The oogheelkundig kampongonderzoek in Groot-Atjeh was the itinerant eye survey conducted by Dr. C. E. Gomperts through the kampongs of the afdeeling Groot-Atjeh from March to December 1937, in the course of which 18,808 Atjehnese were examined, several hundred treated on the spot, and the seriously affected sent for admission to the Militair Hospitaal te Koetaradja. It was the largest eye survey undertaken among the Acehnese population in the colonial period, and produced the statistical basis of Gomperts’s report of 1940.
Origin
The survey grew out of the work of the Dienst der Volksgezondheid in Groot-Atjeh, whose activity had been considerably extended in the five years before 1937, and out of the example of Dr. J. Tijssen, whose call and activity in the field of eye disease had prompted a more extensive investigation and treatment in the afdeeling in the preceding two years. Because Tijssen had worked only briefly in Groot-Atjeh, only a few small parts of the fairly large ressort had profited by his treatment; Gomperts set out to cover the district systematically.
Before beginning, Gomperts wrote to Professor Mulock Houwer asking for suggestions, and the professor was “zoo welwillend gevolg te geven aan dit verzoek” — so obliging as to comply. Mulock Houwer’s interest went chiefly to the frequency of xerophthalmie and to the causes of blindness in Groot-Atjeh, and the eight-point scheme of the survey was drawn up accordingly.
The territory
The afdeeling Groot-Atjeh, forming part of the Residentie Atjeh en Onderhoorigheden, had two onderafdeelingen — Seulimeum and Koetaradja — belonging to the administrative territory of two controleurs. The surveyed area, hatched on the sketch-map accompanying the report, was divided by Gomperts into kust- and valleistreken (coastal and valley districts), a distinction that proved central to his findings.
Among the places named as examined or as districts of the survey were, in the coastal and valley regions: VI Moekims Peukan Bada, Aneu-Glee, Delee-Lheuë, V Moekims Montassie, IV Moekims Lho-Nga, VII Moekims Baet, Leupoeng, Djeroë, VI Moekims Lhong, Lam-Lheuôt, IX Moekims Lho-Nga, III Moekims Keureukon, Seulimeum, IV Moekims Ateuë, III Moekims Lam-Rabo, IX Moekims Toengkob, Lam-Kabeuë, III Moekims Kajeë-Adang, III Moekims Daroij, Moekim Lam-Teuba, Koetaradja, Reukiëh, Indrapoeri and Kroeëng-Raja.
The population examined
Groot-Atjeh was, with the exception of Koetaradja, Lho-Nga, Oelee-Lheuë and Seulimeum, populated exclusively by Atjehnese; in those four places the admixture with other indigenous races — Malays, Padangers and others — was very slight. The estimated population of the surveyed area for 1937, based on the Volkstelling 1930 with an annual increase of 1½ per cent, was 51,122: in the onderafdeeling Koetaradja 8,369 men, 8,882 women and 7,085 children (24,336); in Seulimeum 8,580 men, 9,748 women and 8,458 children (26,786).
Gomperts noted that the immigration factor played no role in the surveyed area, since there were no plantations of any importance and the migration of the Atjehnese population of the ressort to other districts was very slight, so that population increase was determined virtually exclusively by the birth surplus. The Volkstelling 1930 had supposed that in the onderafdeelingen Lho-Nga and Seulimeum a slight natality had existed over the years, connected with a slight fertility of the women through factors not certainly known — avitaminosis among this population group was suggested — and with great child mortality.
The numbers actually examined were 3,732 men, 3,830 women, 6,113 boys and 5,133 girls, together with 154 boys and girls not at first separated by sex: 11,400 children and 18,808 persons in all.
Personnel and organisation
A mantri-ziekenverpleger was attached to Gomperts and “heeft vele- en goede diensten bij dit onderzoek bewezen.” Gomperts’s chauffeur, an Atjehnese, served as “een zeer verdienstelijke tolk” and assisted with the distribution of medicines. In cooperation with the Inheemsche Hoofden, the place of examination was chosen so that the kampongs to be examined lay at most one kilometre away, in order to draw in as many children, blind persons and old people as possible; small outlying kampongs necessarily fell outside the scheme.
The equipment
The ophthalmological outfit had to satisfy two conditions: transport by a passenger car had to be possible, and equally transport by porters, in view of the places not reachable by car; and the instruments taken had to suffice for as complete an examination and treatment as possible.
It consisted of a basket with an insert tray for medicines (cod-liver oil, Wilson tablets, santonin tablets, Epsom salts and the like), batteries and other articles; a folding table of ironing-board model; two folding stools; and a donkere kamertent — a dark-room tent — consisting of a dismountable frame of djati (teak) wood with four two-part uprights joined by tube connections, four roof laths fitting into pins on the uprights, and cross-pieces hooked to laths and uprights for rigidity. Over this frame fitted a klamboe of black cotton with a large flap serving as the entrance, with rings at the upper and lower corners: the upper to hang the tent in some building in bad weather, the lower to fasten it to the ground against the wind. All parts fitted into two etuis of the same material.
A large wooden trunk with an upright handle, handles at each side and a carrying strap held eye-drop bottles and ointment pots in its upper division and the instruments in the lower. The instruments included an electric ophthalmoscope after Comberg with lenses of 10, 13 and 20 dioptres for examination in the direct and inverted image; a keratoscope of Placido; a loupe of Hartnack; a loupe of Berger with celluloid headband and 4½-volt electric lamp; a cotton-wool box after Killian; eyelid holders of Desmarres; a flat and a hollow eye chisel fitted with a ring taking a small electric lamp of fountain-pen model; a spirit burner; platinum wires with eye; enamel wash-basins; nail brushes in a bottle; and dressing basins. The whole could be carried in a five-seater car, which still had room for four persons including the driver.
Limits of the method in the field
Gomperts recorded one limitation candidly. A great part of the patients complaining of wazig zien (blurred vision) who reported at the eye out-patient clinic at Koetaradja showed, with the fluorescein test, a very slight punctate and linear discolouration in the corneal centre, while the cornea often showed nothing remarkable on ordinary focal examination. The fluorescein test was also carried out at the kampong survey, “maar de waarneming van deze lichte cornea-verkleuringen was niet mogelijk doordat de donkerkamertent hiervoor te veel licht doorliet” — but the observation of these slight corneal discolourations was not possible because the dark-room tent let through too much light for this.
Similarly, skiaskopisch examination was not feasible because of the troublesome reflexes of the electric ophthalmoscope, so that refraction anomalies were diagnosed only from the fundus changes typical of them. Of 335 persons examined for blurred vision, 47 — 14 per cent — showed clear abnormalities explaining the complaint, mostly refraction anomalies (30 cases).
Outcome
The survey produced the tables on which Gomperts based his conclusions on xerophthalmia, keratomalacia, blindness, pterygium and the absence of trachoma, and the eleven-point summary of his report. Its total cost, from March to December 1937, was ƒ2,187.
See Also
- Oriënteerend oogheelkundig onderzoek bij de Atjehsche bevolking van Groot-Atjeh gedurende 1937
- C. E. Gomperts
- Xerophthalmie
- Blindheid in Groot-Atjeh
- Methode-Tijssen
- Militair Hospitaal te Koetaradja
- Mantri-ziekenverpleger
- Groot-Atjeh
Source
Oriënteerend oogheelkundig onderzoek bij de Atjehsche bevolking van Groot-Atjeh gedurende 1937 (“Orienting Ophthalmological Survey among the Atjehnese Population of Groot-Atjeh during 1937”), by Dr. C. E. Gomperts, offprint from the Geneeskundig Tijdschrift voor Nederlandsch-Indië, Afl. 19, Deel 80 (1940), pp. 1191-1238 (Batavia-Centrum: G. Kolff & Co.). Received by the editors 25 October 1939. Offprint DLP-157, Bibliotheek KITLV.