Hans Pols dan Vivek Neelakantan Berbicara Sejarah Kesehatan di Indonesia

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Kuliah Umum Undergraduate
Dosen: Dr Vivek Neelakantan
Departemen Sejarah

Health Histories of Southeast Asia: An Introduction
Sejarah Kesehatan Asia Tenggara: Pendahuluan

Recommended Reading
Daftar Buku: Tim Harper and Sunil Amrith. Histories of Health in Southeast Asia: Perspectives on the Long Twentieth Century, edited by Tim Harper and Sunil Amrith. Bloomington: Indiana University Press, 2014.

Why Southeast Asia:

Southeast Asia is a microcosm of the world (mikrokosmos dunia), in terms of economic and social development. Singapore is arguably the most advanced country in terms of socio-economic indicators. Indonesia and Malaysia are soon catching up with economic growth. On the other hand, you have civil strife in Myanmar that has arrested economic development. The region is diverse in terms of multiplicity of cultures, diverse politics, etc. Democratic Indonesia has little in common with the polity of Thailand, or Myanmar. The region lies at the crossroads between India and China and played an important role in the spice trade. The entire region, save the exception of Siam ( Thailand) was colonised at the turn of the 20th c.

Southeast Asia can be defined politically rather than geographically. For eg. India is sometimes culturally and politically considered as a part of SE Asia whereas the ASEAN definition excludes India

The history of health in Southeast Asia is both transnational and international. Internationalisation of health in Southeast Asia can be traced back to the 19 c , i..e maritime trade and the Hajj pilgrimage.Intrnational Sanitary conferences that began in 1851 dealt with Asia as the source of cholera.

International humanitarianism, is the second aspect of health in Southeast Asia. Rockefeller Foundation and hookworm eradication campaign across Dutch East Indies, the Philippines, and
Malaya.

How did European colonialism affect health (Bagaimana penjajahan Eropa di Asia tenggara mempengaruhi kesehatan)?

Contoh 1 : Pada abad 19—an, pemerintah Hindia Belanda bermulai vaksinasi cacar di Jawa. Karena pencacaran, harapan penduduk membaik. Karena vaksinasi, banyak kematian anak mengurangi.

Example: Around 1815, during the British occupation of Java, Thomas Stamford Raffles introduced vaccination, a system that was continued by the Dutch. Due to vaccination, infant mortality rates went down. By 1942 smallpox vaccination system was interrupted and the disease made a comeback by 1946 from Malaysia. 1948 Jakarta epidemic (see Vivek Neelakantan, 2010).

Karena kombinasi surveilans, dan penahanan, kematian anak karena cacar rendah pada 1937. Tetapi karena perang dunia ke-2, sistim vaksinasi rusak dan penyakit cacar kembali ke Nusantara dari Malaysia, dari pulau tidak jauh dari kepulauan Riau. Pada 1948, Jakarta disaksikan wabah cacar.
What was the role of the World Health Organisation in eradicating smallpox in Indonesia?

Bagaimana kita akan menghubungkan perspektif sejarah kesehatan lokal dengan internasional? Untuk riset, mencoba satu puskesmas tidak jauh dari Surabaya. Wawancara dengan petugas kesehatan.

Conducting local research on primary healthcare at a Puskesmas in Surabaya. Trace the evolution of the Puskesmas. Conduct interviews with Camat, Pak Lurah, and functionaries within the Dept of Health. Link these developments to International developments in Primary Healthcare, as enunciated by the WHO.

I advocate a transnational approach to studying the history of medicine across Southeast Asia. Such an approach enables you to trace linkages between local developments at the level of PUSKESMAS and broader international forces such as globalisation, etc.

A correlation between health and crises in Southeast Asia. Take for e.g., the case of the establishment of the Dokter Djawa school in 1851. It was established to train smallpox vaccinators. Crisis played an important role in stimulating local and governmental initiatives in health.

Or, take the example of the influenza epidemic of 1918. 1.5 million people died in the Dutch East Indies alone. Western medicine had little to offer by means of preventing mortality. For e.g. in Dutch East Indies, the colonial government issued pamphlets printed in Melayu entitled “ Awas, Penjakit Influenza!” This pamphlet contains information about how to prevent influenza, using obat asli Indonesia.

The field is relatively new and has a lot to offer.

Scope of Medical History: How it could help you in your career

Knowledge of Traditional Medicine
How international developments like liberalisation, or the battle over tented drugs affect access to healthcare?
Migration and effects on health?
Whether the history of medicine has any lessons to offer for current policy and planning?

Let us delve on a few examples from history

Disease was one of the yardsticks by which Europeans judged Asian societies, especially in the nineteenth century. This was particularly true in the industrial age when the germ theory of disease replaced older notions of contagion, esp. Contagion, the miasma theory of disease. Think of the vibrant trade between India and Southeast Asia. Think of the Hajj pilgrimage to Mecca. How disease travelled along trade and pilgrimage routes.

1) Cholera is one such disease that travelled across Asia. The disease can move with astonishing swiftness. A human being can contract cholera and die a day later. Loss of bodily fluids and diarrhoea. Intestinal particles peel off. The person loses 90% of bodily fluids, suffers cramps and eventually succumbs to death. Holy cities had established quarantine stations to arrest the spread of the disease. Very large number Of pilgrims from the Dutch East Indies,, during the first half of the twentieth century traveled to the holy cities. The Dutch East Indies had a medical representative at Jeddah to deal with outbreaks of cholera. British Malaya also sent pilgrim ships to Mecca. Many returning pilgrims brought with them disease although they were reluctant to use government-run hospitals. In 1899, British troops even entered a Malay village as villagers did not permit the colonial health authorities to fumigate a diseased corpse, a measure that contravened Islamic principles.

2) Influenza: As I had mentioned to you earlier, Southeast Asia lies at the crossroads of the sea routes connecting India, and China. The region is host to migrant labourers, primarily from China and South Asia. The influenza pandemic began in 1918. Coastal areas were worst afffected Historians speculate that the disease was imported from Manchuria. Indian migrant population in Malaya was particularly susceptible to flu. It was labelled as Hukum Kodrat in Netherlands Indies whereas in Malaysia, Muslims of the Klang valley organised special prayers whereas Hindus of the Klang valley organised silver chariots to ward off evil spirits. Some Malays turned to dukuns whereas many Indians turned to Ayurvedic remedies. Chinese medicine was also used. The Dutch East Indies government dismissed traditional medicine as primitive. In the Philippines, the sick were effectively quarantined. The question is how influenza pandemic affected rice prices and availability of food in Burma? The pandemic decimated the workforce and rice prices in Burma, soon after the pandemic rose.

In the Dutch EAST Indies, the flu contributed to an upsurge in violence. A Chinese tobacco company sponsored a festival to banish the evil spirits. The communal clashes between Chinese and Muslims who perceived the festival as an insult to the religion. The flu was a catalyst in the eruption of communal tensions in the Dutch East Indies. Anti-Chinese riots in Kudus, Central Java.

Evolution of preventive healthcare in Southeast Asia

The Dokter Djawa School in 1851 was the first attempt at training local inhabitants in the Dutch East Indies to work as vaccinators. Education in Indonesia developed outside the university. Burma trained hse hsayas to work as vaccinators in rural areas.
By 1916, international philanthropies like the Rockefeller Foundation get involved in educating the local populace about preventive health measures.
Resistance and collaboration in the Dutch East Indies.

The dichotomy between ppreventive and curative healthcare in Southeast Asia

Southeast Asia and the Cold War ( the ideological and military rivalry between the US and the Soviet Union): How public health becomes an important component of national reconstruction? Take the e.g. of Burma, Indonesia, the Philippines.

How Cold War affected the politics of healthcare in Southeast Asia?

Impact of neoliberal policies on health? Medical tourism in Thailand

Possible topics for further investigation
Disease in Surabaya (1900-2000)
History of maternal mortality in Indonesia (1945-2000)
Malnutrition and its linkages with poverty
Medical Tourism in Thailand
History of Mental Health in Indonesia
Social aspects of malnutrition