For bedpans we used tin cans, old mess tins, half coconut shells and troughs or pots made from large bamboo. Toilet paper was the large leaves from nearby trees.
[Tom Morris, 'Memories of the Burma–Thailand Railway', in Gavan McCormack and Hank Nelson, The Burma–Thailand Railway, Sydney Allen & Unwin, 1993, 30.]
Although medical personnel were captured with much of their medical equipment intact, after months in captivity they often had little left, thanks to theft, damage and other factors. The Japanese did little to replace equipment that was lost or worn out. Tools taken for granted in Australia therefore had to be created out of materials taken from the jungle or materials found in the camps.
Bamboo was an important resource. Food and water containers, furniture, brooms, splints, toothbrushes, needles, bedpans, latrines were all made from the plant. As Stan Arneil said:
We use it for troughs, cups, containers, meat tickets for cholera patients, roofing, we sleep on it and burn it.
[Stan Arneil, One Man's War, Sydney, Alternative Publishing Co-operative, 1980, 101.]
Everyday items were also turned into medical equipment. Cutlery was converted into surgical instruments by prisoners skilled in metal work. Tins and petrol drums were made into containers for saline solution or to hold boiling water for sterilisation. Forceps were fashioned from scrap metal. As Rowley Richards of A Force wrote:
He managed to pinch some scrap steel out on the Railway and made me an excellent instrument which I used daily. Among so many men in camp we had access to qualified experts in a wide range of fields, and all of us became skilled at the art of improvisation.
[Rowley Richards A Doctor's War, Sydney, Harper Collins, 2005, 133.]
Medical personnel also cannibalised their own medical equipment. For example, tubing for stethoscopes was used to create drips and to perform blood transfusions directly from one prisoner to another.
The larger hospital camps, could develop more sophisticated medical equipment since personnel stayed there longer and there were more resources available. Prosthetic limbs and physiotherapy equipment were manufactured for men who had lost their legs to tropical ulcers. Just some of the items improvised at Tha Sao Hospital were artificial limbs, bed pans, charcoal pattern sterilisers, bowls, buckets, trays, brooms, pneumonia jackets, lamps, urine bottles, ladles, mugs, pillows and mattresses (rice sacks and straw), funnels, irrigating cans, latrine lids, fly traps, leg rests, instrument boxes (bamboo), vegetable scrapers, clogs, stretchers, even bamboo needles and scalpels.
Medicines, always in short supply, were also improvised. Dutch medical personnel, with more experience of living in Asia, shared their knowledge of tropical diseases and local treatments. Other medical personnel conducted their own trials, studying plants, for example.
Anaesthetic for surgery was also scarce and supplies were diluted to make them last. Spinal anaesthesia, administered directly into the spine, was one way of husbanding supplies. Finding the right amount of anaesthetic was a process of trial and error, and patients often suffered.
The types of illness found on the railway were in many cases caused by malnutrition. Food therefore became a medicine in itself. Local plants, such as grasses, roots and weeds were used to provide vitamins that were otherwise not available.