By Professor Geoff Gill, Liverpool School of Tropical Medicine

During their  three and a half years of imprisonment in the Far East, POWS suffered overwork and maltreatment, but also undernutrition and exposure to various tropical diseases. This frequently led to attacks of malaria and dysentery, as well as various  syndromes of vitamin deficiency. Tropical ulcers and cholera outbreaks also occurred – particularly in the jungle camps of the Thai-Burma Railway.

In September 1945, Professor Brian Maegraith of the Liverpool School of Tropical Medicine (LSTM)  addressed a group of families in Blackpool, whose relatives were ex-POWs on their way home. Maegraith warned of likely relapses of malaria and dysentery, as well as psychological problems. Contrary to standard advice, he told the families to “let them talk” of their experiences. Below is a photo of this meeting published in the local Blackpool newspaper.

A letter appeared in the British Medical Journal in December 1945,  drawing attention to the inadequacy of medical screening of returning Far East POWs.  Dr F E Cayley (himself a former Burma Railway POW doctor) pointed out the high rates of intestinal parasitic infections amongst these men (notably amoebiasis – the main cause of dysentery relapses), and recommended routine microscopic examination of stool specimens.  Such examinations were almost never done, the only relevant precautionary measure being an information leaflet given to some returning Far East POWs, the text of which is shown below –

INFORMATION LEAFLET FOR THE MEDICAL ATTENDANTS OF A REPATRIATED PRISONER   Some diseases, which do not normally occur in this country, are present in the countries in which you have been serving. It is essential for the protection of yourself, your family and your friends and to prevent any possible epidemics of disease in this country that any illness from which you may suffer while you are on leave, or after your release from the Services, should receive immediate medical attention.   Notes for Medical Practitioners The following diseases commonly occur in the Far East POW   – Malaria, Dysentery (including Amoebic Dysentery), nutritional deficiencies, skin diseases and worm infestations.

Failure of adequate medical screening and follow-up of returning Far East POWs was a lost opportunity which was to have lasting effects. Post-war, over 4,000 of these men were seen at the military hospital Queen Mary’s Roehampton (1945 to 1967), and a similar number at the Liverpool  School of Tropical Medicine (1945 to 1999). There were early relapses of malaria and dysentery, increased tuberculosis risk, chronic intestinal worm infections, and permanent neurological damage due to vitamin B deficiency. Perhaps most importantly, over one-third suffered significant psychiatric illness, later recognised as post-traumatic stress disorder (PTSD).

Thankfully, there were some benefits from  this unfortunate episode. The Liverpool School conducted a major research project on the long term  health problems of ex-Far East POWs, leading to a series of papers in the medical literature. These have significantly contributed to the knowledge-base and clinical practice of both tropical and military medicine. As  numbers of ex-POWs declined, the LSTM FEPOW Project has moved to recording the oral, art and medical history of the POW experience. This has resulted in the books Captive Memories (M Parkes & G Gill, 2015),  Burma Railway Medicine  (G Gill & M Parkes, 2017), and Captive Artists (M Parkes, G Gill & J Wood, 2019) – see the captivememories.org.uk  website for more details.