Table Of ContentThis fascinating and absorbing book by Kah Seng Loh and Li Yang Hsu is a
classic in the social history of medicine. Drawing on a broad range of archival
sources, including vivid patients’ accounts, the authors use the history of tuberculosis
control in Singapore as a way to highlight key themes in the city-state’s social
and political history, including the development of the state and the shifting lines
of social and economic inequality. This book will be of interest to scholars of
health and society around the world as a richly detailed case study that is sure to
illuminate wider comparisons. As a collaboration between a social historian and
a physician who specializes in infectious disease, it is also a model of interdisciplinary
scholarship.
Sunil Amrith, Harvard University
Tuberculosis – The Singapore
Experience, 1867–2018
Through a rich account of tuberculosis in Singapore from the mid-nineteenth
century to the present day, this book charts the relationship between disease,
society and the state, outlining the struggles of colonial and postcolonial govern-
ments to cope with widespread disease and to establish effective public health
programmes and institutions. Beginning in the nineteenth century when British
colonial administrators viewed tuberculosis as a racial problem linked to the
poverty, housing and insanitary habits of the Chinese working class, the book
goes on to examine the ambitious medical and urban improvement initiatives of
the returning British colonial government after the Second World War. It then
considers the continuation and growth of these schemes in the postcolonial
period and explores the most recent developments, which include combating the
resurgence of TB and the rise of antimicrobial resistance. Throughout, the book
highlights the special difficulties of Singapore as an open port city with a large
multicultural population, discusses the development of specific government and
non-governmental institutions (especially the Singapore Anti-Tuberculosis Associ-
ation), and describes people’s varied experiences, responses and resistance to the
disease.
Kah Seng Loh is an Honorary Research Fellow at the University of Western
Australia
Li Yang Hsu is Head of the Infectious Diseases Programme at the Saw Swee
Hock School of Public Health, National University of Singapore.
Routledge Studies in the Modern History of Asia
143 Lord Salisbury and Nationality in the East
Viewing Imperialism in its Proper Perspective
Shih-tsung Wang
144 Ulysses S Grant and Meiji Japan, 1869–85
Diplomacy, Strategic Thought and the Economic Context of US–Japan
Relations
Ian Patrick Austin
145 Borneo in the Cold War, 1950–1990
Ooi Keat Gin
146 International Rivalry and Secret Diplomacy in East Asia, 1896–1950
Bruce A. Elleman
147 Women Warriors in Southeast Asia
Edited by Vina A. Lanzona and Frederik Rettig
148 The Russian Discovery of Japan, 1670–1800
David N. Wells
149 Singapore – Two Hundred Years of the Lion City
Edited by Anthony Webster and Nicholas J. White
150 Borneo and Sulawesi
Indigenous Peoples, Empires and Area Studies
Edited by Ooi Keat Gin
151 Tuberculosis – The Singapore Experience, 1867–2018
Disease, Society and the State
Kah Seng Loh and Li Yang Hsu
For a full list of available titles please visit: www.routledge.com/Routledge-
Studies-in-the-Modern-History-of-Asia/book-series/MODHISTASIA
Tuberculosis – The Singapore
Experience, 1867–2018
Disease, Society and the State
Kah Seng Loh and Li Yang Hsu
First published 2020
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
52 Vanderbilt Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2020 Kah Seng Loh and Li Yang Hsu
The right of Kah Seng Loh and Li Yang Hsu to be identified as authors of this
work has been asserted by them in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised
in any form or by any electronic, mechanical, or other means, now known or
hereafter invented, including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent to
infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record has been requested for this book
ISBN: 978-0-367-35453-4 (hbk)
ISBN: 978-0-429-33144-2 (ebk)
Typeset in Times New Roman
by Wearset Ltd, Boldon, Tyne and Wear
Contents
Acknowledgements viii
List of abbreviations x
Introduction 1
1 The pauper hospital 10
2 Disease of town-dwelling Chinese 27
3 Houses and races of the colony 44
4 Struggle for a post-war policy 59
5 The Tuberculosis Control Unit 74
6 The action programme 89
7 Laboratory of citizenship 104
8 Newborns and children of the nation 125
9 SATA: The community against TB 141
Conclusion 155
Bibliography 160
Index 167
Acknowledgements
Our book, written by a historian and a physician both from the small island city-
state of Singapore in Southeast Asia, attempts to combine the disciplines of
history and medicine. Forward-looking and successful in many ways, Singapore
is nevertheless grappling with the difficult issue of tuberculosis like many coun-
tries around the world. Like these countries, Singapore also has a long and
largely uncharted history of tuberculosis and tuberculosis control.
We would like to thank the Saw Swee Hock School of Public Health,
National University of Singapore, for providing invaluable support and funding
for the research that made this book possible through the Infectious Diseases
Programme grant. The programme aims to improve the understanding of infec-
tious diseases in Singapore and the region, and ultimately to mitigate their
impact by conducting rigorous research that can be translated into public health
policies and practices. The support for the book, amid the programme’s current
priorities, recognises the role of history towards achieving these goals.
In particular, we would like to express our appreciation and gratitude to the
following persons from the school: Prof Kee Seng Chia, Prof Yik Ying Teo,
Ms Ai Li Quake, Ms Po Jan Chen, Ms Zunairah binti Lukman, and Ms Sharon
Lee. We also wish to thank the staff of the Singapore Tuberculosis Elimination
Programme and Tuberculosis Control Unit, who continue to work towards the
elimination of the threat of tuberculosis from Singapore.
Documenting the history of tuberculosis has taken us to the archives and more
broadly to social memory. We are grateful to the National Archives of S ingapore
for facilitating our research, particularly Mr Eric Chin, Ms Fiona Tan, Ms Gayathri
Kaur Gill, and Ms Abigail Huang, and to our research assistants, Ms Zihan Loo,
Ms Vaani Parameshwari Kiran Chaudhari, Mr V.P. Vishnu Prasad, Ms Teresa
Barre, Ms Siti Nurain, Ms Dafina Kajtazi, and Ms Valentina Jokic.
We learned much from conversations and discussions – academic and otherwise –
with various people, including Dr Nicholas White, Dr Tony Webster, Dr Barry
Doyle, Dr Alistair Martyn Chew, Prof Paul Anantharajah Tambyah, Dr David
Allen, Dr Anita Lundberg, Mr Edmund Arozoo, Dr Heong Hong Por, Mr Yoong
How Hsien, Ms Nur Sakinah Rahmat, Mr Harbhajan Singh, Ms Meeravathy,
Dr Keng We Koh, Dr Kai Khiun Liew, Mr Joo Teng Teh, Mr Dan Feng Tan,
Dr Guo-Quan Seng, Dr Geoffrey Pakiam, Mr Michael Yeo, and Mr Alex Tan.
Acknowledgements ix
We also wish to thank the publishers at Routledge for greenlighting a manuscript
on the history of medicine in Singapore, particularly Mr Peter Sowden, Editor
for Asia, Russia and Eastern Europe, and his publishing and editorial colleagues.
Finally, we are indebted to the individuals whom we interviewed for their
memories and stories, namely Prof Chin Hin Chew, Dr Seng Kee Teo, Prof Kee
Tai Goh, A/Prof Cynthia Chee, Mr Boon H. Tang, Ms Wendy Tan, Ms Pushparani,
and Ms Chew Yin Leong.
Kah Seng and Li Yang
April 2019
