During almost 200 years of VOC rule, the number of hospitals and their geographic dispersion has known a remarkable course. At least 19 hospitals were founded and the medical provisions in terms of pharmaceutical facilities, finances and personnel had grown accordingly. So, compared to other colonies, the Netherlands Indies took care of its personnel in a generous way, not economizing on the budgets of health care institutions. Still, looking at the vast archipelago, the hospital dots on the imaginary map were scarce and by no means appropriate for the people living there. But then, it had never been the intention of the VOC and the High Government to meet the health care needs of the indigenous population. At home, in the Netherlands, there were no Government initiated health care institutions for the population either. But unlike the home situation, in which the church and charity organizations were called to take responsibility, in the Netherlands Indies there were no such provisions, except for a few Chinese institutions and the Batavia hospital of the Deacons. In general, the indigenous people did not yearn for such provisions either. They seemed content with their traditional ways of taking care of health problems. And so it did not look selfish or inappropriate that the VOC and the High Government took this care exclusively for its personnel, for its civil servants, soldiers and sailors. Besides, for the local population there was no reason to envy the Dutch people enjoying their hospitals, as these not rarely led to a grave-yard.
Whilst the VOC was approaching the end of its existence due to unbearable debts, the investment in the hospitals in terms of improvement of buildings and budget increases was remarkable. For a part this increase was unavoidable in view of the ever increasing number of soldiers, sailors and craftsmen who needed to be hospitalized.Van der Brug calculates the higher expenses due to the necessary recruitment of new personnel and the increased hospital expenditure to be 900,000 guilders a year.
A few additional findings:
In spite of all the efforts and of many reports concerning the death rate, magistrates nor doctors nor chirurgijns arrived at explaining why the state of health of Europeans was so deplorable and the death lists of the hospitals so endless. One of the comments blamed the way the hospitals had been built and made reference to the way the Paris Hôtel Dieu was rebuilt and organized after a recent fire.
Looking at the situation in British India: the number of civil hospitals was only two: one at Madras (1679) and one at Calcutta (in 1796). Only from about the second half of the 19th century a substantial number of small hospitals and dispensaries was called to life. In 1785, medical departments were set up in Bengal, Madras and Bombay with 234 surgeons. At that time the total number of surgeons in the NI was 281, but 10 years later this number had decreased to 86 (see table 2). The VOC went bankrupt by that time and finished its existence in 1796. The other India companies also disappeared from the world stage. Only the EIC more or less continued, but was already more a vehicle for the government of India than a trade company.
Anyway, in the Netherlands Indies one thing became clear: people left the old town of Batavia. One author, who visited Batavia in 1768 and 1774, describes during his second visit, the decay of the once blooming Batavia: country-seats deserted, whole streets depopulated, houses neglected and their value worth a fourth part of the price paid before. People fled the lower town to settle at a higher place alongside the river. The author foresaw the total ruin of the town. He compared the death rate of Batavia with that of the Outer Islands: 44 % against 11 % for the European population in the years 1768-1769.
With reference to this VOC period, we may recapitulate: In total 19 hospitals were described, of which eight general hospitals on Java (Binnenhospitaal, Buitenhospitaal, Company’s hospital, Deacon’s hospital, Bantam, Semarang, Soerabaya and Cheribon), five in the Outer Establishments (Ambon, Banda, Ternate, Macassar and Padang), three for specific groups (Chinese, Moors and Sailors) and three for special diseases (leprosy at Batavia and on Ambon and rehabilitation at Tji Panas).