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APPENDIX III
112
An Account by the Deputy Director of Health Services of the organisation of hear services in Stanley Internment Camp.
I. INTRODUCTORY
January, 1942-August, 1945
Owing to my sudden and unexpected departure from Hong Kong as a patient on a hospital ship most of my records were left behind and, as I have not been able to recover them, I regret that this report cannot be as detailed and as statistically accurate as I would have wished. However, as far as it goes, I trust the account given will present a fairly clear picture of the public health situation in Stanley Camp, the problems encountered, how they were dealt with and the results obtained.
"
2. STANLEY CAMP
The camp was opened by the Japanese in January, 1942, for the segregation, and protection of British, American, Dutch and Belgian natiorals in Hong Kong at the time of its occupation by the enemy. It was situated on Stanley Peninsula, about 11 miles by road from the City of Victoria, and was confined to the area between Stanley Village and the Hong Kong Prison. Originally it covered an area of about 75 acres but successive reductions, usually as measures of collective punishment, reduced it to less than 50 acres. Each reduction added to the difficulties of public health work as it made inaccessible to internees mosquito and fly breeding areas in close proximity and drains and septic tanks serving the camp. Although on a narrow peninsula, the camp was surrounded by a barbed wire fence and access to the foreshore and beaches was not normally allowed, a restriction which seriously affected mosquito control measures. From an aesthetic and climatic point of view the site was probably the best in the Colony and this undoubtedly played an important part in maintaining the health and morale of internees. The distance from the densely populated urban areas was a distinct advantage which gave a high degree of protection against the introduction of infectious disease, nearness to the sea
was of importance during the hot summer weather and many of the buildings were of fairly recent construction. One serious disadvantage was the close proximity of the Hong Kong Prison where the constant stream of new arrivals from town and the lack of sanitary control constituted a constant menace to the health of the camp. Fly-breeding within the prison was extensive and the presence there of large numbers of diseased and neglected prisoners gave rise, I am convinced, to periodic outbreaks of intestinal disease in camp.
3. THE CLIMATE
This was beyond the control of the Japanese Authorities and was generally good. Rather hot in midsummer, it was sometimes very cold in winter. The winter of 1944-45 was particularly cold with temperatures at times as low as 40° F. and this was a great hardship to a community badly nourished, inadequately clothed and bedded and lacking such essentials as heating and lighting. Over the whole period, however, the climate was generous to Stanley internees.
4. WATER SUPPLIES
These were obtained from the Colony's main system and an adequate piped supply was maintained until November, 1944, when a complete stoppage was threatened owing to lack of power for pumping purposes. A gravity supply was possible by a simple manipulation of valves at a high level reservoir but this solution of the problem was rejected by the authorities "for military reasons Wells and streams in and around the camp were quickly put in such order as the limited supplies of cement and other essentials allowed and a supply of about five gallons per head per day became available. But this amount could not be carried by the able-bodied men in camp nor were there anything like sufficient receptacles for transport and storage. There was also the major problem of nightsoil disposal. Trenches were dug by internees in remarkably quick time but the authorities failed to supply materials for stances and superstructures. An issue of 40 shallow pans and 18 old five-gallon oil drums was made to meet the requirements of 2,500 people. The outlook was serious but, eventually, as a result of the strong and repeated protests of the Representative of Internees the Japanese agreed to give a piped supply every third day. This was later reduced to every 5 days with a maximum of 100,000 gallons for the period or eight gallons per head per day. This would have been fairly satisfactory, but, unfortunately, storage facilities were poor and the water main was incapable of supplying 100,000 gallons while the water was on. During this difficult and anxious period piped supplies were supplemented by water from wells and a scheme of regular inspections of toilet facilities prevented any serious lapses in that direction. With the arrival of early sum- mer rains the situation became easier and by June the water supply was on for six hours daily.
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From the beginning supplies were suspect as no information was available regarding he methods of purification, if any, in operation. Accordingly, all precautions were taken id boiled and chlorinated water was supplied in all sections of the camp. While there were adequate supplies of chlorinated water the amount of boiling water available was limited to approximately 2 pints per head daily. Sometimes owing to lack of fuel, this was reduced or even stopped for several days at a time. A good supply of chloride of lime sent into camp at the beginning from Health Department Stores, lasted throughout intern- ment; in fact, on VJ Day there was sufficient in stock to last a further 12 months. Water from wells in camp, used to supplement piped supplies during restricted periods, was all boiled as such was almost certain to be grossly contaminated owing to the authorities/ insistence on the use of nightsoil as a fetiliser on camp vegetable gardens.
The precautions taken appear to have been adequate as the water supply was not at any time incriminated as a source of disease.
5. DRAINAGE
Surface drainage was satisfactory but chokages occasionally occurred outside the camp. These were dealt with, when and where possible, by an anti-malarial gang which was sometimes allowed to operate outside the camp boundary. Sewage was disposed of by means of seven septic tanks, four of which were outside camp limits and entirely dependent on the anti-malarial gang for inspection and maintenance. These tanks dealt with excreta from a population much in excess of that for which they were designed and on the whole stood up well to the strain. The carelessness of some internees led to many avoidable chokages in underground drains and these were difficult to deal with owing to lack of equipment. For instance, a set of drainage rods could often have prevented heavy digging operations but all appeals for such were ignored by the Japanese.
6. VITAL STATISTICS
The population of the camp varied from a maximum of 2,863 in April, 1942 to 2,400 in 1945 with an approximate average of 2,500. The main reductions were caused by the repatriation of United States nationals in 1942 and Canadians in 1943. Children under 16 numbered about 300 in 1942 and remained about that figure. Over 16, males exceeded females by about 50 per cent.
The annual Births and Deaths rates per 1,000 were as follows:—
Year
1942
1943
1944
1945 (8 months)
Births
8.3
4.0
5.2 4'I
Deaths
II.3
7+2*
16.0
II.2
The birth rate was naturally low as the majority of the married women in camp were wives of prisoners of war in military camps but by nature of our circumstances it should have been lower. The deaths for 1945 do not include 14 internees who were killed by a bomb during an American air raid. The death rate was low, surprisingly low, in fact, when one considers the conditions in camp and the high incidence of malnutritional diseases. Several deaths were due to causes which could be regarded as the direct result of inadequate food supplies while many others had an associated condition of malnutrition. That there were no deaths by suicide or even murder is remarkable in view of the serious over- crowding and the nervous strain resulting from the sharing of rooms by social and racial incompatibles.
7. ACCOMMODATION
Apart from a few repairs to damaged buildings, carried out in 1943, accommodation throughout the whole period of internment was substantially the same as described in my Camp Health Report for 1942 which is quoted below. Copies of this report were submitted to the Japanese Authorities and the International Red Cross delegate, but no improvements were effected.
"Accommodation--Residential :
The housing provided can be divided into three
sections for the purpose of general description.
(1) Buildings connected with St. Stephen's Boys College;
(2) Buildings provided for European staff employed at the Prison; and
(3) Buildings provided for Asiatic staff similarly employed.
(1) The first category consists of the College buildings previously used for teaching and residential purposes, three bungalows and a block of servants' quarters. Two additional bungalows once allotted to internees were taken over by the authorities for other purposes some months ago.
* not including deaths by execution.