The History of Medan Pathological Laboratory in 1906-1942

Budi Agustono

, Wara Sinuhaji

, Junaidi

, and Kiki Maulana Affandi

Department of History, Universitas Sumatra Utara, Medan, Indonesia

Department of History, University of Gadjah Mada, Yogyakarta, Indonesia

Keywords: Industrialization, disease, health, pathological laboratory, Medan

Abstract: Plantation industrialization in East Sumatera had made both various profit and problems to the stakeholders.

The increasing of population as the effect of industrialization, at the early of 20

century, not only made a

changes to the economy and politics but also to the health issues. Various diseases began to infect people in

this area. Those diseases were caused by climate, environment and unhealthy lifestyle. In overcoming the

problem, in 1906, the private plantation initiated the establishment of a research institution about tropical

diseases in Medan. The research institution was called as Medan Pathological Laboratory. During its

development, it was able to solve the problem regarding to the diseases which infected people in the

plantation belt such as cholera, dysentery, beriberi, and malaria. The doctors and experts discovered the

correlation between the cause of diseases and lifestyle in plantations and environmental conditions in East

Sumatera. In the period of development, this colonial health institution had decreased the number of

mortality and overcome various epidemics and diseases in East Sumatera.

1 INTRODUCTION

Health issue is a serious matter as well as the

population development in a particular area. In East

Sumatera, health issue is not a priority; at least until

the plantation industrialization entered this region in

1860. The very rapid progress of plantation

industrialization in East Sumatera could be said as

“bagaikan gula yang dikerubungi semut” which this

metaphor illustrates that many people from another

region came to this region to seek for life, besides of

course the natives and the plantation labors. This

condition, of course, gave big impact to the number

of populations in East Sumatera. Besides that, the

environment also changed the effect of drastically

expanding plantation area. At the end of 19

century, the change of demography and environment

which was very drastic giving impact to health issue

which was experienced by people in this region.

One of the health policies which could be

considered as big impact to health issue in this

region, or even in the Dutch East Indies was the

establishment of Pathological Laboratory in Medan

(Donath, 1945). The policy of laboratory

establishment was the initiation of plantation

entrepreneur which then helped by colonial

government in its development. Generally, the

existence of this laboratory had given important

impact to health issue in East Sumatera. This

research is aimed to explain the history of

pathological laboratory in Medan and also the role

and impact within the scope of health in this area.

Before that, there will be an explanation about

plantation industrialization which is considered as

the major factor of health issue in this area.

2 RESEARCH METHODS

This research usages historical method, consists of

four stages, nanely heuristic, critics, interpretatin and

historiography. Heuristic is used for documents

collection, such as documents and goverment

official reports as a primary sources. Magazine like

Medical Journal of the Dutch-Indies as an object of

research as secondery sources. After data collection

require verification, inter and extern critics for data

findings. Therefore, data is interpreted so that

narrated in historiography.

Agustono, B., Sinuhaji, W., Junaidi, . and Affandi, K.

The History of Medan Pathological Laboratory in 1906-1942.

DOI: 10.5220/0010068411331138

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

1133-1138

ISBN: 978-989-758-449-7

1133

3 EAST SUMATRA IN THE 19

CENTURY UNTIL THE EARLY

CENTURY

In colonial era, East Sumatera developed along with

plantation industrialization. The starting point of that

development was initiated by an entrepreneur from

Netherlands, J. Nienhuys. In the beginning of

plantation period, in 1860s-1890s, the expansion had

a concern on the cultivation of tobacco commodities.

From several sources of colonial, it is stated that in

the early period, most of regions in East coast of

Sumatera were tobacco-planted. Lately, after studies

were conducted, it was found that areas which

produced tobacco with high quality are between of

Wampu river and Ular river (Pelzer, 1985).

In East Sumatera, the expansion of foreign

capital was represented in the form of plantation

companies. The first plantation company was NV.

Deli Maatschappij which was established in 1869

(Cremer, 1919; Pelzer, 1985). The other plantation

companies which were established, they are

NV.Tabak Arendsburg Maatschappij in 1875,

NV.Deli Batavia Maatschappij in 1877, and

NV.Senembah Maatschappij in 1889. Those

companies were the parent of some onderneming

(plantation). In its development, there were 15

onderneming in 1873, then increased to 86

onderneming in 1884, and then got increasing to 169

onderneming in 1891. By the end of 1891 to 1892, a

world economy crisis occurred which caused

decreasing level onderneming in East Sumatera. In

1904, there were 114 onderneming. In 1914 that

were 101 onderneming and in 1930 there were 72

onderneming (Jaarverslag ..... 1914, 1915).

The development of plantation industrialization

caused changes in East Sumatera. One of the

changes was demography. The original inhabitants

of this region comprised of Malay, Karonese, and

Simalungunese, which was in the growth becoming

minority group. And the migrant population covered

European, Eastern foreigner (Chinese, India and

Arabian) and the natives or Indonesian ethnics such

as Javanese, Minangnese, Mandailingnese and

others (Loderichs, 1997). This alteration happened

as the consequence of migration owing to plantation

industrialization which grew rapidly at the early of

century. Mostly, the migrants to East Sumatera

would work as a labor in plantation. The first labor

that migrated to East Sumatera in the end of 19

was

Chinese labor, then followed by Javanese labor that

became majority community at the early of 20

century until this time.

Besides the diverse ethnic groups that inhabited

East Sumatera, the quantity of people also increased

significantly. According to prediction data from

Thee Kian Wie in 1850s, East Sumatera had been

inhabited by 150.000 people. In 1890, the number of

citizens in this area rose drastically, that was

285.000 people. The increasing factor caused by the

entry of Chinese labours to plantation in East

Sumatera. Entering the 20

century, the number of

populations in East Sumatera gradually increased.

Based on the data obtained, in 1905, population in

East Sumatera was recorded as many as 568.417

people, in 1913 (773.106 people), in 1920

(1.197.554), and according to the census which was

conducted in 1930 stated that the number of

population in this region was 1.693.200 people

(Wie, 1977).

Plantation industrialization in East Sumatera had

caused several transformations or changes. Besides

the demography aspect, there was an environmental

change, where the area of East coast in Sumatera

which was a “jungle” changed to be

“cultuurgebied” which had very high economic

value. The expansion of plantation area and the large

increasing number of migrants had caused “bad

effect” to East Sumatera condition. One of the bad

effects was related to health issue that will be

explained in the next discussion (Kouwenaar, 1936).

4 HEALTH

The higher number of populations in one region

would give impact to all aspects in life, not only in

economic, political and cultural aspect but also in

health and environmental aspect. The large

increasing number of populations is considered as

supporting factor of the emergence of various

epidemics. Moreover, the conversion of forest into

plantation also caused change on environmental

condition. The change of environment quite

influenced the spreading of epidemic in one region.

In East Sumatera, for instance, before the plantation

industrialization, there was no literature found

clarifying that there were epidemics in this area.

Therefore, the discussion in this article is focused on

the changes and health dynamics in East Sumatera

during the colonial era by Netherlands.

One of the contributors to the high number of

epidemics and death rates in East Sumatera was the

condition of labors-plantation's life and

environment. Many cases of unidentified epidemics

occurred at the end of 19

century until the early of

. The most common epidemics were tropical

diseases. The hygienic issue in working area was the

main cause of spreading epidemics. The diseases

caused by dirty environment and poor sanitation

were cholera, dysentery, typhus, and malaria. Poor

quality of environment and sanitation was the

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

1134

consequence of unsuitable labors’ residence at

plantation era during pioneering time, so it caused

many infectious diseases and became an epidemic at

the end of 19

century (Kouwenaar, 1936). Another

factor was tropical climate which was unusual for

Chinese labors and vulnerable body condition to

disease also accelerated the spreading of epidemics

among plantation labors.

In 1891, cholera appeared an epidemic causing

high death rate in East Sumatera cholera. The source

was from Chinese labors that entered East Sumatera

massively (Snijders, 1921). Besides cholera, the

disease that spread in East Sumatera at the end of

century was beriberi. This disease attacked

labors in plantation because of bad condition of food

and nutrition. This situation happened a lot in the

early of plantation opening, so the spreading of

disease became faster. This situation was also

generated by many companies that were not aware

to labors' health issue since they were only focused

on getting high profit specifically from a plantation

organized personally (Donath, 1945). The next

epidemic occurred in East Sumatera and even in the

Dutch East Indies’ region was commonly influenza

pandemic. In East Sumatera, influenza pandemic

had generated the death of population about 2.027

people (Vervoort, 1921).

In addition to epidemic, the tropical climate in

East Sumatera actually could cause the diseases

which did not find in this area previously. Those

diseases were dysentery, typhus, hookworm

(ankylostomiasis), malaria plague, smallpox,

pneumonia, tuberculosis, fever, meningitis, and

leprosy (Kouwenaar, 1936). Several diseases were

not only generated by unhealthy and unhygienic

environment, but also poor residence and dietary

habit could produce dysentery, typhus, malaria,

hookworm, and plague (Schuffner, 1914).

Epidemics and the disease spreading in East

Sumatera had been the source of high death rate at

the turn of the 19

century to the 20

century.

According to Kouwenaar, a doctor who was on duty

in plantation, the factors generating the diseases and

epidemics was the expansion of plantation area,

specifically the forest and it caused environmental

changes which had “bad effect” than before.

Another factor was demography change through

massive labors recruitment and natives' migration

from other areas arriving to this region to seek life.

Those situations had produced a considerable

increase in demographics, therefore; it impacted on

the change of health quality (Kouwenaar, 1936).

Based on those two factors, two issues were

obtained namely hygienic and sanitation issue which

were crucial health issues at the 20

century.

In responding to the health issues in East

Sumatera, the plantation companies and government

did various endeavors in maintaining people’s

health. One of the endeavors was by upgrading the

healthy facility in this area. Then, this effort was

realized by constructing several hospitals and

placing medical team or doctors in that hospital. In

its progress, there were an increasing number of

hospitals and on-duty doctors. In 1910, there were

22 hospitals and 23 doctors and in 1930, there were

47 hospital and 53 doctors on duty (Kouwenaar,

1936).

According to W.A. Kuenen's, a doctor in

plantation, states that health maintenance is mainly

addressed to labors in plantation. This was because

the labors' conditions were very apprehensive. The

amount of labor in plantation was 120.000 people in

1900s. The cost incurred by plantation entrepreneur

for the maintenance of labors were about f. 7,- to f.

9,- for every year. According to the calculation then

the incurred average cost for labors' health

maintenance in plantation f. 960.000,- per year

(Kuenen, 1910).

Hygien and sanitation issues in East Sumatera

are included as one part of health issue that quite

consumed Netherlands' attention at the end of 19

century until the early of 20

century. For that

reason, several policies and regulations were made

by government in collaboration with plantation

entrepreneurs to overcome that issue by constructing

hospitals' facility and providing the doctors and

other medical teams. Moreover, there was a policy

made in order to overcome health issue in East

Sumatera i.e. establishing an institution or research

institution to conduct studies, as the place of disease

study and topical health issue in the Dutch East

Indies situated and centred in Medan – as the heart

of plantation area – since the location was in Medan

then that institution was labeled as Medan

Pathological Laboratory.

5 PATHOLOGICAL

LABORATORIES

Entering the 20

century, the development of health

issue increased more and more in East Sumatera.

The health issue was not only as a burden for

government but also for plantation entrepreneurs. In

the previous discussion, it had been elaborated that

the various factors affecting health issue were a

massive migration, a worse environmental change,

hygien and sanitation issue in East Sumatera. For

responding and solving those numerous problems,

then, in 1906, health institution was established

namely Medan Pathology Laboratory.

This institution was initiated by two functionary

plantation entrepreneurs those are Van Vollenhoven,

The History of Medan Pathological Laboratory in 1906-1942

1135

the chief of Deli Administrator Maatschappij and

C.W. Janssen, the director of Senembah Matschappij

Company and Medan Tabak Matschappij (Alkema,

1929). At the time of its establishment, this

institution was led by a doctor, who was on duty in a

plantation company namely Senembah

Maatschappij. The doctor is dr. W.A. Kuenen. He is

the one who put the principles of institution and

policy direction of this laboratory. In addition, he

also contributed much in a study about tropical

disease which infected many labors in plantation

(AVROS, No. 358). Along with W.A.P. Schuffner,

they discovered the correlation between the

environmental condition and the cause of a disease

or epidemic. Some previous researches and policies

were made by them then followed by other

plantation companies (Schoute, 1934). On the other

hand, they also had decreased the level of labors'

death in Senembah Maatschappij plantation from

136 death cases of every 1.000 labors in 1891 and it

became 10 death cases of every 1.000 labors in

1906. They applied several policies and regulations

such as maintenance of hygiene in barrack and

labors' residence, concerning on nutritious and

adequate food, and treating a sick labor with good

facilities and infrastructures such as hospital and

clinic in plantation (Schuffner and Kuenen, 1910).

Pathological laboratory had aim to spread widely

and give information about public sanitation issue in

East Sumatera. Besides, the propaganda of health

and hygienic life style was shared. That laboratory

was functioned to help doctors or medical experts

conducting research in this laboratory. In addition,

this laboratory also provided help to the doctors in

conducting a research. Therefore, this laboratory

would have qualified doctors in bacteriology and

serology. There were several activities done in this

laboratory such as prophylaxis vaccination (disease

prevention), treatment therapies and preparation of

diagnosis of disease cases (AVROS, No. 358).

Pathological laboratory is a medium to conduct

research and to diagnose various tropical diseases

existed in East Sumatera plantation at the end of 19

century. The research in it was done in order to find

the cause of a disease, the correlation between

symptoms and the environment with the epidemics

of disease in one region specifically plantation

(Volker, 1928). In its development, this institution

improved gradually. The improvement could be seen

from the number of conducted researches was 1.311

in 1910, and the highest improvement occurred in

1930 become 30.372, but it got downtrend in 1934

which became 28.553 (Kouwenaar, 1936).

In the early stage of operation of this laboratory,

all administrative activities were entirely supported

by the company of Deli Maatschappij, Senembah

Maatschappij and Medan Tabak Maatschappij.

Gradually, along with the development, there were

many plantation companies, private plantations, and

plantation hospitals turned to be the members of this

laboratory. The contribution of the members was to

give donation or membership fee every month. In

the period of 1909-1920, it was recorded that 45

plantation companies were the members of Medan

pathological laboratory (AVROS, No. 358).

The number of members progressively increased

particularly from rubber plantation companies. Each

member donated fund to this laboratory. The

calculation of contribution was based on the large

number of labors in each plantation. The plantation

which was the member of institution was obliged to

pay contribution fee of f. 0.50 for each labor per

month (Wolff, 1930). Except the contribution fee,

there was a contribution from Netherlands colonial

government. In 1918, Netherlands colonial

government issued a policy to assist operational cost

for the institution by giving f. 500 every month

(AVROS, No. 358). The next stage, operational

budget escalated every year. And then, the

management and distribution of the operational

budget of the institution was controlled by

governmental health institution namely BGD

(Burgerlijken Geneeskundige Dienst) (Alkema,

1929).

On 1

November 1920, there was a transfer and

collaboration occurred between laboratory

institution and plantation entrepreneur association

i.e. DPV (Deli Planters Vereeniging) and AVROS

(Algemeene Vereeniging Rubberplanters ter

Oostkust van Sumatra). This transfer was continued

even though the plantation condition was less

profitable in recent years. By this transfer, it caused

a change in the formation of the institution's

management, so the policy issued also changed

(AVROS, No. 358).

In the organizational structure of the institution,

it incorporated the board of directors which was in

1921 consisting of 2 representatives from DPV, 2

representatives from AVROS, and 1 person was the

director of laboratory institution. Moreover, the

institutional structure comprised of the director, the

vice director, laboratory doctor, assistant of

bacteriology and serology department, and the

secretary. Besides the organizational hierarchy

which mostly consisted of Europeans, there were

also staffs and employees from the natives

positioned as foreman, laboratory staffs, assistants,

attendants, office clerks, photographer and drivers

(AVROS, No. 358).

The first director was dr. W.A. Kuenen who was

on duty in the period of 1906-1916. During his era,

the organizational structure and institute's duty were

assisted by vice director dr. J.J. van Loghem starting

from 1908 to 1909 and then dr. H. Vervoort in

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

1136

starting from 1913 to 1914. The assistant of

bacteriology and serology department was held by

J.v.d. Bosch (1909-1912) and P. de Haan (1915).

Meanwhile, the doctors who conducted researches in

the laboratory were dr. J.J. van Loghem (1909), dr.

H. Vervoort (1910, 1913-1916), dr. N.H.

Swellengrebel (1912), dr. M. Bluml and the

plantation doctors were dr. N.H.v.d. Heyden (1913),

E.P. Snijders (1914-1921), a plantation doctor

namely dr. E.v.d. Velden (1915), dr. I.W. Holm, a

plantation doctor namely dr. A. Klett, and three

government native doctors were dr. Abdul Mochtar,

dr. Andu, dan dr. Moh. Sjaaf (1916) (AVROS, No.

358).

After dr. W.A. Kuenen, the next director of

laboratory was held by dr. H. Vervoort in 1916-

1921. Then, the vice director position was held by

dr. E.P. Snijders in 1920-1921 and the assistant of

bacteriology and serology department was held by

dr. P. de Haan (1917-1921), and the doctors working

and conducting researches in laboratory were dr.

R.V. Vollenhoven, dr. O. Imhoff, dr. P.P. Leendertz,

and two government native doctors namely dr.

Sitanala and dr. Raden Pratomo (1918), and four

plantation doctors namely dr. G.W. Pott Holstede,

dr. K. Surbek, dr. E.R. Luyken Roskott, and dr. J.

Feilzer (1919) (AVROS, No. 358).

In the work and research sharing, those were

coordinated entirely by director as the person in

charge of the institution. But, in 1916, there were

some working adjustments implemented by the

institution such as the activity of bacteriology

department, anatomical pathology, and the

supervision of chemical analysis were responsible to

dr. E.P. Snijders, while serology department activity,

vaccination preparation, and cleanliness were

responsible to the director of institute was dr. H.

Vervoort (AVROS, No. 358).

In addition to these internal activities done by

personnel of pathological laboratory institution, the

staffs or doctors conducting research in the

laboratory also did external activity such as

representing various activities i.e. conducting

researches, attending health congress, eradicating the

diseases and others. Some other activities took place

in 1909, the vice director, dr. J.J. van Loghem

represented the institution to attend Bombay Health

Congress in India. In 1913, the director of institute,

dr. W.A. Kuenen gave a lecture about health issue

and handling of amoebic dysentery disease

representing Medical Community in the Dutch East

Indies in Far East Tropical Health Associations

Congress which was held in Saigon. In 1915, dr.

Vervoort along with the director of the Public Works

Department Gemeente Medan, J. Hogervoorst

conducted a working visit to Singapore and the State

Government of the Malay peninsula to conduct a

study about waste disposal and incineration issue

and also some other issues such as urban hygiene

and sanitation issue. In the same year, the director of

institute, dr. W.A. Kuenen a conducted an official

trip to conduct a study about health to Java Island.

Health issue which was studied by him was plague

epidemic issue in Java Island (AVROS, No. 358).

In the early of 1919, dr. Vervoort was assigned

by the head of Public Health Service Inspectorate to

do a further research and study about the

improvement of houses, barracks, warehouses, and

settlements to Java Island. This thing was done after

considering the causes and risks of plague epidemics

which were most in that environment. In addition, he

also got specific order from entrepreneurs

association in Deli related to this issue by visiting

and doing further investigation in the plantation

office and labors' houses. This policy was in line

with the reorganization of health and sanitation

management throughout the plantation region

(AVROS, No. 358).

In November 1919, dr. Vervoort conducted an

investigation to Java Island through the command of

the ADEK (Algemeen Delisch Emigratie Kantoor)

board of director or Deli General Immigration

Office. In his visit, dr. Vervoort was assigned to

ensure that the cause of disease and high number of

mortality due to influenza amongst the immigrant

labors in Java and to identify the steps to improve

the health condition of labors in plantation. The step

done was to re-examine the labors recruited by DPV

and AVROS in Medan. It is coordinated with the

ship's doctor and the doctor at the gathering place of

labors (Hong) in Deli (AVROS, No. 358). This step

was also applied as a precaution to avoid the

spreading of influenza epidemics widely.

Pathological laboratory institution improved

rapidly from time to time, it could be seen from the

number of this institute’s members. In 1929, the

number of members had reached 414 plantations

with 327.200 employees. The details of members

were 93 members from DPV, 278 members from

AVROS, and 43 members from other organizations.

At that time, the operational cost also reached f.

175.232,58. The total of operational budget already

included the contribution fee or subsidy from

Netherlands colonial government which reached f.

12.000 (Wolff, 1930).

6 CONCLUSIONS

Medan Pathological Laboratory established in 1906

was an influential health research institution

concerning on health issue specifically in East

Sumatera. The establishment of this institution was

The History of Medan Pathological Laboratory in 1906-1942

1137

initiated by plantation company especially NV. Deli

Maatschappij, NV. Senembah Maatschappij, and

NV. Medan Tabak Maatschappij. The purpose of

this institution was to be a medium of place to

conduct research and to diagnose various tropical

diseases existing in the plantation of East Sumatera

at the end of 19

century. The research was aimed to

find the cause of a disease, the correlation between

the symptoms and environment, and the spreading of

epidemics in a region particularly in plantation area.

Besides that, this institution also shared propaganda

of health and hygiene life style. This institution was

aimed to provide assistance to doctors or health

experts who conducted a study in this laboratory.

This institution had qualified doctors in conducting a

research related to serology and bacteriology.

During its development, Medan Pathological

Laboratory had conducted some researches and

discovery related to disease and health issues in East

Sumatera. The cause and the correlation of what

makes the disease such as cholera, beriberi,

influenza, and etc. had been discovered. Centred in

Medan, pathological laboratory had several facilities

such as research room, library, and houses for

labors. The members of this laboratory were mostly

plantation companies which provided major

contribution to the operation of this laboratory.

ACKNOWLEDGEMENTS

I would like to thanks USU Research Center for

offering grants for this research. This research was

funded by University of Sumatera Utara as stated in

TALENTA Scheme No. 2590/UN5.1.R/PPM/2018,

March 2018.

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