Khonkan 55 km Hospital Camp - Burma

KHONKAN 55 KM HOSPITAL CAMP, BURMA –  opened 30th July 1943 – 24 December 1943 – Hospital Camp for ‘A’ Force (also F  & H Forces)

When it was decided to set up this hospital at 55km, the sick from 105km and 108 km were transferred to this camp.  Brigadier Varley, Commander of ‘A’ Force suggested the men from Meiloe 75 km Camp also be moved to Khonkan by road and rail under the command Dr. Coates.

“Dr. Coates was remarkable; he was admired by everyone and was very efficient.”

Coates was to Burma what Dunlop was to Thailand – each being a fine surgeon in his own right.   Coates was brilliant senior surgeon. 

In 1914, WW1  Coates enlisted in 7th Battalion as a medical orderly serving a year on Gallipoli.  He was one of the last to leave the peninsula on the night of 19/20 December 1915. The 7th  battalion transferred to France  in March 1916 fighting in the battle of the Somme. 

A skilled linguist Coates came to the attention of his superiors and in February 1917 was attached to the intelligence staff, I Anzac Corps.

Sir John Monash and British authorities recognised his ability and, at the end of the war, he was invited to apply for a commission in the British Army. Coates preferred to go home to Australia.  He then studied medicine.

Captain Claude Anderson of 2/4th was one doctor working here between 1st September to 19th October 1943 whilst Albert Coates was present (after which he returned to Aungganaung 105km Camp).

In July 1943 Dr Albert Coates was sent as Senior Medical Officer to take charge of the hospital; remaining there until end of December 1943. Khonkan was an abandoned working camp of eight bamboo and atap huts with floors of bamboo strips. It was nothing more than a series of huts previously used to accommodate railway workers.

On the 1 Jul 1943 Eric Fraser WX6506 was one of those who assisted Coates part of the way to Khonkan 55km Camp, carrying him on a stretcher.

Arriving at 55 Kilo Camp Coates was carried to his hut on a stretcher. He had travelled partly by train and truck from 75 Kilo Camp. At 75 Kilo camp Coates had became seriously ill with scrub typhus and owed his recovery to two dedicated Australians and a Dutchman who washed and fed him as he lay in rags on his bamboo bed for two weeks. His weight in Malaysia of 12 stone was reduced to 7 stone.

Please read further about scrub typhus

55 Kilo camp had been opened by Major Charles O’Brien as administrative officer and Lieutenant W.W. Tilney as adjutant on 1 June 1943. Captain J. Higgins was initially the only doctor at Khonkan. For the first two weeks Albert ‘Bertie’ Coates was carried around on a stretcher to see patients, and it was during this time he realized amputation was the option to save the lives of ulcer patients.

There were 800 patients of which 500 suffered from medium to large leg ulcers. Of course the men also suffered malaria and other illnesses such as dysentery and beri beri –  prevalent throughout the entire length of the Railway.

Camp rations were very scanty. The Japanese would weigh every man regularly to determine the total weight of all men in the camp. They allowed 1,200 units of rice for each man and then calculated the total amount required.

The huts at Khonkan were in a very bad state of disrepair. There were not sufficient.   Men in the working party were not well enough to repair the leaking roofs. The downpours were frequent and rain came through the roofs. This seemed not to matter much to the men who had no clothing and were so ill and simply overwhelmed with suffering. With continuing illnesses the total weight of the camp became less and less. And in turn, under their ratio the Japanese provided less and less food.

Rather than less rations, what the sick needed was more as the men were starving.

As the men on the railway dropped out sick from other working camps on the railway they were sent to 55 Kilo Camp. The sick men arrived in trucks being too ill to walk. The Japanese refused to allow them to travel to a base hospital camp where there was at least some hospital equipment. Their supply of drugs and instruments may well have been minimal but it was more than that of 55 Kilo Camp – they had zero.

There were 1800 patients with malaria with a quinine supply sufficient for 300 patients. Coates protested to the Japanese medical authorities at Thanbyuzayat.

The Japanese pointed out that they allowed a man to have only one disease! If a man had malaria then he couldn’t have a leg ulcer, and if he had a leg ulcer then he couldn’t have dysentery!

Many POWs had three or more diseases. Malaria was the underlying cause of blood destruction (anaemia) and consequently those men suffered from other diseases. Quinine was the only drug available and supplies were intermittent and sometimes not available at all throughout the Camps. As important was the lack of food.

330 of the 1600 patients died.

Luck improved a little for Coates when Dutch chemist Captain van Boxtel, previously a photographer with the Dutch Air force arrived at the Camp. Coates requested the chemist prepare cocaine from some tablets which he still had with him. This was successfully used for spinal injections for amputations; as Coates wrote “in the next few weeks 120 legs came off”. Many dozens of toes were removed with scissors and without anaesthesia!

 CAPTAIN C. J. VAN BOXTEL, NETHERLANDS EAST INDIES AIR FORCE WHO WAS EMPLOYED AS A CHEMIST AT  55 KILO CAMP HOSPITAL

Coates had already realized that it was useless to work with orthodox methods of amputation as practiced at home and in hospitals. In these jungle conditions the operations were similar to those done in the days of Nelson and Wellington. Indeed it was field surgery with the advantage in some cases of having some pain-relieving anaesthetic!

Ligatures were made of catgut from the peritoneal coat of the intestine of the yak and skin was sterilised with alcohol prepared by van Boxtel from Burmese brandy and waste rice.

In time four medical officers assisted Dr Albert Coates including senior doctors Major Fisher and Capt. Brereton (who went blind after the war from vitamin deficiency). Every morning he supervised these officers to segregate the sick from the very sick.   They worked particularly on the leg ulcers. Coates and his medical team were curetting 70-80 ulcers every morning and supervising the dressing by dedicated volunteer orderlies. In the afternoons he would proceed to amputate 9-10 legs.

Conditions in the Camp were appalling.

The operating theatre was a bamboo lean-to about 6 feet by 8 feet.   Coates had three instruments – one knife, two pairs of artery forceps and used the one and only camp saw shared with the carpenters and butcher. There was a tiny amount of cocaine that Coates used in small quantities as a spinal anaesthetic.

Survival rate was not good.  If the men survived they usually faced other illnesses and without sufficient food it all seemed too hopeless for so many.

The daily procession to the nearby graveyard reminded the emaciated skeletons who were once men that death would soon end their pain and misery. Gangrenous leg ulcers constantly emitted a nauseating stench from which no one escaped.

In November 1943 Reptu 30km Hospital Camp was closed and patients transferred forward to Khonkan 55km Camp.

As Senior Medical Officer Coates visited other Camps from time to time including 50km Camp in the later stages of 1943 where conditions were worse because they had absolutely no medical equipment and were unable to amputate legs. Also the POWs had marched long distances to 55Km. They came from Thailand and included men from H and F Force.

Coates describing amputations at Khonkan 55km Hospital Camp in 1943 in his book

 “The Albert Coates Story” by Albert Coates & Newman Rosenthal

Coates was sent to Khonkan Hospital Camp early April 1943 as Senior Medical Officer and initially was the only doctor.  He arrived on a stretcher from 30km where he had suffered scrub typhus and been seriously ill.  100s of POWs arrived at 55km Hospital – large numbers with advanced ulcers usually with underlying illnesses such as beri beri, malaria, etc. 

When Dutch chemist Capt. Van Boxtel arrived at 55 km Coates asked this capable man if he could turn some of Coates remaining tablets into cocaine to use for spinal injection.    This he did – supplying sterilised measured quantities in discarded cholera bottles.

Coates knew he had no other option other than to attempt amputation of the gangrenous  legs.  Patients would otherwise die.

He remembered his student and post-student days and the work of Ambroise Pare (1510 – 90) and John Hunter (1728 -93).  Pare lived in an era when amputation was an extension of barbering!  French surgeon Pare joined the French army as a barber-surgeon.  He devised artificial limbs and the technique of binding arteries after amputation instead of cauterising them with a red-hot iron. (As we see in movies!)

Please read further about John Hunter

Hunter entered the British Army as a staff-surgeon, regarded as the founder of scientific surgery.  Hunter wrote extensively on his experiences, contributing to understanding the results of removing of a diseased organ which might otherwise infect the whole body resulting in death or chronic illness.   

Patients with penetrating ulcers of the leg were dying of haemorrhage.  The ulcerating process was eating into the main artery and the men were bleeding to death.

Khonkan Hospital had no medical equipment and few medicines – hardly a hospital it was atap huts with bamboo benches set in the jungle often leaking in the wet weather.   It was filthy and essential food rations minimal and poor quality – conditions no better than for Pare and Hunter.  

The hospital was forced to share only camp saw with the POW kitchen and Camp carpenters  – Coates scheduled amputations  for the afternoons.

He adopted the Listerian circular amputation – a cut around the leg, then coning out the flesh and bone (not too much flesh on these POWs wrote Coates!)

According to Coates description: 

• The result was a cut stump, like the open mouth of a fish from in front backwards.

• This was then loosely stitched with cotton and a bit of rag (usually the patient’s pants boiled for sterilisation) and inserted in the lower end of the wound for drainage purposes.

• Large arteries were ligated with the camp’s home-made catgut -not as good as that ordinarily provided. Cotton was unsafe to use as Khonkan’s asepsis was so imperfect.

Operations performed at Khonkan were similar to those done in the days of Nelson and Wellington except Coates provided patients the added advantage of pain relief with the use of anaesthetic.

It was ‘field surgery without modern frills’ wrote Coates – ever grateful for the thorough grounding he received as a student from pioneers Hamilton, Russell and Lister.

Coates removed 120 legs.

—————–

Above:  Statue of Albert Coates at Ballarat as he appeared at POW Camps, Burma and Thailand

In December 1943, the Japanese Commander Colonel Nagamoto informed Lt-Col Coates the 55 km camp would close (the railway was completed in October 1943) –  patients and staff were to be moved to Tamarkan, Thailand.  This transfer of patients would be by train.  Nagamoto assured Coates they were going to a ‘hospital’ with better food and medical supplies!

The sick were divided into two groups.

The Japanese classification – light sick and serious sick. Light sick was a term to describe men who would not die immediately – but men with disease from which they may recover or kill them within 3-4 months. The sick were transported by box truck to near Bangkok. The so-called light sick to Kanchanaburi and heavy sick to Nakompaton.

For the sick men the train journey to Tamarkan was one of terror.  There were insufficient stretchers for the large numbers of very ill men.  Many had to reach the train stop on foot, hobbling and resting when they could. They would wait hours and hours for a train to arrive.  Guards crammed too many men into tiny steel boxes which usually transported freight – some on stretchers, some men stood, some squatted amongst those on stretchers all carrying their possessions –which by now amounted to very little or nothing. Dysentery cases created their own hideous odour, which mixed with the putrid smell of the rotting flesh of ulcers.    There were cries of pain with every jolt of movement as the train rode over the uneven levels of rail tracks built by slave labour.  On one journey each steel carriage was provided one bucket of raw turnips and one with water (for upwards of 20 men).There were cries of pain and soon cries for water.  The carriages were buffeted about, shunted backwards and forwards at certain stages – for three days.

55 Kilo Camp closed down on 24 December 1943. Dr Albert Coates was then appointed Senior Medical Officer at Nakompaton Camp.

The first group of patients arrived soon after Coates. 1,000 men and within three months the camp held 8,000 – the residual heavy sick from the whole of the Burma-Thai railway with the exception of F and H Force who had been returned to Singapore.

It was acknowledged that 30 Kilo and 55 Kilo camps were the bad ones to be in. 30 Kilo Camp had 2000 ‘light sick’ just herded in there. Tanbaya 50 Kilo Camp was the F hospital camp on the Line – it was also a ‘death’ camp.

 For those interested to read of further medical accomplishments at 55 Kilo Camp we suggest reading “The Albert Coates Story” The Will that Found the Way by Albert Coates and Newman Rosenthal, published by Hyland House Melbourne.

RAY WILSON WX8013 worked as an orderly from 6 July 1943 as did WX16332 Jim LIND

Ray Wilson

Above Lind

Men of 2/4th from ‘A’ Force Burma, Green Force No. 3 Btn who died at Khonkan 55 km Camp included:

WX17737 Moher, Kenneth  (Photo above) d. 24 July 1943 amoebic dysentery aged 28 years. Buried Grave No. 27 Khonkan

WX7022 Hope, Edwin James d. 8 August 1943 beri beri aged 23 years.  Buried Grave No. 43.   (Photo below on right)

WX5050 Briggs, John Arthur (above Left ) d. 11 Aug 1943 post leg amputation aged 29 years. Buried Grave No. 136 Khonkan.

WX7504 Chapman, Desmond Bruce d. 11 Aug 1943 tropical ulcer, malaria and dysentery aged 27 years,  buried Grave No. 130 Khonkan. (Photo below)

WX7625 Clarke, James Sydney (photo above) d. 13 Aug 1943 pellagra and cardiac failure aged 25 years.  Buried Grave No. 44 Khonkan.

WX9358 ROBERTS, William Charles ‘Charlie’ d. 16 Aug 1943 of cardiac failure  following bacillary desentry.  Charlie had been evacuated from Aunggang 105 km Camp 1 June 1943. A farmer from Ravensthorpe he was 35 years of age.

WX8798 Biggs, Guy Percival 

(Photo Right)

d. 21 Aug 1943 cardiac

beri beri, dysentery and

tropical ulcers aged 39

yrs.  (buried Grave No. 61)

WX7804 Davison, Thomas Medland 

d. 5 Oct 1943 chronic.           

diarrhoea and malnutrition

aged 34 years.

(Colonel Albert Coates

performed amputation

above leg knee due

to tropical ulcer

4 Jul 1943. Davison was

transferred to Khonkan

55 km Camp.) (buried

Grave No. 204 Khonkan)

WX9231 HODGSON, Leonard Sydney (Tim)

d. 24 Sep 1943 Post leg

amputation and toxaemia

aged 24 years (this was

the second amputation

as the first was below

his knee and the second

above his knee).

WX9214 Lee, John (aka George Lee) d. 26 Aug 1943 cardiac beri beri aged 36 years. John Lee was evacuated from Augganaung 105 km Camp to Khonkan Hospital Camp  28 May 1943. Buried Grave No 87 Khonkan.   (Photo below)

WX10388 Meads Kenneth Lawrance. 14 Sep 1943 toxaemia aged 38 years.  Ken Meads was evacuated from Augganaung 105 km Camp about 10 Sep 1943 due to tropical ulcers to his right foot.  His right leg was amputated above knee but he died post leg amputation as result of toxaemia. Buried Grave No. 139.  (Photo below).

Please read further about Khonkan 55 Hospital Camp

WX16341 Samuel Thomas ‘Sam’ MARTIN with Java No. l4 Williams Force arrived sick at Khonkan Hosplital Camp after July 1943 when the hospital camp was established.  We don’t know from where on Thai-Brma Railway he was evacuated from nor the date.   Sam was evacuated  from  Khonkan probably when hospital closed end Dec 1943 to Tamarkan’s lalrger hospital inThailand and remained there until 6 Sept 1944, which is a considerably long time.

Sam arrived Java and was POW about 8 March 1942.  Sent with Java Force 4 to work on Burma-Thai Railway with Williams Force – the maintenance Force which moved frequently and often at night.

Same Martin returned home from Thailand.

He died in Kalgoorlie July 1972.

55 km Hospital Camp written by Albert Coates

Coates was carried into a hut which was to become his HQ for the coming months two weeks after this camp had been opened 1 June 1943  by Major Charles O’Brien as administrative officer and Lt. W.W. Tilney as adjutant.

55km was a jungle camp with a series of huts originally provided for railway workers with  attap huts with bamboo platforms with no bedding at all.

Rations were very scanty with the Japanese regularly weighing every man to determine the total weight.  Allowing 1,200 units of rice for each man they calculated to total amount required.  Many sick were unable to eat resulting in their weight reduction and an overall much less weight.  The Japanese had to provide less and less in rations.

2,000 men shared between them one yak (as small as a calf) killed every day.  The bones and body made into soup so that a little was available to pour over every man’s rice – there was no meat left.   Coates wrote 55km rations were abominable.  He did make a point about the rations to a visiting Japanese General and they did improve somewhat.

Charles O’Brien and Dutch Lt. Col Gottschell were administrators of the camp – organising camp chores, etc.   The Australian cooks improved their rice cooking skills.

The Japanese continued to send recent sick men from the railway to 55km rather than to base hospital camps where there were larger supplies of medicines.  The sick were transferred by trucks as they were unable to walk.

Capt J. Hggins was the only doctor at 55 km and for the first two weeks while Coates was carried around on his stretcher.  Higgins was worried because some men with penetrating ulcers were dying of haemorrhage.  (The ulcerating process eating into the main artery and the patients bleeding to death.). Coates quickly realised amputation was the only way to save lives.

Fortunately a Dutch chemist arrived at 55 km and Coates still had a some cocaine tablets which he asked Captain van Boxtel to prepare for a spinal injection enabling Coates to provide anaesthesia below the groin for his first amputation.  Following this success 120 amputations were undertaken. Many toes were removed with scissors only.

Coates and his assistants went on to make ligatures of catgut from the peritoneal coat of the intestine of the yak and developed a skin steriliser from alcohol prepared by van Boxtel from Burmese brandy and waste rice.

Coates wrote he believed some of the best work he ever did in his life was accomplished in the primitive jungle hospital camps of Burma and Thailand.

It is of great interest to know the amputation operations performed were similar to those done in the days of Nelson and Wellington with the added advantage in some cases, of a pain relieving anaesthetic. 

The following excepts are taken from an address Albert Coates gave in Melbourne 1946.

JACK THORPE’S RECOLLECTION OF LT COL COATES – Thorpe meets 2/4th’s BASIL CLARK from CADOUX

This story took place at the 105 Kilo Camp in Burma. Jack was on a sick parade this morning, had a good dose of dysentery for the last few days, so he thought he had better go and see the Medical Officer Captain Claude Anderson (RMO 2/4 Machine Gun Battalion) and see what he could do.

Jack says “well a bloody Jap guard came along and he thought he would do a bit of drafting before we got to the doctor. He came to me and I said to him that I had Tuksan Banjo (many times to the lavatory). With that he up with his rifle butt and whacked me in the mouth, well I fell down and the blokes on the sick parade yelled out “stay there Thorpie”, which I did. It was the worst thing I could have done. As it turned out, he gave me a jab in the bum with his bayonet. We were only wearing G strings at that time, and I suppose all my backside was exposed and his bayonet went up my orifice and drew blood. It really did not necessitate going to the hospital camp I don’t think, but the whole idea was to put the Jap in the bad books with his superiors. I was sent down to 55 kilo camp.”

Whilst in the 55 Camp Jack met Basil Clark out of the 2/4 Machine Gun Battalion from Cadoux who he had known previously. Basil had a bad ulcer on his leg. The bottom half of the leg below the knee was 75% eaten away with gangrene, and he was in terrible pain. Jack was talking to Basil this day when the Medical Officer (doctor) came around doing his daily round. He examined Basil, looked at him and said,

“That leg will have to come off Clark. If we leave it on you have got no chance, let me take it off and you have got better than 50% of getting home”.

(The doctor was Lieutenant Colonel Albert Coates later Sir Albert Coates).

Basil turned to Jack Thorpe and said,

“What will I do Thorpie?”

Jack said “You have got no options if you want to go home. Get it off.”

Colonel Coates came around the following morning and said to Basil

“What is your decision Clark?”

Basil said, “I will have it off”.

Coates looked at Jack Thorpe and said,

“I will get you to give me a hand Thorpe”.

Basil said “Oh Thank you Jack”.

The operation was to be done next morning about the same time. Next morning two orderlies arrived with the stretcher consisting of bamboo poles with two rice bags stretched over the two long poles. They took Basil to the operating theatre. Jack walked behind. The operating theatre was nothing more than a lean to at the end of the hut, with a dirt floor. There was a 44-gallon drum outside with a fire blazing. This was to burn the amputated limb.

The Colonel called me outside, with two other blokes, and told us what he wanted. He explained that the anaesthetic he was using would only last a few minutes. Should Basil come out of his sleep, we were to restrain him as best we could to stop any movement, to enable the operation to be completed. The Colonel said that he may lapse back into unconsciousness. The medical orderlies, who were his permanent orderlies. prepared things in the operating theatre.

Jack says, “Basil was good and he was very brave.

As for the Colonel, he was unbelievable. It must be remembered he was a veteran of the WW1 and was not young. He was a nicotine slave, and before starting he lit up a Burmese Cheroot, put it between his teeth, took a look at his two orderlies, gave them a wink and started. The first incision was as quick as a flash and he had gone right round the leg and met where he had started”. Jack stated that he had never seen such co-ordination and precision as displayed by the Colonel and his orderlies that day. Jack said he was marvelous.

Apparently, pre war, Coates lectured at the Medical School in Victoria. One of his students was Weary Dunlop.

(Here was Colonel Coates operating in the jungle of Burma. He had opportunities to return to Australia. Early in 1941, whilst serving in Malacca, he had to return to Australia to do definitive surgery on the Australian Ambassador to Japan, Sir John Latham. He returned to Singapore because of the imminent Japanese threat. Mention should be made to describe how Colonel Coates reached the northern end of the railway. When the fall of Singapore became imminent, Coates received an instruction from General Bennett, through the ADMS Colonel Derham, to join a ship carrying certain key personnel. He boarded Sui Kwong and, under mortar fire at dawn on 12 February 1942, passed through a minefield and reached ]ava. Whilst no further details are recorded in the Official War History, it is a reasonable conclusion that he had been selected as one of a number of key personnel to return to Australia. On arrival at Thambilahan on the east coast of Sumatra, with the help of colleagues, he operated on 15 of the worst casualties and put them in native huts. An emergency Medical facility was set up and, when the party left next day for Australia, Coates and others stayed, and in a week operated on some one hundred patients, about fifty major operations being performed with primitive instruments. As more wounded were brought in from other sunken ships, the medical party went up river on the 21 February and operated at a mission hospital. Coates then stayed and cared for 130 patients in a native hospital, many of whom he had previously operated upon. Whilst he was still caring for patients, on 17 March the Japanese arrived. Coates and a British doctor were the only medical officers left with 1500 POWs, 50 of whom were seriously wounded. Six weeks later, Coates was sent by ship to Burma with 500 British POWs in an overcrowded filthy Japanese transport, met up with other members of A Force, and became a crucial part of their medical team. Reproduced in part with permission of Dr Jim Dixon & Dr Bob Goodwin authors of “Medicos and Memories” ISBN 0 646 33478 6)

Jack says that the Colonel asked him to stay to give assistance with a similar operation the following day. This time on a man he did not know. Following this he left the 55 Kilo camp and did not see Basil Clark again until after the war when they returned to Fremantle. They both returned to Perth on the same day. The two of them were being processed at Karrakatta (receiving Leave Passes, updating pay books etc) when they met up with two other POWs. They were Sid Howard (an amputee who had a double amputation at Chungkai by the brilliant Canadian surgeon Capt Jacob Markowitz (RAMC)) and Arthur Morrison (2/4 Machine Gun Battalion-an Australian aborigine).

Whilst waiting for the bus at Karrakatta Jack said “where do you want your first drink back in Perth?”. They all said “the Alhambra Bars”. (The Alhambra Bars was a bar opposite the Perth Town Hall and patrons had to descend about 20 steps to get in.). Jack said that he thought it bloody stupid with two men on crutches and one leg each. They got to the bar and down the stairs OK and went to the bar and ordered four beers. Jack says “ the bloody bar maid wont serve us because we had a “black fella” with us. I said to her that Arthur Morrison (Snow White by nick name) had been in the King’s uniform for the last five years fighting for our country”. The bar maid said she would call the Police if we did not leave. Jack said to her that it was a bloody good idea to call the Police and waited at the bottom of the stairs for the arrival of the Police. When the Police arrived Jack explained the problem. The policeman went to the bar and told the bar maid to serve them and the first drinks were on him.

Whilst there, Basil read a letter he had received from his mother, which said that his girl friend of pre war days was working at the Mount Hospital. Basil asked Jack if he would ring her at the Hospital and tell her he had lost a leg and would she still like to see him? She said “yes’. Later they married and had several children. Basil returned to farming. Jack said that he regretted that he never got to see Basil again. He was occupied getting his own life in order. Basil’s wife became heavily involved with the RSL Woman’s Auxillary.

Jack Thorpe’s story related to Lt Col Peter Winstanley RFD JP February 2004.
E-mail peterwinstanley@bigpond.com

(Jack Thorpe was a Sergeant in the 105 General Transport Company. He was on the Burma end of he Burma Thailand Railway and in Japan as a POW. Post war he has been the President of the Three Springs (in Western Austraalia) R.S.L for about 40 years and was awarded the OAM in 2002. Over the past 15 years he has raised over $50,000 to send many young people (aged 14-16 years) from his District to the Burma Thailand Railway.)