Jawatte Lunatic Asylum: the forgotten relict of the colonial era



article_image

Nalaka Mendis,


Emeritus Professor of Psychiatry, University of Colombo


In western countries, since the nineteen seventies and eighties a number of new housing, office, cultural and health projects have come up in renovated and remodeled asylums which have become redundant as a result of relocation of mental health care services to General Hospitals and community facilities. It is interesting that in Sri Lanka, the Urban Development Authority together with the Defense Ministry is in the process of renovating a 125-year old colonial building located between Independence Square and Buller’s Road. I am referring to the Jawatte Lunatic Asylum established in the late 1870s at the south-eastern edge of Cinnamon Gardens, three-and-a -half miles from Queen’s House in an area known as "Kumbikelle".


It is indeed a coincidence that in 1876 Governor Sir William Gregory referring to the new proposal to build an Asylum in Colombo said "The building will be a credit to the Colony", and "while every modern appliance for the comfort of the inmates is provided, the building whether the exact present plan be adhered to or modified, will be from its structural merits and decorative character of the grounds attached to it one of the future ornaments of this city".


Emergence of asylums in Europe- The Lunatic Asylum is a product of 19th century Europe and reflected the predominant approach towards care of those with "lunacy". Similarly the disappearance of "Asylum Care" and the emergence of "Community Care" is a twentieth century phenomenon, which evolved in Europe as a result of social, scientific and political developments. This revolution has had far reaching influences all over the world and my aim is to briefly touch on some of the important aspects of this development from a clinical perspective in the colonial and post- colonial period. This review is based on reports on the subject available in the National Archives in Colombo and scholarly work.


People with deviant or bizarre behavior appeared to have been cared for by their families from early times. In the early part of the nineteenth century in European countries, with the introduction of "Moral Care", an approach in line with the care of the sick, Asylums came into being. The tranquil living environment away from crowded centres, engagement in leisure, appropriate food, work and community living was thought to be therapeutic to facilitate early recovery from lunacy. These institutions were established to provide compassionate care with least possible restraint, confinement and control.


Dr. John Connolly the Superintendent of Hanwell Asylum, the first purpose built asylum expressed the underlying philosophy that led to the emergence of asylums in the west thus "man of rank comes in, ragged and, dirty, and unshaven and with the pallor of a dungeon upon him; wild in aspect, and as if crazed beyond recovery. He has passed months in a lonely apartment, looking out on a dead wall; generally fastened in a chair [...] Liberty to walk at all hours of the cheerful day in gardens or fields, and care and attention, metamorphose him into the well dressed and well bred gentleman he used to be".


Most of the asylums were built on a "Pavilion Model" where a central administrative block was connected to two wings on either side, each wing having patient areas with the administration and services located in the middle block. Meticulous attention was paid to organization of spaces in order to provide ventilation, light, water supply, sewage disposal, washing, storage, cooking, easy supervision and care of mentally ill with different grades of seriousness. During the Victorian period large ornate imposing buildings with well landscaped gardens in tranquil surroundings were created in many western countries, away from cities. Similar Asylums were erected in the colonies too.


Disappearance of Asylums - Why did asylums disappear from western countries?


Firstly due to the deterioration of standards of care in the Asylums which led to "incarceration" of ‘lunatics’ rather than "treating" them. Towards the beginning of the 20th century some asylums in western countries could not invest adequately to sustain trained staff, facilities, treatment approaches and funds to provide good quality care. Compassionate and humane care approaches gradually turned into custodial care in prison-like institutions with hardly any opportunity for the inmates to lead an active, sociable life under hygienic conditions. Asylums in general acquired a bad reputation over the years for ill-treatment, cruelty, neglect, inactivity, violation of rights and incarceration of helpless people which were brought to the notice of the public by activists. Asylums were looked upon with ridicule and disgust and were seen as "loony bins" or "nut-houses".


Secondly, the emergence of an alternative model of care In the sixties due to a considerable amount of professional, social and political activism the emerging model of "Community Care" replaced the asylum concept. Biological, psychological and social factors interacting in a complex manner were thought to result in various types and grades of mental distress or disease. The nature of the disease processes was better understood. This approach coincided with the emergence of a new generation of very effective medicines which could be dispensed to patients in General Hospital wards or at home. Recognition and respect of human rights of the mentally ill, reforms of mental health legislation, the changing public attitudes towards mental illness, emergence of psychosocial care, and the advantages of offering treatment close to home have been additional factors responsible for this new development, now called "Community Care".


The Borella asylum- The need to establish an asylum for the care of the insane in Ceylon arose when it was noticed that a number of lunatics were languishing in jails, and consequently in 1839 the Lunacy Ordinance was enacted giving the Governor the power to establish asylums. Initially lunatics were housed in the Leper Asylum and in 1847 they were transferred to the new Asylum built in Borella largely due to the efforts of Dr. Christopher Elliot and Governor Stewart McKenzie. Apart from the first Superintendent who was an assistant to famous Dr. Connolly of the Hanwell Asylum, London, all the successors were Ceylonese. With minimum resources and trained staff the Asylum progressed very well and developed into an institution of good standing with new forms of care including employment, recreation, leisure and existing treatment approaches.


The Jawatte Asylum-. By 1875 the debilitated structure, poor sanitary conditions and constant overcrowding had caused serious health hazards resulting in increasing deaths of inmates in the Borella asylum. On the recommendations of the Principal Civil Medical Officer, Dr. W R Kynsey, a decision was made by the then Governor, Sir William Gregory to construct a new asylum to replace the existing one which accommodated about 230 inmates at the time. From the time this decision was made there had been considerable discussions between the Governors Gregory and his successor, Sir James Robert Longdon, the Superintendent of the Asylum, PCMO, Colonial Office, Lunacy Commission in the UK, Crown Agents and the Special Committee appointed by Governor Longdon on a number of issues related to the new asylum.


These discussions dragged on for the next seven years. The discussions were related to the unsuitability of the site, inadequacy of the extent of land, inappropriateness of the design to tropical climates and care of lunatics, and inadequacy of the number of rooms to suit patients with different grades of illness and social circumstances. Dr. J W Plaxton who was recruited from England by the Colonial Office to manage the new asylum was the chief critic of the plans recommended by the Governor and the local architects. The Lunacy Commission in the U K went on to say that the site has been selected more for "convenience" than for health reasons.


Finally after a lengthy discussion, Governor Longdon with the concurrence of the Colonial Office decided to go ahead with the construction at the 14-acre site at Jawatte with certain modifications to original plans which were considered by the latter as a "partial solution to the question" given the limitations of funds. The entrance and two wings connected to the central administration block accommodated patients, staff and service areas. In 1889 the construction of the asylum for 400 inmates was completed by which time all patients from the Borella Asylum had been transferred to the Jawatte Asylum. Subsequently many additions were made in response to emerging needs. The Governor also had to contend with the criticism that the new asylum was an extravagant project and was palatial in nature and likely to be a white elephant.


Governor Longdon defended his plan and stated " As compared with filthy hovels which some of the insane poor inhabit, the building may certainly be called palatial; and I trust that when new asylums or hospitals are built in this or any other colony, they will be an improvement on the huts of the native peasantry. The asylum is a series of one-storey buildings of the plainest type. The walls are of brick plastered, because of the climate plastering is found requisite for the preservation of buildings. There is no expensive ornamentation, or indeed any ornament at all, unless a short ungraceful and inexpensive tower over the entrance designed for the clock can be called an ornament. The enclosing walls are of ordinary cabook, such as is universally used for garden walls in Colombo.


Problems of the Jawatte Asylum- Dr. J B Spence who succeeded Dr. Plaxton as the Superintendent in the mid 1880s continued to be concerned about the lack of staff, space for patients, staff and the superintendent, fee levying rooms in the context of relative lack of funds. The Superintendent had one assistant medical officer and a few attendants to look after more than 500 patients, attend to administrative and medico- legal work. The new asylum at Jawatte built over a period of 15 years, was overcrowded within years of completing to give way to an even bigger asylum. These problems were in fact predicted by the previous superintendents and other professionals during the planning phase and even earlier but authorities showed very little interest in responding to these. It is interesting that while a considerable amount of discussion, planning and funds were allocated to the building of the Jawatte Asylum, very little discussions took place or resources allocated to train and recruit staff, provide additional facilities or to the improvement of care. Thus the quality of care provided at the Jawatte Asylum became even worse than what was available at the Borella Asylum earlier and this has been referred to over and over again by successive Superintendents. One of them, Dr. Van Dort, went to the extent of questioning the suitability of constructing large expensive buildings instead of structures modeled on "cottage" design which are much cheaper and more appropriate for local conditions. The Jawatte Asylum was closed down in the mid-twenties and the buildings were offered to public institutions including the newly established University of Ceylon.


Angoda Asylum- In 1911 a new Asylum was planned at Angoda and building commenced in 1917 almost on the same design as the Jawatte Asylum. Inherent problems of staff, training and provision of facilities continued to get worse from the beginning. It was inevitable that the new Angoda Asylum built for 1,800 inmates in mid twenties became outdated even faster than the Jawatte Asylum. The 1925 Ceylon Medical Journal in an editorial stated "The question we have now to consider is whether we in Ceylon are marching steadily with the recognized progress of mental treatment of the modern age. It may be a sad revelation to many, but the fact must be stated that in Ceylon mental treatment is keeping pace and marking time with the treatment, which existed in the middle ages in Europe"." Lacs and lacs of rupees have been spent on these structures which seem to have been built for all time". In 1937 Edward Mapother, Professor of Psychiatry University of London, one of the most eminent psychiatrists in the world at the time was asked by the Colonial Government to report on the status of the Angoda Asylum. His report was published as a Sessional paper in 1838 and consisted of a very comprehensive analysis of the problem with ten separate recommendations which would have laid the foundation to establish a modern mental health care system in Ceylon. Angoda, in his assessment, was the worst Asylum in the Indian subcontinent on the basis of staffing, treatments, overcrowding, hygienic conditions, and management.


Post-asylum era- Colonial as well as Post Colonial Governments’ response to the report was delayed, piecemeal and slow, resulting delays in much needed reforms to modernize mental health care. The Asylum was renamed in 1940 as Mental Hospital. The new cadres of psychiatrists and other mental health professionals made use of their newly acquired professional knowledge to treat those attending the newly established out-patient clinics in Colombo and the short-stay wards. The institutional reforms progressed relatively slowly. The very ill and long- term disabled people continued to accumulate in Angoda, the new hospital established at Pelawatte in the mid-forties and the third hospital established at Mulleriyawa. The inevitable deterioration of standards due to lack of resources resulted in poor care, and the mental hospitals became the last resort for seriously ill people, many of whom became either permanent residents or perished while being inmates due to infections acquired in the asylum.


This sad state of Angoda is well documented in Sessional papers published in 1955 and 1967. In the late fifties and sixties both these hospitals lost valuable land to encroachments and acquisitions. Today both Angoda and Mulleriyawa mental hospitals have only a fraction of their land remaining out of a total of more than two hundred acres. In the early eighties some of the old three-storey buildings at Angoda were replaced by new buildings and recently most of the buildings at Mulleriyawa have been acquired to establish a new General Hospital. The Pelawatte Mental Hospital with more than five hundred acres of land was closed down in the early seventies.


Continuing influence of Angoda - For nearly hundred years Angoda has been synonymous with lunacy, the insane and the mentally ill. The deeply ingrained pervasive negative impressions of Angoda are slow to disappear in the community and its influence continued to hamper the development of mental health services outside Colombo for a long time. In the mid sixties the efforts of a then young group of psychiatrists led by Professors Rodrigo, Wijesinghe and Dr. Arulampalam resulted in opening up psychiatric facilities in Kandy, Colombo and Jaffna. Since then other psychiatrists established a few more units in major provincial hospitals. However in the following two decades progress has been slow with very low investments in both physical facilities and staffing resulting in many areas of the country being devoid of mental health services. Thus, until recently Angoda was the only option for the seriously ill and the long-term mentally ill. However nineteen-eighties saw the emergence of a district focused community oriented mental health movement due to the leadership given by a few psychiatrists with a community orientation who have been working in General Hospitals. Since nineteen-nineties successive governments institutionalized the above developments which led to the emergence of the District Mental Health Programme which now has expanded very rapidly, most districts having basic mental health services including residential care.


With the continuing development of district mental health services the need for centralised large institutions providing similar care such as Angoda become redundant. How best can we make use of the buildings at Angoda? Professor Mapother in his report stated, "No reconditioning of the present lunatic asylum at Angoda will ever render it suitable accommodation for any but the chronic type of insane. The housing of such is only part of the much larger problem of providing for various stages and degrees of mental disorder which has to be faced in Ceylon". Now it is up to the government, health authorities and the other agencies such as the UDA to identify how these large colonial buildings at Angoda could be utilised to best realize their potential while developing facilities to provide a modern mental health care at a local level.


Please address correspondence to nalakam@gmail.com


 
 
 
 
 
 
 
 
 
 
animated gif
Processing Request
Please Wait...