Education And Debate

The hard boiled saint: Selwyn-Clarke in Hong Kong

BMJ 1995; 311 doi: http://dx.doi.org/10.1136/bmj.311.7003.492 (Published 19 August 1995) Cite this as: BMJ 1995;311:492
  1. Mervyn Horder
  1. a4 Hamilton Close, London NW8 8 QY

    Percy Selwyn Clarke by birth, he adopted the name Selwyn-Clarke by deed poll during the first world war, expressly so that he could collect his letters more promptly on active service, there being already a surfeit of ordinary Clarkes in his division. It was the kind of original, independent act that was completely typical of the man.

    Early career

    He was born in North Finchley in December 1893, the fifth of a London solicitor's 11 children. Educated at Bedales, he joined St Bartholomew's Hospital Medical School in 1912 and qualified in 1916. He served as medical officer with two different units in France, was twice wounded, and was awarded the Military Cross in 1918. Some brief excursions into general practice led him to resolve that never again would he take a patient's money in exchange for his medical services; so that after the war in 1919 he volunteered for the Colonial Medical Service, which gave him his first civil posting abroad, to the Gold Coast.

    Few Europeans survived the savage heat of West Africa for more than a few short tours of duty. Selwyn-Clarke served there (including a two year secondment to Malaya) for more than 17 years. In addition to his routine public health duties, he immersed himself in the pioneer work on control of yellow fever that was being carried out in West Africa; his share of the work included inoculating himself with some of the experimental vaccines. He remembered with the greatest pride that, when all the former European street names were changed (with the coming of the new state of Ghana), the name of Selwyn Market, which he had caused to be built in Accra, was alone retained and is retained to this day. During his period in Malaya in 1929 he travelled widely all over the Far East, including Japan, and home across America; and in 1933 he took a short Intourist trip to Russia.

    Hong Kong

    In 1937, at the age of 44, he was transferred to the post of Director of Medical Services, Hong Kong, at the special request of the incoming governor, Sir Geoffrey Northcote. In 1935 he had married Hilda Browning, a country loving girl from Kent whose strong social conscience and forward looking ideas were a match for his own. Their daughter, born in 1936, went out to Hong Kong with them.

    There is no room for any discussion of the defence problems posed by Hong Kong, so many miles away from any other British possession, or for any account of the well mounted assault which enabled the Japanese to capture the place after only 18 days' fighting in December 1941. The official decision had been taken in the 1930s that, whatever the military situation in the rest of the world, the colony was to be prepared to withstand a siege of 130 days. The brunt of such preparations naturally fell on the director of medical services, who applied himself with energy and ingenuity to the various extra tasks falling to his lot—mainly the stockpiling of foodstuffs, food supplements, and medical supplies; the proper dispersal of hospitals and Air Raid Precautions facilities; and the accommodation of thousands of new refugees from Japanese occupied China. One of his most original measures was to prebake millions of soya flour biscuits and store them in vacuum cans in the basements of Lane Crawford, the local department store. When these were later recovered from the invaders the biscuits, neither appetising nor intended to be, proved a useful addition to the monotonous civilian rations of verminous rice, sweet potato tops, and boiled chrysan themum leaves.

    OCCUPATION

    At the end of hostilities, on Christmas Day 1941, Selwyn-Clarke went to the incoming Japanese military governor and secured his permission to carry on as director of medical services. Two things certainly influenced the Japanese decision—the termination of hostilities much earlier than they had expected and their terrors about an outbreak of infectious disease, smallpox or cholera, for which, if it had happened, they would have liked to blame someone else. The unorthodox transition was made smoother by the fact that the incoming Japanese medical officer, Colonel T Eguchi, had paid an earlier peacetime visit to Hong Kong and knew and admired Selwyn-Clarke. The official consent of the imprisoned British governor, Sir Mark Young, to the arrangement was also obtained. This was not quite so unusual as it might now seem; the Japanese insisted that British staff at banks and law courts continued their daily work for a month or two, until the time came to intern them.

    In Chungking and other places comfortably far from the scene of events, and sometimes in Hong Kong itself, Selwyn-Clarke's action was simply labelled collaboration. Fully aware of this, he considered that his shoulders were broad enough to shrug off the imputation. It was a “collaboration” in accordance with his Hippocratic oath and one that served to save or prolong the lives of thousands—allied, neutral, Eurasian, and Chinese—the whole duty of a doctor. To a complete singlemindedness about his work he added a talent for organisation at all levels, which alone could make the work effective, and an exceptionally tough physique. A lifelong teetotaller and early riser, he seemed able to view with something like indifference the privations of rationing and regularly achieved a 14 hour working day. Tall, ascetic, military in bearing, he was a familiar figure striding the streets of Hong Kong wearing his Japanese army staff armlet; and it was in the street that he often received from passers by gifts of money and other offers of help in his welfare work.

    THE HARD-BOILED SAINT

    The tasks confronting him and his skeleton staff were unending, beginning with the disposal of some 3000 corpses left from the street fighting. There was also the rehabilitation of the sewage system; antimalarial measures; food distribution and inspection; the promotion of Japanese relations with the International Red Cross (uphill work since they had not signed the 1929 Geneva Convention); and the organisation of hospitals to serve all classes of the community, which now included prisoners of war and internees. The choice of a salubrious site for the main civilian internment camp on the Stanley Peninsula was Selwyn-Clarke's idea. The 2500 people sent there in January 1942 included 40 doctors and 100 trained nurses, so that medical service of a kind was possible there throughout the war. The provision of drugs, diet supplements, vaccines, and surgical instruments was Selwyn-Clarke's responsibility. Some of these had to be spirited away from under the noses of Japanese guards from depots where they had been stored for just such an emergency. Others were bought on account from friendly Chinese chemists or extracted, after many delays, from the Red Cross. All these operations were coordinated, supervised, provided with transport, discreetly assisted financially, and, where possible, led in person by Selwyn-Clarke—all the more remarkable since he spoke only a minimum of conversational Chinese and Japanese. It was at this time that one of his white women helpers coined the description “the hardboiled saint,” which he hated.

    A specimen operation was the procurement of a dentist's chair for the Stanley camp. One was known to be blocked in a dockside warehouse at Wanchai. It took two weeks of reconnaissance to determine the one moment of the day when the sentry was changed and the place left unguarded for 15 minutes. Two volunteers succeeded in prising off the padlock bar, getting the awkward chair safely stowed in Selwyn-Clarke's waiting ambulance, and restoring the padlocks just before a Japanese naval patrol appeared at the end of the street. It was a heart stopping moment: what saved them was either the ambulance markings or the army staff armlet—anyway the patrol turned aside and made room for the ambulance to drive away.

    At his side was his wife, Red Hilda, as everyone called her—from the colour of her hair and from her political ideas. She was no less strong a character than he, and she too wore her Japanese staff armlet, undertook endless welfare and liaison tasks, and continued to make a home for him in whatever ruined flats or odd corners of bombed hospitals the Japanese allowed them to occupy—and they were constantly chivvied to and fro.

    ARREST

    Early in 1943 things became much more difficult. Colonel Eguchi and another of Selwyn-Clarke's original sponsors on the Japanese foreign office staff were both posted away. In addition, the escape of allied prisoners along an established route into China began to be more organised and included a large party of young doctors, and the Kempeitai secret police were now fully established. Selwyn-Clarke knew that, because of the pathological Japanese suspicion of foreigners, however careful he had been not to involve himself in nonmedical matters he was not likely to be left long at liberty. He chose this moment to communicate his arrangements and the whereabouts of his secret stores to two trusted Chinese women helpers, who continued to operate his system successfully until the end of the war, when both received the OBE for their services.

    The Japanese came for him at last on 2 May 1943. They took his wife and small daughter to Stanley camp and him to the Kempeitai headquarters under the Supreme Court building. Here he began 19 months of solitary confinement, of which 10 were taken up with repeated tortures designed to secure his confession to a list of 40 charges (the first of which was that he was the head of British espionage in Hong Kong). The water and hanging tortures used by the Japanese were exactly those used by the Spanish Inquisition in the 16th century: the first consists in repeatedly drowning the victim until just before it is too late. Repeated beatings reactivated an old spine wound from the first world war and left him with a twisted knee and permanent damage to his left leg so that he walked with two sticks for many years thereafter. All this secured no admissions from him since there was nothing to admit, but similar “investigations” of other less resolute victims provided all the incriminating evidence that the Japanese required. At a formal trial, carried out in Japanese with an interpreter, he was sentenced to death, but the sentence was not carried out and the torture continued as before.

    Day and night he lay on the filthy concrete floor of his 6 1/2x5 feet cell wearing nothing but shirt and trousers and crawled over by cockroaches from a nearby latrine—conditions particularly revolting to a hygiene loving medical man and at their worst in the damp heat of a Hong Kong summer. In this loathsome spot, his legs painfully swollen with beriberi, he passed his fiftieth birthday on 17 December 1943. A Bible and a copy of the works of Shakespeare were smuggled in to him by his wife through a well disposed Indian guard. It was mainly too dark to read, but he managed to memorise large parts of Richard III. He was reduced to playing childish games with the squares of newspaper allotted to him once a day for his visit to the latrine. The Japanese were careful to give European newspaper to Chinese prisoners and Chinese to Europeans so that no information could be derived from them, but sometimes mistakes were made and in this random fashion news of a kind reached him from the outer world. After a time he devised a miniature chessboard from these squares of paper.

    His cell adjoined the main torture chamber, and he could hear the screams of his fellow victims all day. Many were driven mad by the treatment or tried to commit suicide (failure to succeed usually resulted in further beatings). Lying on the floor, too broken to stand, he constantly raised his voice to give whatever consolation or encouragement he could manage to his fellow victims.

    I dwell no longer on these matters because he was emphatic that he did not wish to dwell on them himself. Few men had more reason to abominate the Japanese, and none was less inclined to do so. He added to the gospel injunction not to hate one's enemies his own much harder injunction—not to have enemies at all. He refused to give any evidence at the postwar Japanese was crimes trial, and in 1946 it was found that he had arranged, at his own expense, for every Japanese prisoner still in captivity in Hong Kong to be issued with his own toothbrush (before you start laughing consider how suitable such a present was for fortifying the self respect of such a hygiene conscious people).

    Early in 1944, still under sentence of death, Selwyn-Clarke was moved to Stanley prison and given a second military trial, at which his indefinite imprisonment was reduced to three years and the capital charges dropped. Here, in extremis himself, he began to treat his Japanese guard for venereal disease. By now venereal diseases had joined starvation, cannibalism, malaria, dysentery, and tuberculosis as consequences of the incompetence and barbarity of the Japanese occupation (which effectively reduced the colony's population from 1.5 million in 1941 to 500000 in 1945). The courtyard of Stanley prison was overlooked by the Stanley internment camp next door, and casual watchers in the camp were astonished to see a lanky, emaciated, white bearded figure crawl slowly to the prison parapet on hands and knees and wave to them feebly. Nothing had been heard of Selwyn-Clarke for months and the worst was feared, but here he was at last.

    REPRIEVE

    In December 1944 he was officially reprieved, for reasons still obscure. Some believe it was because of his early work on yellow fever, which saved the lives of thousands of Japanese, while others think that the reprieve was simply one of those sudden unpredictable about turns that are almost the only predictable feature of Japanese behaviour. What is certain is that no one on either side expected him to live, but he did.

    The Japanese employed him for the rest of the war as medical officer in Mah Tah Chung, a mixed international (mainly Chinese and South American) internment camp on the mainland near Kai Tak airfield. He was reunited with Red Hilda and his daughter, Mary, now aged eight. He was once more active as physician, surgeon, obstetrician, and dentist, though his injuries were such that he could scarcely stand. Re-establishment of his contacts with Chinese nurses and chemists, and with the British consul in Macao, now had to be done for him by two British internees, who also managed to unearth and hoist Union Jacks at various key points on, or even before, the day of reoccupation in August 1945.

    His efforts to get the colony's medical services restored included the care of interned Japanese in conditions far superior to those that they were used to and the protection from reprisals of the six or seven individual Japanese who had been humane and independent minded enough to help him in his work. He finally left for England on rehabilitation leave in October 1945. Pushed on board in a wheelchair, he occupied the captain's cabin, specially vacated for him. In this cabin every evening he used to entertain members of the crew off duty and exchange with them stories of their was experiences.

    In his official report on Hong Kong 1941-5, written for the British government while he was on leave, he cast round almost in vain for something to say in favour of “the vanquished,” and gave prominence to the one concrete—literally concrete—thing the Japanese did for the colony during their tenancy. They had constructed sewage maturation tanks which enabled, and still enable, farmers of the New Territories to fertilise their fields in the Japanese manner with some of the colony's vast nightsoil production, ordinarily dumped out at sea.

    Later activities

    His period of duty as director of medical services in Hong Kong from 1937 to 1947 was succeeded by four years as governor and commander-in-chief of the Seychelles. It was unprecedented for the Colonial Office to transfer anyone from their medical branch to a political post in this way. Though it was kindly meant as some sort of a rest cure after his experiences, no one took account of the fact that Selwyn-Clarke was by temperament incapable of resting. There were many problems in this leisurely tropical paradise—unemployment at 14%, housing, the colour bar, taxation, and education—and he set out to tackle them rather faster than was acceptable to the well entrenched locals. He regarded the provision of simple hygienic housing for copra workers as a high priority but could seldom get the planters to pay for it; the prompter collection of income tax required more vigilant tax officers than the island could provide; the vast capital sums needed to develop the islands for their present day tourist boom were not yet forthcoming; and it was only in education that he had some successes.

    Finding school truancy to be a major problem (normal daily attendance was about 30%), he tackled it typically, not by writing reports or summoning psychiatrists, but by direct action. An announcement that he would appear in person in a large school on a given date was enough to secure full attendance that day, the children being curious to see their strange looking governor. Once there he made every child raise his or her hand to heaven and swear to him personally to attend regularly in future—the result was a dramatic improvement.

    In 1951 he returned to London and, for the five years until his retirement, resumed his career at the Ministry of Health. He worked on various problems incidental to his post: medical training, facilities for the disabled, hospital staffing ratios, and other teething troubles of the newly constituted National Health Service. After retirement he found time for the matter closest to his heart, the welfare of prisoners. He served for three and a half years in the induction wing of Pentonville Prison, and later among detainees awaiting deportation. In this way he maintained to the end his tireless efforts for the underprivileged of the world without distinction of race, creed, or class.

    At the age of 82, within four months of his death, he was still active, protesting constructively in the Times against the overcrowding he had seen in prisons. His view was that at least four well defined classes of prisoner (chronic drunks and derelicts, mild offenders, deportees, and drug addicts) did not require the attentions of expensive prison officers and could be cared for better and four times as cheaply in special hostels.

    A younger doctor who met him often on committees in these last years remembers him as an immensely distinguished figure; tall, solid, white haired and white moustached, rising to speak on nearly every subject in a stately, meticulous manner with a strong regard for minor matters of procedure, protocol, and finance. They all knew vaguely that he had been in Hong Kong during the war, but no one knew of his experiences there nor did he ever refer to them.

    In 1973 he sat down to write the story of his life, showing himself to be as original an author as he had been in action. After some vain efforts to get a British publisher to take the book, he finally had it published in Hong Kong, where—to come full circle—it was printed by the Dai Nippon [Japan] Publishing Company. Little known here, Footprints is a fantastic story of one man's vision, energy, magnanimity, love for his fellows, and old fashioned cussedness (“mulish obstinacy” are the words he uses himself). “Having read it,” wrote Sir Theodore Fox, former editor of the Lancet, “I cannot get it out of my mind. Nor do I wish to.”

    Sir Percy Selwyn Selwyn-Clarke KBE, CMG, MC, MD, FRCP, DPH, DTM&H, CSTJ Barrister at Law died in Hampstead on 13 March 1976, leaving his body to St Bartholomew's Hospital for research. The nation can seldom have produced so unconventional a recipient of so many conventional honours. That “mulish obstinacy” had kicked up clouds of dust in Whitehall, and he was proud of it. We too have our Schweitzers, if only we care to honour them.

    I acknowledge essential help with this article from Sir Percy Selwyn-Clarke's daughter, Mary Seed; Mrs Margaret Sloss; Mr and Mrs C R Boxer; and Dr Charles Fletcher.