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PATIENTS of the COLONIAL STATE the Rise of a Hospital System in the Netherlands Indies,1890-1940

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PATIENTS of the COLONIAL STATE the Rise of a Hospital System in the Netherlands Indies,1890-1940 PATIENTS OF THE COLONIAL STATE The rise of a hospital system in the Netherlands Indies,1890-1940 PROEFSCHRIFT ter verkrijging van de graad van doctor aan de Universiteit Maastricht op gezag van de Rector Magnificus, Prof. dr. Rianne M. Letschert volgens het besluit van het College van Decanen in het openbaar te verdedigen op donderdag 29 september 2016 om 14:00 uur door Sjoerd Zondervan Promotores Prof. dr. E.S. Houwaart Prof. dr. P. Boomgaard (Universiteit van Amsterdam) Beoordelingscommisie 1. Prof. dr. F.G. Huisman, UM/ UU (voorzitter) 2. Dr. E.Q. Hesselink, Leiden 3. Dr. A. Krumeich 4. Prof. dr. J.A.M. Maarse 5. Prof. dr. H. Schulte Nordholt, Universiteit Leiden 2 CONTENTS Acknowledgements 8 Preface 9 1 INTRODUCTION 11 Historiography of health care 12 Historiography of hospitals 13 Primary Objective 14 Conceptual framework 15 Civil Hospitals in colonial times in the Netherlands Indies 16 Description of the object 16 Periodicity of the object 18 Geography object 18 Database 18 Arrangement of chapters 19 2 HEALTH CARE AND HOSPITALS IN VOC TIME 21 The VOC, Diseases and Health Care 21 The VOC and its medical staff 23 Batavia and its population 24 The VOC and its hospitals 25 General hospitals on Java 29 The Schepelingen Sieckenhuys (Sailors’ Hospital) at Jayakarta (1670-1790) 29 The VOC hospitaal (Company’s Hospital) at Batavia (1619-1640) 29 The Binnenhospitaal (City Hospital) at Batavia (1641-1808) 31 The Buitenhospitaal (Outer City Hospital,1743-1836) 33 The Hospital at Bantam (1682-1817) 34 The Hospital at Semarang (1776-1836) 35 The Hospital at Soerabaja (1780) 36 The Hospital at Cheribon (1778) 36 General hospitals in the Buitenkantoren (Outer Establishments) 36 The Hospital on Ambon (1648) 37 The Hospital on Ternate (1658) 37 The Hospital on Banda (1664) 38 The Hospital at Padang on Sumatra (1690) 38 The Hospital at Makassar on Celebes (1699) 39 General hospitals for specific groups 39 The Chinese Hospital of Batavia (1640-1912) 39 The Moorsche Hospital (1751-1785) 40 The Hospital of the Poor Relief Board (1635-mid 19th century) 41 Specialized hospitals 41 The Lazarushuis or Leprosy Home at Purmerend (1665-1800) 42 The Leprosy Hospital on Ambon (1699-1765) 43 The Convalescent Hospital at Tji Panas (1744-1761) 43 Summary 44 3 3 HEALTH CARE AND HOSPITALS IN THE 19TH CENTURY 47 Introduction 47 Health policy in the 19th century 49 General medical policy 49 Medical science and training 51 Organization of medicine 53 Vaccination 55 Public Hygiene 57 Metamorphosis of hospitals 57 From VOC hospitals to military hospitals 59 Public general hospitals 61 The City Hospital 61 The Outer City Hospital 61 Stadsverbanden (City Dressing Stations) 61 Indigenous hospitals 63 Private general hospitals 64 Chinese hospitals 64 Company hospitals 65 Specialized hospitals 66 Leprosy institutions 66 Hospitals for treatment of syphilis 67 Psychiatric hospitals 68 Beriberi hospitals 70 Convalescent homes 70 Quarantine facilities 70 Summary 71 4 A PERIOD OF TURMOIL (1890 –1910) 73 Introduction 73 The rise of modern imperialism in the Indies 73 Economic developments 75 The ethical movement and legislation 76 The other side of the story 77 Developments in medical science and practice 78 Popularity of indigenous medicine 79 The rise of tropical medicine 79 Medical surveillance of diseases 80 The rise of civilian hospitals 82 Survey Hospital situation 1890 85 The motives of the new hospital initiators 86 Hospital architecture 87 Polyclinics 87 Decreasing importance of military hospitals 89 4 Personnel 89 Distribution and capacity military hospitals 90 Architecture 91 Research and education 92 The impact of the military hospitals in the Netherlands Indies 93 General hospitals for civilians 93 Public general hospitals 94 Personnel 94 Patients 95 Finances 97 Architecture 98 Terrain and buildings 99 Private general charity hospitals 99 The Deaconess hospitals 100 The Missionary hospitals 101 Private general company hospitals 103 Plantations 104 Mining industry 104 Oil industry 105 Other company hospitals 105 Specialized hospitals 105 Hospitals for syphilitic patients 106 Leprosy institutions 107 Eye hospitals 110 Convalescent clinics 111 Hospitals for beriberi patients 112 Psychiatric hospitals 113 Hospitals for infectious diseases 114 Some hospital figures 114 A new future for the Civil Medical Service 115 Summary 117 5 TIMES OF EXPANSION, TIMES OF AWAKENING (1910-1930) 121 Introduction 121 Politics, economics and society 121 Economics of the period 123 The war and its aftermath 124 Modernization of everyday life 126 Nationalist movements 127 Health care 1910-1930 128 New accents in health care 129 Medical research and tropical medicine 130 Medical legislation on epidemics 131 The personnel: more training facilities for the workers 132 5 The patients: more hospital admissions 136 Financial accessibility of hospitals 138 Remaining role of military hospitals 140 Strong advance of civil hospitals 141 General hospitals for civilians 144 Public hospitals 145 Central Government hospitals 145 Government Civil hospitals 147 Municipal or provincial hospitals 148 Private hospitals 149 Private company hospitals 150 Private charity hospitals 153 Specialized hospitals 158 Leprosy institutions 158 Sanatoria for tuberculosis 160 Eye hospitals 163 Psychiatric hospitals 164 Outpatient services 166 Summary 167 6 A PERIOD OF DECENTRALIZATION (1930-1942) 169 Introduction 169 Emancipation and the standard of living 169 Countering rebellion 170 Welvaartsdiensten 170 The effects of the economic depression 171 The Public Health Service 172 From direct health care to rural hygiene 172 Further decentralization of health care 174 Personnel public health service 175 Finances public health service 176 Hospitals 1930-1942 177 Some general characteristics 178 The internal organization of the hospitals 178 The patients of the hospitals 179 Other hospital services rendered 182 Pharmacy 182 Laboratory and X-ray department 183 Hospital Personnel 183 Hospital Finances 184 Private hospitals 1930-1942 186 Missionary hospitals 187 Company hospitals 188 Specialized hospitals 190 6 Leprosy institutions 190 Eye hospitals 191 Sanatoria for tuberculosis 192 Balance 194 After May 1940: War time and occupation 199 May 1940 and the German occupation 200 The Japanese occupation March 1942 200 Summary 202 7 REFLECTIONS ON THE RISE OF A HOSPITAL SYSTEM 205 Hospital system: Naissance and development 206 Evaluation 208 Answering questions 208 Initiators hospitals: Who and why? 209 Establishment of hospitals: Where and when? 211 Characteristics of design and organization 213 May we speak of a medical market? 214 May we speak of a hospital system? 215 Outcome: a decentralized system of private and public hospitals 216 APPENDICES 219 SOURCES AND LITERATURE 229 CURRICULUM VITAE 250 LIST OF FIGURES AND TABLES 251 GLOSSARY 253 ABBREVIATIONS 255 7 ACKNOWLEDGMENTS I owe the completion of this thesis to the support and guidance of many people, whom I wish hereby to thank. First, I want to thank my two supervisors, Eddy Houwaart and Pe- ter Boomgaard, who had a lot of patience with the lack of focus from which I suffered at the beginning of my efforts. They inspired me with many ideas and alternatives and were very strict on language. My brother in law, Sipke van der Velde, corrected my use of language and patiently and in a meticulous way revised my texts. Joe Sergeant, my friend and coach during my endeavours in the field of science, did the same and man- aged to improve my texts in such a way that I need not feel afraid that native speaking scholars fail to understand my work. Some years ago, the Leiden University decided to liquidate the Department of Medi- cal History. By mutual agreement with Harm Beukers, Professor of Medical history at Leiden at that time, I decided to move my research to de Vrije Universiteit at Amster- dam. However, a similar fate befell the same department at de Vrije Universiteit at Am- sterdam during the academic year 2013. Now in the last year of my research, I had to move again, this time to Maastricht, where my supervisor Eddy Houwaart holds a chair. Prior to starting this research project, I received a lot of inspiration from the national master course Medical History that Houwaart started in 2005. This initiative took place in close cooperation between the Vrije Universiteit and the Leiden University. This course continues to inspire medical and history students. Liesbeth Hesselink was one of my fellow students, who followed this course. She preceded me some years ago in de- fending a thesis on indigenous healers in colonial Netherlands Indies. I am indebted to her for her study, which gave me the confidence to continue my own research in the medical history of the Netherlands Indies. I want to thank the KITLV at Leiden, the KIT at Amsterdam and the Nationaal Archief and the Koninklijke Bibliotheek (Royal Library) at Den Haag.1 The library of these institu- tions provided me with much source material. The annual courses that the KITLV orga- nized in cooperation with the Vrije Universiteit on the subject of Indonesia inspired me with new energy and enthusiasm.2 1 KIT, Koninklijk Instituut voor de Tropen (Royal Tropical Institute) at Amsterdam. 2 KITLV, Koninklijk Instituut voor Taal-, Land en Volkenkunde (Royal Netherlands Institute of Southeast Asian and Car- ibbean Studies) at Leiden. 8 PREFACE My first contact with health care in a tropical setting took place in the Ivory Coast, a for- mer French colony that obtained independence in 1962. I was employed by the Method- ist Missionary Society at London and my assignment for the Ivory Coast was to adminis- ter a number of projects, among which a small hospital at Dabou. After my return to the Netherlands, I obtained employment in the Dutch health care. With this dual back- ground, I occasionally received invitations to pay consultancy visits on health care in de- veloping countries. In 2001 and 2003, the PUM (Netherlands Management Cooperation Project) invited me to look into organization and finances of a private hospital at Ujung Pandang (Makassar).3 On that occasion, I visited some hospitals in the northern part of Sulawesi, the Minahasa.
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