Tuberculosis in Malaya - the Early Days

At the end of the 2nd World War, when the British returned to Malaya, tuberculosis ranked as the biggest single killer, and the cause of the most suffering in our country.

For the next 15 years tuberculosis continued to be the biggest health problem in Malaya.

By the year 1957 conservative estimates put the prevalence of infection amongst children at 25% at the age of 5 years, 50% at the age of 10 years, and 75% at the age of 15 year.

Tuberculosis is usually a disease of townsfolk or urban communities, but in Malaya the rural areas were affected almost as seriously as the towns.

The prevalence of tuberculosis even among the aboriginal population was found in surveys to be as high as in towns.

Rural folk particularly in Kedah and the east coast states had an incidence almost as high as was found in slum areas of our cities and towns. Malays, Chinese and Indians contracted this disease with equal facility and spread it as readily. Rich and poor alike were prone to it.

More than a quarter of the hospital beds were occupied by tuberculosis patients, most of whom were in an advanced stage of the disease. Advanced chronic cases for whom little could be done occupied the available beds for several years , and early treatable cases were turned away for lack of accommodation. There was a long waiting list of in all hospitals of tuberculosis patients clamouring for admission.

  What was appalling was the total indifference of the Colonial Government’s Medical Services to this alarming situation.

In the absence of any effective Government action, a band of civic-minded community leaders decided to take upon themselves the task of starting a country-wide anti-tuberculosis movement, and formed the Malayan Association for the Prevention of Tuberculosis (MAPTB).

The Malayan Association for the Prevention of Tuberculosis (MAPTB) was launched in Kuala Lumpur on 27th June 1948.

For the newly formed Association the message was loud and clear. The following actions were required as a matter of the highest priority.

1. Provision of more TB beds for the ‘treatable’ TB patients.
(Nearly 25% of all hospital beds were occupied by tuberculosis patients, but these patients were advanced chronic cases. There was an urgent need to have more beds for treatable cases.)

2. Provision of better diagnostic facilities in the hospitals.
( In order to pick up cases of tuberculosis early, it was necessary to have more X-ray facilities set up in all hospital chest clinics. Mass miniature X-ray units were also required, as they could X-ray large numbers of patients quickly)

3.Construction of isolation hospitals (sanatoria) for the ‘infectious incurable’ TB cases
(This would enable hospital beds to be freed for treatable cases.)

4. Construction of sheltered workshops for the ‘infectious chronics’.
(To give employment to chronic cases in surroundings away from the public)

5. Provision of a TB Treatment Allowance and Dependants’ Relief Scheme.
(To ensure that poor and needy tuberculosis patients undertook their full course of treatment.)

For the next thirteen years MAPTB was the sole champion of the anti-tuberculosis movement in the country.

It was only by 1961 that a National Tuberculosis Control Campaign was launched by the Government.

Chronology of the fight against TB in Malaysia

Before Merdeka no organized attempt was made to combat the spread of Tuberculosis in Malaya.
Only those who voluntarily sought treatment in our hospitals were given treatment.

The facilities for accommodation and treatment for these cases in our hospitals were grossly inadequate.

All hospitals were embarrassed by the number of cases who sought treatment. There was a long waiting list of cases seeking admission.

Most TB patients in hospital were in an advanced stage of the disease requiring long- term care.

In order to appease the public clamour for action, experts were invited to study the TB problem and to recommend measures for its effective control. All their reports and recommendations were neatly filed away and never disclosed to the public.

During the 10 years, 1947 to 1957 the risk of healthy individuals contracting tuberculosis increased fourfold.

In 1957, with the coming of Merdeka, our elected Government had a greater sense of responsibility for the well being of our people.


One of the first steps taken by the Ministry of Health after the general election was to create the post at Federal level of a Senior Tuberculosis Specialist who was charged with the responsibility of studying the tuberculosis problem in the country and drawing up a plan for its control. With the help of Sir Harry Wunderly the chief WHO Consultant on Tuberculosis (a recognized world authority on Tuberculosis) a thorough study was made of the existing resources foe the prevention and treatment of tuberculosis.

A report and recommendations were made to the Government and accepted. With the blessing of Government a comprehensive long-term plan for the control of tuberculosis was drawn up by the Ministry Of Health in 1960.

A separate Division of Tuberculosis was set up at the Ministry of Health.

A National Tuberculosis Control Campaign was officially launched in 1961 to eliminate tuberculosis as a public health problem in Malaya, and funds were made available for this programme under the 2nd National 5year Plan for the period 1961-1965.

At long last the serious problem of Tuberculosis started to be tackled seriously.


MAPTB..... the beginning.

On 29th September 1947, a number of concerned citizens from Kuala Lumpur and other States met together at Majestic Hotel to discuss the terrible scourge of Tuberculosis that was spreading all over the country. Each of the persons who came for the meeting had experienced great difficulty in securing treatment for persons suffering from Tuberculosis.

Mr. Khoo Teik Ee (who later became the first President of MAPTB) managed to secure an appointment with Lady Newboult at "Carcosa". At this meeting At this meeting Lady Newboult agreed to interest the Central Welfare Council on the need for voluntary Anti-TB activities to augment Government’s efforts against TB.

It was then decided to set up an ‘association’ (sponsored by the Central Welfare Council) to assist in the fight against TB.

Launch of the Malayan Association for the Prevention of Tuberculosis

On 27th June 1948, a public meeting was held , and the "Malayan Association for the Prevention of Tuberculosis (MAPTB)" was officially launched.

Launching of State Associations

Between 1948 and 1952 all the States had their own Anti-TB associations. Some states like Perak and Johore also established branches at District level.

Here and there

Some anecdotes of MAPTB activities in the past:

Launched in 1948. By 1949 had established branches at districts level.
Established a Tuberculosis sanatorium in Tampoi in 1965 (137 beds).
Established the Johore Anti-tuberculosis Rehabilitation Organization (JARO)
(Tun (Dr.) Ismail was the founder chairman.)

Launched in 1950.
In 1974 MAPTB Penang started their own Moblie X-ray services.

Launched in 1950.
Dr. Mahathir bin Mohamed (then a Senator) was Chairman from 1959 to 1974.
Established the Johore Anti-tuberculosis Rehabilitation Organization (JARO)
(Tun (Dr.) Ismail was the founder chairman.)

Launched in n. Perak also established active district branches.
Established a TB Rehabilitation Centre in Batu Gajah in 1951. By 1971 it had to be closed as the TB situation had improved greatly, and there were no patients seeking admission into the center. In 1975 the complex was rented out to the Help Services Center for the rehabilitation of drug addicts.

Launched in 1950.

Launched in 1952 (SABATA)

Special Note

Dato Sir Clough Thuraisingham was the longest serving President of the MAPTB (28years).

A Diagnostic Center established by MAPTB in Setapak in 1963 was named after him. It had both Static as well as Mobile (mass miniature) X-ray units and played an very important role in the early diagnosis of TB patients.

One of the major activities of MAPTB (Federal and States) in the early days was to launch a major propaganda campaign informing the public about Tuberculosis , how it was spread, and how the public could play a vital role in combating this problem.

A large amount of publicity was disseminated through the press in all the different languages.

MAPTB (with Government approval) started a public lottery to obtain funds for its activities. It used the monies to:-

Build TB wards in Government hospitals, and provide the hospitals with X-ray machines, and laboratory equipment to diagnose TB patients.
Build sanatoriums for long term treatment and isolation of infectious chronic cases.

Start a Treatment Allowance and Dependant’s Relief Scheme to ensure that TB patients would continue prolonged hospital treatment.

During those early days over 3 million ringgit was provided by MAPTB from the monies received from lotteries fund to help finance the above projects.

MAPTB is happy to note that TB has started to decline in some States, with an overall improvement since year 2000 as follows :

1995 11,778
1996 12,902
1997 13,539
1998 14,150
1999 14,908
2000 15,057
2001 14,830
2002 14,389

However, in some States ( Perlis, Kedah, Selangor, Malacca, Pahang and Kelantan ) TB continues to be on the rise.

The Malaysian Association for the Prevention of Tuberculosis at National and at State level have drawn up a plan of action aimed at informing the public of this growing problem. This plan has been endorsed by the Ministry of Health.

The plan of action basically involves the following:-

1. Informing the public of the signs and symptoms of Tuberculosis.

2. Encouraging those with such signs and symptoms to seek early medical advice and treatment if necessary.

3. Educating those diagnosed as having tuberculosis to realize that they must undertake the full course of treatment, as advised by the doctor, to ensure full recovery.

4. Encouraging close contacts of persons diagnosed as having tuberculosis to seek medical advice.

5. Giving financial assistance to needy TB patients where necessary to ensure that they come for their full course of treatment.

6. Assisting the Ministry of Health in their campaign against TB when requested.