People & Events: Prisoners' Diseases
It was malaria I had to begin with. Then I had dengue fever, which, well, you are worse with dengue fever than malaria, but it is not fatal like malaria can be. Then I had amoebic dysentery, and there was nothing you could do. Then beri-beri came along and there were two types. There was wet and there was dry. [I had] the wet and my head swole up and everything swole up; and then there was the dry and there was no swelling it just hurt. Your feet hurt all the time, you couldn't put them on the ground. And then I went blind for a couple of days from some lack of vitamin.
-- Bob Body, Cabanatuan POW
A Museum of Disease
Disease was a constant in the camp. In the first six months, the primary causes of death were malaria, dysentery and starvation. As time wore on, diet-dependent diseases became more prevalent. The men suffered from all types of vitamin and mineral deficiencies which caused a host of debilitating diseases including beri-beri, pellagra, rickets, and scurvy; and, which caused a ghastly array of bizarre conditions as the men's bodies stopped supplying "unnecessary organs" with nutrients. The men's hair, nails, eyes, feet, teeth, nerves and genitals all suffered. Dr Hibbs, the Cabanatuan camp doctor, recalled "the whole place was a pathological museum... Most doctors would never see such cases in their entire lives."
"I Can't, I Can't"
The most ubiquitous disease in the camp was beri-beri, which in some form affected nearly one hundred percent of the POWs. Beri-beri gets its name from a Singhalese phrase meaning "I can't, I can't." It is a debilitating disease. The dry form causes intense pain in the feet; the wet form causes extreme swelling, enlarges the heart, and can cause sudden death. It is caused by vitamin B1 (thiamine) deficiency.
The prisoners were particularly susceptible to beri-beri because of their diet, which consisted mainly of something called lugao. Ex-POW Harold Amos remembered: "They gave us a little lugao, that was rice mixed with water. The worms and bugs and weevils would float to the top and at first you'd pick them out and then after a couple of meals, why you just, as a little protein, you just ate it raw." Lugao is extremely low in thiamine because the husk of the rice which contains the thiamine has been removed.
Bugs, Frogs and Dogs
On a typical day the prisoners received less than 300 calories of this rice porridge. Many supplemented their diets with insects, frogs and even the occasional dog or cat. In Cabanatuan, prisoners perfected the art of stealing ducks from their Japanese captors at night -- an activity they termed "gorking."
Because their calorie intake was so low and they were required to engage in strenuous labor, all POWs suffered from malnutrition, by far the biggest killer in the camp. Pellagra, a disease caused by deficiency of vitamin B3 (niacin), was one of the biggest causes of psychosis in the camps. Dysentery plagued all the POWs.
Sanitation in the camp was a major problem. Fly control was the order of the day. Ex-POW James Hildebrand remembered: "they gave us a little round glass and we had to turn in ten flies a day... that was an easy task, you could find ten flies and turn them in like crazy."
The physicians, like everyone else in the camp, improvised. They smuggled and cajoled medicines and fresh fruit. They created pills for dysentery from cornstarch, guava leaves and charcoal. They even conducted surgeries within the camp. Far too often though, men died.
Keys to Survival
Due to limited medicines and facilities, survival was more clearly linked to the individual's ability to withstand disease and the harsh realities of existence. Two factors other than physiological ones came into play: the role of friends and the individual's own physical-emotional makeup.
Social and Psychological Factors
Friends were important. They not only could attempt to procure essentials -- medicine, a bit of extra protein, a better assignment -- but they provided attention, encouragement and moral support. Ex-POW Tommie Thomas recalled: "I started encouraging people. I remember a boy who couldn't eat the lugao. He says 'I can't stand that stinkin rice, it doesn't taste good.' And I said, 'Let's make a deal, I'll take a mouthful and you take a mouthful.' And that's what we did. I had some faith because that worked."
Traits for Survival
According to a study done in 1952 for the American Journal of Psychiatry, traits that favored survival included:
A strong motivation for life with persistent exertion of will, good general intelligence, good constitution, emotional insensitivity or well-controlled, balanced sensitivity, a preserved sense of humor, a strong sense of obligation to others, controlled fantasy life, courage, successful active or passive resistance to captors, luck, opportunism, and a few preceding years of military experience.
Tommie Thomas, who survived surrender, the death march, a firing squad, cerebral malaria and diphtheria, exemplified this characterization. A man with luck, faith in God, and determination, he said of himself: "I had faith, I knew I was going to make it, and if anyone walked out of the camp, I was going to be one of them." On January 30, 1945 along with 511 other POWs, Tommie Thomas walked to freedom.
To this day, most of the men who returned still suffer from physical and psychological ailments related to the extreme deprivation and torture they experienced as prisoners of war.
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