To improve civil sanitary conditions, sanitary boards were formed in each province in Sanitary Inspector Generals later named as Sanitary Commissioners replaced these boards and took over the charge of sanitation. In , the sanitary department was merged with the vaccination department to form a central sanitary department. From to , sanitary departments were set up in each province. Under the orders of the Governor General of India in , Sanitary Engineers were employed in all major provinces. The Sanitary Commissioner of India and the provincial sanitary commissioners had no executive powers and were advisors to the government.
They carried out the inspection of sanitation, the supervision of vaccinations, the maintenance of vital statistics, and the collection of meteorological data. The local self-government policies of Lord Ripon strengthened the efforts to improve sanitation by increasing the availability of funds at the local level.
In , the Local Self-Government act was passed and local bodies came into existence. These were now responsible for sanitation at the local level but the necessary staff was not provided by the Central Government. In , the Government of India sanctioned the appointment of Deputy Sanitary Commissioners and Health Officers with the local bodies and released funds for sanitation. The history of vaccinations can be traced back to when a Superintendent General of Vaccination was appointed in India after the discovery of the small pox vaccine.
In , four European superintendents of vaccination with one Indian vaccinator were appointed to the Bombay presidency. Great efforts were made for vaccination under the charge of the superintendents of vaccination. In , the vaccination work was transferred to the supervision of the Sanitary Commissioners and their staff.
The district public vaccination staff was supervised by the Civil Surgeon except in Bombay where it was under the control of the Deputy Sanitary Commissioners. In , an act was passed for the compulsory vaccination of children in municipalities and cantonments. Small pox was the main target during that period, although vaccinations were also carried out for plague and other diseases. Variolation an Eastern inoculation technique was also used initially to control small pox.
In and , people were vaccinated in Bengal, the United Provinces, and Punjab while more than 5 million people were vaccinated in the same provinces in and In all of British India, the vaccination rate was 2. Successful vaccinations at birth were The budg et al located for vaccination was about 0. That figure rose to approximately 1. In , the Birth and Death Registration act was passed. Vaccination and sanitary staff was responsible for the maintenance of vital statistics i.
In , the first Indian Factories Act was passed and the first all-India census was held. To control epidemics, special officers, committees, and commissions were appointed. At district headquarters, the Civil Surgeons carried out the medico-legal work. At the provincial level, it was under the orders of the Surgeon General Medico-legal. For the purpose of forensic chemical examination and drug testing, laboratories were created at provincial headquarters under the control of the Chief Chemical Examiner. In , the Drugs Act was passed and drugs were made under the control of the government for the first time.
Timeline of major famines in India during British rule
When the British Empire came into power in India, they faced the challenge of a new set of diseases that were endemic in that region. India was a vast country with environments ranging from the world's highest mountains to plain green fields, and from tropical forests to barren deserts. Such a diverse region had its own peculiar diseases, which were difficult to prevent with the limited resources of the IMS.
Enormous amounts of work was done for the prevention of epidemics to save the lives of people in India in general, and the Imperial troops and officers, in particular. Epidemic diseases that had devastating effects during that period were plague, leprosy, cholera, and malaria. The British government took great efforts to prevent diseases but due to insufficient medical officers and funds, the major target was to alleviate suffering and render curative services as it was solely a state responsibility during that period with virtually no volunteer or private-sector organizations.
Prevention and environmental hygiene had long been neglected. There are reports of various plague outbreaks in India but trustworthy information is present about the outbreak in Kutch that spread to Gujarat and Sind, and lasted for approximately 10 years. A disease having all the symptoms of plague was reported in and in Hansi in the Hissar district of Punjab. In , plague was reported to be prevalent in the Marwar state of Rajputana. The first official records date back to when an epidemic of bubonic plague broke out in Bombay. Initially, it was reported in the port cities of Bombay, Pune, Calcutta, and Karachi.
In the first year, it was confined to Bombay except for minor occurrences in other parts of the country. It devastated almost the whole of India until about Up to the end of , that deadly epidemic took the lives of about 2 million people according to state records but the actual figures might be much more. Being on the international trading route, there was immense pressure on the British Imperial government of India to control this emergency. The Plague Commission was constituted in under the chairmanship of Prof. It comprised of members from various departments including J.
Hewett, Interior Secretary to the government of India, Prof. The report of the Plague Commission in concluded that the disease was highly contagious and considered human transit as an important source of spreading the disease as they carried the germs with them.
The commission recommended necessary preventive measures to disinfect and evacuate infected places, to put a control over mass transit, and to improve sanitary conditions. The commission also suggested strengthening of public health services and development of laboratories. The Epidemic Diseases Act was passed in and the Governor General of India conferred special powers upon local authorities to implement the necessary measures for control of epidemics.
There was a vigorous execution of the act. Colonial power was used for forceful segregation of infected persons, disinfections, evacuation, and even demolition of infected places was carried out. Medical and administrative officials had the right to inspect any suspected person or place; they may have called for detention of any person from ships and railways. That gave rise to many concerns in the native people and riots were reported in some areas but the government used the military power to ensure proper enforcement of necessary preventive measures. Intensive research work was carried out.
As indicated in reports of Surgeon Maj. Childe, various types of research was conducted in Its main sources were poor sanitation and the resultant spread from excretions of humans and animals. Haffkine's Anti-Plague vaccine was used and inoculations were made on a large scale that proved useful as reported by W. Professor Lusting's curative serum was also used and found effective as described by the reports of G. Detailed surveillance was carried out with individual case histories; camps and field hospitals were established and various extensive reports were drafted. Five plague committees were constituted to monitor the preventive measures.
Couchman — ; 17 Brig. Condon for the years — Wilkinson, Chief Plague Medical Officer, also carried out extensive surveys of the epidemic in Punjab as depicted by his reports on plague administration and inoculation in the plague infected areas of Punjab and its dependencies — Leprosy was a big problem in British India. IMS medical officers did enormous amounts of research on the scientific treatment for leprosy. Despite its limitations and hardships, leprosy research in India received worldwide recognition; many Indian remedies for leprosy have been incorporated into western medicine.
Because of G. Hansen's discovery in that leprosy is spread by contact, H. Carter of the Bengal Medical Department gained an authority over leprosy control in India.
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He earned great recognition in the central imperial government of India and suggested isolating lepers. He urged the establishment of Leper Asylums in India as these were formed in Norway in those days. A Leprosy Commission was formed to investigate the etiology and epidemiology of leprosy. The Leprosy Commission concluded that leprosy is a disease sui generis caused by a bacillus having striking resemblance to tuberculosis.
It is not a hereditary disease, there is spread by contagious means but the chances for that are very small.
British Rule Indian Economy by Neil Charlesworth - AbeBooks
However, its spread is indirectly influenced by poor sanitation and malnutrition. The Commission suggested that segregation might not be fruitful in India. It suggested a prohibition on the sale of food articles, prostitution, and other occupations involving direct interference with people like barbers or watermen by the infected people. It insisted on the improvement of sanitary and living conditions. Different provinces furnished various surveys and reports. Excessive surveillance and research work was carried out on the distribution of lepers, hereditary transmission, and predisposition possibilities, contagiousness, and relation of disease with sanitation and diet.
These were excellent statistics keeping in view the high birth rate in India.
Officers of the British East India Company were not familiar with cholera. Before , cholera was confined to Bengal but the — cholera epidemics in India shocked the Company. By the s, cholera was known to be a life-threatening disease to the western world. In India, it gained the focus of medical services due to its serious impact on the troops and officers of the Company; otherwise, it was a disease of poor people.
Due to the lack of effective treatment for cholera in that period, the main focus was set on its prevention. The British Indian government stuck to metrological theories about cholera after the Constantinople International Sanitary Conference of , believing that atmospheric conditions are the basic cause of spreading the disease.
After the cholera epidemic in India, the Cholera Committee was set up to investigate the causes of the disease. The origin and generation of cholera, the epidemicity and endemicity of the disease in India, transmissibility and propagation of cholera, and measures necessary for its prevention were studied. The committee concluded that cholera was frequent especially at religious festivals and fairs. Epidemics were attributable to the importation of disease by pilgrims, travelers, and troops.
The committee suggested improving sanitation, ensuring proper management of festivals, and developing hygienic conditions in institutions like hospitals, jails, and military cantonments. Townsend, Sanitary Commissioner for Central Provinces and Berar, also reported his cholera epidemic investigations. In the s and s, Dr. James L. Bryden, India's first epidemiologist and government's chief advisor on epidemic cholera, studied cholera extensively.
He had first-hand experience with cholera during his work as a statistical officer in IMS in Bengal. But, he considered cholera to be an air-borne disease probably spread by a seed-like organism. He reported that cholera is not transmitted by contaminated water. DeRenzy, Sanitary Commissioner of Punjab, opposed his views and stated that it would hurt the sanitary work going on in India to prevent the spread of cholera. Although there was evidence of contagiousness, Murray believed that environmental factors precipitated the attacks of cholera, but he gave valuable treatment guidelines for cholera in that period.
Cornish, Sanitary Commissioner for Madras, challenged metrological theories about the spread of cholera and carried out detailed surveillance and research work to establish the contagiousness of disease, which is evident from his reports on cholera in Southern India in and his investigations of cholera outbreaks in H. Other significant works include reports from H. Bellew, Deputy Surgeon General and Sanitary Commissioner for Punjab, about the cholera outbreaks in India from to , and the reports of Commissioner Benarus Division United Provinces about the disease outbreaks in the sub-division of Bulliah and the district of Mirzapore.
New treatment options evolved along with better prevention methods resulting in the marked decrease in cholera mortality. Fever was one of the leading causes of deaths in India. The situation worsened in the early 19 th century. One of the contributing factors was the establishment of the railways and irrigation network by the British government of India without keeping in view the efficient drainage systems for floods and rainwaters. This created many fresh water reservoirs for the propagation of mosquitoes. Due to the heavy death toll, economic loss, and risk to the lives of British officers serving in vulnerable areas like Punjab, a lot of research was done for malaria control.
In the s, attention was paid to proper drainage and chemoprophylaxis was started with Quinine. He started to study malaria in This discovery opened new horizons in malaria research and shaped the malaria control programs toward a new direction mainly focusing on the eradication of mosquitoes. In , Christophers, Stephens, and James conducted detailed research on mosquitoes in the military cantonments in Punjab.
James conducted research on the causation and prevention of malarial fevers. He wrote useful reports for the prevention and treatment of malaria for health care providers. Christophers and Dr. Bentley investigated the malaria and black-water fever in Duars in Black water fever was one of the consequences of hyper-endemic malaria. Large-scale tropical aggregation of labor had an important role in the epidemiology of malaria in the tropics. They found that a lack of registration of vital occurrences; malnutrition, differential labor system, poor sanitation, and the formation of foci with infected immigrants were responsible for epidemicity in that region.
Bentley studied causes and prevention of malaria in Bombay in Bently suggested efficient mosquito eradication and the improvement of drainage systems for malaria control. Marjoribanks, Deputy Sanitary Commissioner for Western Registration Districts, studied malaria in the Islands of Salsette and drew similar conclusions. Malaria was a major problem in Punjab. After initial works by Christophers, the Punjab Malaria Bureau carried out detailed surveillance and research on malaria. It is evident from the extensive investigations and reports of Chief Malaria Medical Officers of Punjab from to who were Capt.
Clifford A. Gill , Lt. Lane , Col. Hendley , and Col. MacWatt , that malaria was a major problem in Punjab and extensive work was done for its prevention and control. These volumes are the comprehensive summary of works on malaria control in Punjab in those 6 years. The malarial death rate was Research on malarial vectors i. After Stephens and Christophers in , noteworthy works on mosquitoes were the Stegomyia survey by Maj. Mhaskar in In high-risk areas like some parts of Punjab and the tropics, quinine was made available at special institutions like jails and post offices in small packs that contained 5—7 quinine granules with a price of only quarter-anna.
In the province of Assam, Indian Officers faced a strange disease endemic called Kala-azar and Beriberi by the natives. An investigation about Kala-azar was carried out by G. He concluded that the disease was anchylostomiasis with slightly different symptoms. Spleen and liver enlargement observed in these cases by Ross was not a character of malaria.
Anchylostomas were found but these do not cause such symptoms. Ross concluded that it was not a malarial fever but a disease microscopically and macroscopically similar, except for the absence of parasites and melanin; and the presence of visceral invasion especially that of spleen and liver. Hewlett studied enteric fever in and conducted detailed studies on individual case histories and environmental conditions. Mackie studied the disease and preventive measures. James in and on Hookworm disease by Maj. Clayton Lane in Tuberculosis had long been recognized as a lethal disease.
It was present in India especially in lower socio-economic classes. In , The Tuberculosis Foundation of India was established. As there was no clinically effective treatment available for tuberculosis at that time, tuberculosis sanatoriums were formed in hilly areas to provide a healthy environment and segregation. Although there were groundbreaking works on a variety of diseases, which proved to be very helpful in the prevention of epidemics, the British government of India discouraged innovation and research due to a lack of funds and other difficulties.
This branch of medical systems had long been neglected in India. In the late 19 th and early 20 th century, situations improved and it was widely accepted that medical research was an integral part of preventive medicine. In , the foundation stone of India's first medical laboratory was laid down.
A central laboratory was established in Kasauli near Simla. Provincial laboratories were then established at major provincial headquarters to carry out public health and bacteriological laboratory work. In , the Indian Pasteur Institute for the treatment of patients bitten by rabid animals was formed in Kasauli and later such institutes were also formed in other parts of the country. A Nutritional Research Laboratory was set up in Coonoor in The British Imperial government set up and strengthened an organized medical system in Colonial India that replaced the indigenous Indian and Arabic medicine systems.
Slow progress in early years was due to indifference on the part of people and a lack of funds and medical professionals on the part of the government. The people of India resisted the British colonialism, and they were reluctant to support any services by the foreign government. These trends slowly changed as the natives were educated according to the British system. They then decided to serve in Indian civil and military services and lessen their hardships by taking part in government affairs.
That is why Indian Medical Services flourished in the late 19 th and early 20 th century. There were dramatic improvements in medical and sanitary conditions in British India. IMS efficiently coped up with deadly epidemics like the plague and cholera. Almost all the diseases prevalent at that time in India like small pox, leprosy, and malaria were controlled successfully.
There were very few epidemics in later years and many of the diseases were almost eradicated. Officers and researchers of Indian Medical Services contributed a lot to the study and prevention of diseases. The role of medical officers serving in India should be better judged by their aspirations, priorities, and limitations. Although the archetypical colonial design of medical services, Eurocentric policies, and neglect of the indigenous population failed to relieve the plight of the poor for many years, the work completed during that period of time formed the basis of what we have achieved today to improve the health of people.
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