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The Dutch Hospital – Sri Lanka

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Sri Lanka, known as Ceylon till 1972, is an island which was successively occupied by the Portuguese (1505-1656), the Dutch (1656-1796), and the British (1796-1948).
This hospital was built by the Dutch during their period, but a definitive date is not available. A Dutch map drawn in 1732 shows the hospital on its present site, and a description by a German, Christopher Schweitzer, who was in Sri Lanka from 1676 to 1682 in the service of the Dutch, implies that it was already there in 1681

This was the country’s leading hospital during the Dutch occupation. A canal which ran by one side of the building has long since disappeared, and its only memorial is the name of a narrow lane that passes one side of the building, Canal Row. The narrow lane that skirts the building is known as Hospital Street, and perhaps this is the only reminder of its past. It occupies about half a hectare of land, which is a relatively large area in terms of the size of the Fort. The building appears hardly to have changed during the last two centuries. The hospital was located close to the harbour because it was convenient to transport patients from the ships to the hospital. The intention of the Dutch in establishing a hospital in Colombo was to look after the health of the officers and other staff serving under the Dutch East India Company.

Paintings of the front and rear views of the hospital done in 1771 by a Dutch artist were found at the Royal Institute of Language, Country and Ethnology in Leiden by the writer of which the front view is reproduced here.
Its design is simple: it has five wings, four of which are joined to form a square with a courtyard in the centre. The fifth wing constitutes the façade of the building and is situated in front of the square with a second courtyard intervening.
The only part of the hospital with an upper floor is the front wing. However, this first floor is limited in extent, and appears like a compartment sitting atop the roof in the centre of the wing. A wooden staircase leads to this storey, which now has the appearance of a small hall. The flooring is made of wooden planks.

As with other Dutch buildings in Sri Lanka, the walls are over 50 cm. thick and the teak beams that bear the roof are massive both in girth and length. These features of solid construction have undoubtedly ensured the survival of the building. A long and wide open verandah runs along the length of each wing, another characteristic of old Dutch architecture in the tropics. The high walls, large windows, and spacious verandahs provide a comfortable environment within, in contrast to the humid heat outside.
The ornamental shrubs that formed a prominent feature against the rear windows in 1771 are no longer present. The Dutch were adept at building canals in and near Colombo for transport. While some of these canals still exist outside Colombo, those within the Fort were filled up by the British soon after they took over the city, and some of them are now busy motorways.

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Most of the medicines used in the hospital were imported from Europe and other countries, while the rest, such as spices, were obtained locally.
A close check was kept on the medicines, which were kept locked up in special medicine boxes. These boxes were probably imported from Amsterdam at first, but later produced locally. Their keys were kept by the doctor, and without his presence no one was allowed access to them.

The local drugs that were used were mainly spices, such as cinnamon, ginger, and cardamom. It may be mentioned that one of the major attractions that induced the Dutch to conquer Sri Lanka was the availability of spices there. Cinnamon, for example, was grown only in Sri Lanka. Coriander, well known as a diaphoretic in ayurvedic medicine, was another item that figured in the Dutch pharmacopoeia. Towards the latter part of their rule, the Dutch began to appreciate and make use of the superior knowledge of herbal medicines possessed by the local ayurvedic physicians.

The preamble to the instructions issued to the steward of the hospital states that ‘it has been considered that it is a duty of the Company to restore the health of its officers who are on board ships as well as in the out posts’.

A memorandum submitted to the Political Council records that ‘its (the Company’s) invalid officers could be brought back to their former state of health with the blessings of the God only by way of good care and attention…’. With this objective the Company established the considerably large hospital in Colombo especially to provide medical facilities to the Dutch local and floating population as they were subjected to tropical diseases and the sickness that are rife during long sea voyages.
The medical staff of the Colombo hospital at the end of the Dutch occupation consisted of a chief surgeon, a surgeon, three junior surgeons, three third surgeons and five interns. The higher grade surgeons were generally graduates from Amsterdam, Utrecht or Leiden. It was uncommon for ships’ surgeons to be appointed to the hospital and there was no strict rule that only qualified graduates could be appointed as surgeons. The surgeon with the longest service at Colombo hospital was Barend Alleman. He served the hospital for nearly a third of the period of the Dutch occupation (1756-1790). The most famous of all the surgeons who worked in the Colombo hospital was Paul Hermann, who has been described as the father of botany in Sri Lanka. He was attached to the Colombo hospital from 1672 to 1679. His main interest was botany, and except for three plants, all the others he saw in Sri Lanka were new to him. While in Sri Lanka Hermann was offered the chair of botany at Leiden, which he took up in 1680. Although he was acknowledged as a distinguished botanist, he was most unpopular with his patients and subordinates. Schweitzer wrote: “The Chief Inspector that had the care of it [hospital] in my time was Dr. Hermannus, now Professor of Medicine [sic] at Leiden. He took no good praise away with him from the soldiers and seamen that came under his hands. “He was a true tyrant over his slaves, with blows and whippings; he was also accused of killing a female slave whom he let bury [sic] in the garden behind his house, and was for some days under arrest in his house, but was after set free.” Another botanist of repute who worked as a surgeon in Colombo was Nicholas Grimm, a Swedish doctor, who came to Sri Lanka in 1674 and worked under Hermann. He too wrote a book on Sri Lankan plants.

The chief surgeon of the hospital came fairly high in the order of precedence observed at official functions.
The duty of the surgeons was mainly to visit the hospital twice a day, but they were obliged to call on patients in their homes on request, provided these visits did not interfere with their hospital routine. A visit of this nature was recorded by the Englishman Robert Knox, who was held captive by the king of Kandy for twenty years. In 1679, he, along with his fellow prisoners, managed to reach Dutch territory. On their arrival in Colombo, the companion developed fever (probably malaria) Knox wrote, ‘My consort’s ague increased and grew very bad; but the chief surgeon by order daily came to see him, and gave him such potions of physic, that by God’s blessing he soon after recovered.

On special occasions, a surgeon from Colombo was sent over long distance on politically important professional missions, for example, the despatch of Dr. Danielsz in 1739 to Kandy at the request of King Narendrasinha, (1707-39) who was suffering from an ulcer in the leg. Danielsz however, was obliged to beat a hasty retreat to escape the wrath of his royal patient, who disapproved of his treatment.
Junior surgeons were on call at all hours of the night, except those who were married and living outside the city. Unmarried junior surgeons were expected to live close to the hospital so that they were easily available in case of an emergency.
The hospital had on its staff an apothecary, who worked under the medical superintendent and was responsible for dispensing of medicines to an approved pharmacopoeia. In 1786, Alleman recommended that separate quarters be provided for the apothecary and his dispensary. In response, the Political Council, decided to construct or convert a suitable building for the purpose.

The Colombo hospital was served by a considerable non-medical staff including a steward, cook, porter, laundryman and several slaves. Slaves attended to the duties that present day labourers handle. There is no indication that the hospital was served by nurses, male or female. The hospital could accommodate approximately 180 patients who were admitted on a first come first served basis. The patients had to pay a levy which was deducted from their monthly salaries.
This hospital served a large military and sea-faring population in the 17th and 18th centuries, especially for diseases such as dropsy, epilepsy, colds, diarrhoea, fever, scabies and venereal ailments. The leech, which abounded in the Kandyan areas was an enemy of the foreign soldier on the march and an ally of the defending Kandyans. Leech-bites sometimes developed into maggot-infested ulcers, which resulted in loss of limb or life. Malaria was a problem outside Colombo.

The increase of leprosy drew the attention of the Dutch to construct a separate hospital in 1708 in a location in Hendala, a few kilometres away from Colombo by the side of the Kelani river, which could be seen even today.
Several European visitors to Colombo during the Dutch occupation have commended the hospital and its management. Among them, Johan Wolfgang Heydt, a German who under the Dutch East India Company was in Sri Lanka from 1734 to 1737 records in his work that the Colombo hospital had a good reputation.
Another German Christopher Schweitzer states “There is a well built hospital in which the sick Dutchmen are laid and well served by surgeons and slaves with medicants and plaisters’. Captain Robert Percival, an Englishman who stayed in Colombo at the very early days of the British occupation also praised the Dutch hospital in his work ‘An Account of the Island of Ceylon’ published in 1803.

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