Translation of writings from Doctor Springers diary first published in Holland 1946.
Edited by J G Lee
A report for the use of doctors regarding the treatment of Dutch and British POWs of the Japanese on the island of Harukoe during the Japanese occupation of the Netherlands East Indies and the difficulties we doctors had to work under.
In expectation that my Dutch colleagues are interested in the working of doctors during their imprisonment under extremely trying conditions, and after a lot of consideration, I have taken the liberty of extracting notes from my diary covering that period.
The New Prosperity Spheres of the Sons of Nippon proved to be nothing special; as far as knowledge goes, all doctors outside Java and Singapore had to do their tasks under extreme conditions whereas in Java conditions were a little better, although not much. This was because of better facilities in the larger hospitals in the cities although soon the asiatic liberators began to send the large X-ray installations to other places through their momentary freedom of movement although the flow of medicines and technical equipment was soon taken over. Only during the latter stages of the occupation were small quantities given to doctors, usually with the warning that this would be the last, but were insufficient to counter the lack of food and vitamins let alone bring about a cure and because of the lack of everything, became much worse in the latter months of our stay in the Moluccas. Trying to obtain supplies of medicine and food was hopeless so the morale in the camps was very low and as far as the patients were concerned, they feared they were lost forever, never to get better. We had nothing and received nothing.
HARUKOE is a small island south of Ceram in the Moluccas group of islands near Ambon and it would appear that the building of airstrips in various places in the Archipelago was for defence rather than offence. This was started after the sea battles, around the Solomon Islands in the Coral Sea. It would seem certain that when these airstrips became operative they would soon become targets for Allied bombers, therefore putting the prisoners at risk, which did happen.
On 18th April 1943 a transport of 2,070 men, mostly Royal Air Force ground personnel with some Dutch military, were shipped from Sourabaya, Java, in two Japanese cargo ships which were mostly laden with bombs, petrol and other warlike materials. It seemed that we had no expectations from the Japanese enemy. The living conditions were bad, the food was bad, the treatment was bad and on top of this was cruel.
In every hold were crammed 250 men of all ranks - officers, doctors etc. The wc's were inadequate in number and badly set up - put over an open sewer with just a trickle of water to keep them clear. The food consisted of white husked rice, just pure starch and always with some local products like hot chillies and some root vegetables which was more like our horseradish and a marrow. When fish was given to the Korean guards, the bones were made into soup for the prisoners. It was no wonder, therefore, that the first victims of Dysentery occurred among the jam-packed human mass. Poor diet in Sourabaya alone caused many to fall ill with deficiency diseases and beriberi. The filthy toilets were very difficult to reach and the many tropical rainstorms plus bodily and mental strain and tiredness of the men very quickly developed into them not caring for themselves anymore. It was plain to see to a doctor that an epidemic was on the cards. Thanks to some clandestine appropriation of daganum tablets we arrived at Harukoe on 5th April 1943 without any deaths and our hope was that the many patients would be provided with facilities to rest with some comfort. However, there was none, only the unloading in the dead of night, in a tropical rainstorm, in pitch darkness broken only here and there by smoking oil lamps amid the animal-like screams of the guards whose slapping and kicking drove us into an open space where the night had to be spent in the mud.
The following morning we realised we had been put into an uncleared jungle where only a few posts had been put up to direct us where to build our camp - for the sick no place had been made available. They had to lie in the mud. Many, however, were too weak to stand and very soon large parts of the camp site were already polluted with the bloody and slimy stools on which thousands of flies were laying their eggs.
Notwithstanding our efforts to improve matters, as it was clear that the situation would worsen into a huge epidemic, the reply from the Japanese doctors and camp leaders was - "Your job is to obey orders."
When some of the huts were ready about 200 men were packed in with the remainder sleeping on the wet ground. It was impossible to isolate the sick and suspected victims. The result was that in the dark moonless nights the men could not get to the primitive toilets which consisted of a pole over an open trench thereby dirtying the camp area much more.
I will now give you some notes from my diary giving an image of conditions in the first few days of our arrival on Harukoe.
May 6th 1943 - With fatigue parties under the direction of the Japs, we built the huts fast in order to isolate the dysentery carrying patients. Feeding very bad as kitchens not yet functioning; men dying of thirst because of shortage of fresh water.
May 7th - Although we asked repeatedly for permission to bathe the sick in the sea, this was not granted and latrines very bad. No permission to build them over the sea. No permission to wash pots and pans in the sea. The condition of the sick very bad - many still lying on the ground in the mud. A lot of diarrhoea lying on the ground, watery stools with slime without blood.
May 8th - Because of underfeeding the Dysentery became more dangerous as the patients had less resistance, some delirious, still too little water so that the patients dry out. Allowance by the Japanese sergeant to boil water in a certain place for the sick as only a small quantity of chlorine is available; the water is fetched from the small river which is badly polluted because the open trench latrines were in the wrong place and sewage was contaminating the water but it was not allowed to take water from outside the camp area where the water was cleaner. The kitchens were allowed to be situated near the river.
May 9th - The kitchen now working more regular, twice a day - pap rice cooked in water without sugar or fat in the morning and in the evening stew with a little vegetables but the quantity of food was still too small. Dysentery remains more stable although some very bad cases with sunken faces from hunger - also the doctors feel weak.
May 10th - Conference with Japanese doctor who sees the difficulty although not capable of lending a hand because of the war saying as an officer I do not understand but as a doctor I do. One hour after being examined by Jap doctors 40 patients were set upon with bamboo sticks to set them to work scrubbing. At the moment over 400 very sick patients and 150 near to death and the officers were beaten because they could not supply 1,200 men to work on the airstrip.
As the days went on, all the time the situation got more and more out of control as the Japs got the idea that we doctors kept the men from work on purpose, therefore the beatings became a daily occurrence among the sick. Later they tried to get the non dysentery patients out of the general ward but these were very weak from lack of food and vitamins and were certainly too ill to work. If this treatment did not work, the doctors were punished because they were not working hard enough to make the men well. If, as occurred in a few cases, the men did improve by working the doctors were beaten for not letting them work before.
The first death occurred on 12th May 1943 and every day following more died and more became victims of lack of vitamins which was to prove to be the main cause of death in the weeks that followed. Dysentery became comparatively harmless which, according to the Japs who had made tests on Ambon, was classed as a Y infection but because of the continual shortage of water, the patients were suffering a great thirst, more noticeable in the first weeks. They dried, resulting in continual hiccoughs sometimes for days on end but we were not allowed to regulate their feeding ourselves.
When eventually the death total was five to ten a day and we had 1,300 sick, we received a message from the Jap doctors that they had washed their hands of us and we must do the best we could, but this made no difference as they had not helped in any way.
In Nippon, apparently, no one dies from dysentery. Everybody is treated by injection but this was what we had been asking for, together with fruit, fish, meat and vegetables and vitamins but in Nippon the patients only received pap till they got better.
A certain improvement was achieved when the Japs allowed soya beans, coconuts and bananas to be added to our food. The coconut was grated then roasted and added to the rice. Later small quantities of kadalee milk was produced from soya beans which were soaked overnight then boiled in water, then pressed finely into milk which was easy to give to the patients. We were then able to make yeast from boiled and soured rice which was used to counteract beriberi and other vitamin deficiency diseases. We were also able to set up a tempi factory, tempi being a dish widely used in these parts by the natives and is made from soya beans. For the next few months we were able to improve the general health of the camp. However, as soon as the camp closed down and we were transported to Ambon to be shipped back to Java we were unable to make these products so the symptoms of vitamin deficiency soon returned.
As my thoughts wander back over the years in Japanese captivity there are two facts that always present themselves in the foreground. Firstly, the most pleasing way in which the doctors, chemists and nurses worked with good results in their battle against the results of the pure ignorance, cruelty and inhumanity of the Japanese. Secondly, the speed with which the vitamin deficiency diseases developed.
Organisation of the medical profession on Harukoe. The whole profession was led by the oldest doctor who was also the contact between the prisoners and the Japanese doctors and camp leaders.
The huts containing the sick were fenced off from the rest of the camp with barbed wire consisting of nine huts each containing 100 to 125 patients per hut, allowing only 80cm for each to lie on although this had to be reduced to as little as 50cm at times. They lay in rows down each side of the huts on bali-bali, that is split bamboo platforms raised 40cm off the ground. Only in the hut containing the most severe dysentery cases was any space left between patients.
According to planters among us, these huts would have been condemned immediately on their plantations for the housing of their workforce coolies.
The roof covering and side walls of the huts consisted of dried coconut leaves and, of course, every time it rained or there were strong winds, the water poured in.
The sick huts were divided as follows. Two huts for the extremely sick dysentery cases with two doctors. Three huts for the not so critical cases, with two doctors in charge, and two huts for the not so critical cases with one doctor in charge. On top of this each doctor had to attend to the everyday treatment of those who were still able to work.
The chief medical officer had to report daily to the Japanese sergeant as the Japanese doctor did not want to know. In some respects this proved beneficial because of the fast way he could talk when he was able to make some deals, especially over food for the sick and soon got the name 'The Haggler'. One evening it came as a great surprise to see him carefully leading two goats across the camp. He knew exactly how the Jap mind worked and could wheedle some essential supplies, also getting essential supplies for special diets in special cases.
In Sourabaya I had been put in charge of a section consisting mainly of RAF ground crew aged about 25 and even at that early stage, a lot of symptoms of vitamin deficiency was evident. A lot complained of burning feet, blurred vision, a dead feeling around the mouth and sometimes around the ears as if they had been injected with cocaine. Some had an embarrassing itch around the scrotum which the British soon referred to as fairground balls and it was to be expected that, as conditions became worse on Harukoe, these symptoms became much worse and any appeal to the Japs was like speaking to the wind.
We soon learned the effect of anorexia. A lot of dysentery patients kept complaining of not feeling hungry although their motions showed no sign of blood.
Anorexia is a symptom of vitamin B deficiency which we knew but other symptoms that should have been there were absent, thus we came to the conclusion that these symptoms were the main ones pointing to vitamin B deficiency. Even the sight of rice made some patients sick and it was with great difficulty that we were able to get them to take some vegetable soup although this at times caused sickness.
As the diarrhoea worsened the motions showed signs of entrail colitis, with watery stools, undigested particles of food and some slime. There was no pain in the beginning although this became severe, mainly in the region of the navel, together with swollen stomachs and severe shooting pains. This started mainly from the back then to the navel causing the patients to double up and roll on the ground.
Although we doctors had only seen beriberi in a very mild form we now felt that we could add many more symptoms to those already known, by the lack of vitamin B. We considered ourselves fortunate that the type of malaria was not as severe as that experienced by those who had been stationed on the island of Flores, although some deaths did occur.
On 24th November 1943, seven months after we left Java, the worst patients were transported back to Java. This happened after the death roll reached 363.
The move was arranged in typical Jap fashion. The patients were packed into the hold of a cargo boat and moved to Ambon where other men were loaded onto another boat which was later torpedoed, never to be heard of again. A colleague of mine, who had worked on Leon and Ambon, also died on this ship.
With the diminishing number of dysentery cases now on Harukoe, due to the fact that most had died and 780 had been sent to work on Ambon or returned to Java, the pressure on the doctors became less. Part of a hut was made available to observe certain patients while another section was set up as a dentistry and another as a barbers. After a successful operation on a perforated stomach ulcer we were able to set up a makeshift operation unit with the aid of the ever useful bamboo.
The barber's shop proved very useful as the Japs, apart from their bald heads, had an obsession for cleansing their noses and ears for which they had to pay with food or medicine.
This calmer existence was short-lived with an epidemic, this time tropical ulcers being the main concern, with all the possible complications, including gangrene.
Footwear and socks had been in short supply for some time and for the men who had to work daily on the airstrip, in all weathers, wounds through to the bone, due to the sharp rock surface, were very frequent. Within the first 24 hours signs of infection were evident and if the patient could not be treated immediately, as often was the case, the battle was lost as a systematical treatment was not possible because of the meagre supply of medicine. However, if more iodine had been available this could have been used with success for continuous treatment. Unfortunately only a low quality iodine was supplied on rare occasions. Bandages could not be used because the men had to keep working, besides which all articles of suitable material had been collected through the camp and the Japs refused to supply bandages. To top it all each person only had on a piece of modesty clothing which had to be maintained to safeguard some dignity.
Another concern arose as more air raids were directed against the airfields on the islands, especially Ambon, which cost some lives and it was necessary to keep some material for any casualties of such raids. This foresight proved correct in later raids.
From January 1944 to June 1944 34,293 bandages from all types of material were used although the camp strength was now only 1,500 men.
Many men had between 6 and 16 ulcers which were at least as big as a guilder piece (10p). Often during the night, the pain was very bad causing a chronic lack of sleep making it impossible for many to work and these, by the order of the Japs, were given very little food - "No work, no food" was the Jap method. Therefore those unable to work would soon die.
The Japs pointed out that in Japan if a buffalo was unable to pull a plough he was no longer working for the Emperor and therefore was not entitled to any food and the same applied to POWs.
Looking back, the one thing that gives me greatest relief is the fact that we did not have to carry out any amputations although it was a close call at times. It was like a miracle that our own concoctions, made from Jap tooth powder, coconut oil, chalk and bolis alber, were used to coat the ulcers and form a hard seal. This proved extremely successful but sometimes it was necessary to keep a patient off his feet. In these cases surgery was often possible with a deep incision near the ulcer to drain off stagnant blood which caused large areas of discoloration, using only boracic powder as an antiseptic then covered with our own type of plaster. These operations were very distressing, carried out mostly without anaesthetics unless some local anaesthetics could be wheedled from the Japs.
Some men had to have this treatment as much as ten times and someone coined the phrase - "On the table we are able to use any language possible before the most passive doctor imaginable" and the terminology was just as powerful in Dutch or English.
Once the battle against infection was won, the healing could be rapid. This was also true with cases of appendicitis and war wounds.
In July 1944 it seemed that the intentions of the Japs was to send us, together with other camps at Leon and Ambon, back to Java. Thus Harukoe camp was moved to Leon leaving behind 415 graves on Harukoe. Then on 15th August we were moved to the town of Ambon from where the transportation was to be arranged. Here the feeding and accommodation was so bad that every prisoner showed signs of beriberi and other vitamin deficiencies.
The now superior power of the Allied air forces became evident by the regular bombing raids on Leon and was also evident here at Ambon with regular bombing of the airfield and harbour. The defence from the Jap ground forces was almost nil.
We began to dread the thought of the journey back to Java without any medicines and the prisoners in such a dreadful state. Then, for the first time, we received 200 sulphur tablets from our friends, the Red Cross. Until then, all Red Cross supplies had been withheld by the Japs which was later to be proved by the stacks of Red Cross parcels and medicine found in warehouses in Singapore and Java that had been held for years.
The feeding in those last few weeks on Ambon was now almost non existent. Every day one saw more and more wrecks of people who, with the help of a comrade or a stick, moved through the camp trying to find food including leftovers from the Jap guards' meals which were thrown onto rubbish heaps. This was eaten on the spot without any thought of cleanliness with the rapid deterioration of resistance to disease, not improved by the beatings and terrorising by the now very nervous and touchy Korean guards because of the continuous bombing.
There was the pain of trying to sleep with the ever gnawing hunger only to rise still with the same hunger which had to be fought throughout the day. No one had any hope of coming out alive and for the first time there were signs of a breaking of the spirit that had been maintained throughout our imprisonment. The men became depressive, without any feeling for the blows from the guards but although the humour over the last years had been bitter, it was still humour but that had now gone, to be replaced by downright bitterness and distrust.
We were at last put aboard a cargo boat bound for Java and of the 650 on the boat that I was on 306 men found their sea graves during the journey which took nine weeks to cover. Six weeks of this was spent in the harbour of Macassar. All the men were crowded together in a boat of five or six hundred tons without food and little drinking water, within reach of Allied bombers and not allowed to have the sick taken ashore. Therefore, most died in lunacy, cerebral palsy playing a large part in this.