By Leo Van Bergen
At the beginning of the twentieth century, the Dutch East Indies Army gained control of the most northern part of the expansive island of Sumatra, called Aceh. For thirty years the Aceh people had kept colonization at bay, but bloody, murderous campaigns brought them to their knees. The conquest did not put an end to violence, however. One of the paths of resistance adopted by the Acehnese was a series of suicide attacks against Dutch residents, which became known as the ‘Aceh-murders.’  These attacks were intimately connected to the history of leprosy in the region, and offer an insightful avenue into the role of medical discourse for Dutch colonial administration.
For the colonized, resistance against the Dutch was an endeavor of religious significance. Opposing the Christian oppressors was a matter of Holy War in the eyes of the largely orthodox Islamic Acehnese, and martyrdom a legitimate avenue to achieve this. The Dutch authorities, by contrast, framed the attacks as the actions of psychologically disturbed individuals. Killings were explained away as symptoms of a condition related to the well-known ‘amok,’ a term used by the colonial authorities to refer to acts of killing at random without provocation. ‘Amok’ was portrayed as typical behavior of the so-called ‘autochthonous races,’ a pathological manifestation of their inability to control emotions and behave rationally. The challenge for the Dutch in the case of the Aceh-murders, however, was that the killings had been consciously planned, while ‘amok’ referred to a form of spontaneous frenzy.
Leprosy sufferers played a significant part in these killings. In 1914, the Dutch Algemeen Handelsblad (General Trade Journal) reported that ‘again’ attacks by Acehnese leprosy sufferers had occurred. In 1917 a soldier was heavily injured after an attack by a leprosy sufferer, and in 1918, the same occurred with a military doctor who died from his wounds. In 1917, a veteran of the Aceh-wars declared in the Sumatra Post that the killings were closely related to Islam and were nothing less than a suicide attempt in the hope of taking several Dutch lives in order to achieve martyrdom. However, he added, ‘this horrible disease called leprosy’ was often a contributing cause. By seeking death in the fight against the Dutch infidels, the lives of these leprosy sufferers would perhaps find meaning, so the veteran believed. Religion and illness had, he thought, become a dangerous combination.
In 1920, the psychiatrist F.H. van Loon extended this hypothesis. He was the first Dutch doctor to point out reasons besides religion and a racially-determined inclination to mental instability for the attacks. He argued that abuse of alcohol as well as opium, and illnesses such as malaria, framboesia and syphilis were causes. He also agreed with the Aceh-veteran that leprosy was a possible cause for these martyrdoms.
The suggestion of a connection between leprosy and the Aceh-murders was picked up in 1923 by J.J. van Lonkhuyzen, the head of the Dienst Volksgezondheid (Public Health Service). Lonkhuyzen hypothesized a relationship between leprosy and madness, which could manifest as a ‘fanatical religious conviction’. This connection, he argued, might explain the part played by leprosy sufferers in the ‘numerous murders on non-Acehnese.’ Due to their status as social pariahs, leprosy sufferers stood an even greater chance of becoming involved in activities of religious fanaticism. In their state of mental imbalance, Lonkuyzen explained, they were more susceptible than healthy Acehnese to believe they would reach heaven by killing infidels. Lonkhuyzen therefore concluded that the battle against leprosy in Aceh was of the utmost importance in the fight against madness, and ultimately, in the battle for colonial stability.
In September 1928, all inmates of the leprosarium at Agoesan, both male and female, were reported to have attacked a nearby military camp. With around 70 inmates, Agoesan was one of the largest of 19 leprosaria at Aceh. The establishment was placed in the area of Gajoe Loeös, at the eastern coast of Aceh, the location where Dutch soldiers had waged bloody attacks during the last years of the war. After a failed attempt by a government official to ‘ease the emotions’, the murders at the military camp had taken place. Soldiers opened fire on the attackers, who were described as being in a state of ‘mental frenzy’ and many were killed.
In accordance with Van Lonkhuyzen, a comment in the Nieuwe Rotterdamsche Courant (New Rotterdam Paper) explained away this attack by pointing out that the Acehnese, to an even greater degree than inhabitants of the Dutch East Indies generally, were susceptible to sedition by fanatics wanting them to choose death in the name of a higher cause. This was especially true for leprosy sufferers, the paper suggested. Because Acehnese dealings with leprosy sufferers had always been harsh, it was more than likely that at Agoesan there had been individuals who, ‘in the atmosphere of such a lonely colony filled with miserables’, had riled the locals.
However, in the Volksraad (Peoples Council), it was pointed out that living conditions and treatment at the leprosarium at Agoesan were highly unsatisfactory. This was partly because it was positioned at an almost unreachable spot. According to council member Apituley, the attacks therefore should be seen as a consequence of, and a protest against, harsh conditions. These grievances were also present in other colonies, he pointed out, making chances of repetition considerable. But the official report published after the events in Agoesan only spoke of world-weariness, and the ‘incident’ was portrayed as having little political meaning. It was certainly not considered as a prompt for political change.
As a result of the attacks, Agoesan was closed. The surviving leprosy sufferers were moved to a leprosarium nearer to the city of Blangkedjeren, in order to enable, as it was framed, more regular medical care. However, another rational solution, concentration of all the numerous small leprosaria at Aceh, was not considered and decided upon before 1939, although the remainder of the sprawling island of Sumatra only had a couple of leprosaria, containing hundreds of inmates. As a consequence of the Japanese occupation at the beginning of 1942, however, this plan never left the drawing-board.
The Agoesan attacks point to a close relationship between rebellion against domination by Dutch Christian colonizers and a practice to exclude leprosy sufferers in Aceh, not only by the Dutch, but also by the Acehnese themselves. The Acehnese people never fully submitted themselves to military defeat. There is no reason to assume that the leprosy sufferers among them submitted either. Perhaps they were prepared to sacrifice their medically-debilitated lives not so much to end their suffering, or because it had any greater negative effect on their state of mind, but to show their hostile countrymen that they too were true Acehnese who could contribute to the Holy War against the Dutch usurper. If this is the case, it might explain why it took so long before a decision to concentrate the small leprosaria at Aceh was reached. An uprising in a big leprosarium would have been much harder to suppress. Van Lonkhuyzen’s conclusion that the fight against leprosy benefited the fight against madness can therefore be enlarged: Dutch leprosy policy in Aceh was intimately connected to measures against resistance to Dutch rule.
Leo van Bergen is a Dutch medical historian researching the topics of war and tropical medicine. His book Before my Helpless Sight: Suffering, Dying and Military Medicine on the Western Front (Ashgate) was published in 2009 and he is currently writing about leprosy in the Dutch East Indies.
 For the Aceh-killings see: David Kloos, ‘A Crazy state. Violence, psychiatry and colonialism in Aceh, Indonesia, ca. 1910-1942’, Bijdragen tot de Taal-, Land- en Volkenkunde, 170 (2014) 25-65
 Idem, 35-36
 ‘Gemengd’, Algemeen Handelsblad, 15-10-1914, Ochtend
 Handelingen des Staten generaal, Koloniaal verslag 1917, Chapter C3: 11; Idem, Koloniaal verslag 1918, chapter C3: 10
 ‘Overste Veltman’, Indische Gids, 1917, II, 1205-1210: 1209; H.C. Zentgraaf, Sumatraansche Indrukken. Overdruk uit een serie artikelen uit het Soerabaiasch Handelsblad (Soerabaia, z.d.) 277, 282
 Idem, 40-46
 ‘Verplichte opsluiting van leprozen’, De Sumatra Post, 13-11-1923, Dag; Kleiweg de Zwaan, De Lepra, 20
 ‘Atjeh’, NRC, 29-12-1923, Ochtend; ‘Oost-Indië. Een overval door lepra-lijders’, Het Vaderland, 4-1-1924, Avond
 ‘Kroniek. De tragedie in een leprozenkolonie in Gajoe Loeös’, NRC, 25-9-1928, Avond
 Installed in 1918 in an attempt to democratise Dutch East Indian rule. But the council remained largely powerless.
 Handelingen Volksraad, 16-11-1928, 1856; 31-7-1929, 540, 547; 16-8-1929, 1069; 19-8-1929, 1123, 1136; Bijlagen (1928-1929) ond. 75, afd. IV, st. 3: 12; Idem, Bijlagen (1929-1930) ond. 1, afd. V, st. 9: 30, 34; Idem, 31-7-1929, 540: Begroting Nederlands-Indië voor 1930, O&E
 ‘Naar centrale lepra-bestrijding ook in Atjeh’, De Sumatra Post, 11-12-1939, Dag; ‘Nieuwe leprozerie’, De Indische Courant, 5-3-1940, Dag