Epidemics in South Asia — the plague

Despite being quickly dealt with, the disease seemed to have been spreading in the Punjab by the end of 1897

The Bubonic Plague was by far one of the deadliest diseases in South Asia, causing the deaths of over twelve million people between 1896 and 1930. Initially, a port city and then an urban phenomenon, it quickly spread to the rural areas and caused high rates of mortality.

The Punjab suffered the most from the dreaded disease with over 3.5 million deaths, followed by the North Western Provinces (later, United Provinces), with 2.9 million deaths and the Bombay Presidency with 2.4 million deaths. Interestingly, southern, central and eastern India escaped the high mortality rates.

More than any other disease the plague remains a major marker of not only the medical, but also the social and political history of South Asia. This because by the time the plague arrived in India, the vernacular press had picked up to a large degree. There were literally hundreds of newspapers in local languages, with many depending on sensational, tabloid type news to make ends meet, and so comment on the disease was rife. Furthermore, unlike responses to smallpox and cholera, the British intervened dramatically in the social and cultural life of the people in order to contain this disease.

The plague also had a novelty since it was ‘new’ to India, and did not have any deity or religious history associated with it. As such, dealing with it was unknown territory for Indians and, hence, rumour and panic easily set in. As Professor David Arnold has noted, “Because of the manner in which it was perceived by the colonial authorities and the nature of the sanitary and medical measures deployed against it, bubonic plague provoked an unparalleled crisis in the history of state medicine in India. The significance of plague for the political epidemiology of colonial India was far greater than that of the concurrent epidemics of malaria or influenza, even though in any given year the mortality they caused might have been considerably greater.”

The bubonic plague arrived in India from China (where it had originated) via ships from Hong Kong. Apparently, it had arrived in Bombay by May 1896, but the unknown nature of the disease and its complicated diagnosis prevented discovery. However, by October 1, 1896, the government had admitted that ‘true bubonic plague’ had entered the port city. Almost immediately it sprang into action.

The city of Bombay quickly extended the powers of the municipal commissioners and embarked on a wide-ranging plan which included segregation, hospitalisation and disinfection. In just a few months over Rs 100,000 was spent on disinfectants alone, which were sprayed across the city, in sewers, drains, shops, warehouses, streets, and even inside slum dwellings.

The central government also took the matter seriously and a special Epidemic Diseases Act of 1897 was hastily passed through the Viceroy’s Executive Council. Under this Act, in the event of an outbreak the government could, if it “thinks that the ordinary provisions of the law for the time being in force are insufficient for the purpose, may take, or require or empower any person to take, such measures and, by public notice, prescribe such temporary regulations to be observed by the public or by any person or class of persons as he shall deem necessary to prevent the outbreak of such disease or the spread thereof…” This gave the government almost draconian authority to do anything to contain the epidemic.

One reason for the swiftness of government action has been given by Ian Catanach who argues that it was largely international pressure which prompted the British Indian Government to take immediate and strong action. The international sanitary conferences which had been happening since the 1850s were already very concerned about cholera which had spread from India to Europe, and the advent of the plague added urgency to their calls for action. The tenth international sanitary conference in March-April 1897 impressed upon the Indian government that stern action must be taken immediately to contain the plague, otherwise trade with India would be stopped. Concerned not just about the halting of trade, but also reputation and ridicule as an irresponsible empire (especially during the high-day of the ‘white man’s burden’ argument), the British in India did not want to be seem lukewarm to the plague, either at home or abroad.

Historian David Arnold identifies another reason for rapid government action, in what he calls, “the growing crisis of urban control”. The ports were the “central nodes of colonial power in India,” Arnold argues and as such the most visible signs of British control. The ports were the centre of economic activity and it was here that most of the British in India also resided. In fact, Arnold notes, that one of the reasons for the radical measures in Bombay was the fear that it might spread to Calcutta, the port city which was not just the capital of the British in India but also called the “second city of Empire,” after London.

To tackle the epidemic, the government created plague committees in major cities. In Bombay, a committee was initially headed by Commissioner Snow, soon to be replaced by Brigadier WF Gather, mainly because troops were being used in the operations and also because it was thought that military discipline could hasten the control of the disease. In Calcutta, the secretary of the Financial and Municipal Department, HH Risky headed a committee, while in Pune, WC Rand led the plague committee.

Together with the largely civilian officers (except in Bombay), for the first time, medical doctors became the source of information and decision making. There were medical boards and advisors attached to each plague committee, with both European and Indian doctors, and their advice was almost invariably followed by the government. As Arnold notes, “Never before in British India had medical science and the medical profession been afforded such administrative authority and been placed in a position to exercise it with such apparent freedom.”

The first major consideration for the British was to contain the spread of the plague. Therefore, almost immediately controls were introduced on sea and rail passengers, where it was mandated that everyone boarding the vessels had to be examined first. The British even risked the ire of the Muslims of India in 1897 by suspending the Haj pilgrimage, in fear that just like cholera earlier, plague might spread through it.

Within India, the British also tried to ascertain how the plague was spreading. The 1897 Report on the Sanitary Administration of the Punjab, describes in detail how the plague might have come to the province. The report notes that a Brahmin by the name of Ram Sarn had left his village of Khatkar Kalan in Jullundur district, in February 1897, to go on a pilgrimage to Hardwar. When he returned on April 29, 1897, he was found to be with high fever and delirium, and he died a few days later. Since the plague had hitherto been unknown in the Punjab, the people in the village gave scant attention to the case. However, shortly afterwards a woman by the name of Mussamat Malin, a relative of Ram Sarn, also contracted the disease and ran a high fever, together with some other people. But still there was no concern in the village of about 1,200 people. By late July, the report noted, “rats were noticed to be dying in some curious way in some cattle-sheds…” which were near the well where Malin also lived. Still, there was no reaction from the villagers.

The Sanitary Report of 1897 then goes on to note that it was only in October when the Chamars who lived adjacent to the Brahmins, began to be infected in large numbers that the villagers sensed that some new disease had descended upon them. The four deaths on October 14, 1897, frightened them and they informed the authorities of the presence of this strange fever. Soon the civil administration arrived at the scene and on October 21, 1897 the sanitary commissioner declared the disease as the bubonic plague.

The manner in which the authorities swiftly and effectively dealt with the incidence of the plague shows the radical intervention by the state in the lives of the people, perhaps for the first time in history. As soon as the plague was confirmed in Khatkar Kalan, all the people of the village were removed to grass huts near the village. The sick were removed to hospitals while those living in close proximity with the infected were moved to a ‘segregation camp,’ near the hospital. The rest were moved into the ‘health camp’ away from the incidence of the disease.

Interestingly, the Sanitary Report clearly notes that in the health camp, the “Muhammdans, Hindus and the low-castes were all in separate divisions and arranged so that no disputes about mingling of castes should arise.” The British were quick to realise that any mingling of caste would create an adverse reaction against not only the government but also the plague control measures, and so they tried to keep such considerations addressed as much as possible.

Once the population of the village had been removed, disinfection was carried out for a full month. According to the Sanitation Report, the disinfection drive consisted of “…spraying the rooms with disinfectants, removing the furniture, white-washing the walls, making large openings in the roofs of all the houses to allow sunlight and air to penetrate freely, while in all the infected houses the entire roof was removed and the floor dug up to the level of three inches.” By the end of December 1897, the villagers were allowed back and after examination of every single person, the village of Khatkar Kalan was declared plague free.

However, while the plague had been contained in one village, it had managed to spread in other villages. On November 24, the plague was discovered in the larger village of Khan Khana, while by early December it was also found in the village of Berampur, in Hoshiarpur district. At Berampur, the disease was quickly traced to Khatkar Kalan as a woman had run away from the village to Berampur after her husband had been attacked, and got sick and died. Despite being quickly dealt with, the disease seemed to have been spreading in the Punjab by the end of 1897.

(To be continued)

The writer teaches at the IT University in Lahore. He is the author of ‘A Princely Affair: The Accession and Integration of the Princely States of Pakistan, 1947-55.’ He tweets at @BangashYK

Epidemics in South Asia — the plague