English medicine

PUBLIC HEALTH IN BRITISH INDIA: ANGLO INDIAN PREVENTIVE MEDICINE (1859-1914) Mark Harrison Cambridge University Press Rs 395

By Rita Anand
Published: Saturday 04 July 2015

MARK Harrison's book is a tale of the trials and tribulations of the Raj on the battlefield of disease and medicine. The colonial government's political strength hinged on the wellbeing of its troops. Hence, its interest in public health - soldiers cannot be kept in perpetual quarantine. Harrison's book takes a sympathetic view of colonial efforts to grapple with disease in an alien environment.

Early British medics advised fellow sufferers to adjust to the Indian climate; The "atmospheric theory" of Joseph Fayrer, a British surgeon, was widely respected in the Indian Medical Association (IMA) circles. Fayrer stated simply that sudden climate change led to disease.

But mortality rates among British troops till AD 1859 were high, writes Harrison - about 69 for every 1,000 troops. By mid-18th century, specific causes of disease were being discovered. In 1880, Robert Koch isolated the cholera bacillus and Ronald Ross discovered the malaria vector. Older notions of disease were junked as being "fanciful 11 and "incomprehensible" . Alongside, the approach to disease control based on segregation, ventilation and removal of filth, began to be replaced by inoculation, vaccination, and administration of drugs.

The history of public health administration in India dates from AD 1859. Budgetary deficits led Lord Mayo to fob off public health from provincial governments to municipalities. And in AD 1882, Lord Ripon, by making municipalities open to elected Indian members, passed on responsibility to them.

Harrison holds the indifference of the Indian elite responsible for the dismal performance in local sanitation and health.

The government too had abdicated responsibility: between AD 1889 and AD 1894, expense on pgblic health was only 0. 15 per cent of the government of India's total expense.

In Bengal, landlords dominated municipal commissions and were reluctant to increase house tax or water rates. In Madras, he says, municipalities failed to make use of their sanitary allotments and the local awareness of public health was abysmal. The commissioners were more interested in cosmetic improvements such as street lighting rather than sanitation.

Water purification schemes, Harrison writes, were particularly a very sensitive issue since they interfered with the indigenous bathing and cremation rituals. Very often opposition to drainage work in rural areas arose because they disrupted traditional water systems of drainage and British officials were insensitive to local innovations.

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