We had no bedpans, no facilities for bathing patients, no soap or disinfectants, and no special diets. The only medicine we had was Condy's crystals and ground charcoal. Yet the Japanese had the gall to call it a hospital.
[Tom Morris in Gavan McCormack and Hank Nelson, The Burma–Thailand Railway, Sydney, Allen & Uwin, 1993, 30.]
Hospitals were set up along the Burma-Thailand treat the large numbers of sick prisoners of war and rǒmusha. They varied in size from a handful of medical personnel and a single building to large base hospitals accommodating thousands of patients.
The smallest 'hospitals' were no more than areas set aside in the jungle camps for care of the sick. They were not hospitals in the traditional sense. Usually, they consisted of one or more huts staffed by perhaps one or two medical personnel. Apart from what doctors and their staff managed to bring with them into captivity, there was little equipment or medicine.
'Hospital' buildings were usually made of bamboo and attap (a type of thatch). Patients slept on rough bamboo beds, often with little more than a coarse sack to warm them. Larger hospitals were divided into wards for the various illnesses but these wards were difficult to keep clean and cross infection was common. Cholera victims were quarantined in separate areas, sometimes desolate and water-logged, to contain the spread of this highly infectious disease.
The base hospitals received seriously ill patients brought down from further up the railway. These journeys often left prisoners in an even worse condition than they were when they left their camps. As a British major at Chungkai reported:
They arrived in Chungkai camp in shocking condition, emaciated, debilitated and in many cases obviously dying. They were herded into the camp like cattle by the callous Japanese or Korean guards.
While better than the facilities at work camps, base hospitals could also be crudely built and inadequate. The 1200 patients at 55 Kilo camp in Burma, for example, were housed in just eight huts. Another smaller hut, termed the 'death house', held those patients who were dying.
On the Burma side of the railway the main hospitals were 30 Kilo Camp (Reptu), 55 Kilo camp (Khonkhan), Thanbaya and Thanbyuzayat.
Thanbyuzayat Hospital, a base hospital at the Burma end of the railway, was established in January 1943 but soon, in mid-1943, had to be evacuated as a result of Allied bombing. Patients were dispersed to camps at Kilos 4, 8 and 18. At the same time, sick prisoners further up the railway were concentrated at 55 Kilo camp.
Nearby, at Thanbaya, another hospital was set up in August 1943 under Major Bruce Hunt to accommodate the sick from F Force. Though supposedly a base hospital, it was a dismal place, appallingly under-resourced. Between 1 August and 24 November 1943 about 45 per cent of the patients died.
In Thailand the major hospitals were at Tha Sao, Chungkai, Tha Markam, Kanburi (Kanchanaburi) and Nakhon Pathom.
Chungkai hospital, located where the Commonwealth War Graves Commission cemetery now stands on the southern outskirts of Kanchanaburi, was one of the early base hospitals, established in November 1942. The first influx of ill prisoners arrived in March 1943. At its peak Chungkai would hold two thousand patients.
In early 1945 Tha Markam hospital near the Bridge on the River Kwai was moved to Chungkai, which was itself closed in June 1945 as part of a further Japanese consolidation of POW camps.
Tha Sao (near today's Nam Tok) began as a camp hospital but grew to become the base hospital for all of POW Group 4, some 13 000 men. By November 1943 Tha Sao had around 2400 patients, one third of whom were Australian. Lieutenant-Colonel E.E. 'Weary' Dunlop, who commanded the hospital there in late 1943, later wrote:
the most distressing picture of all was seen in the tropical ulcer 'wards' which resembled horrible 'butchers' shops, filled with the stench of gangrene and buzzing with flies which hovered tenaciously on the crude rags of clothing.
['8th Division in Captivity' AWM54 554/5/1]
The biggest hospital to receive patients from the Burma-Thailand railway was Nakhon Pathom, close to Bangkok. Established in January 1944 by men moved from Tha Sao it held 8000 patients at its peak. Alongside Tha Muang Hospital, it remained in operation until the end of the war in August 1945.
Although the base hospitals offered relative comfort compared to the work camps, they still experienced significant death rates. Between 60 and 100 men died a month at Chungkai in late 1943.
Australian medical personnel were also formed into forces (K and L Forces) in mid June 1943 to treat the rǒmusha. These two groups, of 230 and 115 personnel respectively, worked with rǒmusha in Thailand at Kanchanaburi, Wun Yi, Kinsaiyok, Konkoita and Ni Thea (Nieke).