A History of Plague in Java, 1911–1942

Bubonic plague appeared in Southeast Asia near the end of the nineteenth century. It had been present in China for at least one hundred years before that, mostly in endemic form but with regular epidemic flare-ups. When it appeared in Hong Kong, one of the most important harbors worldwide, in 1894, economic life came to a standstill. Not only did it cause widespread panic because of the high number of infected people and deaths, it also inspired intrusive public health measures in an attempt to stem infections. Infected individuals were segregated and treated on a hospital ship, their houses and possessions burned or disinfected, and the movement of Hong Kong's population were severely restricted. Since it was primarily poor Chinese neighborhoods that were affected, many inhabitants fled the city. Soon after, the plague was exported by ships following the world's most important shipping lines, thereby triggering a global pandemic.The cause of the plague, the bacillus Yersinia pestis, and its mode of transmission, fleas, were both discovered within months of the outbreak. Rat fleas were identified as the disease vector and rats as the disease reservoir; the fleas bit humans when rat populations were decimated. With both cause and disease vector known, many hoped that effective measures against further spread of the plague would be readily implemented. Public health authorities did indeed initiate rat eradication campaigns and quarantine measures, disinfecting houses and whole neighborhoods, but these measures had little effect. Public health interventions were not able to stop the spread of this dread disease in any meaningful way.The Dutch East Indies remained unaffected for more than a decade. In 1910, the plague reached Surabaya, one of the most important harbor cities of the archipelago. It soon spread to Malang, Eastern Java, where numerous individuals fell sick and died. Public health measures were implemented quickly, which initially consisted of segregating hundreds of infected Indonesians and placing severe restrictions on their movements. Rat eradication campaigns were initiated as well, but of note, none of the (field) rats dissected at makeshift medical laboratories had been infected. Unfortunately, public health measures had no effect; the plague only disappeared from the Dutch East Indies around 1942 following the introduction of a vaccine in 1935. According to official estimates, approximately 215,000 people died from the plague—a negligible number when compared to the death toll of the Spanish flu (1.5 million) and malaria (not officially counted but far more numerous). Nevertheless, public health authorities spent large sums organizing extensive and expensive campaigns to limit the spread of the plague.Maurits Bastiaan Meerwijk's book provides a superb analysis of these campaigns, how they affected the lives of Indonesians, and how the campaign's many photographs were used to propagandize the modern, progressive, and benevolent attitudes of the Dutch colonial administration toward the Indigenous population of the Indies. After dead infected (house) rats were found inside the bamboo poles used in the construction of Javanese houses, they set up a large housing improvement scheme that “colonized” Javanese houses by making them rat-proof and hygienic. Rat-proofing houses would interrupt the cycle of infection and thereby limit the spread of the plague. During the following three decades, more than 1.6 million houses were built, which constituted, according to Meerwijk, “one of the most invasive, sustained, and best-advertised health interventions of the Dutch colonial period” (1–2). Previous campaigns had aimed to improve Indigenous neighborhoods and housing by focusing on hygiene, cleanliness, sewers, and fresh drinking water. Officials hoped that, through the anti-plague housing improvement campaign, the Javanese would be acquainted with civilized housing and experience improvements in their health at the same time.The Javanese were expected to contribute both free labor and finances. Unfortunately, as Meerwijk relates, this expansive campaign had a negligible effect on the incidence of the plague but contributed to the spread of malaria, as building sites provided excellent breeding grounds for mosquitoes. Meerwijk considers this a fatal flaw of the housing improvement program, a flaw that was only discussed publicly after the plague vaccine became available in 1935. Interestingly, it did not slow the housing improvement program down.According to Meerwijk, the plague was the “first pandemic to be photographed” (13). In the Dutch East Indies, plague photographs rarely focused on patients, rats, and symptoms, but rather almost exclusively on houses. Meerwijk's book not only provides an excellent analysis of the uniquely Dutch housing improvement program but also investigates the role of visual representations in convincing Indonesians, Europeans, and international health authorities of the program's brilliance and effectiveness. These photographs fit neatly in the tradition of portraying the spectacle of engineering and modernity, which at that time featured railways, electricity poles, automobiles, modern roads, dams, and irrigation works. The Dutch, Meerwijk comments, attempted to engineer the plague away. Comparisons between photographs of Javanese houses before and after reconstruction provided a strong rhetorical resource to demonstrate the program's effectiveness. The spectacle of home improvement was presented in the colonies, in the Netherlands, and all over the world.A History of Plague in Java, 1911–1942 provides a succinct account of the most expensive and invasive public health campaign undertaken in colonial times, and how the hundreds of photographs that document it were used to illustrate Dutch colonial benevolence. It is a pleasure to read and is illustrated well. It provides a novel contribution to the history of colonial medicine in the Dutch East Indies.