We sadly report the recent death of Dr Kamal Khan, who as a Consultant Psychiatrist befriended, treated and supported many hundreds of ex-Far East POWs who suffered mental health problems as a result of their experiences in captivity.
Dr Kamaluddin Khan – widely known as “Kamal” – was born in India in 1937, and qualified in science (BSc at Agra University) and medicine (MB,BS at Lucknow University). He later moved to the UK and trained in psychiatry, including as a Senior Registrar at Sefton General Hospital in Liverpool. It was here, in the mid-1970s, that Kamal was approached by Dr Dion Bell from the Liverpool School of Tropical Medicine (LSTM). Dion was the tropical diseases consultant in charge of the School’s inpatient beds at Sefton. These were at the time mostly occupied by ex-Far East POWs (often known as “FEPOWs”) undergoing tropical diseases investigation. Dion was concerned that many had significant psychiatric disturbances related to their imprisonment, and asked if Kamal could see some of these patients. Kamal agreed, and after assessing a small number, was so concerned by their mental health status that he offered to see all the ex-POWs referred to the tropical unit.
The men had varying degrees of depression and anxiety, often associated with nightmares and flashbacks of their captivity experiences. Retrospectively, this represented a form of post traumatic stress disorder (PTSD), but this diagnostic label had not at the time been clearly defined.
In 1977 Kamal was appointed to a Consultant Psychiatrist position on the Wirral (close to Liverpool) and continued to regularly assess and treat ex-Far East POWs, establishing a weekly “FEPOW Clinic” . He also began a major research investigation into the mental health of a randomised group of ex-Far East POWs, comparing them with a similar group of non-imprisoned members of the 2nd World War Burma Campaign. He found that 40% of the POW group had significant psychiatric consequences of their captivity, and the work was successfully written up for a PhD degree. All of this clinical and research activity was carried out in addition to his routine busy NHS caseload.
When he retired in 1995, many of his POW patients were devastated at losing such a caring doctor and good friend. In an oral history interview to the Liverpool Tropical School, one ex-POW said,
“he was a wonderful man… I was able to tell him things that I couldn’t tell anyone. I went on a regular appointment, there were lots of FEPOWs there ….. and each time he was wonderful”
Kamal’s contribution to the Far East POW community was immense, and his unique research was of major academic value to our understanding of the Far East POW experience and its outcomes.
Much has been written on the physical privations and diseases suffered by Far Eastern prisoners-of-war (FEPOWS) but less has been said of the psychological challenges and the post-traumatic illnesses that they experienced when in civilian life. The resourceful, fortunate and resilient group who survived provide an opportunity to study coping mechanisms and survival techniques in the most extreme circumstances.
Evidence gathered from survivor accounts suggests that there was no single method that worked for all. Prisoners devised coping strategies that fitted with their pre-capture skills and personality traits. Alistair Urquhart, for example, distracted himself through music and song, and a determination to survive:
‘I decided to stay apart from everyone else and focus totally on survival. I lived a day at a time in my own little world, a private cocoon, and adopted the position of self-sufficient loner… If someone spoke to me, I replied but there was no sense of community’.
By contrast others formed themselves into small groups so that if one fell sick or struggled to work, the others would provide cover or find extra food. Crucial for many was a skill or experiences that had prepared them for the challenges of captivity. Lt Arthur Scrimgeour of the Straits Settlements Volunteer Force had medical knowledge acquired in his job as manager of Glaxo’s Far East Company. When suffering from beriberi, he treated this by swallowing the husk polishings of uncooked rice as they contained vitamin B and used banana leaves as dressings for leg ulcers. Religious faith has been shown in many studies to serve as a protective factor during captivity and torture. Eric Lomax, a member of the Episcopal Church, wrote that his ‘moral conviction of being saved, that I really had found God’ reinforced his determination both during captivity and afterwards. Ashley Prime who had grown up in multi-cultural India was able to identify the good in people from whatever race they came.
Although these coping mechanisms enabled prisoners to survive extended periods of privation and danger, they were not a guarantee of an easy transition to civilian life. Urquhart and Lomax both reported troubling thoughts and enduring symptoms even when settled in civilian life. Recurring dreams of war were often a reminder of the trauma they had suffered. Urquhart wrote, ‘even after I married, life could be hell. To this day I suffer pain, and the nightmares can be so bad that I fight sleep for fear of the dreams that come with it’. Yet Urquhart also demonstrated the skill of being able to take something positive from adversity, adding ‘my sufferings as a prisoner taught me to be resilient, to appreciate life and all, to appreciate life and all it has to offer’.
The unilateral cease-fire on 15 August should have resulted in an immediate improvement of the plight of the PoW. The Japanese had been ordered to do so. However, in some places the conditions had deteriorated to such an extent that the dying continued before the situation was brought under control.
The predicament at Palembang
RAPWI team ‘Blunt’ entered its assigned camp at Palembang, Sumatra on 4 September and four days later reported: ‘908 PoW, 272 hospitalized and 249 died of malnutrition and illness’. According to a message 10 September the situation had not improved: ‘British 470, hospital 150. Many dying. Civilian men, women and children. Need urgent medical relief air supplies.’ Another two days later SEAC HQ in Ceylon received a request from Palembang for a medical team immediately because ‘Doctors here are as weak as patients and cannot cope. Medical supplies […] urgently required. Immediate evacuation of sick essential; 50 by air and 200 by sea’. Even Lord Bevin (Minister of Foreign Affairs) in London was worried (message 12 September): ‘Almost complete absence of information about Java and Sumatra in contrast to voluminous publicity about other areas is causing alarm…. There is in fact ground for concern since deaths actually reported by Japanese through International Committee Red Cross in Geneva are much higher in proportion than anywhere else in the Far East.’
Dr. Reeds analysis of the sharp increase in mortality is equally clear: ‘a policy of starvation’ as he called it. On 27 May 1945 the rationing was cut by the Japanese (measured in grams of rice):
none / ill
Even these rations were not met; one week only 233 gr was issued. On 21 August, a week after the cease fire, the rations increased. Dr Reed noted that before 27 May the main cause of death was disease (dysentery); after 27 May it was starvation. He also noted that the starvation due to the 27 May decease became apparent in 6 weeks; whereas the recovery from 21 August was immediate. Dr Reed allowed for the psychological factor of liberation and the increase in morale: “The general effect of being able to put a man off duty and tell him to lie back and absorb his 500g of rice per day had to be seen to be believed.”
Air Supply by the RAPWI
Before the arrival of the RAPWI teams, the RAF dropped supplies to all known camps in South East Asia. This operation to supply the camps by air was called ‘MASTIFF B’ and started with Red Cross supplies of a general nature. As the RAPWI teams entered the camps they would take stock of the material needs and place orders with RAPWI Main Control on Ceylon. RAPWI Main Control would make an assessment of all the requests of all the camps in SEAC and the availability of supplies and aircraft and allot them accordingly. There were 4 categories of supplies and 2 kinds of packing: containers and packs. For Palembang the supplies were delivered:
Capt Mockler RAMC parachute
The chart shows that the after the initial Red Cross supply droppings, the supply ceased until the RAPWI team Blunt managed to place orders mainly for food and medicine as well as an additional medical team.
Evacuation to Singapore
Following the advent of RAPWI team Blunt the situation improved and after 12 September things happened quickly:
12 live broadcast of surrender ceremony in Singapore shared with PoW
13 Medical team lead by Dr. Mockler arrived (by parachute) from Ceylon
14 Japanese finally cooperated: they were helpful in giving supplies of food and
clothing. “Their attitude has lately been correct” as RAPWI team Blunt put it.
15 new hospital was put in operation
19 Palembang visited by Lady Mountbatten which was ‘extremely popular’
15 – 20 all 240 ill PoW evacuated by Dakota to Singapore
21 – 25 evacuation of the 600 British by Dakota to Singapore
Medical evacuation of PoW from Pakan Baroe to Interview of PoW from Singapore, 17 September. Pakan Baroe, Sumatra Palembang in Singapore is not Palembang, but the scene was similar.
Two pictures of Lady Mountbattens tour on Sumatra 15-19 September, camp not known.
The Japanese should never have mistreated their PoW and put their heath and lives in peril. Throughout the war and in all camps the treatment had been brutal and negligent. But Palembang may have been one of the few camps genuinely in acute danger of mass starvation for whom the Japanese cease fire came in just time. It did not, however, result in an immediate improvement of the situation; this only occurred a week later when the rations increased. The advent of the RAPWI team Blunt on 4 September lead to improvements, although it took yet another week (11 September) before the RAF started delivering the supplies that were desired. But the end was in sight; the evacuation of the ill PoW commenced 15 September and after completion is was the turn of the healthy to leave.
One cannot undo the past, but one can count the possible difference made by compliance by the Japanese to the terms of the Allies and a much sooner arrival of the British RAPWI teams on Sumatra.
 Captain J. Mockler is one of the few RAPWI-personnel that died in active duty. On 5 November Mockler (IAMC) and J.W. Smith (RAA) were supervising the evacuation of RAPWI at Benkulen, Sumatra. They were attacked and Smith was wounded. Mockler died and was buried in Palembang; he now rests in Jakarta.
 The AWM description is problematic. There weren’t any Australians in Palembang and the men seem very emaciated despite having had food and rest for a month.
Remembering captivity across Southeast Asia and the Far East during the Second World War