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(3) Ophthalmic clinic. This clinic was held daily in the office of Tweed Bay Hospital. Anyone suffering from affections of the eye, defective vision, or other visual abnormalities, was referred to the eye specialist. Without the assistance of special apparatus, visual fields and scotomata were charted in all cases. Night blindness was a common complaint, but improvement followed the administration of shark's liver oil. In spite of giving riboflavine, peanut butter, yeast or egg yolk, no improvement ensued in cases of central nerve blindness. Very complete records were kept and some very interesting data
obtained.
(4) Ear, nose and throat clinic. Similarly, patients suffering from disorders of the ear, nose or throat, were seen twice weekly in Tweed Bay Hospital. Mastoidectomies and tonsillectomies were performed on a few cases. Aphonia, due to avitaminosis B2, was a common complaint.
(5) Dental. Due to the enthusiasm and energy of one of the dentists, a blitzed room on the ground floor was transformed into a dental surgery. The Director of Medical Services managed to procure a dental chair and a foot drill. Some very valuable work was carried out, for apart from ordinary extractions, the teeth of children received special conservative attention. While materials were still available, it was possible to make new dentures and to repair broken ones.
Other special clinics were: gynaecological, ante-natal, social hygiene, diseases of the skin, massage and electro-therapy.
Though not held as a special clinic, one of the lady doctors made it her special work to attend to the health and welfare of infants and school children.
(e) DRUGS
In the first instance, the drugs available were those brought into camp by the medical staff of the various hospitals. Private doctors brought in a considerable supply from their personal stocks. The bulk of the stock contained in the small medical store in Tweed Bay Hospital was brought direct from the Queen Mary Hospital.
After a time replenishments became more difficult but thanks to the efforts of the Directos of Medical Services valuable additions were made, especially of preparations such a sulfanilamide and sulfapyridine, nicotinic acid, thiamin, and multivite capsules, the price of which in the open market had soared to impossible heights. The Swiss delegate of the I.R.C. was instrumental in sending in medicines occasionally but at exorbitant cost, which made it necessary for the Camp Medical Officer to issue repeated instructions for the exercise of the strictest economy in the use of these medicines. In fact, towards the end of internment scarcely any prescription was allowed to be dispensed without the countersignature of the Camp Medical Officer. This was naturally irksome to doctors
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but it was only by this means that the supply of certain important preparations lasted There were six patients who required twice daily doses of insulin, some as much as 60 units a day. It was an anxious time for both doctor and patients when only one week's supply remained, but fortunately fresh supplies always turned up in the nick of time.
The most valuable additions of drugs and dressings were those received from the British and Canadian Red Cross Societies.
It would be ungracious to omit to mention that the Japanese authorities did, from time to time, send into camp medical supplies. Welcome as they were, the actual items were not always in response to specific requests, but appeared to be merely such stocks of preparations that they happened to possess. Perhaps the most valuable of their contri- butions was the supply of stationery. Until March, 1943, prescriptions had to be written on scraps of paper, cigarette wrappings, etc. The medical notes of in-patients were recorded on the backs of temperature charts, and many of these had to be used over and over again.
(f) EQUIPMENT
It
As in the case of drugs, most of the surgical instruments and other hospital equipment were brought into camp at the time of internment by various doctors and persons connected with the outside hospitals, but again the majority from the Queen Mary Hospital. was, however, possible by the pooling of all equipment from all sources to provide for the hospital, including the operating theatre, and the district clinics. For weeks after internment the Director of Medical Services, on his periodic visits, never failed to furnish us with additional impedimenta,-as for example, a microscope, a diathermy machine, etc., etc. Repeated requests were made to the Japanese authorities for a portable X-ray set, but without success. During the first two years a limited number of patients were sent into town to be X-rayed, but for the last two years no radiography was carried out at all. Though frequently required, it was not possible to obtain a cystoscope.
Some very ingenious surgical appliances were manufactured at the camp workshop at the hands of skilled engineers. They made excellent aluminium splints, bone-holding forceps and a high pressure steam steriliser,
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(g) MISCELLANEOUS ACTIVITIES
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(1) Diet kitchens. After the early months of internment it became very apparent that something would have to be done about making the diet as supplied by the Japanese more suitable and palatable for very young children, elderly invalids, and those suffering from chronic peptic ulcers. The setting up of these special kitchens was made possible by the fact that there were available in the camp a number of electric cookers. The Inter- national Welfare Committee provided the extra foodstuffs. The district medical officer exercised general supervision but a trained nurse--a specialist in dietetics was in charge of each kitchen. She had the assistance of other women experienced in invalid cooking. These kitchens proved a great success. The time came when the electricity was cut off and firewood became scarce, and these kitchens were forced to close. deterioration in the health of many of the regular patients followed.
A very definite
(2) Milk.-A limited number of 8 oz. bottles of unpasteurised cow's milk were sent into camp daily, though the supply was somewhat irregular and diminished considerably as time went on. This was kept for the hospital and children under 5 years of age. Full cream powdered milk was reserved for infants only but this supply was exhausted by January, 1945. Thirty to forty pints of soya bean milk were made daily. This was reserved for use in the hospital and sanatorium and for debilitated out-patients.
(3) Yeast. Next to loss of body weight the earliest manifestations of food deficiency were those due to lack of vitamins B1 and B2. Owing to the difficulty of supplying the deficiency medicinally, it was decided to manufacture a limited quantity of yeast administration. The daily dose of 3 to 4 oz. proved efficacious though the media consisted of weevil-infested flour, soya bean residue and sweet potatoes.
(4) Medical meetings.—An association consisting of all the doctors, dentists and pharma- cists was constituted somewhat on the lines of the British Medical Association. A president and vice-presidents were elected annually, also a secretary. Many interesting and instructive papers were read. Minutes were duly read and confirmed, and complete records of all discussions were kept.
(5) Hospital visitors board.—This small committee, consisting of the Camp Medical Officer as chairman, the Hospital Supervisor (a member of the Clergy) as secretary, and six other members representing the community at large, was appointed by the Repre- sentative of Internees. The object of this Board was to assist the hospital administration in matters concerning the welfare of patients, and to act as a liaison between hospital and community. The Board met every two or three weeks throughout internment. There is no doubt that this Board performed valuable service.
(6) Camp relief.-A group of four medical officers including the Camp Medical Officer, the medical officer in charge of the Nutrition Clinic, the medical officer in charge of Tweed Bay Hospital, and the medical adviser to the Camp Relief Trustees, was empanelled to give advice in the matter of giving aid to those requiring extra foodstuff. Advice was also given to the Representative of Internees on problems concerning the best use of foodstuffs held in the camp store.
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(7) Pathology and bacteriology. The Government bacteriologist continued his work in the camp to the best of his ability. His small bed-living room was his laboratory. He was severely handicapped by the lack of materials and technical equipment. His work was almost entirely confined to the examination of blood films, sputa, and stools, and doing red and white blood cell counts. He was occasionally called upon to perform post-mortem examinations. Towards the end of internment the supply of bacteriological stains gave Malaria and pulmonary tuberculosis had to be diagnosed on clinical grounds alone.
(8) Births and deaths registration.-No time was lost after internment in opening fresh registers for the registration of births and deaths respectively. They conformed as closely as possible to the official registers kept in peace-time. Copies of the entries in the registers in the form of births and death certificates respectively, were made out and given to the interested parties. Without the actual registers to refer to, it is impossible to give accurate figures. Suffice it to say that the death rate each year remained remarkably low; for instance, during the year 1943, there were only 18 deaths, and the majority of these were of persons over the age of 60. The infant and maternal mortality rates were so low as to be negligible.
D. J. VALENTINE,
Camp Medical Officer.
January, 1946.
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