The story of a coast road

Under the District Surgeon of Klang are two other districts, namely Kuala Langat and Kuala Selangor; the three are commonly known as the Coast Districts of Selangor.At the time I assumed duty, the populations of Kuala Langat and Kuala Selangor,like that of Klang, were suffering from malaria. In the annual Medical Report of the State of Selangor for the year 1899 it is thus described:

During the last two years the Coast Districts have been visited by severe outbreaks of malarial fever. All nationalities have been affected by it, and Government clerks, Tamils and Chinese coolies, and Malay settlers have been equally attacked. … It is difficult to assign a cause for these outbreaks of malarial fever. It was thought at one time that the earth work in connection with road-making, granite quarrying and spreading, might account for the increase of the fever at Jugra in the Kuala Langat District; but it has been found to be equally prevalent on the sea-beach in the Jeramand Kuala Selangor Districts, among Chinese fishermen, where no road work or quarrying operations had been undertaken.

Two years later, writing in his annual report for 1901, the State Surgeon says:

By far the greatest number of cases of malaria were admitted to hospital in the coast districts, which have during the last two and a half to three years been attacked with what may be called a wave of malaria, principally of a malignant type.

The reader will have gathered from the previous chapters some impressions of what this wave of malaria meant to the towns of Klang and Port Swettenham, and of the results obtained in our attempts to control it. It is now time to turn to the wave as it affected the district of Kuala Selangor. Its study there threw a flood of light on the whole malarial problem, broadened the outlook, and had a profound influence on the subsequent anti-malarial policy which I adopted. It convinced me that controlling malaria over wide rural areas, even in low-lying localities with high ground water, and in a tropical country with heavy rainfall, was within the range of practical politics.

North of the district of Klang, etc., lies that of Kuala Selangor. It stretches away towards the N.N.W. for about sixty miles, and is, like Klang district, flat for some miles inland from the sea.

When I assumed duty as District Surgeon of Kuala Selangor districtin addition to that of Klang, I found malaria was very severe. In 1902, being desirous of obtaining as much information as possible about it, I went through the hospital registers for the previous years, and obtained the figures listed in Table 5.1, as far as then possible.

These figures could be no mere statistical vagary. A definite rise in the percentage of the malaria treated at the hospitals during a series of years appeared to me to represent the existence of some definite fact—a phenomenon, the investigation of which was of urgent importance.

The census had shown an increase of 30.7% in the population of the district, and while the increasing population might have accounted for the rise in the malaria wave, it could hardly account for the remarkable subsequent fall. I had no idea to what to attribute the phenomenon, but I thought some explanation might be found in the history of the district. Accordingly I read up all the Annual Reports of the District Officers, and also those of the State Engineers for the previous ten years. The explanation was soon forthcoming. In order to open up the country, to which access hitherto had been possible only by rivers and creeks, Government had constructed a road and bridle tract for a distance of some sixty miles from Klang to Sabak Bernamon the Perak boundary. The road passes through the villages and mukims (sub-districts) of Kapar (10^th mile),Jeram (20^th mile),and Kuala Selangor (28^th mile).

Before the construction of the road the inhabitants had opened up the land at certain places, and malaria was not present to any serious extent. The road interfered with drainage, as there is abundant evidence to show, and it was followed by the outbreak of malaria. The road was put through in the early years of the nineties, and complaints were soon found in the reports of the District Officers, who in no uncertain terms accused it of doing serious damage. Mr. A. Halein his Annual Report for 1897 says:

Javanese who took up land on the Bukit Rotan roadand planted it with coffee which was destroyed by flood water, the drain having been dammed by the Public Works Department to use as a canal for transport of metal, have now most of them planted cocoanuts, as also have many others who hold land on the inland side of the coast road, which, as my predecessor pointed out, acts like a long dam from Sabak to Kapar, as if built purposely to prevent the water getting to the sea.

Stronger evidence could hardly be obtained, but if it was required, it was to be found in an Annual Report of the then State Engineer. Referring to the Klang end of the Klang-Kuala Selangor road, he congratulated the Government on the low cost of constructing the road due to the drain on the inland side of the road having been used as a canal. There is thus evidence that from end to end the road had acted as a serious obstruction to drainage of land on its landward side, and coincident with this there appeared the remarkable increase in the malaria of the district.

Now about the end of the nineties, we find in the reports proposals for a great irrigation scheme for the cultivation of rice in the same district. The first step in irrigation is the provision of drains to carry off water, so that the amount of water on the land may be properly regulated. In 1898 a start was made with the Jeram drainage scheme,but before it was completed all idea of rice cultivation had been given up by the natives in favour of the more remunerative dry cultivation of cocoa nuts and coffee, made possible by means of drainage. More and more land came under this cultivation; the drainage begun in 1898 has steadily proceeded; European cultivation of rubber had spread over the district, and with it the district has become populated by the Tamil coolie, who is non-immune to malaria.

Yet the health has improved steadily. Malaria in serious extent is to be found only in the hilly land as in the Klang district. On the same Bukit Rotan road,where Mr. Halesaid the Javanese coffee was destroyed by flood, a large population is now living practically free from malaria. Dr. J. Lang Niven,who was in charge of the estates there, kindly informed me that of seventy five children whom he examined, only 4 or 6.1% had splenic enlargement, and three of the four children had been on estates in Southern India before coming to Kuala Selangor.

The parts of this district which are drained are now as healthy as any to be found in the country; while the parts still undrained and the hilly land, where Anopheles maculatusis still present, are unhealthy. I think, therefore, we may reasonably conclude that the rise of the malaria epidemic which coincided with the obstruction of the land drainage by the road, and the fall in the epidemic which coincided with the more efficient drainage of the land, were respectively due to obstruction and to drainage.

The preceding was written in 1909. Another ten years have served to prove the correctness of the conclusions reached in 1903. The following extract published in that year seems worth reprinting [8,9]:

This sudden decrease in the amount of malaria, as a result of draining comparatively small areas [Klang and Port Swettenham], is in striking contrast to the gradual decrease, the result of the draining of Kuala Selangor district. In that district the population is scattered along the coast for many miles. The road runs parallel to the coast about a mile inland, and when first constructed acted according to the official reports of the district officers, as a dam preventing the land from being drained.

After giving the table of malaria treated from 1895 to 1902 inclusive, I continue.

In 1898 a start with extensive drainage works was made. The first result of the introduction of the labour force was further to increase the amount of malaria. The work has, however, been steadily pushed on, and the result has been a steady fall in the amount of malaria as the drainage works became effective. This, I think, forms an interesting contrast to the results obtained in Klang and Port Swettenham.

The next chapter will show how soon the idea of controlling rural malaria was to bear fruit.