Science, Public Health and Nation Building in Soekarno-Era Indonesia by Vivek Neelakantan

Abstract

168 BOOK REVIEWS This book has direct appeal for Antipodean readers too. In tracing the political imaginings of Britain’s imperial medical market, the book offers insight into the changing influence of British medicine and its regulatory authority over former colonies and dominions. This was particularly apparent in the era of decolonisation as Haynes recognises and examines. However, the appeal goes beyond historical interest. According to a recent OECD (Organisation for Economic Co-operation and Development) report, Australia and New Zealand are among the top five contemporary destinations for overseas-trained doctors. Therefore, Hayne’s study has contemporary relevance, provoking reflections on the historical processes through which Australia and New Zealand have constructed who is ‘fit to practise’. FALLON MODY UNIVERSITY OF MELBOURNE Vivek Neelakantan, Science, Public Health and Nation Building in Soekarno-Era Indonesia (Newcastle upon Tyne: Cambridge Scholars Publishing, 2017). ISBN 978-1-4438-8654-3 (HB). 237pp. The post–World War II era was an exciting, yet trying, time for people across the sprawling archipelago east of the Indian Ocean that would become Indonesia. The Japanese invasion of the Dutch East Indies colony in 1942 ended with its ignominious surrender after three years. Two days later, on 17 August 1945, at the urging of young revolutionaries, Soekarno and Mohammad Hatta seized the moment to declare Indonesia’s independence and Soekarno assumed the presidential office. The political, administrative, and military events highlighting Soekarno’s presidency have been well observed. In contrast, the process of redefining public health and science in the framework of an Indonesian nation was more incremental and has been less scrutinised. Vivek Neelakantan’s dissertation-turned-book, Science, Public Health and Nation Building in Soekarno-Era Indonesia, marvelously unveils these processes, setting out how defining the new nation’s public health concerns was an essential part of Indonesia’s consolidation as a distinct, independent polity. Health & History ● 20/1 ● 2018 169 Neelakantan begins by presenting the medical figureheads responsible for the period’s push and pull of paradigms in social medicine issues. His description of their religious and moral stances, experiences in education and training, and the official positions they eventually took illuminates the various (and sometimes contending) principles that inform nationalist approaches to public health in Indonesia. Their influence is still observable and reproduced today. Building on this beginning, Neelakantan subsequently explores how the interaction between nationalist approaches to public health and the influence of global power restructuring (due to the wave of decolonisation and ideological competition between postwar superpowers) manifested in the Indonesian health system. The author elegantly centres this analysis on Johannes Leimena, a multi-period minister of Health and ‘architect of the “Bandung Plan”’(p. 68), an idealistic pilot project in Java’s Bandung Regency for a health governance influenced by principles of rural health. This plan soon unravelled, but aspects of the design withstood the test of time and are still recognisable in the organisational structure of Puskesmas (Pusat Kesehatan Masyarakat, the sub-district community health centre). Another chapter explains the pressures from competing demands for health care, not only geographically but also between holistic (horizontal) and disease-specific (vertical) approaches to public health. The latter, with a technocratic flair, was in part a result of the soft power strategy that the United States—through the United Nations and its agencies—employed in developing countries worldwide to gain moral leadership during the Cold War. Neelakantan uses four cases of disease-specific programs (namely those concerned with malaria, tuberculosis, yaws, and leprosy) to unearth the complex array of successes and failures in the public health arena. To a large extent the public health outcomes were also influenced by the Indonesian regime’s desire to put its own nationalistic twist on these ‘foreign’ programs. Neelakantan also provides readers with an in-depth description of the transformation of Soekano-era medical education in Indonesia. The enterprise had one goal: to produce more Indonesian doctors. Whereas the Dutch medical school lecturers grew increasingly irrelevant, the US medical academics became influential, challenging the few surviving lecturers and the struggling under-prepared students. The heart of this chapter lies in its telling of the micro-tensions within and between the established 170 BOOK REVIEWS and newly...