Quarantine was formally introduced as a public health control measure in Singapore in 1868. It was an important method of disease control before the widespread adoption of vaccination and antimicrobial therapy.1 As a cosmopolitan port settlement, Singapore was particularly susceptible to the import of infectious diseases from abroad. Though this vulnerability was recognised early on, initial proposals to formalise quarantine measures were met with fierce resistance by the mercantile community as they were seen as costly and an inconvenience to trade. With the growing acceptance of quarantine as an epidemic control method in Britain, quarantine was finally introduced into law in 1868.2 To this end, the first quarantine facility was established on St John’s Island in 1874 to screen incoming vessels and isolate the sick.3 Over the years, the ordinance has been revised and reorganised multiple times to reflect new and changing requirements for infectious disease control. The fundamental concepts of the Quarantine Ordinance can be found today in the Infectious Diseases Act, which was first enacted in 1976.4
History of quarantine
Since antiquity, quarantine has been used by various societies to limit the spread of contagious diseases such as leprosy. The word “quarantine” is derived from the Italian term quarantina, which means “40 days”. During the scourge of Black Death that swept through Europe in the 14th century, Venice, a major port for commerce and trade, set up a system to detain ships arriving from infected foreign ports for a period of 40 days. A “lazaretto”, or quarantine station, was also erected on an island close to the city to carry out such inspections. The Venetian model was subsequently embraced by many other European countries, leading to the common use of the term “quarantine”.5
Earliest reference to quarantine in Singapore
The earliest known references to quarantine in Singapore date back to 1821 when the Austrian Consul-General requested permission for a sick Austrian vessel travelling from Batavia (present-day Jakarta) to dock at the Singapore harbour. In a series of letters exchanged between Singapore’s first Resident Sir William Farquhar, the Austrian Consul-General and the medical officers of Singapore, it was recorded that many of the sailors onboard the ship Caroline Augustus were reportedly ill. By this time, the first cholera pandemic that had emerged from India in 1817 had already found its way to Penang, Malaya, Thailand, Indonesia and the Philippines. To prevent the entry of cholera into Singapore, assistant surgeons William Montgomerie and Thomas Prendergast were directed by Farquhar to assess the vessel before its crew were allowed to disembark. The medical officers found that the crew, though recently stricken with cholera morbus, was en route to recovery. They assessed that excluding persons with new infections, it was safe for recuperating sailors to disembark at Sandy Point (present day Tanjong Rhu).6
Differing viewpoints on quarantine in Singapore
Smallpox and cholera were rife in Singapore during the mid-19th century. Despite periodic disease outbreaks in the region, vessels were allowed to enter Singapore’s port without restrictions and quarantine measures were carried out in an ad hoc manner. The lack of proper facilities and qualified staff hindered the strict imposition of maritime quarantine measures. More crucially, the effectiveness of quarantine was not universally agreed on. There were two main schools of thought at the time. The first, based on the theory of specific contagion, held that strict quarantine was necessary to curb the transmission of contagious diseases. The second, based on the miasma theory – an antiquated belief that disease was spread by inhaling foul gases that emanated from decaying matter – maintained that sanitary surveillance alone was sufficient. The latter was less disruptive to trade and commerce and hence the more popular view in Singapore.7
Early attempt on legislating quarantine
In 1857, a smallpox epidemic in Singapore had grown to such a worrying extent that the Municipal Commissioners petitioned the Governor to adopt or legislate measures to prevent the import of infectious diseases from incoming ships into the settlement. They called for arriving vessels to be inspected by a health officer before it was permitted to dock. They also proposed that ships with infected crew or passengers should be isolated until they were declared disease-free. During the period of detainment, contact with these said vessels should also be limited to the provision of medical aid or fresh supply of provisions.8
However, the appeal was turned down by the Governor and Resident Councillor on grounds of the lack of qualified manpower to carry out enforcements and that the scheme would add considerable cost to the running of the port. Any additional expenses would have to be borne by port levies, which had previously been fervently rejected by the mercantile community. The Governor noted that the freedom of the port was a jealously guarded policy by the mercantile community, particularly with respect to the Singapore’s status as a tax-free port and the ease of conducting trade. He also pointed out that medical opinions on the benefits of quarantine were divided.9
Enactment of the Quarantine Ordinance
Conditions in Singapore remained largely unchanged until the 1860s. In 1867, a report with recommendations on maritime quarantine by the British Cholera Commission was published in the Straits Settlements Government Gazette. This report played an influential role in reshaping public opinion on quarantine controls. In the same year, the Straits Settlements, the administrative unit comprising Singapore, Melaka and Penang, became a Crown Colony under the direct rule of the Colonial Office in London. This fundamental change led to the establishment of a Legislative Council, which carried the authority to introduce local laws. Harry Ord, the newly installed Governor who also wielded greater powers than his predecessors, was keen to improve the running of the Straits Settlements.10
Under the new administration, the Quarantine Ordinance (No. 7 of 1868), together with two other laws on public health, the Vaccination Ordinance and the Registration of Births and Death Ordinance, were enacted in 1868. The quarantine bill, which provided for the better prevention of the spread of contagious diseases, was introduced at the Legislative Council on 6 May 1868. It was read for the second time on 12 June 1868 and passed on 22 June 1868.11
However, the order drew protests from two unofficial members of the council, Dr Robert Little and Thomas Scott of the trading company, Guthrie & Co. Their views were echoed by the Straits Settlements Association in London, a lobbyist group comprising former residents who represented the commercial and political interests of the mercantile community in the Straits Settlements. As all ordinances had to be approved by the Secretary of State for the Colonies, the Straits Settlements Association wrote to his office voicing their strong objections on a move that was seen as an interference to free trade. The Secretary of State deferred the matter to the Medical Officer of the Privy Council for his expert advice. As the Colonial Office had previously approved other quarantine papers, the Medical Officer saw no grounds to object the order and the ordinance came into force.12
Implementation of the Quarantine Ordinance
The ordinance continued to draw criticisms in the years following its introduction. To address these complaints, a quarantine station on St John’s Island was set up in 1874, together with a quarantine anchorage established just outside the limits of the harbour for the screening and isolation of infected vessels. The quarantine station on St John’s Island remained in use until its closure in 1976.13 In town, European and Eurasian patients with infectious diseases, such as cholera and smallpox, were treated at the General Hospital and the Asian population at a quarantine camp at Balestier Road within the vicinity of the Tan Tock Seng Hospital. It was not only until 1913 that a proper Infectious Disease Hospital (the precursor to today’s National Centre for Infectious Diseases) was established at Moulmein Road.14
In the early years, it was common practice for contacts of sick persons to be isolated at St John’s Island, placed under house quarantine, or put under medical surveillance at the discretion of the Health Officer. However, public fear of these quarantine measures and the inconveniences they posed to daily life meant that many cases went unreported. In 1912, the government tried to encourage members of the public to come forward by paying those who were quarantined at St John’s Island. The scheme was scrapped after a year due to a lacklustre response. In 1915, the ordinance was revised to exempt healthy contacts of diseased persons from quarantine, on the condition that they reported daily to the Health Officer or an appointed medical practitioner for examination.15
With the rapid growth in air travel and in adherence to the signing of the International Sanitary Convention for Aerial Navigation by the United Kingdom in 1933, Singapore began health inspections on aircraft arriving at Seletar Airport in 1934. Aerial quarantine measures were strengthened in 1937 with the opening of the new Kallang airport, which incorporated a quarantine zone and an on-site hospital.16
Changes to the Quarantine Ordinance
Since its inception in 1868, the Quarantine Ordinance underwent many changes to reflect new and changing requirements for infectious disease control. In 1886, the Quarantine and Prevention of Disease Ordinance was enacted to give the government greater powers to tackle the spread of infectious diseases that affected men and animals, thereby repealing two older laws, the Quarantine Ordinance 1868 and the Cattle Contagious Disease Act 1867.17
In 1911, a commission was appointed to study the Quarantine Ordinance and its regulations, as well as the efficacy of existing measures to curb the spread of infectious diseases. The resultant report provided a comprehensive overview on the state of infectious disease prevention in the Singapore, covering areas such as the adequacy of hospital facilities, new hospital plans, facilities on St John’s Island, patient and mortality numbers, the management of smallpox, cholera and the plague, the practices of other Eastern ports, water supply and vaccination. Among the recommendations on legislation were penalties for the breach of quarantine rules and the requirement for immigrants to show proof of vaccination before entering Singapore or consent to vaccination on arrival.18
Some of these recommendations were adopted in whole or in part when the ordinance underwent a substantial revision in 1915. That year, the Quarantine and Prevention of Disease Ordinance (No. 33 of 1915) was enacted to consolidate and amend eight related ordinances: the Vaccination Ordinance 1868; the Quarantine and Prevention of Disease Ordinance 1886; the Prevention of Disease Ordinance 1894; the Diseased Cattle (Prevention of Export) Ordinance 1894; the Plague Ordinance 1899; the Plague Ordinance 1899 Amendment Ordinance 1900; the Quarantine and Prevention of Disease Ordinance 1886 Amendment Ordinance 1904 and the Infectious Diseases Ordinance 1913.19 In 1933, the ordinance was revised to comply with the International Sanitary Convention that the United Kingdom had signed in Paris in 1926.20 Further revisions were made in 1939, 1946, 1952 and 1958, though it appears that these were mainly to consolidate and clarify the law, with no substantial changes introduced.21 The ordinance was finally supplanted by the Infectious Diseases Act of 1976 when it came into force in 1977.22
1. Hsu Li Yang and Vincent Pang Junxiong, Infectious Diseases and Singapore: Past, Present and Future (Singapore: Society of Infectious Disease, 2015), 2. (Call no. RSING 362.1969095957)
2. Y. K. Lee, Quarantine in Early Singapore (1819–1874), part I (Singapore: Stamford College Press (Pte) Ltd., 1977), 374–81 (Call no. RCLOS 614.46095957 LEE); Straits Settlements, An Ordinance to Make Provision for the Better Prevention of the Spread of Contagious Diseases, No. VII of Government Gazette, 3 July 1868, 349–50. (From BookSG)
3. Y. K. Lee, Quarantine in Early Singapore (1819–1874), part II (Singapore: Stamford College Press (Pte) Ltd., 1978), 82–83. (Call no. RCLOS 614.46095957 LEE)
4. Parliament of Singapore, Infectious Diseases Bill, 24 November 1976, cols. 1096–100; Infectious Diseases Act, Cap 137, The Statues of the Republic of Singapore, rev, ed, 2020.
5. Lee, Quarantine in Early Singapore (1819–1874), 374; W. A. Nicholas, “Changing Concepts in Quarantine,” Medical Journal of Malaya 6, no. 1 (1951): 113–28. (Call no. RCLOS 610.5 MJM)
6. Lee, Quarantine in Early Singapore (1819–1874), 375.
7. Lee, Quarantine in Early Singapore (1819–1874), 375–78; “Cholera in Victorian London,” Science Museum, 30 July 2019; Stephen Halliday, “Death and Miasma in Victorian London: An Obstinate Belief,” BMJ 323 (7327) (22 December 2001): 1469–471.
8. Lee, Quarantine in Early Singapore (1819–1874), 378.
9. Lee, Quarantine in Early Singapore (1819–1874), 378.
10. Lee, Quarantine in Early Singapore (1819–1874), 379–80.
11. Lee, Quarantine in Early Singapore (1819–1874), 381.
12. Lee, Quarantine in Early Singapore (1819–1874), 381–82; Lee, Quarantine in Early Singapore (1819–1874), 79–82.
13. Lee, Quarantine in Early Singapore (1819–1874), 82–87.
14. Kah Seng Loh and Li Yang Hsu, “The Origins of Singapore’s Communicable Disease Centre: Hanging Fire,” Kyoto Review of Southeast Asia no. 26 (November 2019)
15. Loh and Hsu,“Origins of Singapore’s Communicable Disease Centre”; Brenda S. A. Yeoh, Contesting Space in Colonial Singapore: Power Relations and the Urban Built Environment (Singapore: Singapore University Press, 2003), 110, 121–22, 133 (Call no. RSING 307.76095957 YEO); “Gazette Notifications,” Singapore Free Press, 3 August 1899, 70; “Untitled,” Singapore Free Press, 13 February 1901, 2; “Plague Patients: Precautions Taken By Singapore Authorities,” Straits Times, 17 May 1907, 7; “Infectious Disease,” Straits Times, 6 July 1912, 10. (From NewpaperSG)
16. Loke Tuck Whye, The Control of Contagious Diseases in Colonial Singapore, 1867–1959 (Singapore: Department of History, Faculty of Arts & Social Sciences, National University of Singapore, 1990), 51 (Call no. RSING 362.19690095957 LOK); “International Sanitary Convention for Aerial Navigation,” American Journal of International Law 31, no. 1 (January 1937): 28–50 (From JSTOR via NLB’s eResources website); “Infection Carried By Air Liners: Precaution Taken in Singapore,” Straits Times, 28 October 1935, 19; “Disease-By-Air Precautions,” Straits Times, 25 December 1938, 15. (From NewspaperSG)
17. Straits Settlements, A Bill Intituled an Ordinance to Make Provision for the Better Prevention of the Spread of Infectious and Contagious Diseases of Government Gazette, 22 October 1886, 1720–724 (From BookSG); Straits Settlements, An Ordinance to Make Provision for the Better Prevention of the Spread of Contagious Diseases, No. XIX of Government Gazette, 17 December 1886, 2139–142. (From BookSG)
18. “Prevention of Infection,” Straits Times, 4 September 1911, 7; “Infectious Disease”; “Quarantine Commission,” Singapore Free Press, 6 July 1912, 12. (From NewspaperSG)
19. Straits Settlements, A Bill Intituled an Ordinance to Make Provision for Preventing the Introduction into and Spread in the Colony, and Transmission from the Colony, of Infectious Diseases, vol. 50 of Government Gazette, 14 May 1915, xiii–lvi; Straits Settlements, An Ordinance to Make Provision for Preventing the Introduction into and Spread in the Colony, and the Transmission from the Colony, of Infectious Diseases, no. 33 of Government Gazette, 31 December 1915, 2093–135. (Call no. RRARE 959.51 SGG; microfilm NL1088)
20. Straits Settlements, A Bill Intituled an Ordinance to Amend and Consolidate the Law for Preventing the Introduction into and Spread in the Colony, and the Transmission from the Colony, of Infectious Diseases, vol. 20 of Government Gazette, 20 October 1933, 2189–2249 (From BookSG); Straits Settlements, An Ordinance to Amend and Consolidate the Law for Preventing the Introduction into and Spread in the Colony, and the Transmission from the Colony, of Infectious Diseases, no. 37 of Government Gazette, 29 December 1933, 2873–932 (Call no. RRARE 959.51 SGG; microfilm NL1246); “International Sanitary Convention, June 21, 1926,” Library of Congress, accessed 17 April 2020.
21. Quarantine and Prevention of Disease Act, Cap 166, The Statutes of the Republic of Singapore, 1970, 277–47 (Call no. RCLOS 348.5957 SIN-HWE]); “Quarantine Bill,” Straits Times, 28 October 1939, 11; “New Quarantine Bill Shortly,” Malaya Tribune, 28 October 1939, 3 (From NewspaperSG); Parliament of Singapore, Infectious Diseases Bill.
22. Parliament of Singapore, Infectious Diseases Bill; The Infectious Diseases Act, Act 20 of 1976, Government Gazette. Acts Supplement, 231–58 (Call no. RSING 348.5957 SGGAS); Infectious Diseases Act, Cap 137, The Statues of the Republic of Singapore.
W. L. Blakemore, How Singapore Is Protected against the Importation of Dangerous Infectious Diseases (Singapore: Government Printing Office, 1940) (Call no. RRARE 616.9045 BLA, microfilm NL26033)
Walter Makepeace, Gilbert E. Brooke and Roland St. J. Braddell, One Hundred Years of Singapore, vol. 2 (Singapore: Oxford University Press, 1991), 492, 503, 506. (Call no. RSING 959.57 ONE-[HIS])
Wan Nur Syafiqa, “The British Once Built a Quarantine Island in Singapore for Migrants,” Kopi, accessed 17 April 2020.
The information in this article is valid as at September 2020 and correct as far as we are able to ascertain from our sources. It is not intended to be an exhaustive or complete history on the subject. Please contact the Library for further reading materials on the topic.
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