The Jakarta Post
In good hands: A photo taken in 1939 shows a dormitory with sanitary facilities at the children's ward of the Central Civil Hospital and Medical (CBZ) in Batavia, now Jakarta. The hospital had a separate building to treat dysentery patients. (Common Wikimedia/Tropenmuseum)
The capital city is not a newbie when it comes to deadly epidemics, having experienced several in the span of about 400 years, most caused by poor public health and sanitation.
Jakarta has recorded more than 6,800 cases of COVID-19, more than other regions of Indonesia.
On May 27, the number of patients increased by 137 – a new spike after four days of seeing the curve descending. Of those registered as COVID-19 positive, 2,043 patients were still being treated at hospitals, while 2,584 others were self-isolating.
Both while the city is struggling to flatten the curve of infections, COVID-19 is not the first pandemic to hit Jakarta.
Ancient Javanese manuscript Babad Nitik Sarta Cabolek holds a story that boasts about the greatness of Sultan Agung of Mataram, the Islamic kingdom in Central Java in the 17th century. It says that the sultan flew to Mecca every time for Friday prayer and that he once had tried to secure a spot for his grave next to Kaaba.
When his request was rejected, he got his sultana to send a plague, but the Kaaba imams tackled it with prayers. To stop the conflict, Sunan Kalijaga – one of the “nine saints” who disseminated Islam in the archipelago – stepped in. He threw a handful of soil from Mecca to Java, proclaiming that it would land in the future resting place for the kings.
The soil landed in Imogiri hill, the Royal Graveyard, where Sultan Agung was buried in 1645.
Some parts of the story were exaggerated to generate fear and respect for the sultan, especially because history recorded the death of Sunan Kalijaga a century earlier.
In a less mythical story, Sultan Agung did cause a plague by blocking the river and planting animal carcass in the water while invading Surabaya. He used the same strategy to paralyze Batavia – now Jakarta, which was occupied by the Dutch East India Company (VOC). Both attacks in 1628 and 1629 failed.
There was also speculation that Sultan Agung died of an endemic disease, as he was absent from the throne for three years.
As historian Adolf Heuken explains in his book Historical Places in Jakarta, “half of the Mataram army died of hunger, diseases, fatigue, punishment, and the Dutch bullets”.
Historian Yahya Andi Saputra, the co-founder of Betawi Kita – an organization of Betawi community that aims to promote the culture of the native Jakartans, said Batavia suffered a cholera plague soon after the occupation by the VOC.
“As the city was built, a demographic problem arose. There were slums and the dwellers threw the garbage into the rivers and caused cholera outbreaks,” he said during a public discussion held online on April 18 and titled The History of Plagues in Batavia.
“VOC governor-general Jan Pieterszoon Coen reportedly died of a stomach ache in 1629. He was among the high-level officers who fell victim to the plague,” added Yahya.
He further said there were no records of relief efforts until the VOC administration build hospitals for military personnel and European civilians decades later. In 1640, the Chinese community built its own hospital.
In the 1700s, deaths were recorded that were caused by either typhoid fever, malaria, thiamine deficiency, chickenpox or dysentery.
A century later, the administration – which was taken over by the Dutch monarchy – built schools for vaccinators, vaccine laboratories, a medical school and public health office.
“But there is no record of Betawi people or ‘pribumi’, the indigenous people of Batavia, suffering from plagues all the time,” said Yahya. “All efforts and facilities were provided only for people of the higher castes.”
“Pribumi were left with their own devices, so they turned to herbal medicines and shamans to treat hawar or awar-awar,” he added, referring to Betawi’s words to describe a plague.
Archeologist Candrian Attahiyyat, a member of the expert team for Jakarta’s cultural sites, said the first indigenous patient submitted to a hospital was recorded in 1753, although information on the illness was not available.
“The hospital built by the Chinese community was later designated to treat non-European patients and therefore accessible for the indigenous people,” he said.
Candrian said the old Jakarta never fully rested from dealing with different diseases, as cases kept reoccurring.
He said that there was a leper epidemic in the 1600s, and the patients were treated away from the center of Batavia, near the border with Tangerang, Banten. Decades later, the facility was moved to Bidadari islet in what is today the Thousand Islands regency.
“In a digging site on the islet we found hundreds of human skeletons stacked up. Leper is very infectious, so I’m grateful I did not contract it during the digging work. But one of my crew showed symptoms decades after touching the skeletons. The key is to wash hands often.”
He said that only one Dutch doctor had been assigned to treat the leper epidemic in Batavia, who discouraged people to sleep outdoors during full moon or when they were inebriated as a way to prevent contracting the disease.
In the early 1900s, Batavia was paralyzed by cholera, which was closely followed by leptospirosis. The Dutch administration set up quarantine facilities on the islets of Onrust and Kuyler (now Cipir).
Off the shore: An aerial image shows the islets of Onrust and Kuyper (now Cipir) in Thousand Islands regency circa 1925. The islets were designated as quarantine sites for leptospirosis patients. (Common Wikimedia/Tropenmuseum)
According to Candrian, a health check for newcomers and the wide use of disinfectant were also enacted during the epidemic.
The deadliest plague was malaria, which was first recorded in 1733 and reappeared in 1939. The second wave killed thousands and was reported by foreign media.
“The endemic only occurred in the northern coastal part of old Jakarta as the city was developing by conversing the mangrove forest into a settlement, port, and fish ponds. The neglected ponds became breeding grounds for mosquitoes carrying the parasite,” said Candrian.
Although malaria was known as a disease endemic to tropical regions, Candrian suggested that the diseases that hit Batavia were mainly caused by the people’s poor sanitation and the lack of a public health system.
“Other factors were that Batavia was a port city and open to migrants and visitors, so epidemics were inevitable,” he said.
The widespread diseases, according to Candrian, temporarily changed the culture of the local people as they could not shake hands, hold mass prayers or throw gatherings for festive events.
“After an epidemic fading away, the Betawi people could also easily return to their old habits, including neglecting sanitation. To deal with the current pandemic, we should continue practicing good sanitary habits to keep the Betawi culture alive and to save the lives of our community and this nation.”
The last speaker in the discussion, Betawi physician Sibroh Malisi, said the causative agents of the diseases that had hit Jakarta since old times still existed, but changes in people’s sanitary habits could keep the number of cases low.
“We’ve learned that viruses can evolve into new strains. The current pandemic should be seen as a challenge to develop the country’s research institutions and virology science, while making good sanitary habits a new culture and prioritizing public health.”
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