I wish to document something of the history of my grandfather,
Sir Albert (Bertie) Coates, a most extraordinary Australian. Through his
story I would like to reflect on some of the most remarkable aspects of
the Australian experience in WWII, the activities of the medical staff
throughout the grim days of the war in SEAsia.
In 1914 world war broke out, and shortly after young Albert
enlisted in the AIF. He was considered too short for combat and so was
eventually given the role of medical orderly. He was sent to Egypt in
the first convoy from Albany, and he continued to learn various languages
from the troops and civilians he met. His French and German became fluent.
He was present at Gallipoli landing but the horses and wagons of the medical
teams were not landed, and he watched from the ships for 18 long days
before returning to Alexandria. When he eventually got onto the peninsular
he served there for many months, until the final Australian evacuation
in 1915. He continued service in Ypres and on the Somme. As a medical
orderly in WWI he witnessed first-hand the horror that war brings. He
taught himself Dutch and as his language skills became prominent, he was
drafted for intelligence work. The British Army subsequently offered him
a commission in the Intelligence section, after nearly executing him themselves
In 1939 war was declared again, and despite being nearly 45 years old, with 5 children to support, he enlisted in the 2nd AIF. The 8th Division sailed for Singapore in 1941, and Lt-Col Coates aboard the Queen Mary was Senior Surgeon of the 10th AGH in Malacca. In Malacca, he learned about tropical medicine first hand. Under Col E R White, clinical meetings were begun and the staff studied tropical ulcers, amoebic dysentery, malaria and other tropical syndromes in depth. Coates got permission, after much official resistance, to train a number of medical orderlies here. They eventually proved to be a great asset when the invasion came as most of the nurses were evacuated. During his time there, Coates was called to Singapore to perform emergency surgery on Australia’s Ambassador to Japan, Sir John Latham. He subsequently accompanied him to Melbourne to conduct definitive surgery for him. They became great friends. Coates managed three short weeks with his family before being urgently recalled to Malaya.
By January 1942, the Japanese were advancing quickly on Singapore, and the 10th AGH in Malacca was broken up. Coates was sent to 13th AGH in Singapore and he operated there on the troops returning from the advancing war front. The hospital was filled rapidly, patients even being nursed on the lawns. Unfortunately for the hospital, a battery unit was setup at one end of the garden and soon air-raids were occurring daily. Bombing around the hospital more than once meant pieces of roof would descend into the middle of the operating theatre. They often operated in total blackouts. One case Coates recalled of that time was a soldier with a sword cut from neck to buttock. While he was being sewn up he told Coates that he had, despite his fearsome wound, successfully dispatched his samurai assailant. In the four weeks before the British surrender and the Australians were ordered to lay down arms, 1789 Australians were killed in action in Malaya and another 1306 wounded.
Singapore fell in February 1942, and Coates was evacuated under mortar fire aboard the Sui Kwong with a large body of mainly British troops on a ship towards Java. The ship was bombed en-route and sunk, the majority of the troops being landed by life-raft on Sumatra. On arrival at Tembilahan, he operated on the worst 15 casualties and put them in native huts. Much of the party then left for Australia, but Coates stayed to tend to the sick and injured. He performed over 100 operations in the next week in a small Indonesian hospital. As more casualties began arriving, they moved up-river and operated at a mission hospital at Rengat. They then began a journey toward Padang, across country. Many of them had only the clothes in which they stood, many had no boots, and they had to sleep out. Like many of them, Coates not surprisingly got his first bout of dengue fever here. He was one of two doctors, and the only surgeon, for the 1500 troops, with about 50 serious cases. He was required to operate at various places at which they stopped through this journey, using local Dutch facilities. Another case he noted at this time was a woman with a large shrapnel wound of the buttock, which had severed her sciatic nerve, and associated pelvic abscess. Coates drained the abscess, and repaired the nerve as best he could in the village hospital. He met the woman after the war and was pleased to note she had only a slight drag of her toe. He had through this time, several chances to be evacuated but chose to continue to support and care for the troops in his immediate care, who otherwise would be left without any surgical care. Unfortunately by the time they reached Padang, the Japanese had captured Sumatra, and they were surrendered to the Japanese there. It was here that Coates received his first beating from the Japanese soldiers.
In May 1942, Coates with 500 British and 1000 Dutch POW, were sent to Medan and loaded onto a small coastal steamer and sent to Burma to join the 3000 Aussie POW of A-force who had been sent from Changi. There were twelve Australian doctors and two dentists already with this force. Initially there were rumours of road construction but it then became apparent that the Japanese wanted to build a railway from Thailand to Burma and that they intended to use the POW to do it in contravention to international conventions on POW. Little did they know then that the Japanese had no interest in the well being of the POW, in fact quite the contrary. The Japanese officers viewed the starvation, torture and neglect were justified in the service of their Emperor. Brigadier Varley was in charge of A force, and they were joined by more POW by Jan 1943. At the Thai end, 600 British POW under Major Sykes arrived in June 1942, and were soon joined by 3000 more British POW by August. The first teams had to build large camps at the ends of the line, smaller working camps in the jungle, and commence preparations for the work on the railway. Albert Coates was the senior surgeon at the Burma end, working under Lt-Col Thomas Hamilton, SMO. ‘Weary’ Dunlop, was a senior surgeon and CO for the first group of Australian POW to reach the southern end in Thailand in January 1943, the force pushed forward and later known as ‘Weary’s 1000’. In all, about 13,000 Australians worked on the railway, among some 60,000 POW and about 200,000 conscripted native labourers from various Asia countries. Some 2646 Aussie POW died among the 13,000 POW deaths in total, and at least 80,000 Asian labourers. The lower rate of deaths amongst POWs can be attributed to the presence of about 150 doctors, many British, 43 Australian, with some Dutch and one or two Americans, and the many medical orderlies, mostly volunteers, who worked on the railway, spread from Thailand to Burma, and who treated the injured and sick, and gradually developed systems for minimising infectious disease.
Conditions were appalling. Malaria was rife, the average attack rate was about 2 attacks per man per month. The Japanese only supplied limited quinine, so only severe cases were considered for treatment. Dengue fever and scrub typhus were common, and enteric illnesses such as dysentery and cholera took their toll. Large outbreaks of cholera would follow the rains. The Japanese were terrified of cholera, and one notorious case occurred when a POW was shot for having developed the disease. The Australian troops had been vaccinated against cholera, typhoid and smallpox, although only the smallpox vaccine was very efficacious. The Japanese provided booster vaccination against cholera for the Allied POW in the later stages, and they would often wear masks if cholera cases were apparent. Smallpox was reported at one camp, but the Japanese provided some vaccination for this too and it did not pose a serious threat for POW. The commonest causes of death of POW, were from malaria or dysentery. Accidents and injuries from the guards accounted for a lesser but important number, and suicide was a fortunately infrequent but terrible aspect of the degree of suffering. The weather was no friend to the POW, summer meant soaring temperatures and high humidity, monsoon meant constant soaking wet, and winter meant cold nights. Clothing rotted and most men were soon in loincloths only. Diphtheria and pneumonia occurred in the crowded conditions and appendicitis was not uncommon. The ever present threat from violent outbursts from the guards also meant constant management of a wide range of trauma.
Nutritional disease became common, neuritis, beri-beri,
and pellagra due to poor diet. Men were fed a small amount of poor quality
rice, with some gruel poured over the top. Vegetables were rare and when
supplied were usually rotten. Red-Cross supplies were blocked and stockpiled
by the Japanese who also refused to allow POW to buy supplemental food
from local traders, as this would imply the Japanese were not providing
enough. As the men lost weight, the Japanese would weigh them. They had
arranged that food allowances were based on weight. Lighter men were given
less food, so the effects of malnutrition and starvation accelerated as
time went by.
In Burma, Coates was responsible for the major and some
minor camps. He worked with Lt Col Hamilton, SMO, as well as Majors Ted
Fisher from Sydney, Allan Hobbs and Sydney Krantz from Adelaide and W
E Harris, a Brit. Fisher treated Coates for amoebic dysentery in Tavoy,
luckily when some of the small supply of emetine was still available.
He became a close companion and physician in the latter days of captivity.
A large proportion of the Sumatra prisoners developed acute fulminant
amoebic disease and many died. Two Dutch doctors Coates later recalled
there were Maj Neileson and Capt Slaghter. Initially in Mergui, then in
Tavoy, where camp base-hospitals were located, Coates performed a large
number of operations. At one point it included finishing a botched appendix
operation that the Japanese doctor was doing on one of their own men.
He was stuck, and Coates finished the operation, allowing for some face-saving.
The embarrassed Japanese doctor later gave him a tin of condensed milk
and a pack of cigarettes, and an Aussie wag commented that it was probably
his lowest fee ever.
In February 1943, as the plans for the railway progressed,
he was moved to Thanbyuzayat and first met the infamous Korean guards
who would become such a torment for the POW. On the night before leaving
with the last POW, mostly sick or incapacitated, with no equipment, Coates
performed a successful appendicectomy on a POW using only a razor blade.
An improvised stretcher was made for the patient to be carried on. They
were then sent up the track, initially to Reptu at 30 kilo, where the
“light sick” were housed. These were men who the Japanese
considered not too sick for work, having only malaria, and malnutrition,
although many could hardly stand. He reported the death rate amongst the
native labourers was very high already here, bodies lay around commonly.
At the 75 kilo camp conditions were the same and at one point of 1300
very sick men, the Japanese ordered 1000 to work.
Coates reflected later that his interest and knowledge
of the history of surgery, of Pare, Hunter and of Lister, enabled him
to perform the surgery and minimise infection in such primitive conditions.
He adopted the Listerian circular amputation, taught to him by Hamilton
Russell, a circular cut around the leg, then coning out of remnant flesh
and bone. A boiled piece of the patient’s pants was inserted into
the hole and the skin stitched loosely with cotton. Ox-gut sutures were
used for ligating arteries. This was surgery from the days of Nelson and
Wellington, and the only effective method when asepsis was not possible.
It was reputed that his fastest amputation was completed in 8 minutes.
When the 415 km of railway was joined in late 1943, moves
began to shift the POW to a new camp to be made in Nakhon Pathom in Thailand.
The Burma camps and hospitals were dismantled and the journey into Thailand
was done by train. Coates recalled getting into a crowded railway truck
and sitting on someone’s leg. On enquiring whose leg it was, the
digger said “ It’s mine sir and that’s one leg your
not going to take off!”
In Nakhon Pathom, Coates, was appointed Chief Medical Officer,
and was charged with developing the new hospital, and with Krantz and
Capt McNeally to help he supervised as many of the POW arrived and they
constructed a hospital of up to 10,000 beds. By January 1944, 50 large
huts for up to 200 men were built, and separate medical huts were constructed.
There were 1500 in the dysentery block alone. A general purpose medical
committee was formed by Coates as CMO, Lt-Col Malcolm (British), and Lt-Col
Larsen (Dutch), to direct medical policy.
The doctors now acted as a team and the burden of illness was still very great, as the men had survived to date more than two years of starvation and hard labour. Groups of survivors from up the line would arrive still in need of great care. The operating theatre remained busy, and a wide range of surgery was done, including 5 craniotomies, 3 laminectomies, 3 nephrectomies and 3 splenectomies. Some general anaesthesia was available with chloroform and an improvised mask, but all surgery below the nipple was done with spinal anaesthesia. This was not without potential problem too, and lessons were learned about this important technique. Red Cross ‘cutocaine’ was available from July 1944. Surgical alcohol was being made on a larger scale, sutures were still made from the gut of water buffalo. A suction device was made from an old Ovaltine tin, some leather from an ox and some stethescope rubber tubes. Instruments were still fashioned from bits and pieces, and rehabilitation equipment was devised under the guidance of Dunlop. Bamboo was used to make orthopoedic beds and even a dental chair. TB was treated with pneumothorax, and a laboratory for basic pathology work was developed. No x-ray was available so diagnosis relied on classical bedside symptoms and clinical signs.
Three important improvisations were of particular note,
all with Sapper Dixon’s contributions. First, an autoclave, for
sterilising instruments was made from an old petrol drum and proved effective.
Of this time, Frank Foster described in his 1946 book about
the railway, “Comrades in Bondage”:
Despite being CMO, Coates did a major proportion of the surgery here, Dunlop described him as ‘indefatigable”. Coates also wanted post-mortems to be done, to help the doctors learn about what could be done to save the living. The Japanese would not allow it however, as the few that were conducted showed too clearly the effects of the Japanese cruelty and neglect. Death certificates had to be marked as “malaria” as the cause of death, malnutrition, fatal injury from assault or suicide all had to be recorded as “malaria”.
In mid-August 1945 the Japanese surrendered, and freedom was finally won. The transition was joyous, and gradually the sick were able to be moved to Bangkok and homewards. Coates and the medical staff had access to the Thai hospitals, and some admitting and operating permission was obtained for Chulalongkorn Hospital in Bangkok. Coates’ first patient was ‘Weary’ Dunlop who, in trying to open a much desired bottle of Fosters with a pocket-knife, cut the tendons in his hand and required repair.
Albert Coates returned from the war 32 kilos lighter, and
went straight back to work at RMH. His family were waiting, and unknown
to Coates, his eldest son had enlisted and served in PNG in the latter
part of the war. He quickly settled back to family life and continued
to lead a distinguished career. He was a key witness at the Tokyo War
Crimes Tribunal in ‘46, was awarded an OBE in ’47, was an
RSL delegate at the signing of the Peace Treaty in the USA in ’51,
was knighted by the Queen in ’55 and received an Hon Dr Laws in
’62 from University of Melbourne in its medical school centenary
year. He worked as an honorary surgeon at RMH for 27 years and as Stewart
Lecturer in Surgery, moulded the training of hundreds of young doctors
and medical students. He was elected president of the Victorian AMA on
Albert Coates died at the RMH in 1977, survived by his
wife, two sons (both doctors), three daughters, (two nurses and a teacher),
as well as 20 grandchildren. A moving eulogy was given at his funeral
by ‘Weary’ Dunlop, who concluded by saying:
I had the pleasure and honour of knowing my Grandfather of course. I recall he was particularly pleased when I gained entry into medical school at his alma mater, the University of Melbourne. I know his latter life was moulded by his experiences during 3 years as a “Guest of the Emperor”. One story he related was of a dinner party in Melbourne after the war and being asked by a woman what he did in the war. When he replied that he had been a guest of the Emperor, she asked, “Oh, did you stay in the palace?” The fact that some authors suggest that Coates was probably responsible for saving more lives than any other on the Burma-Thailand railway, seemed to have passed this lady by.
There are obviously several reasons that cause us to lionise
these special medical men. They provided an opportunity for life and survival
in a place where death was a daily reality. They provided succour for
the distress of the ill, injured and dying, and they formed a barrier
of sorts between the Japanese and the men. They provided a constant example
of dogged application and unreserved commitment to the support of every
POW, to the interests of every single man as a person. And they became
the leaders of the camps in seniority, in skills and in compassion. They
encouraged great innovation and perseverance.
All the Australian doctors and dentists on the Burma-Thailand
Railway survived the railway, but not all survived the war. Those who
survived were able to return to active civilian practice, many becoming
well-known figures and specialists, contributing strongly in medical issues
in the community and providing strong advocacy for the medical and social
welfare of Australia's returned servicemen and women.
Dr Tony Gherardin, Australian Embassy Bangkok, November 2004
Australian doctors and dentists on the Burma-Thailand railway:
A Force, (3000 men), Burma
D Force , (5000 men), Thailand
Dunlop Force, (2000 men), Thailand
F-Force, (7000 men), Thailand
H Force, (4000 men), Thailand
L Force, (medical only), Thailand
K Force, (medical only), Thailand
Coates AE, An Address, Med J Aust, 1942, Jan 17;1(3): 63-67
Coates, A E. Clinical lessons from Prisoner of War Hospitals in the Far East (Burma and Siam). Med J Aust, 1946, June 1; 1 (22): 753-760
Coates A E. Fundamental principles in medical practice. Med J Aust, 1946, Nov 30; 2(22):757-763
Coates A E. Surgery in Japanese prison camps. Australian and New Zealand Journal of Surgery. 1946, Jan ;15(3):147-158
Duncan. I L. Life in a Japanese prisoner of war camp. Med J Aust 1982;1:302-306
Duncan I L. Makeshift Medicine. Combating disease in Japanese prison camps Med J Aust. 1983, Jan 8;1(1):29-32
Dunlop E E. The War Diaries of Weary Dunlop, Java and the Burma-Thailand Railway. 1942-1945. Melbourne, Thomas Nelson, 1986
Dunlop E E. Clinical lessons from prisoners of war hospitals in the Far East, Med J Aust,1946, June 1; 1(22):761-766
Dunlop E E. Medical experiences in Japanese captivity, British Medical Journal, 1946, Oct 5;474-786
Dunlop E E. Surgical treatment of dysenteric lesions of the bowel among allied prisoners of war in Burma and Thailand, British Medical Journal, 1946,Jan 26;1:124-127
Fagan K J. Surgical experiences as a prisoner of war. Med J Aust. 1946, June 1;1,(22): 775-6
Russell K F, Dunlop E E. Obituary- Sir Albert Coates. Med J Aust 1979, April 7;1(7):276-7
Walker A S Clinical Problems of War. Canberra Australian War Memorial, 1952 (Australian in the War of 1939-1945; series 5 (medical); vol 1)
Webb R. Sir Albert Coates 1895-1977, Aust NZJ Surg. 1988, May; 58(5):419-422
Winstanley P G, Collected papers and articles, 2004, Perth, www.pows-of-japan.net
Medicos and Memories, Further recollections of the 2/10th Field Regiment, Dr Jim Dixon and Dr Bob Goodwin, 2000, 2/10 Field Regiment Association
Comrades in Bondage, Frank Foster, Skeffington and Son, 1946
Behind Bamboo, Rohan D Rivett, Angus and Robertson, 1946
The Burma-Thailand Railway, Gavan McCormack and Hank Nelson, Allen and Unwin, 1993
Prisoners of the Japanese. POWs of WW2 in the Pacific, Gavan Daws, New York , William Morrow, 1994
POW: Prisoners of War. Australians Under Nippon, Hank Nelson, Australian Broadcasting Corporation, 1985
Note. This article was prepared by Dr Tony Gherardin,
grandson of Lt Col (later Sir Albert) Coates.