South East Asia Colonial History V3 by Paul Kratoska

Author:Paul Kratoska [Kratoska, Paul]
Language: eng
Format: epub
ISBN: 9781000558180
Barnesnoble:
Publisher: Taylor & Francis
Published: 2021-12-16T00:00:00+00:00

55 HEALTH AND HEALTH SERVICES IN BRITISH MALAYA IN THE 1920S

DOI: 10.4324/9781003101680-23

J. Norman Palmer

Source: Modern Asian Studies 23(1) (1989): 49–71.

Introduction

British Malaya was a very unhealthy place in the early years of this century. Malaria, ankylostomiasis or hookworm, venereal disease, tuberculosis, dysentery, pneumonia, beri-beri, cholera and still other diseases accounted for thousands of deaths annually in the 1920s. Typically, persons suffered from two or more maladies at the same time. In the Federated Malay States (F.M.S.) probably more than half of those listed as dying from malaria also suffered from hookworm. Many pneumonia deaths were due to tuberculosis. Chronic malnutrition combined with malaria, hookworm and diarrhea in many, perhaps most, pregnant women to produce high infant and maternal mortality.1 The majority of the living were more or less continuously afflicted with disease. Most of the diseases were debilitating and slow to kill. Most were preventable although that was imperfectly understood.

The purpose of this essay is to provide an introduction to health conditions and health services in British Malaya in the 1920s.2 No attempt is made to assess the impact of disease and death on attitudes and values or on energy levels and productivity although it must have been substantial. Nor is any serious effort made here to apply insights gained from this study to other questions of historical interest although it would be valid to do so.

Very little historical scholarship has been undertaken on health in Malaya for any time period. Historians of Malaysia have mostly treated the tin and rubber industries; the plural society; and constitutional, political and administrative subjects; and the Malays and their values. Although scholars are beginning to turn to the subject of health,3 much of what has been published has been by British or Malaysian medical persons who were themselves participants. They have focused on particular diseases or aspects of the medical services or their own roles.4

The paucity of scholarly attention may in part be due to the implicit acceptance of one of the conventional wisdoms about western imperialism, viz., that western medicine benefited indigenous people by waging a successful struggle against disease and death usually in a context of dirt and ignorance. But it may not be fully appreciated that in Malaya the very high incidence of disease and death in the early years of this century was the result of the large capital investments in export agriculture, mining, and public works which accompanied British rule. Existing ecological balances were disturbed, and conditions were created for some parasites to multiply and spread.5 The many hundreds of thousands of Indian and Chinese immigrant workers brought to Malaya—without whom the capital investments could not prosper—were unprepared. They lacked natural immune systems, were often poorly nourished, were sometimes diseased on arrival, and were usually placed in working and living situations in which multiple infections were virtually certain. The resident Malay population did not escape the spread of sickness. The Government’s medical officers and staff, the principal providers of western medicine and of medical care generally, lacked sufficient knowledge and experience to cope.

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