Pols’ book is an exceptional account of growing nationalism and the movement towards independence of Indonesia. The author has highlighted the roles of Indian physicians and medical students in the twentieth century in these areas. The author is well versed in the languages and culture of the region and uses under-explored sources, including the journals, letters and speeches of medical men. He takes a stand against the Dutch administration and against European doctors, who ‘harboured an especially strong and forthright hostility towards Indies physicians’. In his opinion, their involvement in the colony, though often motivated by good will, ultimately served only to lard the Dutch treasury.
Pols’ account of the founding of the first organisation of medical students, the ‘Boedi Oetomo’, contrasting with the European part of society is revealing: Indies medical men had a range of profoundly different views (some preferring to Europeanise, some favouring classical Javanese culture, some focussing on noneducated populations). There were two medical colleges, one in Batavia and one in Surabaya, for the formation of ‘Indies’ physicians, a rank subordinate to that of European doctors. Both schools were breeding grounds for nationalistic sentiment. Quite a few graduates were able to study in the Netherlands and some went back with a medical doctorate. Interesting are the stories of some individuals and their careers in medicine or politics, like Abdul Rivai. However, colonial Europeans generally regarded educated Indies individuals as overly ambitious mimics who had forgotten their place in colonial society. One of these early voices, that of Dutch physician J.H.F. Kohlbrugge, receives ample attention from the author. Kohlbrugge was vocal and extremely conservative – including in medical matters – however his influence was perhaps not as significant as Pols’ emphasis on his accounts suggest. There were ‘progressive’ Dutch forces as well. In the wake of the ‘Ethical Policy’ of The Hague, the Civil Medical Service was established. It focussed more on the health and (prevention of) diseases in local populations, but the many Indies physicians who served in it received low salaries. After the Association of Native Physicians was founded, their discontent grew and strikes were considered. Finally, the government gave in with a salary increase. Yet, as the author stresses, most European medical men considered Indies physicians as ‘hybrids’, that is, well educated for their jobs, but unfit to socialize with.
Whether that also applied to students at the Medical Academy in Batavia (opened in 1927 on equal footing with Dutch universities, including with the authority to award doctoral degrees) is not mentioned. The author only states that it was more difficult for Indonesians to study there and that they were in the minority. Other authors give very different student figures.
The involvement of the Rockefeller Foundation in Java is significant here. Its public health activities, including educational campaigns on village level, were acclaimed by Indies physicians, but less so by the Dutch cure-oriented and often bureaucratic physicians. In this context, the author makes a praiseworthy attempt to uncover the activities of Dr Abdul Rasjid. In 1935, Rasjid was impressed by the Rockefeller project of involving the public to reduce hookworm infection. He became a leading voice in campaigns to include more Indian physicians in the Public Health Service, to respect local ‘adat’ (custom) and to incorporate traditional herbal medicine. He also revitalised the Association of Indonesian Physicians with a programme of medical nationalism.
Sometimes, the religious or philosophical background of an Indies physician is mentioned. For example, Protestants were seen as more loyal to colonial society. It would have been interesting to read whether Muslim students and doctors were more motivated to join nationalistic movements. Nor does the author mention the reactions of European physicians to nationalistic tendencies overtly expressed by Indonesian doctors. More detail on this topic would have made the context clearer.
The Japanese occupation brought about the elimination of European elite from society, as they were imprisoned in internment camps. This tragic event is hardly mentioned in the book, but was hugely significant, because the disappearance of Dutch doctors, teachers and nurses created a niche that came to be occupied by local health experts under Japanese leadership. Japanese expertise opened a new approach towards communal medicine, enthusiastically embraced by Indian physicians and students. Rasjid restarted his dismantled Association of Indonesian Physicians as the Java Medical Service Association. He stated that medicine had previously served only the Dutch, with negligible benefit for Indonesians. The author calls this ‘pro-Japanese rhetoric’, but does not give a realistic picture of western medicine that reached the people until the Japanese occupation (with the exception of the Rockefeller endeavour).
The bloody chaos that followed the power vacuum after the defeat of the Japanese, commonly called the bersiap period, is downplayed as the activities of ‘revolutionary youths’. A few (Muslim) students joined, but the majority restricted themselves to their medical work and did not involve themselves with politics.
After disappearance of the Japanese, the reinstalled Association of Indonesian Physicians had no chance to survive, because of its members’ loyalty to the Japanese medical leadership. The author makes an effort to re-establish the importance of doctor Abdul Rasjid. He courageously puts his finger on the disappearance in historical Indonesian accounts of the attitudes of Indian doctors towards the Japanese colonisers; these uncomfortable questions were avoided in independent Indonesia. Following the declaration of independence, the engagement of medical men in the political sphere declined.
The two Dutch military campaigns, meant to regain control, came with casualties and cruelties. The author describes this period with restraint, mentioning that Indies health personnel busied themselves with their wounded compatriots. When the Dutch finally recognised the independence of their former colony in 1949, regular life returned, including education and health care.
It might have been revealing to mention that the newly formed Indonesian Medical Association founded a medical journal in 1951. Majalah Kedokteran Indonesia exists until this day. Early volumes were mostly filled with articles by Indonesian physicians. However, Dutch physicians contributed as well, which is remarkable, given the recent Dutch military interventions. Most articles were in Bahasa, quite a few in Dutch and some in English or German. This attitude of tolerance and collegial respect was undermined with the expulsion of all Europeans and people loyal to the Dutch, or of mixed descent (between 1945 and 1965 some 300.000 people were ‘repatriated’ to the Netherlands).
Meanwhile, the young nation faced a shortage of medical personnel, and malnutrition was rampant. Again, public health came at the tail end of the health budget. Sukarno’s bending towards communism did not help to resolve the crisis. It was only in the aftermath of the slaughter of 1.5 million Indonesians under Suharto that a national health infrastructure was created. And the doctors were no longer politically active; they felt safe in their private practices or profited from career possibilities offered by international health programmes. There is still a huge task ahead for Indonesia’s women and men in health care and health sciences.
This book fills a gap in our knowledge about the role of Indonesian medical men in the movement towards independence. A fascinating story, though almost inevitably one-sided.
