeit, a steady but slow physical deterioration was the rule.
(c) DISTRICT CLINICS
The Camp was conveniently divided into three districts :-
(1) The St. Stephen's area, comprising St. Stephen's College and five small residential
bungalows.
(2) The "Indian" Quarters,-so-called because the several three-storied blocks, used in peace-time to house the married Indian warders and their families.
(3) A group of nine blocks of three-storied tenement flats that used in peace-time to
accommodate European warders, married and single.
The mean population of each of these districts was 850. Each district had a clinic or surgery which was in charge of a medical officer. Here daily, out-patients were attended and surgical dressings applied. Here also were kept the records and the medical history sheets of every internee who attended, and daily returns were made to medical head- quarters situated at Tweed Bay Hospital. Whenever necessary patients were sent to the special clinics for further advice and treatment. In this manner a very detailed record was kept of the state of health of all internees.
(d) SPECIAL CLINICS
(1) Surgical-Surgical specialist attended each morning from 9 to 12 in the out-patients department at Tweed Bay Hospital.
(2) Nutrition-All cases attending district clinics and found to be suffering from symptoms attributable to lack of a suitable diet were referred to the nutrition clinic which was in charge of a medical specialist and several assistants. The results of treatment were carefully watched and reported. The functions of this clinic had a two fold advantage, firstly, the standardisation of diagnosis and secondly, economy in the use of drugs, such as thiamin, nicotinic acid, and the consumption of yeast and shark's liver oil. Moreover, the physician in charge kept a detailed record of all food consumed, i.e., the daily rations as supplied by the Japanese, food purchased at the canteen, and food received from time to time from the International Red Cross. It was possible in this way to correlate the incidence of avitaminosis and loss or gain of body weight with the state of the diet throughout the period of internment. Some extremely interesting statistics were thus obtained and depicted on coloured charts. (Seo-special repor Dr. Dean Smith.)