34 INSIGHT A Glimpse

intoMedicine the in (PartPast 7) February 1942 to : The Japanese Occupation Years This is the seventh instalment of a series on the history of medicine in Singapore.

To understand some of the events committed to Europe and the Middle and northern Malaya. Penang fell to that occurred in relation to medical East by 1940. Britain was confident the Japanese on 18 , education, it would be appropriate that Singapore could withstand any Kuala Lumpur on 11 to briefly review the history of the attack, which they assumed would and Malacca on 15 January 1942. naval base and the Japanese invasion come from the south and from the When the Japanese reached of Singapore. sea. Thus, heavy guns defended Johor Bahru on 31 January 1942, the port and the city, and machine- the last of the British troops crossed In 1923, the British began building a gun bunkers lined the southern to Singapore and blew a gap in naval base in Singapore in response coast. The only local defence forces the causeway. to 's increasing naval power. were the four battalions of Straits The King George VI Dock was Settlements Volunteer Corps and a Singapore faced Japanese air raids completed in 1941 and was defended small civil defence organisation with almost daily in the latter half of by artillery, searchlights and the units trained as air raid wardens, January 1942. Fleeing refugees newly built Tengah Airfield nearby. firefighters, medical personnel and from the peninsula had doubled the Singapore was called the “Gibraltar debris removers. On 8 December 550,000 population of Singapore. On of the East”. However, there were no 1941, two large Japanese naval the night of 8 February, the Japanese ships because the British fleet was convoys landed in southern Thailand landed, using collapsible boats, under

SMA News / AUG 2016 INSIGHT 35 cover of darkness on the north-west course of the disease was a long and coast of Singapore. The Japanese hectic one, of six to eight weeks of PROFILE then bombed the city by day and fever and loss of flesh… The greatest shelled it at night. Governor Shenton danger is from haemorrhage (30 Thomas cabled stating that percent of cases) and perforation with “[t]here are now one million people fatal general peritonitis (30 percent within radius of three miles… Many of cases) in the hospital record, dead lying in the streets and burial with an overall mortality rate of 40 impossible. We are faced with total percent. Surgery of these peritonitis deprivation of water, which must cases did not help. (Author’s note: text BY result in pestilence...” On the evening Chloramphenicol, the treatment for of 15 February 1942, at the Japanese typhoid fever, was not discovered headquarters in the Ford Factory in until 1944) … I was put in charge of A/Prof Bukit Timah, the Japanese accepted Middleton Hospital, … having been Cuthbert Teo Britain’s unconditional surrender of evacuated from the GH and TTSH Singapore. The Japanese occupied []… Apart Editorial Advisor Singapore from 1942 to 1945. They from the epidemics… the hospital designated it the capital of Japan's was inundated with sick people who A/Prof Cuthbert southern region and renamed were suffering from malnutrition, Teo is trained as a it Shonan, meaning “Light of the famine oedema and tropical ulcers forensic pathologist. South” in Japanese.1 of the legs… infectious diseases… The views expressed took a heavy toll of lives of children in the above article Medical education was interrupted of occupied Singapore… Chinese are his personal by the Japanese invasion of Malaya medicine men to whom these cases opinions, and do not in 1941. When it was realised that were first sent would blow in a represent those of the Japanese would soon be arriving mercuric compound into the trachea his employer. in Singapore, the College brought and lungs to dissolve the membrane. forward the March Final Examination These powders only added to the to January 1942, and this allowed five obstruction with a dirty mucoid gritty doctors and five dentists to qualify. matter, which was difficult to aspirate diphtheria diagnosed after rubbing of even after tracheostomy… In no other chest with an egg, which when cracked, During the Occupation, the Japanese illness is the saying truer – that showed a black hair in it. My father Armed Forces commandeered the death lurks in the shadow of delay… had later apparently been treated with General Hospital (GH) for their own The hospital had run short of anti- diphtheria serum made in this way.) casualties, and the GH became the diphtheria serum and the Japanese main surgical centre for the Japanese could not supply the hospital The Kandang Kerbau Hospital (KKH) army and navy in Southeast Asia. requirements… But two facts gave became the main civil hospital, Patients from GH were transferred me the solution to my problem. One was renamed as Chuo Byoin and to the Mental Hospital. The medical was that I had a culture of diphtheria became known as the Central Civil department was under the charge bacilli which were able to grow on GH. The maternity service was of Dr K Ando, Director of Medical the surface of a liquid media, and the scaled down to one ward. It was Services (he graduated from King toxins produced would sink to the manned by local and Japanese staff, Edward VII College of Medicine fluid portion… The second was that with Dr Benjamin Sheares as the in 1912), and his deputy, Dr Gopal I had eight goats presented to us for deputy medical superintendent. Two Haridas. (Dr Haridas later became the food in case of necessity. I injected Japanese dentists (Dr Murakami and first Singaporean paediatrician and firstly two goats with graduated Dr Itoh) were posted to take over the senior physician at the GH. He was doses of the diphtheria toxin which maxillo-facial unit in the hospital, the first graduate from the College I obtained by filtration. I gradually while the expatriate dentists were to receive the MRCP in the 1930s. increased the dosage… After eight made prisoners-of-war. Dr Tay Teck Dr Thiruchelvan was the first local weeks, I bled the goats. The blood Eng, a dental tutor, was instructed graduate to obtain the FRCS.) During was allowed to clot, and I separated by the Japanese to set up a dental the Occupation, medical services the serum from the clot. I tried it on clinic at Woodbridge Hospital and in Singapore broke down; disease guinea pigs inoculated on the skin he was later transferred to the clinic became rife and deaths mounted. with diphtheria toxin, and it worked. at KKH. TTSH was initially used as I used this crude serum from goats a military hospital by the Japanese, In one example, Prof ES Monteiro and cured many cases of diphtheria.” but after one year, it became a civil described the effects of typhoid fever (Author’s note: I remember a story hospital and was renamed Hakuai and diphtheria during the Japanese that my deceased grandmother told Byoin, functioning as a subsidiary Occupation:2 “… I was a victim myself. me about my father who, as a child general hospital to KKH. When There was no specific cure then. The during the Japanese Occupation, had accommodation was inadequate,

AUG 2016 / SMA News 36 INSIGHT schools were used as hospitals for the Japanese invasion, local doctors over to the Singapore Government the wounded. treated the local population in KKH in connection with the withdrawal (Chuo Byoin), TTSH (Hakuai Byoin) of British troops from the region. First-aid posts were set up in various and the Mental Hospital (Miyako In 1994, Alexandra Hospital was buildings, manned by a Medical Byoin). The chaos in these civilian designated the Alexandra Campus of Auxiliary Service (MAS). The MAS was hospitals during the first few months the National University of Singapore. formed by the government before the was gradually replaced with some In October 2000, it became part outbreak of war, from a nucleus from semblance of order due to the efforts of the National Healthcare Group; the St John’s Association and Brigade. of the medical personnel. Equipment Alexandra Health in 2008; and Just before the Japanese occupied and drugs became very scarce. JurongHealth in 2010). Singapore, over 200 students from the Students of the College who had King Edward VII College of Medicine been in their clinical years when the joined the MAS and the Passive Japanese invaded received clinical References Defence Forces (which was part of the instruction from the hospital doctors 1. US Library of Congress. World War II. In: Barbara MAS). They received $45 a month and and dentists. Occasional clinico- Leitch Lepoer, ed. Singapore: A Country Study. free board and lodging. They rendered pathological meetings were held Washington: GPO for the Library of Congress, yeoman services to those injured by at KKH. 1989. Available at: http://countrystudies.us/ the bombing and shelling, and worked singapore/8.htm. 2. Monteiro ES. Excerpts from a personal 12 to 18 hours a day. Local graduate The Mental Hospital and the perspective of medicine in Singapore in the last 50 3 doctors who were in private practice Alexandra Military Hospital, built years. Singapore Med J 1977; 18(2):118-25. joined their government colleagues by the British Armed Forces in 3. Urban Redevelopment Authority. Alexandra tending to the injured in the hospitals. 1938, were used by the Japanese. Hospital. In: Conservation. Available at: https:// At that time, it was the largest and www.ura.gov.sg/uol/conservation/conservation- Two doctors were said to have been best-equipped hospital in the British xml.aspx?id=ALXDH. killed by shelling at KKH while they Command. (In 1971, the were attending to casualties. After British military handed the hospital

SMA News / AUG 2016