Health and Medicine in Soekarno Era Indonesia: Social Medicine, Public Health and Medicine Education 1949 to 1967

Abstract

In 1949, newly-independent Indonesia inherited a health system that was devastated by three-and-a-half years of Japanese occupation and four years of revolutionary struggle against the Dutch. The country suffered from an acute shortage of doctors who were mostly concentrated in urban areas where a minority of the population lived. Additionally, the Ministry of Health had to cope with the resurgence of smallpox outbreaks, and endemic diseases such as malaria, tuberculosis, yaws and leprosy. By the early 1950s, the Ministry of Health initiated a number of symbolic public health initiatives that resulted in a noticeable decline of mortality. These initiatives demonstrated to the international community that Indonesia was capable of standing on its own two feet. Unfortunately, by the mid-1950s, Indonesia’s public health initiatives faltered due to a constellation of factors resulting from political differences between Java and the outer islands, political instability, rampant inflation, and corruption. The initial exuberance that characterised the early years of independence paved way for pessimism. This thesis reveals the benefits of linking the historiography of postcolonial Indonesian medicine with political history of the 1950s more generally. The synthesis of these two streams of historiography serves as a useful vantage point to examine how Indonesia’s leadership sought to cautiously balance the country’s ambition of safeguarding its political sovereignty in health with increased openness to international health assistance administered through the channel of UN agencies, particularly the WHO. Indonesian leaders elected to follow what I have characterised as the ‘Bandung approach to health.’ Indonesia adhered to a non-aligned foreign policy without the intervention of either the US or USSR, established Afro-Asian solidarity, and creatively appropriated international assistance in health to reflect the country’s unique demographic and epidemiological requirements.