Perhaps unsurprisingly, the answer was inequality. Diarrhoeal diseases continued to ravage the island because the means to prevent them were a luxury few could afford. For the poor, malnourished, and the people living in pestilential slums, firm stools was an aspiration as distant as a freehold condo in 2019.

Hot tea with sugar, for example, was—and is—a relatively effective means of preventing diarrhoea because boiling kills off germs. Unfortunately, few coolies could afford hot tea, at least not in sufficient quantities.

Driven half-mad by Singapore’s scorching weather and by the immense physical exertion of pulling a rickshaw on bad roads—sometimes running for more than 10 miles at a stretch—most coolies threw themselves at any available roadside well, ditch, or stream. After drinking from these contaminated sources out of sheer exhaustion, they fell sick and died.

Today, we would probably call it an ‘occupational hazard’.

Clean reservoir water was available, of course, if you happened to be a passing merchant vessel. According to Contesting Space In Colonial Singapore by Professor Brenda S.A. Yeoh, dirty well water was the norm for ordinary people. If you were a ‘native’ living in Chinatown or Kampung Glam, your daily water needs were met most by a backyard well. The upside was that water was free. The downside was that it was poisonous because these makeshift wells lacked impermeable linings to protect them from the surrounding filth.

Filthy groundwater and latrine discharge could contaminate the well and kill you. Nightsoil men, who washed their buckets by throwing them in the well, could contaminate the well and kill you. Diarrhoea sufferers who didn’t wash their hands before drinking could contaminate the well and kill you.

In a 1902 Municipal health survey of some 3,877 wells, 3265 of them were considered toxic. They were not wells per se, but in the words of one Dr. G.A. Finlayson, government bacteriologist, they were ‘more or less diluted cesspools’.

These diarrhoeal diseases were not just physically painful, but financially hurtful as well. Due to the lack of effective treatment, and an ignorance of (admittedly limited) medical options, bowel complaints were often left to god or nature. In the meantime, the sufferers were unable to earn a living and thus the disease sapped them of both their ‘strength and savings’.

Even after they recovered, many were too weak to work, or alternatively, worked extra hard to make up for the debts incurred during their illness. As a result, some of them fell ill again, thus continuing the vicious circle of poverty and diarrhoea.