Van Baarsel Letter

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DENTISTRY IN A P.O.W. CAMP

When the war against Japan broke out in the Pacific (December 8, 1941), I joined up as a Dental Officer in the Royal Dutch Indies Army. The military hospitals had dental clinics and for fieldwork we were equipped with a portable dental ourfit [sic] consisting of four cases, one containing a foldable operating chair (S.S. White), another a foot engine, one case with instruments, forceps, sterilizer, all the necessities for the treatment of jaw fractures, etc., while the fourth case was filled with mateirals. We had no special dental cars.

After the capitulation (March 1942), we were taken prisoner and placed in P.O.W. camps, where we set up dental clinics with our field equipment. Fortunately, we were in the possession of the well-stocked supply cases, which enabled us to treat our fellow P.O.W.'s for about two years. First we ran out of amalgam and provided for that by filing silver coins, of which there were still a few around. The next problem was denture base material and artificial teeth. Then we modelled the dentures totally in wax and cast them in one piece (base and teeth) in aluminum from the dish-tins, using normal plaster as investing material mixed with sand. The same plaster could be used over and over after grinding and heating. The dentures were useful but gave the owner a very unusual smile. When the mercury ran out we could only fill with zinc oxide and eugenol. Extractions could be done for the first year with local anaesthesia and then we were back in the middle ages. The Japanese did not provide us with any material and the camp-guards also claimed treatment from us.

During the years of occupation, parties were sent overseas regularly to unknown destination, [sic] but as we learned later, to work on airdromes on remote islands on railroads (Burma-Sumatra) and factories and mines in Japan. If the Japanese would give their consent and if there was one available, those parties were joined by one of our dentists, supplied with amergency [sic] kit, and so I happened to go with a party of 6500 Dutch, Australians, English and Indonesian P.O.W.'s on a small ship (5000 tons). What was our destination??

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On the fourth day of the journey, which was by no means a tourist cruise, we were hit by two torpedoes and our ship sank within ten minutes, and with her went my emergency kit, accompanied by my most prized possession, a small can of corned beef, which I had saved for years just for an eventual "emergency."

I was one of the 630 survivors and was transported to the jungle of Sumatra to start a combined career: dentist with my bare hands and railroad worker. My wardrobe consisted of a gunny-sack, which I presume is the most simple professional costume ever worn by a practising dentist.

After a few days in the new camp, the "Ha-isha" (Japanese for dentist) was summoned to the guard-house, where one of the guards opened his mouth as wide as he could and pointed to a really nasty cavity, which according to the sounds he uttered, must have been causing him a lot of pain. I spent a few anxious minutes and all my knowledge of Japanese in explaining that I could not help him without instruments. My anxiety was great, because the hands of the guards were usually pretty loose (you will understand what I mean). Finally he let me go and I can't say that I was too sorry but without showing it however.

When many of the P.O.W.'s got complaints, I gelt that something had to be done, moreover the extracting of a tooth with normal bending-pliers is not an easy job. Try it out for yourself some time. So back I went to the Japanese guard and told him that I would try to make some instruments if he could provide me iwht the materials and would give me permission to use the railroad workshop. He consented but the only material available were railroad spinkes, telephone wire, hammers, pliers, files, a hand-drill and a cold chisel.

As my experience as an instrument-make was nil, I started my experiment with the simpler instruments as explorers, excavators, tweezers and scalers. The second step were [sic] some elevators which I thought might come in hand after that I felt ready to try my masterpiece, the forceps, because these were acturally [sic] most badly needed.

I had to forge the railroad spikes to the approximate shape, and then file the pieces in the desired form. The forging was not too easy because there

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was only an open wood fire to heat the iron, a middle-sized hammer and for an anvil a piece of rail fromt he railway. It took me two weeks of ten hours daily work to make two forceps, a lower and an upper with which I thought I could do the trick. Then I tried to harden them by heating and chilling (I remembered something of but in those days I was not as good with "Skinner" as I am now.) Anyhow, whatever I tried, it did not work out very well.

I will admit that I was quite excited when I had to do my first extraction wiith my home-made forceps, but they did a quick and neat job, which pleased me and even more my patient, because as you know anaesthetics were a long-forgotten luxury.

Since then the instruments have been used extensively; mostly the forceps because lackilg [sic] filling material, I could not do very much in the line of operative dentistry. I tried to excavate cavities and fill them with Latex (from the hevea rubber trees) or a mixture of latex and zinc-oxide, the only chemical I could find in the Japanese drug kit. But it did not work out very well, because the latext after a couple of days got a very bad odour, which according to the patients was more unbearable than their toothache.

I always had a file handly, [sic] because after every use I had to sharpen the working-ends of my instruments.

The most important part of my practice consisted of removing gold crowns and bridges. Barbaric as this may sound, it was a necessity, because the owner of this valuable metal could trade it with the native population for food, and so was many a life saved. This trade had to be secretly, for if the man was found out he would have been punished severely. If the trade had been profitable, my patients sometimes expressed their feelings by giving me a duck's egg or a banana.

The reader may understand that after it was all over and I was back in my practice, there were gay moments when one of my old jungle-patients walked in to have the damage I did restored.

J. M. van Baarsel

Second Year's Dental Student,

Faculty of Dentistry,

University of Toronto,

14th of March, 1954