As early as the 1800 an, nursing in Malaysia began with the arrival of the East India Company where hospitals for the sick were established in Penang and Singapore.These hospitals were run by the Catholic nuns and which were later replaced by the nurses from England. Nursing practice in the pre-war era in Malaya then was carried out by nurses who received, on the job training, with lectures given by expatriates i.e. by European sisters, matrons and doctors at the hospital level. Each state/straits settlement organized its own nursing services, training and conducted its own examination, resulting in a varying standard from state to state. The emphasis of nursing practice then was the curative aspects of patient care.