Epidemics in South Asia-IV — the plague

The manner in which the government of India and provincial governments reacted to the plague was unprecedented

The spread of plague in India alarmed the government, and very quickly measures were taken to contain its spread. A special focus was on railways passengers, where over four million were examined between 1897 and ’99 upon entering Bengal, for example, as David Arnold notes.

The examination of the passengers was done on the railway platform itself for third class passengers. The first and second-class passengers were examined in their compartments. Those who were infected were immediately removed while those suspected were as Sacha Tandon notes, “…taken to a separate disinfecting tank and quarters where they were disrobed, and their clothes were disinfected with the steam apparatus after which the passengers were allowed to proceed with their journey.” Just in Bengal over 72,000 were detained in this manner in two years.

The government also heavily relied on quarantines and cordoning off areas. Since medical understanding of the disease was still developing, the separation of the infected from the healthy was seen as the best way to prevent the spread of the disease. Thus, fairs, both religious and otherwise, were banned, the movement of people between areas was restricted, and local administrations given wide authority to enforce quarantine measures in their areas as needed.

In the Punjab, for two years, from 1897 to 1899, the government was able to confine the plague to the two districts of Jullundur and Hoshiarpur and drastic measures were taken to contain it. As the special plague report on the two districts noted: “Plague is no ordinary illness. It is far more infectious than any other disease…and more deadly than most. It consequently calls for severer and more thorough measures to check its spread.”

The first measure was always to cordon off the village or the area where the plague had been found. However, the report noted that often enough the government would get to know of the plague after it has already spread to other areas, and that cordoning off the areas was not sufficient to contain the disease. Captain CH James of the Indian Medical Service, therefore, noted that in 26 instances the infection had been carried out of an infected village before the cordon was put in, while a staggering 48 times the infection had spread after the cordon had been enforced, signifying that the cordon was not always effective — a very significant lesson for today’s measures against the coronavirus.

After the cordon had been put in place, a roll of the whole village was done by the revenue or other officials and a list made of missing people. These people were then traced so that their whereabouts and activities could be found out. Then an examination of the whole village would be carried out, to ascertain the extent of the infection. The removal of the people to ‘healthy’, ‘suspected’ and ‘infected’ camps would then commence, with the arrival of government made huts which were usually situated on higher ground with close access to wells.

The government report notes that while the government huts might not be that comfortable the authorities tried to dissuade the villagers from making their own huts, since if there were further instances of the plague in the healthy camps the people would have to be removed and the hut burned. Thus, Captain James noted that if the people had made the hut themselves, its burning would lead to resentment, and so the preference was always for a government sanctioned hut, which at times would arrive within 24 hours of first confirmed case of plague in the village.

The people were usually given a day to move to the camp, with an additional day to get things they might have forgotten, after that the main village would be out of bounds for them for six to eight weeks. A roll call, usually twice a day, by hospital assistants would ensure that people remained in the camps, and were not infected—but as seen above, many did manage to escape and usually frequent return to the village itself became a major source of infection. Within the camp, the infected people would be put in a makeshift hospital, with an attached dispensary, cook house and a bathing spot, and daily inspection would be made of their condition.

After the last case of the plague had been observed, and the village throughout disinfected, the government would still wait anywhere between three to four weeks before allowing people to move back into the village.

Disinfection would be routinely carried out within the camps. According to the government report, the plan was that as soon as people arrived they were told to spread out all their belongings on the ground outside their hut, “every box had to be opened and every sack undone.” “The hospital assistants then came round with garden syringes, and thoroughly soaked everything in strong phenyl solution. All earthenware articles, as well as all cooking utensil…were dipped in a vessel containing the same solution. Beds, boxes, almirah’s, &c, were squirted with the same…grain, seeds, flour, &c. were simply exposed to the sun.”

People were also made to take phenyl baths, and European nurses were especially brought in to supervise the bathing of women. Big pots were used to boil clothes of those infected and suspected of the plague.

The village itself would be disinfected in four stages: first was a thorough spray of disinfectants throughout the village, followed by a rigourous cleaning process of the streets, wells, drains, etc. The third stage was to ensure ventilation by making large opening in the ceilings of most dwellings, and lastly, the whole dwelling would be whitewashed. Captain James noted in his report that perhaps just one of the measures above might have led to disinfection but “on account of the difficulty of making sure,” all four stages were carried out wherever possible.

The government also ensured that the burial of Muslims or cremation of Hindus and Sikhs would only be done under supervision. The report on the two districts of Jullundur and Hoshiarpur observes that a hospital assistant would always accompany the funeral procession and “personally supervised the bathing in phenyl of all persons attending the funeral before their return.” The graves were also especially dug to a depth of six feet so that there would be no chance of the infection spreading, and often bodies would be buried with quicklime to ensure fast decomposition.

After the last case of the plague had been observed, and the village throughout disinfected, the government would still wait anywhere between three to four weeks before allowing people to move back into the village. Before moving back in the people would again be bathed in phenyl and their clothes and belongings disinfected. After their return the village would remain under observation for ten days with daily visits to households by the hospital assistant and regular roll calls, so as to ensure that the cordon was being maintained.

In penning the report, Captain James noted that disinfecting the people and the villages was the best possible way of prevention. He noted that its success can be measured by the fact that “if plague is introduced into a village, recently disinfected, it shows little or no tendency to spread, and the evacuation of one or two houses is usually sufficient to check the second outbreak.”

Similarly, Captain James argued that “there cannot be any doubt in anyone’s mind that cordons were most essential.” However, the problem was always in maintaining them, since there were never enough policemen to guard all entrances and exits round the clock, and people usually found creative ways to escape it. One way suggested by Captain James was a double cordon by the police and then the military so that a level of strict and continued enforcement could be preserved. To leave the cordon a pass would be required, provision of which was strictly controlled and monitored.

The manner in which the government of India, and provincial governments, like the government of Punjab above, reacted to the plague was unprecedented. Soon there were manuals for plague administration and elaborate administrative measures and personnel. Since the plague affected the rural populations to a much larger degree than the urban dwellers in its initial years, this was perhaps the fiercest, if not the first, government penetration into the lives of rural people. Thus, as David Arnold notes, “With the enforcement of far-reaching anti-plague measures, many Indians inevitably felt that they, and not just the disease, were under attack.” Many, therefore, strongly reacted to these measures.

To be continued.

Epidemics in South Asia-IV — the plague