Today's Editorial

Today's Editorial - 01 April 2023

First pandemic of modern India

Source: By Arjun Sengupta: The Indian Express

On 11 March 2020, the World Health Organisation (WHO) officially declared the Covid-19 outbreak to be a ‘pandemic’. “We have made the assessment that Covid-19 can be characterised as a pandemic,” said WHO Director-General Tedros Adhanom Ghebreyesus in a media briefing, speaking about the spike in cases reported outside of China.

A pandemic is a disease outbreak that spreads across countries or continents. It affects more people and takes more lives than an epidemic. The Covid-19 pandemic would go on to fundamentally alter the lives of many Indians, from the thousands who suffered from the disease to those who were impacted by its economic fallout.

But it was not the first pandemic to affect the country.

Arguably, the first major pandemic to affect India was the Third Plague Pandemic. Beginning in Yunan, China, in 1855, according to the WHO, the pandemic was considered active until 1959, when worldwide casualties dropped to under 200 per year. In this period, it killed anywhere between 12-25 million people across the world, with 75 percent of recorded deaths occurring in British India alone (1896 onwards). It was a truly global pandemic, affecting cities like Hong Kong and Bombay in the same breath as San Francisco, Glasgow and Porto.

What is plague?

Bubonic plague is caused by the bacteria Yersinia pestis. It is transported by flea-bites — they transfer the disease from infected rodents to human beings. It first presents flu-like symptoms — fever, chills, and a headache — followed by an inflamed, dry, extremely painful region developing around the bitten area. As the infection spreads in the body, it causes fatigue, swollen lymph nodes, excruciating pain and generally kills the infected person due to multiple organ failure within a week after infection.

The modern understanding of the disease developed only after 1896, when the Third Plague Pandemic was causing havoc in India. By January 1897, scientists identified that plague first affected rats, serving as a warning sign for an approaching human epidemic. In 1898, the role of fleas would be ascertained.

How did the plague arrive in India?

According to experts, there were smaller outbreaks of the plague in various parts of the country as early as the beginning of the 19th century. These were typically contained both by the relative sparseness of the population as well as its immobility. Also, for most of the 19th century, cholera was the bigger concern.

The Third Plague Pandemic began in China and arrived in India through the sea, presumably from Hong Kong. During the initial outbreak in Hong Kong, British authorities had imposed a quarantine on ships coming from the city. However as the situation eased in Hong Kong, so did quarantine norms, leading to the plague entering India around 1896. Colonial port cities were the worst affected: Calcutta, Bombay, Karachi, and Poona were first to report outbreaks.

How bad was the plague pandemic?

Simply speaking, very bad. While the colonial authorities initially tried to downplay the severity of the crisis due to concerns around Britain’s image as well as trade, panic spread like wildfire globally.

Bombay was the worst affected and would later be called the “The City of the Plague”. Within the first months of plague, Bombay saw large numbers of the population flee out into the countryside, almost 380,000 out of a population of 850,000 by February 1897. This exodus would spread plague across the country. Also responsible was the grain trade – grain stores were frequented by rats which brought with them the rat-flea. By the end of 1897, the plague had spread as far north as present day Punjab. Punjab would go on to see some of the highest number of deaths.

Charles Creighton, a plague physician working in India, recorded that just in 1906 India saw over a million deaths, with almost half occurring in Punjab. Historian Myron Echenberg writes in Plague Ports: The Global Urban Impact Of Bubonic Plague, 1894-1901, “Between (the) plague’s arrival in 1896 and 1921, an estimated 12 million Indians lost their lives”. The rest of the world would see around three million deaths, according to Echenberg’s estimations.

How did the British authorities respond?

As debilitating as the plague itself was, so was the authorities’ response, rife with attitudes of European superiority as well as an incomplete understanding of the disease itself.

The authorities started conducting extensive sanitation drives in Bombay – often destroying houses of the poor in the process. This was followed by forced inspections and hospitalisations, sometimes even triggering violence between the authorities and the natives. Also, medical inspections would be carried at all train stations and ports.

Finally, with cases continuing to rise and international pressure to institute a trade embargo growing, the government introduced the Epidemic Diseases Act (1897), which gave authorities unprecedented powers to stop the plague. This is the same Act (though amended since then) that was invoked in India in 2020 when the Covid-19 pandemic first began.

The Act gave greater control over building inspections and disinfections to the sanitation and municipal officers – medical officers examined people across the city and hospitalised those found with plague symptoms. Where there was resistance, force was used. In Medicine and the Raj, historian Anil Kumar writes about the situation in Poona, “reports of sexual harassment, insult and abuse by British troops soon began to circulate in the city”. To combat this, there were increasing attempts to hide diseased family members so that they could escape the forced hospitalisation. Multiple riots would break out across the country during this period.

Caste attitudes were a major reason for the opposition to hospitalisation. “Rumours of caste mixing and uncleanliness increased Indian wariness, and many refused to go to the hospital when sick,” writes Rebecca L Burrows in her research paper The Third Plague Pandemic and British India: A Transformation of Science, Policy, and Indian Society.

The plague exposed fundamental differences between India and its colonisers. While the British were simply unable to grasp Indians’ aversion to modern medicine and ‘scientific’ practices, Indians, subject to traumatic and insensitive actions of the authorities, were never able to view them without suspicion. This led to confusion, resentment, and perhaps many infections and deaths that could have been avoided.

By 1900, efforts were shifted, with some of the more repressive methods abandoned, replaced with a focus on inoculation instead. But even this was not easy as rumours about the vaccine were rife. Of particular note was the rumour that vaccines destroyed people’s “sexual powers”.

When did the pandemic end?

While the worst years of the pandemic were in the late 19th- early 20th century in India, it never fully disappeared. The vaccine developed by Russian-French bacteriologist Waldemar Haffkine in the late 19th century would eventually be more widely available, cutting down mortality rates by nearly 80 per cent. But as with the Covid-19 vaccine, it did not prevent the disease from happening in the first place. The pandemic was further slowed down when large-scale rat-killing was carried out.

Periodic outbreaks would be seen across the 20th century, with the most recent being in 1994 where the death of an unusual number of rats in Surat sparked fears of plague and triggered migration unseen since the Partition.