Decreased Mortality of falciparum Malaria in Anemic Prisoners of War?

Modern clinical trials have suggested that anemia protects against malaria mortality. Military records of the Second World War in Asia were examined to see if there was support for this hypothesis. When relatively well-nourished Imperial Japanese Navy sailors captured on Nauru (n = 799) were imprisoned on the Fauro Islands, 26% died from falciparum malaria. Similarly treated but very malnourished colocated Imperial Army soldiers experienced low stable malaria mortality. One-fifth of previously healthy Australian Army soldiers (n = 252) retreating from New Britain died largely because of malaria in April 1942. Malnourished prisoners of war, who were as a group very anemic, both Australian Army soldiers in Thailand and Japanese Army soldiers in Papua New Guinea, had high malaria rates but very low (< 3%) mortality rates. Malaria immunity does not adequately explain this dichotomy, suggesting that severe nutritional deprivation may be protective against malaria mortality possibly because of iron-deficiency anemia.

The destiny of Italian prisoners in Austro-Hungarian POW camps during the First World War: remembering the defeat of Caporetto 100 years on.

The living conditions of Italian prisoners during the First World War were extremely difficult. At the end of the conflict, the treatment of Italian soldiers in Austro-Hungarian POW camps and in those of the German territories was recognized as particularly harsh in comparison with that of other prisoners. The reasons may be ascribed to three main factors. The Italian prisoners paid the price of being considered traitors, since Italy was allied with the Austro-Hungarian Empire and with Germany until 1914, subsequently switching to the side of France, the United Kingdom and Russia. The Italian government and the Italian High Command considered their soldiers poorly inclined to engage in a war which became over time increasingly costly in terms of human sacrifice. The strategy pursued by the General-in-Chief Luigi Cadorna was very aggressive and showed little care for the life conditions of his troops, who were frequently thrown into the fray and exposed to potential slaughter. Due to this negative judgement on their troops' willingness to fight, the government did not help, and even hindered, the despatch of packages of food and clothes to prisoners in the Austro-Hungarian and German camps via the Red Cross. The idea of a better life in the trenches compared with that expected in the camps as prisoners was widespread. Thirdly, the maritime blockade of the Adriatic Sea over time reduced to starvation the populations of Austria, Hungary and Germany, which obviously had grave repercussions on prisoners. It was estimated that around 100,000 Italians lost their lives in POW camps; after the defeat at Caporetto, when over 250,000 prisoners were captured, the number of deaths rose. The main causes of death were: tuberculosis, pneumonia, malnutrition and typhoid fever. At the end of the war, when coming back to Italy, former POWs were interned for months in camps (located predominantly in the Emilia region) and had to face interrogation and trials to demonstrate they were not deserters and were free to go back home. In the meantime, many lost their lives due to "Spanish" flu, pneumonia and other infectious diseases. Only the mobilization both of families and public opinion forced the Italian government to close the camps at the end of the year 1919.

Nazi victims on the dissection table - The Anatomical Institute in Innsbruck.

Since Vienna University's 1997/98 inquiry into the background of Eduard Pernkopf's anatomical atlas, German and Austrian anatomical institutes have been forced to confront their past, particularly the widespread procurement of bodies of victims of National Socialism. This paper focuses on the Anatomical Institute in Innsbruck, which received bodies from an unusually broad array of sources: from prisoners executed at Stadelheim Prison in Munich, prisoners of war from three different camps, military personnel sentenced to death by martial courts, patients from a psychiatric hospital, and several bodies of Jewish Holocaust victims. As in other comparable cases, these bodies were used for scientific publications and medical teaching until long after the war. The Anatomical Institute's collection is currently undergoing a detailed analysis in order to identify any human remains dating from the Nazi period. At the Institute of Histology and Embryology, recent research has led to the discovery of approximately 200 histological slides pertaining to at least five individuals who had been executed under the Nazi regime. In a number of cases, the specimens had been provided by Prof. Max Clara, head of the Leipzig Institute of Anatomy. This study is based on an analysis of the Innsbruck Anatomical Institute's unusually detailed records and numerous documents from various archives, including files pertaining to an inquiry into the institute held after the war by the French occupation authorities.

War Imprisonment and Clinical Narratives of Psychiatric Illness, Psychiatric Hospital Charité, Berlin, 1948-1956.

While the historical analysis of psychological trauma from warfare has been extensive, traumatic illness in East German psychiatric practice after the Second World War has drawn little attention. The dominant literature uses West German political and medical discourses as sources to investigate the relationship between traumatic experience and psychiatric illness. This paper instead draws from East German patient files from 1948 until 1956 to examine efforts at the Charité Hospital in Berlin to interpret the psychiatric illness of former prisoners of war (POWs). By examining Socialist Party discourse at the time, the paper argues that psychiatric explanations created parallels with political debates by foregrounding social readjustment difficulties as the cause of postwar illness. Against this background, the final section explores the way in which war imprisonment could constitute a challenge to the clinical restructuring of former POWs' patient histories. Using strategies of confabulation, POWs confronted the documentary negotiation between bodies and meaning, provoking ambivalence.

Malaria-Associated Mortality in Australian and British Prisoners of War on the Thai-Burma Railway 1943-1944.

During the building of the Thai-Burma railway in 1943 Australian and British prisoners of war died at high rates from tropical infections and nutritional deficiencies. Mortality records from "F" Force (n = 7,000) showed nearly half (44%) of the soldiers perished in a single year, yet only 4% of these deaths were primarily attributed to malaria, with another 7% where malaria was listed as a major contributing cause. Case fatality rates were < 1%, with nearly all soldiers chronically infected with Plasmodium vivax > Plasmodium falciparum. Separate labor camp point prevalence malaria rates by microscopy ranged from 28% to 69% (median 54%) despite intermittent quinine suppression. During complex public health emergencies, malaria mortality may be disguised by its combination with other common infections and nutritional deficiencies.

Disease and survival on the Thai-Burma railway: lessons for modern tropical medicine?

During the 2nd World War, large numbers of allied military personnel in south-east Asia became prisoners-of-war (POWs) of the Japanese. During their internment of three and a half years, they suffered undernutrition, exposure to tropical diseases and frequently overwork. Perhaps the harshest POW experience was the construction of the railway between Thailand and Burma. This paper explores the medical conditions during Far East imprisonment, and in particular on the Thai-Burma Railway, as well as the long-term health effects in post-war decades.

From Nuremberg to Guantanamo Bay: Uses of Physicians in the War on Terror.

Seventy years after the Nuremberg Doctors' Trial, health professionals and lawyers working together after 9/11 played a critical role in designing, justifying, and carrying out the US state-sponsored torture program in the CIA "Black Sites" and US military detention centers, including Abu Ghraib, Bagram, and Guantanamo Bay, Cuba. We analyze the similarities between the Nazi doctors and health professionals in the War on Terror and address the question of how it happened that health professionals, including doctors, psychologists, physician assistants, and nurses, acted as agents of the state to utilize their medical and healing skills to cause harm and sanitize barbarous acts, similar to (though not on the scale of) how Nazi doctors were used by the Third Reich.

The Study on the Lives and Health Conditions of Internees in Santo Thomas Camp of Philippines - Based on McAnlis's The War in Manila (1941-1945).

When Japan invaded the Philippines, two missionary dentists (Dr. McAnlis and Dr. Boots) who were forced to leave Korea were captured and interned in the Santo Thomas camp in Manila. Japan continued to bombard and plunder the Philippines in the wake of the Pacific War following the Great East Asia policy, leading to serious inflation and material deficiency. More than 4,000 Allied citizens held in Santo Thomas camp without basic food and shelter. Santo Thomas Camp was equipped with the systems of the Japanese military medical officers and Western doctors of captivity based on the Geneva Conventions(1929). However, it was an unsanitary environment in a dense space, so it could not prevent endemic diseases such as dysentery and dengue fever. With the expansion of the war in Japan, prisoners in the Shanghai and Philippine prisons were not provided with medicines, cures and food for healing diseases. In May 1944, the Japanese military ordered the prisoners to reduce their ration. The war starting in September 1944, internees received 1000 kcal of food per day, and since January 1945, they received less than 800 kcal of food. This was the lowest level of food rationing in Japan's civilian prison camps. They suffered beriberi from malnutrition, and other endemic diseases. An averaged 24 kg was lost by adult men due to food shortages, and 10 percent of the 390 deaths were directly attributable to starvation. The doctors demanded food increases. The Japanese Military forced the prisoner to worship the emperor and doctors not to record malnourishment as the cause of death. During the period, the prisoners suffered from psychosomatic symptoms such as headache, diarrhea, acute inflammation, excessive smoking, and alcoholism also occurred. Thus, the San Thomas camp had many difficulties in terms of nutrition, hygiene and medical care. The Japanese military had unethical and careless medical practices in the absence of medicines. Dr. McAnlis and missionary doctors handled a lot of patients focusing mainly on examination, emergency treatment and provided the medical services needed by Philippines and foreigners as well as prisoners. Through out the war in the Great East Asia, the prisoners of Santo Thomas camp died of disease and starvation due to inhumane Japanese Policy. Appropriate dietary prescriptions and nutritional supplements are areas of medical care that treat patients' malnutrition and disease. It is also necessary to continue research because it is a responsibility related to the professionalism and ethics of medical professionals to urge them to observe the Geneva Convention.

Flight Lieutenant Peach's observations on Burning Feet Syndrome in Far Eastern Prisoners of War 1942-45.

INTRODUCTION: 'Burning Feet Syndrome' affected up to one third of Far Eastern Prisoners of War in World War 2. Recently discovered medical records, produced by RAF Medical Officer Nowell Peach whilst in captivity, are the first to detail neurological examinations of patients with this condition. METHODS: The 54 sets of case notes produced at the time were analysed using modern diagnostic criteria to determine if the syndrome can be retrospectively classed as neuropathic pain. RESULTS: With a history of severe malnutrition raising the possibility of a peripheral polyneuropathy, and a neuroanatomically plausible pain distribution, this analysis showed that Burning Feet Syndrome can now be described as a 'possible' neuropathic pain syndrome. CONCLUSION: After 70 years, the data painstakingly gathered under the worst of circumstances have proved to be of interest and value in modern diagnostics of neuropathic pain.

[The history of detained Polish veterinarians in Switzerland 1940-1947]. / Zur Geschichte internierter polnischer Tierärzte in der Schweiz 1940-1947.

As part of the recent history of veterinary medicine in Switzerland, in Poland and in other countries biographies ofveterinarians among Polish soldiers detained to Switzerland during WWII are described. The information is derived from a number of Swiss and Ukrainian archives and personal contacts with descendants and colleagues of these veterinarians living in Switzerland and abroad.

Vivian Bullwinkel: A model of resilience and a symbol of strength.

BACKGROUND: The story of one of Australia's most well-known women in history, Vivian Bullwinkel, is a symbol of strength for nursing. She and her companions who were prisoners of war during World War II, refused the position of victim and went on to contribute much to the world after their ordeal. DISCUSSION: These women embody important elements of resilience that it is our duty to convey to generations of nurses so that they may be inspired to rise above adversity, foster connection with like-minded others, use adaptive coping mechanisms and soft power, be gentle yet persistent in their resistance practices, and most of all to do good work throughout their nursing careers. This paper argues that oppression theory provides only a limited understanding of present woes affecting nursing. Resilience theory suggests future actions and is therefore further enlightening. By examining the experiences of Bullwinkel, students can be assisted to see that stress has been a constant theme across nursing history. However ways of rising above adversity can be illuminated by critically and deeply examining aspects of iconic leaders and heroic stories such as can be found in the life of Vivian Bullwinkel. Summary: Students who are offered the chance to examine this symbol of strength in our profession may decide to internalise some of the positive traits and resolve to use the behaviours she and her contemporaries used to help them create for themselves a fulfilling career, pride in their profession and strong sense of purpose.

POW and Detainee Operations: Lessons Unlearned.

Throughout the history of modern warfare, tales of atrocities have repeatedly surfaced that depict active and passive aggression toward prisoners of war (POWs). Yet, with each conflict, new tales are born and an undeniable reality of warfare inflicts fresh scars for aggressors to bear. It is understandable, based on human nature and the goals of war, that a government (or its representatives) will feel malice toward enemy prisoners captured during a conflict. It is unquestionably a challenge to overcome that human nature, despite the statutes that outline lawful treatment of POWs. While most aspects of warfare have been revolutionized throughout history, the means by which a military deals with its POWs remains somewhat mired in the reticence of leaders to acknowledge that it will factor into every conflict--that it will, in fact, become a source of controversy as long as it is handled as an afterthought. As shown in accounts dating back to the Revolutionary War, the law can only influence human nature to a point, especially when resources are limited, ignorance is a reality, and no one is watching.

A Rare Case of an Intact Bone Plug Associated with a Gunshot Exit Wound.

This case study presents an unusual manifestation of gunshot trauma in skeletal tissue from a post-World War II human rights abuse sample uncovered in Vilnius, Lithuania. After briefly reviewing the typical wound appearance of projectile trauma in the cranium, we discuss the presence of an intact bone plug associated with a gunshot exit wound in an individual from the Tuskulenai Case. While this individual demonstrated typical gunshot entry and exit wounds to the cranium consistent with high-velocity trauma, the bone plug indicates that the projectile likely lost much of its kinetic energy while traveling through the cranium resulting in a low-velocity impact at the exit site. This study reviews a similar instance of a bone plug recovered from a bioarcheological sample in Peru and emphasizes the importance of thorough archeological excavations of mass graves.

A Horrible Experiment.

A patient presented to my office who had been tortured in the course of a wartime medical experiment many years ago. Seeing him prompted me to explore my personal reaction to his case and to reflect on the history of the ethics of medical experimentation in the 20th century.

Shell shock in Ireland: The Richmond War Hospital, Dublin (1916-19).

The history of mental disorders occasioned by World War I is a complex and important history, indelibly linked with social, political and cultural circumstances, and the history of the war itself. The Richmond War Hospital was a 32-bed establishment on the grounds of the large Richmond District Asylum in Dublin which, from 16 June 1916 until 23 December 1919, treated 362 soldiers with shell shock and other mental disorders, of whom more than half were considered to have recovered. Despite the limitations of the Richmond War Hospital, it was a generally forward-looking institution that pointed the way for future reform of Ireland's asylum system and, along with the other war hospitals, brought significant changes to the practice of psychiatry.

Understanding the POW experience: stress research and the implementation of the 1955 U.S. Armed Forces Code of Conduct.

Facing accusations about weak military discipline following the supposedly poor behavior of American soldiers held captive during the Korean War, President Dwight Eisenhower instituted a Code of Conduct for the Armed Services in 1955. In response, military leaders hired numerous social and behavioral scientists to investigate the nature of the prisoner-of-war (POW) experience. These researchers not only challenged official government accounts of POW activities but opened up a new field of study-stress research. They also changed military training policy, which soon focused more on stress inoculation training, and, in so doing, helped lead the shift in psychology away from behaviorism to ego and cognitive psychology. In this sense, my article ties shifts within the social and behavioral sciences in the 1950s to the military history of the early Cold War, a connection generally missing from most accounts of this period.