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Liew Kai Khiun

Loh Kah Seng. Making and Unmaking the Asylum: Leprosy and Modernity in Singapore and Malaya. Malaysia: Strategic Information, Research and Development Centre, 2009. 152 pages.


The impression of a leprosy asylum is one of isolation of seemingly contagious patients with repulsive skin lesions away from main population centres. Practically cast away from society, it would be assumed that these inmates would also be abandoned by the forces of history. A former inmate in Singapore’s leprosy asylum at the Trafalgar Home in Buangkok recalled one night during the Japanese military occupation of the island between 1942-45, Japanese soldiers raided the place after a tip off about the existence of a gambling den. A hapless suspect was promptly interrogated on the spot and determined to be guilty.

Ever since they captured the city from the British, the Japanese authorities had in both a demonstration of their presence and efforts to contain disorder from the war, had swiftly beheaded criminal suspects. The same fate was about to happen to the victim, when suddenly the officer realised that his sword would be tarnished by the blood of the leper. He ordered the jaga (local reference to mainly security guard) to get him a tongkat (truncheon). Realising this would also be fatal, the latter provided the Japanese officer with a branch from a tree instead. The branch was use mercilessly on the victim, but he survived (p. 52). This anecdotal episode not only highlights the harsh exposure and the responses of the most stigmatised peoples the forces of history. More importantly, in contemporary Singapore where the word “Buangkok” is associated with that of a subway station, historian Loh Kah Seng intends to give a voice and a history to the former residents of the asylum. In an age of emerging and re-emerging infectious diseases, Loh feels the experiences of these subjects should serve to sensitise societies and governments to be “mindful of how ordinary people are treated, and mistreated, in the campaign against disease and infection” (p. 118).

The recent decades have seen a proliferation of scholarly works on the historiography of leprosy and historians like Edmond Rod have drawn a critical relationship between the framing of the disease and the process of colonialisation in his works on Leprosy and Empire: A Medical and Cultural History (Cambridge University Press, 2006). In this respect, scholars have increasingly recognised leprosy as not just a clinical problem, but one inflected with complex socio-cultural meanings and legacies. As such, it deserves not only to have its own history, but it should be an integral part of every society’s past. This historiographical consciousness also explains the driving force behind Loh’s research.

More than just a clinical description, Loh illustrates the intimate relationship between leprosy, developments in modern notions of diseases and contagion and the operations of British colonialism. While leprosy had been familiar to the non-Western world for centuries, it was the modern notions of bacteriology that the disease was classified as a contagious pathogen by the 19th century. Although stigmas did exists in pre-colonial societies, it was under Western colonial governance that witnessed more systematic and institutionalised efforts in identifying, segregating, quarantining and treating people with the disease, leading to the birth of the modern leprosy asylums.

Aside from the Trafalgar Home in Singapore, the legacy of leprosy in British Malaya can perhaps be located in the asylums established in Sungei Buloh near Kuala Lumpur and Palau Jerejek, an island off the coast of Penang. Physically fenced off by barbed wire installations and armed guards, the layouts and regimentations of these leprosariums were little different from prison camps. In spite of being seen as negatively dissimilar to the wider mainstream public, it is interesting to note that not only the demographic composition. With schools, temples and recreational facilities, the religious and cultural practices of these inmates closely paralleled that of the world which had systematically shunned them.

What distinguished Loh’s work has been his ability to vividly reconstruct the social conditions of the leprosariums as well as the experiences of actual former residents through his oral interviews. Those doing historical research on disease in the colonial context would find that this is a difficult undertaking, particularly for illnesses that carries a deeper social stigma. To begin with, the collective memories of these marginalised peoples as dignified and autonomous subjects are often given scant recognition by institutions that would often regard them as medical statistics. Added to this, locating and gaining the trust of these survivors at the social peripheries would also be daunting for prospective researchers. The graphic and voluminous accounts collected by Loh here reflects in turn the confidence and trust that his subjects had for him, feelings that must have involved substantial efforts on the part of the author. Part of his emphasis on reaching to the subjects personally comes from his inclinations to go beyond official records that have tended to reduce their subjects into faceless statistics and pitiful sufferers. From these accounts, he has pieced together more vibrant narratives of the painful memories of separation and dislocation from families, active and passive resistance of the medical regime, as well as the continued battle against the lingering social stigmas even leprosy is no longer seen as a dangerously contagious disease.

Another outstanding aspect of Loh’s study has been his refusal to fall into the ideological claims of both modern science and the progressivistic claims of the contemporary nation-states of Malaysia and Singapore. From his findings, both supposedly “rational” Western biomedical sciences are as guilty as well as “superstitious” vernacular folk healers were guilty of misdiagnosing and mistreating patients suspected with leprosy. On a broader macro scale, attempts by the postcolonial officialdom to spread the fruits of development in rehabilitating former inmates to new modern concrete buildings became another form of arbitrary and traumatic displacement from one set of walls to another.

In sum, for both academia and the general public, Loh’s historical study becomes a critical reminder of the necessity in looking at the past from not just sultans, colonial administrators and prime ministers, but those from the very margins of society.


Liew Kai Khiun obtained his B.A (Hons) and M.A. from the National University of Singapore, and was awarded his doctorate by the Wellcome Trust Centre for the History of Medicine at University College London. Among his main research interest has been that of medical history in British Malaya. He has just edited a book on Liberalising, Feminizing and Popularising Health Communications in Asia (London: Ashgate 2010). He is currently at the Wee Kim Wee School of Communications and Information at the Nanyang Technology University.


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