In 100 years, India’s response to a pandemic hasn’t changed much

Why You Should Read This

  • As this article is being published, India is still reeling from the second wave of a pandemic which has devastated the country and led to a lot of criticism of government mishandling.
  • This paper shows how the colonial government mishandled a pandemic as well – the Spanish Flu.
  • Through newspaper reports from the time, this article shows how despite a century passing, many things have not changed.
  • We have condensed the original 8,000-word paper into a 1,800-word summary. You can read it in fullClick on each point to dig deeper and get the complete picture. in 9 minutes or skim itRead only the numbered points. in 2 minutes.
  1. In the beginning of the summer of 1918, Indian newspapers announced that a deadly new disease, the “Spanish Flu,” was spreading rapidly across the world. By June, it had arrived in Bombay, which quickly became “a huge incubator of the germs of the disease.” By the time it reached the rest of the country, the disease was popularly known as “Bombay Fever”.
    • Towards the end of 19th century, Bombay experienced an industrial boom led by the rapid growth of textile mils. This caused a massive labour migration into the city leading to extreme overcrowding.
      • A health officer’s report from the time provides a sense of the congestion in the chawls where the city’s poor lived: with the floors fully occupied, it was common for people to create a second level of sleeping spaces by suspending bedding in the air using ropes.
    • These conditions were ideal for the rapid spread of the influenza virus, which was spread either through insects or direct human contact. Lack of sanitary living conditions and proper nutrition greatly increased the number of deaths that the flu caused – especially among the poor.
  2. The flu’s advent in Bombay can be traced back to a military ship which arrived from Iraq on 4 June 1918. Most of the ship’s crew were suffering from an unknown illness, but the harbour health officer did not report this. By the time he did inform the authorities on 26 June, the disease had already spread rapidly among Bombay’s working classes.
    • The flu began spreading into the city from the port – a policeman who had been posted there was one of the first to be admitted to a hospital with the disease. Subsequently, outbreaks of the disease were recorded among dockworkers, Port Trust employees, in a shipping firm, a merchant bank, and among several police squads all over the city.
      • By mid-June, there were further outbreaks in the telegraph office, the mint, and in a major textile mill. By 24 June, The Hindu was reporting that 600 men who worked in the docks were down with illness and that 300-400 workers of the mint were also absent from work due to illness.
      • Interestingly, the lowest incidence of disease in this first wave was among Dalit Muslim sweepers employed by the government. Even though they were considered especially vulnerable due to their generally poor health and financial condition, only about 4% of them were infected. A report from the Municipal Health Office speculated that they had been protected by their untouchable status, since the flu required direct contact to spread.
  3. Initially, the Health Department of Bombay did not take the disease seriously. It declared that the infection was nothing more than the seasonal influenza virus that affected people every year. Meanwhile the flu began to spread beyond the city: within a week, it had reached as far as Delhi, Meerut, and Shimla and by August it had become widespread in Punjab and the United Provincespresent day Uttar Pradesh.
    • The impact of the flu was particular severe in rural areas. The Times of India reported that in the five districts of Sholapur, Nasik, East Khandesh, Ahmednagar and Satara, more people died due to the flu in one month than due to all other causes over a year in the city of Bombay.
      • Dinshaw Mehta, personal physician to M.K. Gandhi, observed in the same paper that the rapid spread of disease flu had stunned everyone: “It was among us and before we could gather our wits, it had done its deadly work and had disappeared.”
  4. The second wave of the pandemic, which started in September 1918, hit even harder. “Never within the memory of the oldest man living in Bombay has this city witnessed so many people stricken down with fever and so many of them dying in a helpless condition,” reported the newspaper Gujarati on 6 October 1918.
    • By 28 September, the number of deaths had increased to unprecedented levels. The Hindu reported that burning ghats and cemeteries were overflowing with mourners.
      • Unlike in the first wave, the worst impact of the second wave was felt by the poor and marginalised, whose poor living conditions greatly increased their odds of dying if they got infected. In Bombay, for example, the mortality rate among caste lower caste Hindus was 61.6% while it was only 18.9% for upper caste Hindus and 8.3% for Europeans.
      • Women also had a higher mortality rate than men. This was thought to be because they cared for the sick in their families and were largely confined to their homes.
  5. Spreading outward from Bombay, the pandemic blitzed through most of India’s major northern and western cities. However, caught between the flu and the famine it had caused, it was India’s villages that were the worst-hit. By one estimate, 12-13 million people had died within a few months.
    • Most newspapers acknowledged that the villages had a complete lack of doctors, healthcare facilities, and even medicines. Speaking on this issue in October 1918, Bal Gangadhar Tilak’s newspaper, Kesari, wrote: “In big cities, doctors, volunteers and hospital arrangements can be had. But how can this assistance be obtained in the villages? Is it not the duty of the government to maintain travelling dispensaries in villages at such a time?”
    • The spread of the disease in the villages caused famine and a sharp rise in the price of food and other essential commodities. This, in turn, resulted in mass migration of the starving rural poor to cities. A Times of India report from February 1919 estimated that Bombay’s population had increased by 2-3 lakhs in just a few months, which further aided the spread of the disease in the city.
  6. Not only was the administration unprepared for the pandemic, it also seemed to have no plan for providing medical or food aid once the crisis had set in. It seemed to have abandoned the people to their fate. In Bombay presidency, the overwhelmed colonial government simply packed up and moved to the hills.presumably to the summer capital of Mahabaleshwar
    • According to the Bombay Chronicle, when officials were asked about the government’s retreat to the safety of the hills when Bombay was in the midst of a crisis, they replied that “though absent in body, the Government is with us always present in spirit.”
      • The Sunday Chronicle pointed out that the government had left the entire responsibility of dealing with the pandemic to low-level municipal officers and charities. Terming the government’s behaviour a “gross dereliction of duty,” it commented on 20 October that the “paralysing atmosphere” in the Bombay Secretariat has kept “the ma-baap (guardians) of the people in a state of coma”.
  7. British neglect of India’s sanitation and healthcare needs was systematic and long-standing. A government report published in January 1918 revealed that the issue of sanitation in the villages had been under consideration for 39 years, with no action taken. The British justified this inaction using the convenient excuse that Indians were “resistant to change.”
    • The official position of the British was that was “a repository of diseases.” However, they also argued that improving sanitation and public health across the sub-continent was a task “too gigantic to contemplate” because it would require them to “meddle deeply and dangerously in the habits and customs of the natives.”
      • The net result of this argument was that the British not only did nothing to improve India’s public health facilities, they also blamed Indian attitudes as the cause of this inaction.
  8. The native press played a crucial role in this crisis. Newspapers not only brought to light the suffering of millions, but also strongly attacked the government for its inaction, leading to eventual changes in policy.
    • Writing on 5 October, the bilingual newspaper Jam-e-Jamshed demanded that the government start publishing official statements explaining what steps it had already taken and what it planned to do with regard to the pandemic.
    • “A shocking state of affairs exists as everybody in the community knows except those who live on Malabar Hill and at Colaba,” an article published in Young India pointed out on 16 October. “Something is radically wrong with regard to the municipal administration in this city and drastic changes must be undertaken because the health of the communities can no longer be allowed to be threatened in this manner by a recurrence of such calamities.”  
    • “It is not enough to call the epidemic a world scourge and then sit with folded hands,” the Ahmedabad correspondent of The Times of India wrote on 13 October. The article argued that the the class and income disparities between ordinary people and important government officials meant that the latter were simply not aware of ground realities – and this was apparent from the lack of sympathy in the government’s efforts.
    • In the Bombay Chronicle of 23 October, Sir Dinshaw Mehta called for a radical overhaul of the municipal administration to make it more a democratic body that would listen to the will of the people. He described the condition of Bombay as such that “would not be tolerated even in a third rate city in Europe” and argued that the situation had arisen because the city was run “on the whims of the executive and the amiable platitudes of a self-satisfied plutocracy.”
  9. With most doctors away on war duty, whatever relief efforts the government and charitable institutions managed to arrange were limited and mostly ineffective. By the admission of a senior military doctor, the medicines the government began handing out had almost zero effect on the disease. Eventually, the flu subsided.
    • On 6 October 1918, the newspaper Gujarati criticised the unaffordable prices of medicines, arguing that the government needed to step in and provide them to the poor from its own stocks.
      • By mid-October, the Times of India reported that six roadside dispensaries had been opened across the city of Bombay. They supplied milk, blankets, and medicines.
      • According to Thomas P. Herriot, Captain of the Royal Army Medical Corps, the medicines being distributed could not “be ascribed any power of either cutting short of the disease or in the preventing of appearance of the symptoms of the virulent type of the disease.”
    • By mid-November, the flu pandemic was subsiding across India, but Indian newspapers continued to do their jobs, critically analysing the government’s actions despite the threat of censorship that hung over their heads.
  10. The 1918 pandemic offers important lessons for today’s world. It reveals how disasters can expose the apathy of governments, colonial or not, that do not value the welfare of all citizens. It also shows how civic institutions like the press are often the only hope to shame them into action.
    • The events of 1918 point to the clear need for leadership and strategic planning in overcoming a crisis. When the government prioritises other agendas in such a situation, as the British did with the war effort, the result would be disastrous.
      • The other important learning from the episode was the vital necessity of a watchdog to hold the government accountable when it fails at its duties. By maintaining a constant attack on the colonial government’s apathy, the native press was able to force some sort of response in terms of relief efforts.

Source text: Bombay Fever / Spanish Flu: Public Health And Native Press In Colonial Bombay, 1918–19
Publication: South Asia Research (2021)
Author: Madhu Singh

Note: This is a summary of a single research paper. It reflects one argument that we think would be interesting or useful to discuss. It may not offer the full picture or represent consensus on this topic, both of which are always evolving.