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Leprosy and Modernity in Singapore and Malaysia

How a “high modernist” approach to leprosy control was subtly subverted.

Alongside modern diseases such as AIDS and SARS or the H1N1 strain of influenza that is
currently in the headlines, leprosy does not attract as much attention or the same level of
research. Often, too, the voices of those affected by leprosy have been neglected or simply
ignored.

Providing a corrective is Making and Unmaking the Asylum. At the center of Dr. Loh Kah
Seng’s study are men, women and children from different ethnic groupings in Singapore and
Malaysia who, as a result of being diagnosed with leprosy, ended up in sanatoriums such as
Singapore’s Silra Home and the Sungai Buloh leprosarium north of Kuala Lumpur.

The book examines how a “high modernist” development ethos impacted on the history of
leprosy in colonial and postcolonial Singapore and Malaysia. As defined by social scientist
James Scott, cited by the author, this is “a self confidence about scientific and technological
progress.”

The ideology and practices that grew from this have had, according to Dr. Loh, paradoxical
outcomes upon the management of leprosy in the two countries. On the one hand, the high
modernist state’s will to clean up social ‘messiness’ — combined with the coercive powers to
do so — led to the segregation of people affected by leprosy and near-total control over them
by the state, which sought to protect society from an imagined social danger.

On the other hand, the author documents how the high modernist logic was subverted, or at
least resisted, by the very people it sought to dominate. The majority for whom the asylums
became their permanent home devised strategies to salvage their ‘bad’ lives. They formed
friendships, married, practiced their religion and put on cultural performances. Some joined
secret societies, gambled, smoked opium, trafficked in contraband items, and partook in riots
and strikes. In so doing, they sought to contest and remake the terms of their confinement.

What this thoughtful and discerning study underscores is the need to be mindful of how
people are treated, or mistreated, in the campaign against infection. Leprosy may be an old
disease compared with modern pandemics, but the lessons it teaches are no less relevant for
it.

Making and Unmaking the Asylum: Leprosy and Modernity in Singapore and Malaysia by
Loh Kah Seng (SIRD, Petaling Jaya, Malaysia, 2009).

AUTHOR: Syed Muhd Khairudin Aljunied is a lecturer in the Malay Studies Department of
the National University of Singapore.

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Straits Times review article: Living with stigma of leprosy

November 1, 2009 by pathslks

31 October 2009
Straits Times
Review – Others

Living with stigma of leprosy

Cheong Suk-Wai, Senior Writer
899 words
(c) 2009 Singapore Press Holdings Limited

LOCATED on the eponymous isle that flanks Penang Bridge, the Jerejak Rainforest and Spa
is an idyllic retreat hugged by thick Malaysian jungle.

The visitor is greeted by glossy darkwood floors, intricate wood carvings adorn its walls and
the linen is spotless white-and-blue. But for those old enough to remember, from 1871 till
World War II, this was a fearsome no-go area that served to isolate leprosy patients

It was, in fact, colonial Malaya’s first such colony, to be followed much later in 1930 by the
Sungai Buloh leprosarium set up in Selangor.

In Singapore, from where the British governed the rest of Malaya, there were holding areas
for leprosy sufferers only in Kandang Kerbau Hospital and then McNair Road. Eventually,
such patients were sent to Pulau Jerejak for good.

What a world away Jerejak’s Balinese body scrubs, steam baths and jacuzzis seem from the
frightful 4,000-year-old disease whose name comes from the Greek word lepis for scale.

Since 1873, leprosy has also come to be known as Hansen’s Disease, after Norwegian
scientist G.H. Armauer Hansen, who first discovered that it was caused by the bacterium
Mycobacterium leprae.

Up till the early 20th century, leprosy was thought to be incurable, but a cocktail of drugs
proved to be effective in stamping out this badly disfiguring and nerve- deadening disease
that often results in the loss of sight and limbs.

Unfortunately, it was often confused with syphilis and thus erroneously thought to be highly
contagious when, actually, scientists have since found that 95 per cent of people are immune
to leprosy.

All this makes the disease’s tortuous and sometimes callous course in Malaya all the more
tragic.

It was only in 1949, after three British nuns from the Catholic order of the Franciscan
Missionaries of the Divine Motherhood settled down here and agreed to nurse leprosy and
tuberculosis (TB) patients, that the British authorities were willing to set up a leprosarium
proper, the Trafalgar Home in Woodbridge.
Such things are all but forgotten these days, but local historian Loh Kah Seng has just
launched his book, Making And Unmaking The Asylum: Leprosy And Modernity In
Singapore And Malaysia.

The book tracks how the British authorities were bent on compulsory segregation of all
sufferers, which in effect rendered anyone stricken by leprosy effectively a walking corpse.

It was from late 2004 that Dr Loh had been researching the history of leprosy in Malaya for
the International Leprosy Association’s Global Project. His core finding is that, in banning
leprosy sufferers from mingling with the rest of society as a means of minimising the risk of
contagion, Singapore’s early governments prioritised the control of society for economic
progress and modernisation above the needs of individuals.

Dr Loh, who has also studied the effects of the Great Depression in 1930s Malaya, points out
that even so, the British were selective in how they regarded leprosy sufferers in their
colonies. For example, he argues, because Singapore was important to them economically,
they made it illegal not to confine institutionally anyone with leprosy. In India, under its 1898
Lepers Act, by contrast, only paupers had to be segregated.

While the colonial government pursued compulsory segregation on the grounds that leprosy
was highly infectious, Dr Loh points out that they backslid badly when they were short on
funds. In 1937, when the Great Depression squeezed budgets and housing people became a
great cost, the British government in Malaya admitted that leprosy was only ‘very slightly
infectious’ and that compulsory segregation was ‘unnecessary and costly’.

His book abounds with examples of the British taking a sledgehammer to flies in dealing with
the hundreds of leprosy sufferers, especially considering that TB was vastly more contagious
but patients were allowed to roam freely.

Dr Loh records former leprosy sufferer Kuang Wee Kee as saying that, of the most-feared
diseases in mid-20th century Singapore, ‘leprosy, TB and mental illness were the three
brothers. Mental illness was…the little brother. Second brother was TB. Leprosy was the big
brother. These were the three big clans’.

Once segregated, however, the leprosy sufferers were well fed and encouraged to be active in
the open air as much as possible. They even grew vegetables and tended livestock, albeit
within the confines of their delineated compounds.

Many gave up the struggle against the hopelessness to which society had consigned them.
Many thus became incorrigible gamblers, instigating fights and killing themselves.

Yet many other leprosy sufferers ‘unmade the asylum’, as Dr Loh puts it, by founding
musical troupes, writing and performing plays, and publishing inmates’ stories in magazines
for sale.

Unfortunately, the push of progress continues to belittle their efforts to live with self-respect.
In September 2005, residents of the Singapore Leprosy Relief Association had to move from
their leafy premises with generous spaces to a flatted factory-like building. There, even for
married couples, privacy is no priority. Finding their own digs is often a pipe dream given the
stigma that still sticks to the disease.
Noting how contagious diseases are rearing their ugly heads these days, Dr Loh muses: ‘We
have a social duty to be mindful of how ordinary people are treated, and mistreated, in the
campaign against disease and infection.’

suk@sph.com.sg

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Book Launch in KL

August 2, 2009 by pathslks