Medicine and Colonial Engagements in India and Sub-Saharan Africa 1527508846, 9781527508842

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Medicine and Colonial Engagements in India and Sub-Saharan Africa

Medicine and Colonial Engagements in India and Sub-Saharan Africa Edited by

Poonam Bala

Medicine and Colonial Engagements in India and Sub-Saharan Africa Edited by Poonam Bala This book first published 2018 Cambridge Scholars Publishing Lady Stephenson Library, Newcastle upon Tyne, NE6 2PA, UK British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Copyright © 2018 Poonam Bala and contributors All rights for this book reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. ISBN (10): 1-5275-0884-6 ISBN (13): 978-1-5275-0884-2

Dedicated to My (late) father for the love and inspiration he gave me during his living years, and My mother for her unceasing support, guidance and blessings

TABLE OF CONTENTS List of Images ............................................................................................. ix Acknowledgements ..................................................................................... x Chapter One ................................................................................................. 1 Introduction: Understanding Colonial Engagements in the Imperial Project Poonam Bala Chapter Two .............................................................................................. 11 Ayurveda and the Raj: Agenda for a ‘Nationalist Project’ Poonam Bala Chapter Three ............................................................................................ 27 Indigenizing Population Control: Yashoda Devi and the Construction of Population Politics in Late Colonial India͒ Rachel Berger Chapter Four .............................................................................................. 46 Toward a Transnational Modernity: Managing Female Sexuality, Conjugality and Reproduction in the Bengali Magazine, Nara-Naree (1939-1950) Sutanuka Banerjee Chapter Five .............................................................................................. 69 Feeding Empire: Wet Nursing and Colonial Domesticity in India ͒ Narin Hassan Chapter Six ................................................................................................ 88 Gandhi’s Moral Politics and Plague in South Africa ͒ Srirupa Prasad Chapter Seven.......................................................................................... 107 Beyond the Brown Tick: Colonial Racial Hegemony and the Control of East Coast Fever in Swaziland, 1902-1920 Estella Musiiwa

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Table of Contents

Chapter Eight ........................................................................................... 131 Inimitable Colonial Anxiety: African Sexuality in Uganda’s Medical History, 1900- 1945 Nakakyike Musisi and Seggane Musisi ͒ Chapter Nine............................................................................................ 154 Building a ‘Healthy’ Empire: White Women, Race and Health in Colonial Zimbabwe Ushehwedu Kufakurinani Chapter Ten ............................................................................................. 176 Medical Philanthropy: Missionaries in Colonial South India Sam Nesamony Chapter Eleven ........................................................................................ 201 Tropicality, Race and the Production of Medical Knowledge in Colonial Kenya Osaak Amukambwa Olumwullah Contributors ............................................................................................. 232 Index ........................................................................................................ 235

LIST OF IMAGES

Image 4-1

Image 7-1 Image 7-2 Image 7-3 Image 7-4 Image 7-5 Image 8-1 Image 8-2 Image 8-3 Image 8-4 Image 8-5 Image 8-6

An Overview of the Editorial Board and the Management Committee of the Magazine, Nara-Naree, 1347 {1940} East Coast Fever in Swaziland, 1908 East Coast Fever in Swaziland, 1909 Fence erected to control East Coast Fever in Swaziland, 1912 Dip Tanks in Swaziland, 1914 Dip Tanks in Swaziland, 1916 Colonial Ethnic Districts of the Uganda Protectorate under British Administration Picture of the First Mengo Hospital, 1897 The New Mengo Hospital of 1904 as renovated and repainted in recent years, 2015 Mengo Hospital today, 2015: The Sir Albert Cook Wing Female missionary-trained nurses continue to dominate Uganda’s nursing and midwifery profession, 1995 Mengo School of Nursing and Midwifery as it appears today, 2015

ACKNOWLEDGEMENTS

I take this opportunity to express my sincere gratitude to the authors for their chapter contributions to this volume. Their patience, support and enthusiasm, despite unforeseen delays during various stages of this volume, made this work a reality. It was a long journey which was taken by all my authors with much professionalism and understanding- thank you all! I am also thankful to Wendy Regoeczi and Phil Manning at Cleveland State University for their collegial support. An appreciative mention cannot go amiss for Phyllis Smith for her help and to staff at Michael Swartz at Kelvin Smith, University of Calcutta and Jawaharlal Nehru University libraries as well as at the West Bengal State Archives for their assistance enabling access to sources. Thanks to Diane Grabowski for prioritizing my work for the final edits on a short notice and to Rebecca Cotton for the detailed edits of the foot notes in a timely manner. I also thank the reviewer for his/her valuable comments and suggestions. Thanks are also due to staff at Cambridge Scholars Publishing, especially Victoria Carruthers for her initial and supportive collaborations for the project and Amanda Millar for her promptness in communications, patience and help in addressing last minute amendments. As always, I hold a special place for my mother who has been a great source of inspiration in my academic pursuits. Her joy in seeing my work is a blessing for me and I thank her wholeheartedly for her love, appreciation and support in whatever challenges I have undertaken in life.



CHAPTER ONE INTRODUCTION: UNDERSTANDING COLONIAL ENGAGEMENTS IN THE IMPERIAL PROJECT POONAM BALA

While a history of medicine encompassing aspects of disease and health in relation to colonial imperatives, generally, has been a major focus of scholarship in recent years, discussions and debates on race and racial purity, gender and sexuality and their changing meanings in the metropole have significantly contributed to new perspectives in understanding these changes. Medical ideologies and their relationship with race and gender constructions, as well as with hegemony and resistance in colonial regimes, now call for a detailed analysis, prompting a fresh look at these issues. The primary aim of this volume is to understand the dynamics of colonial engagements with the colonized peoples by looking at medicine, race and gender as constituting an indispensable apparatus of the imperial project in two former regions of the British Empire—India and sub-Saharan Africa— and their deployment in the colonizing process. In effect, the essays in this volume dwell upon two main arguments: firstly, race, medicine and gender were sites and fundamental structures through which and within which, colonial governance was enabled within the imperial project. Secondly, while these sites and structures played out differently in different sociocultural contexts, within the two former British possessions of India and sub-Saharan Africa, the new forms of medical knowledge and practice produced as a result reshaped colonial knowledge as well as the imperial project, thus revealing new dialectical relations between knowledge and power. In understanding these dynamics, it is important to address issues of not only how only notions of race and gender dynamics were imposed but how new forms produced as a result of resistance against cultural encounters and confrontations in the colonial context, influenced their connotations within the larger ideologies of the metropole.



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Chapter One

Colonial engagements and colonial encounters produced colonial anxieties, largely articulated as concern for imperial hegemony and the maintenance of health and social order within the colonies. In this respect, they also rendered race, medicine and gender, which I call sites of desire, indispensable, for it was through these sites that the fear of disease and disaster underlying colonial anxieties could be allayed. Moreover, they were the focus of desire in that they addressed and fulfilled aspirations of the colonial enterprise. Thus, as Siddiqui remarks, if imperial rule produced anxieties about hegemony and identity, the forms these anxieties took, shaped the way power was wielded.1

For the most part, in India and Africa, health anxiety followed from European beliefs that health was a result of interaction among various social and environmental factors. While in the tropical colonies, this led to new modalities of investigation of the environment, it also created insecurities about “loosening the grip” on these colonies.2 Helen Tilley’s recent study3 on the role of science in the colonization of British Africa portrays a tumultuous trajectory of the dynamics between scientific erudition and imperialism. It was not the mere knowledge acquired through research and scientific expertise in the colonies but the actual colonial experiences during episodes of disease, epidemic and popular resistance, expressed through various modalities, that evoked panic, anxiety and fear of imperial instability. This also increased imperial intervention, for it precipitated colonial feelings of vulnerability and insecurity regarding loss of imperial power.4 Moving beyond these modalities, Robert Peckham,5 in his recent study, highlights the relationship between panic and the changing nature of the imperial state as governed by communication and dissemination of the knowledge of disease.



 1

Yumna Siddiqui, Anxieties of Empire and the Fiction of Intrigue (New York: Columbia UP, 2008), 20. 2 James Beattie, Empire and Environmental Anxiety: Health, Science, Art and Conservation in South Asia and Australasia, 1800–1920 (London: Palgrave Macmillan, 2011), 45. 3 Helen Tilley, Africa as a Living Laboratory: Empire, Development and the Problem of Scientific Knowledge, 1870-1950 (Chicago: Univ. of Chicago Press, 2011). 4 Harald-Fischer-Tiné, ed., Anxieties, Fear and Panic in Colonial Settings: Empire on the Verge of a Nervous Breakdown (London: Palgrave Macmillan, 2016). 5 Robert Peckham, ed., Empires of Panic: Epidemics and Colonial Anxieties (Hong Kong: Hong Kong UP, 2015).



Introduction

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The chapters in this volume focus on various aspects of colonial engagements in India and sub-Saharan Africa under British rule in the nineteenth and twentieth centuries for several reasons. Firstly, the undeniable and continued existence of historical connections between India and Africa, dating back several years, has left a history of cultural contacts between the two; these were apparent, for instance, in the social interactions as seen in, for instance, the dhow culture that became “the benchmark history of the early Indian Ocean,” facilitating “social interaction between sailors and traders with their hosts around the rim of the Indian Ocean.”6 These transoceanic interactions also generated an immense “body of navigational knowledge through…commercial contacts and exchanges,”7and were, at the same time, significantly indicative of social connections and a shared and connected history of India and Africa. Tony Ballantyne and Antoinette Burton’s pioneering work, Bodies in Contact: Rethinking Colonial Encounters in World History, an engaging piece of scholarship in colonial gender studies, also elucidates these connections through a focus on “bodies as a means of accessing the colonial encounters....,” 8 which, they argue, is also one way of “reimagining world history and ‘the structural events and changes’ and their ‘impact on microprocesses and the historical subjects who lived with and through them.’’”9 Moreover, the way Europeans saw their bodies in relation to the colonies changed with shifting power relationships in the colonies and new trends in the intellectual currents emanating from the metropole.”10 Secondly and following on the preceding point, awareness of claims to authority and indigenous medical traditions and their socio-spatial location becomes imperative in understanding the role of traditional medicine as an agency of change, resistance and accommodation, as evident in the British Empire. These connections, along with African–Indian encounters, also gave rise to a new “African” or “indigenous” knowledge, which could be seen “as an amalgam of many cultural and political influences” where

 6

For details see, Abdul Sheriff, Dhow Cultures of the Indian Ocean: Cosmopolitanism, Commerce and Islam (London: Hurst & Co, 2010). 7 Poonam Bala, “Review of Dhow Cultures of the Indian Ocean: Cosmopolitanism, Commerce and Islam by Abdul Sheriff,” African Historical Review 44 no. 1 (2012): 138–42. 8 Tony Ballantyne and Antoinette Burton, eds., Bodies in Contact: Rethinking Colonial Encounters in World History, (Durham: Duke UP, 2006), 4. 9 Ballantyne and Burton, Bodies in Contact.͒ 10 Mark Harrison, “The Tender Frame of Man: Disease, Climate and Racial Difference in India and the West Indies, 1760–1860,” Bulletin of the History of Medicine 70, no. 1 (1996): 68–93.



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Chapter One

“Indians not only adopted the ailments of their African counterparts but became practitioners and purveyors of African medicine itself.”11 The relation between indigenous medicine, knowledge and power can be gauged with absolute clarity in Megan Vaughan’s discussion on colonial East and Central Africa, where she highlights the role played by “medicine and its associated disciplines in constructing ‘the African’ as an object of knowledge, [and by] the elaborated classification systems and practices which have to be seen as intrinsic to the operation of colonial power.”12 More significantly, Russel Viljoen’s fascinating work on the Khoikhoi society amply demonstrates the extent to which indigenous medicine and medical practice were embedded in that society prior to its colonization.13 The significance of indigenous medicine became more revealed in the course of the “shifting power relations between indigenous healers and foreign scientists [not only] in Africa but across the world.”14 Abena Dove Osseo-Asare, in her recent study, Bitter Roots: The Search for Healing Plants in Africa, provides a highly illuminating account of the changing trajectory of drug discovery “in taking traditional medicines to the laboratory,” which “created a new scientific identity in modern African settings.”15 On a slightly different note, Warwick Anderson's case study of the Philippine experience16 unravels new perspectives of the colonial process by viewing colonial medicine “as linking metropole with colony through interconnecting practices, people, technologies and ideas. This movement of ideas and people has profitably allowed for a balanced appreciation of the ‘experience of empire’ in a far too neglected part of the

 11

Karen Flint, Healing Traditions: African Medicine, Cultural Exchange and Competition in South Africa, 1820–1948 (Ohio: Ohio UP, 2008), xi. 12 Megan Vaughan, Curing Their Ills: Colonial Power and African Illness (Cambridge: Cambridge UP, 1991). 13 Russel Viljoen’s study of the Khoikhoi in South Africa is one of the most comprehensive and informative biographies of a Khoikhoi man living under Dutch colonial rule, illuminating the lives of the Khoikhoi peoples whose cultures were destroyed by Dutch colonizers.͒For details on the status of indigenous medicine in South Africa, see Russel Viljoen, Jan Paerl, a Khoikhoi in Cape Colonial Society, 1761–1851 (Leiden, Boston: Brill, 2006); and Russel Viljoen, “Disease and Society: Cape Town, Its People and the Outbreak of the Smallpox Epidemics of 1713, 1755 and 1767,” Kleio 27 (1995): 22–45. 14 Abena Dove Osseo-Asare, Bitter Roots: The Search for Healing Plants in Africa (Chicago: Univ. of Chicago Press, 2014), 3. 15 Osseo-Asare, Bitter Roots, 6. 16 Warwick Anderson, Colonial Pathologies: American Tropical Medicine, Race and Hygiene in the Philippines (Durham and London: Duke UP, 2006).



Introduction

5

world.”17 Although medicine in the British colonies has drawn considerable attention from scholars, there is a need to understand the dynamics between British imperial identity and knowledge, both of which were defined and shaped by the colonies, their practices and their knowledge. For instance, with regard to understanding gender in colonial empires, it has been suggested that the British medical women’s quest to carve out a professional sphere in the colonies, not only shaped the direction that medical education for women in Britain would take but also led female medical reformers to construct their goals as different from and in some ways superior to, traditional missionary reform as carried out by women.18

While these studies make significant contributions to a better understanding of British Africa and India, they offer limited knowledge of the connecting dynamics of colonial power in the two. The present volume bridges this gap to build new perspectives on the engagements of imperial ideologies within the two colonies and on the linkages drawn upon various colonial expressions of medicine, race, gender and disease. In her seminal work, Carnal Knowledge and Imperial Power, Ann Laura Stoler provides a detailed account of the complexity of the issues underlying colonial cultures and politics. Illustrating these in the context of race, gender and class perspectives, she argues that “colonial cultures were never direct translations of European society planted in the colonies but unique cultural configurations, homespun creations in which European food, dress, housing and morality were given new political meaning in specific colonial social orders.”19 While the newly created colonial categories were essential for imperial governance, they also led to “racialized politics of classification.”20 Equally significant in understanding

 17

More details can be obtained from a review by Raquel A.G. Reyes, “Colonial Pathologies: American Tropical Medicine, Race and Hygiene in the Philippines,” Medical History 52, no. 3 (July 2007): 424–26. 18 Antoinette Burton, “Contesting the Zenana: The Mission to Make ‘Lady Doctors for India,’ 1874–1885,” ) 3 (July 1996): 368–97, 371. See also Janaki Nair's essay, “Uncovering the Zenana: Visions of Indian Womanhood in Englishwomen’s Writings, 1813-1940,” Journal of Women’s History 2 (Spring 1990): 8–34, in which she discusses the different ways in which the zenana was constructed by English women writers as an “ideological and vocational space.” 19 For details, see Ann Laura Stoler, Carnal Knowledge and Imperial Power: Race and the Intimate in Colonial Rule (California: Univ. of California Press, 2002), 24. 20 Ibid., 7.͒



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Chapter One

the relevance of these encounters and creations is their role in explaining the “growing empires’ demand to become morally conscious” so that they would uphold their “racial, national and religious superiority,”21 while still maintaining their centrality in imperial politics. In this vein, as Durba Ghosh, in her pioneering work, Sex and the Family in Colonial India, remarks, “fundamental elements of colonial racial hierarchies were put in place much earlier as the bodies of native women became the site upon which the probity of colonial rule and the boundaries of Britishness were established.”22 While race and racial descriptions were important markers of colonial attitudes, concomitant changes took place with the emergence and dissemination of new policies and developments in the nineteenth and twentieth centuries. One such development was seen in the rise of the printing press in the colonies which enabled the development of national literatures. Moreover, “in Asian and African contexts, standard print cultures were powerful forces in forging national identities among the colonial intelligentsia, following from the European model”23 while also focusing on "high" literature, perpetuating “images of a Western-educated indigenous intelligentsia effecting modernization and reform.”24 The rise of the printing press linked the “colonial society in India and Victorian Society in England” by producing a “shared national (imperial) identity.”25 At the same time, “in the active intellectual climate that had been stirred up following the close encounter with the West, Bengali became the medium of self-expression of a conscious and articulate urban literati. The canons of polite speech and literature that came to dictate the cultural life of the educated classes in Bengal led to an intense drive to cleanse and standardize an untidy colloquial and to stamp it with “authenticity” and

 21

Durba Ghosh, Sex and the Family in Colonial India: The Making of Empire (Cambridge: Cambridge UP, 2006), 1. 22 Ghosh, Sex and the Family, quoted in Tony Ballantyne, “The Changing Shape of the Modern British Empire and its Historiography,” The Historical Journal 53, no. 2 (June 2010): 429–52. 23 Benedict Anderson, Imagined Communities: Reflections on the Origins and Spread of Nationalism (London: Verso, 2006), 86, quoted in Anindita Ghosh, “An Uncertain ‘Coming of the Book:’ Early Print Cultures in Colonial India,” Book History 6 no. 1 (2003): 23–55. 24 Ghosh, “An Uncertain ‘Coming of the Book.’” 25 Benedict Anderson, Imagined Communities, rev. ed. (London: Verso, 1991), quoted in Denise P. Quirk “True Englishwomen and Änglo-Indian: Gender, National Identity and Feminism in the Victorian Women Periodical Press,” in Imperial Co-histories: National Identities and the British Colonial Press, ed., Julie F. Codell (NJ: Fairleigh Dickinson UP, 2003), 167–86.



Introduction

7

“respectability.”26 Such developments were also reflected in health and women’s health, in particular, when vernacular languages helped to initiate new public discussions on sexuality and reproductive health and population politics and control that gained prominence in colonial policies. In discussing engagements of medicine with colonial ideologies and through case studies focusing on colonial India, South Africa, Swaziland, Uganda, Zimbabwe and Kenya, Medicine and Colonial Engagements explores several themes. First, the ways in which gender, race and medical knowledge were conceptualized, reframed and re-defined as necessarily imperial; second, production and dissemination of specific forms of knowledge created through these engagements; third, the emergence of transnational knowledge and scientific discourses; fourth, the complex nature of colonial engagements expressed through colonial anxieties, body politics, health and self-discipline; finally, construction of racial hegemony and sexuality and new perceptions of gender. While studying colonialism, imperial relations and their dynamics become significant as they are understood in terms of cultural encounters and knowledge encounters which included both “indigenous and colonial as well as elite and popular”27 elements “in diverse locations of the empire.”28 In India, these cultural engagements,” interwoven into indigenous epistemologies,”29 produced a kind of “mixed” or alternative modernity.”30 The rise of the national movement was one such outcome of the colonizing process that created and re-created new ideas of scientific modernity, involving nationalists, medical practitioners and the people of India. As a cultural force, nationalism also offered distinct strategies of acquiring not only political freedom but also social, cultural and medical autonomy that would ensure and sustain an indigenous collective identity. Not surprisingly, some indigenous medical practitioners attempted to validate, for instance, Sikh solidarity by appropriating indigenous knowledge in vernacular languages.31 Set within the framework of a nationalist agenda,

 26

Ghosh, “An Uncertain ‘Coming of the Book.’” Fa-ti Fan, British Naturalists in Qing China: Science, Empire and Cultural Encounter (Cambridge, MA: Harvard UP, 2004).͒ 28 Richard Drayton, “Knowledge and Empire,” in The Oxford History of the British Empire: The Eighteenth Century, vol. 2, ed. P.J. Marshall (Oxford: Oxford UP, 1998), 231–53.͒ 29 See Tony Ballantyne, “The Rise of Colonial Knowledge,” in The British Empire: Themes and Perspectives, ed. Sarah Stockwell (Malden, MA: Blackwell Publishing, 2008), 186. 30 Ballantyne, “Colonial Knowledge.” 31 Kavita Sivamakrishnan discusses this in her study on indigenous medicine in 27



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Chapter One

Bala examines the trajectory of Ayurveda as a significant element of the national consciousness. Equally significant was the paradigm of Hindu domesticity that Berger highlights in her chapter on the development of population politics. She sees this as part of a process where controversial information, especially that concerning sexual and reproductive health, was conveyed to women; in this process, a new order for a ‘healthy nation was created in the domestic lives of women.’ The rise of print culture and its engagement with the public signified continuity in meaningful (re) negotiations of medical techniques, therapeutics and new methods of diagnosis. The indispensability of print culture can be gauged through Banerjee’s chapter, which highlights the role played by the Bengal periodical, Nara-Naree as a vehicle for dissemination of ideas on the female body, sexuality and conjugality and their impact on gender roles and in the emergence of global sexology. In trying to unravel the complexities in understanding gender roles, the female body and sexuality and procreation imbrication across colonial regimes, the chapter shows that printed literature advocated and circulated global knowledge on these issues, at the same time addressing ideas of scientific modernity. Banerjee’s discussion also focuses on the engagement of women as agents as well as subjects in the propagation of ideas on sexual science and contraceptive knowledge beyond the elite and Western framework—the private domain impacting upon the public domain. This process was furthered by the employment of the wet nurse, whose intimate relationships and bodily transactions with British babies reaffirmed her role as more of an agency on which imperial mandates depended; in her discussion on locating the wet nurse in the colonial context, Hassan provides a lucid explanation of the various perspectives involved. The wet nurse’s position in a colonial household, she argues, created new ideas for the negotiation of colonial and familial relations. Other allegories of the body also formed an essential component of political ideas and impressions, especially during the time of the national movement in India when issues of power and contestation with colonial imperatives reigned supreme. In 1909, Gandhi expressed his thoughts on self- discipline in terms of “real home-rule (national self-government),” which he advocated in terms of “self-rule or self-control.”32 In this context, Prasad offers a

 colonial Punjab. For details, see her Old Potions, New Bottles: Recasting Indigenous Medicine in Colonial Punjab (1850–1945) (New Delhi: Orient Longman, 2005), 13. See also details in Nandini Bhattacharya, “Between the Bazaar and the Bench: Making of the Drugs Trade in Colonial India, ca. 1900– 1930,” Bulletin of the History of Medicine 90, no. 1 (Spring 2016). 32 Anthony J. Parel, ed., M.K. Gandhi: Hind Swaraj and other Writings



Introduction

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detailed explanation of the close ties between the political and moral desires required for self-rule and self-care in the form of health and healthy living which also became indispensable to colonial dictates of “policing food consumption.” In recent years, scholars have examined the relationships between veterinary science and medicine under colonial regimes in order to understand their impact on various policies of the colonial administrators. The chapter by Musiiwa goes beyond these perspectives to look at how racial hegemony was constructed through the coming together of knowledge on stock disease and the anxiety to control East Coast fever, providing much-needed new insights into the racial “disease, medicine and empire” perspective. On a similar note, attitudes regarding gender and sexual development, as Musisi and Musisi highlight in their chapter, underwent major changes as a result of colonial public health measures. While the “enclavist” agenda of colonial policies may have been apparent, transformations in gender perceptions were as a result not ruled out. In addition, women, as “mothers of empire,” as Ushehwedu discusses in his chapter, also produced “racial discrepancies” in delivering health services to the native population, producing an “unhealthy” empire. Central to understanding imperial history in the nineteenth and twentieth centuries is recognition of the prominence attained by much of the scientific and medical enterprise. However, their engagements with the colonized populations had resulted in “the cultural framing of political ideologies.”33 Discussed in this vein, medical institutions and Westernstyle schools were major avenues for evangelization, humanitarianism and dissemination of Western education and culture. Christian missionaries played a significant role in facilitating colonial powers as they expanded, often acting as “go-betweens”34 while the colonists increasingly gained control. In India, the “medical mission-cum-salvation” strategy operating through “touring clinics,” as discussed by Nesamony, not only provided much-needed health benefits but also catalyzed amicable relations and prevented contestation between the missionaries and the people. Placed in this context, medicine in the colonial setting, as Roy MacLeod and Milton Lewis contend, entails “the experience of European medicine overseas, in

 (Cambridge: Cambridge UP, 1997), 118. 33 Stoler, Carnal Knowledge, 13. 34 James R. Lehning, European Colonialism since 1700 (Cambridge: Cambridge UP, 2013), 217.



Chapter One

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colonies established by conquest, occupation and settlement.”35 The conceptualization and production of medical knowledge were important markers in the framing of colonial policies in Africa. Olumwullah does justice to this aspect in his chapter, arguing that the production of medical knowledge was largely based on understanding the role of the African woman as central to the colonial economy; this also meant that anxieties over the fertility of the African woman were prevalent in the minds of scientists who, in the course of establishing knowledge in the area of tropical medicine and epidemiology, were also compelled to learn about the exact role of African women in society. In understanding the dynamics of disease, health and medicine in relation to colonial engagements, thus, it is significant to note that colonial encounters and engagements with and within indigenous societies deemed race, gender and medicine as necessary sites of desire- for they provided the necessary colonial space (s) within which, and through which, colonial negotiations and conceptualization of new knowledge could be sought; the latter became the guiding force behind health and medical policies in the empire. At the same time, colonial engagements also destabilized existing social spaces within the sociocultural environment of the colonized peoples in India and Sub-Saharan Africa, often defied through nationalistic, racialized and gendered forces and policies, thereby increasing colonial vulnerabilities in an otherwise optimistic colonial enterprise.





35

Roy MacLeod and M. Lewis, eds., preface to Disease, Medicine and Empire: Perspectives on Western Medicine and the Experience of͒European Expansion (London: Routledge, 1988), x.



CHAPTER TWO AYURVEDA AND THE RAJ: AGENDA FOR A ‘NATIONALIST PROJECT’ POONAM BALA

The study of the nationalist movement and the dynamics of medical practice(s) under colonial rule in India has led to new understandings of issues relating to identity, the emergence of modernity and medicine. While the rise of nationalist perspectives and sentiments in the second half of the nineteenth century witnessed strong links of medicine with broad cultural awareness of autonomy and self-rule alongside recognition of traditions, Ayurveda provided new visions of engagement of medicine with the prevailing political ideologies. It also represented part of a nationalist agenda, at the same time complementing biomedicine in the latter’s appeal in the making of modern science and scientific ideologies. Framed in this context, the chapter will focus on the emergence of nationalism and the engagement of Ayurveda in creating and re-creating new ideas of scientific modernity under colonial imperatives while negotiating with its Western counterpart as an indispensable part of the nationalist project. Much of the nineteenth and early twentieth centuries witnessed social and political changes in India that eventually altered the way in which India’s heritage and culture were to be perceived in encounters with colonial imperatives. These encounters were reflected in attempts at according a new place to Indian medical knowledge vis-à-vis Western medicine when issues of reassessment of medical essentials came to the fore. In locating the emergence of knowledge and power within the colonizing process, Arnold remarks, …..the diverse array of ideological and administrative mechanisms by which an emerging system of knowledge and power extended itself into and over India's indigenous society [was] in many respects characteristic of bourgeois societies and modem states elsewhere in the world. . . . There is

12

Chapter Two indeed a sense in which all modern medicine is engaged in a colonizing process. . . . It can be seen in the increasing professionalization of medicine and the exclusion of “folk” practitioners, in the close and often symbiotic relationship between medicine and the modern state, in the far-reaching claims made by medical science for its ability to prevent, control and even eradicate human diseases.”1

While medicine, as a system of knowledge and power, was instrumental in enabling the colonizing process, it also served to provide legitimacy to the process by addressing the needs of the colonial administration through the expansion of modern medicine and provision of medical services; along with indigenous medicine, it became a powerful force for medico-cultural change in India, which paved the way for promoting new ideas of modernity. Thus, instead of being a “tool” of empire2, it was an agent of medico-cultural change, which also provided a paradigm of analysis of the processes of construction of theories of disease. The oft-quoted claims about the need to resuscitate Indian medical knowledge and practice in the optic of Western medicine call for a clearer understanding of the construction of Ayurveda as a professional body of knowledge under colonial rule. From this perspective, while a social constructionist approach3 to understanding diseases has been controversial,4 its significance as “the centre of medical history”5 within the rhetorical construction of health and healing in particular social situations cannot be overlooked.6 Moreover, the desire to relocate Indian medicine in the changing political scenario under the Raj was indicative of a “progressive” science requiring attention of a different kind—attention that would focus on proving the scientific existence hitherto unrecognized by the colonial administrators.7 It is, thus, in (re)locating Indian medicine that various 1

David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley:Univ. of California Press, 1993), 9-10. 2 Daniel Headrick, The Tools of Empire: Technology and European Imperialism in the Nineteenth Century (Oxford: Oxford UP: 1981). 3 Ludmilla Jordanova, “The Social Construction of Medical Knowledge,” Social History of Medicine 8 (1995):361-81, 367. 4 For further details, see Keir Waddington, An Introduction to the Social History of Medicine: Europe since 1500, (Basingstoke: Palgrave Macmillan, 2011). 5 Waddington, An Introduction to the Social History, p.11. 6 David Harley, “Rhetoric and the Construction of Sickness and Healing,” Social History of Medicine 12, no.3 (1999): 407-35, 432. See also Waddington, An Introduction to the Social History, p.11. 7 Poonam Bala, “ ‘Nationalising’ Medicine: The Changing Paradigm of Ayurveda in British India” in ed. Poonam Bala (ed.), 2012 and 2016, Contesting Colonial

Ayurveda and the Raj: Agenda for a ‘Nationalist Project’

13

issues of modernity come to the fore. But what was the impelling need to (re)locate Indian medicine? As Prakash argues, “the modernity of the Indian nation…was predicated on the science of the ancient Hindus,” which also “became a pervasive and enduring feature of nationalist imagination.”8 The nationalist project in India gained strength in response to the consolidation of Western medical authority and intervention. In the colonial process, while ideas of race and gender were rearticulated and formed and reframed, ideas of medicine were also revisited as the latter became more professionalized over the years.

Early Years of Medical Education Several events characterized the gradual emergence of Indian medicine as a ‘nationalist project’ in response to the shifting policies of the colonial administration: firstly, the trajectory of medical education and its impact on the local population and secondly, the development of colonial policies that governed medical practice in India. The Bhadralok in Bengal were the first social group to, under British rule, embrace the benefits of Westernstyle education and aspire to achieve what was denied to them by the economy.9 As one of the most successful groups, with successful alliances with British colonial administrators and the wealthy, landed and educated, they were recognized as “superior in social status to the mass of their fellows,” adopting Western-style educational ideals and the “literate professions and office jobs” as their main sources of livelihood.10 In later years, it was the Western-educated Bhadralok who were at the helm of medical and cultural deliberations. It must also be noted that Bombay would become equally indispensable as a force behind the growth of the medical profession. In addition to its status as an important port and hub of communication both within and outside India, it offered a unique social structure, claiming the Palshikar Brahmins, the Pathare Prabhus, the Authority: Medicine and Indigenous Responses in Nineteenth- and TwentiethCentury India (Lanham: Rowman and Littlefield and New Delhi” Primus Books), 1-12, 2. 8 Gyan Prakash, “The Modern Nation’s Return in the Archaic,” Critical Inquiry, 23, no.3 (Spring 1997), 536-56. 9 Partha Chatterjee, The Present History of West Bengal: Essays in Political Criticism (Delhi: Oxford UP, 1997) 11. 10 David Kopf, “A Bibliographic Essay on Bengal Studies in the US,” in Aspects of Bengali Histoy and Society, ed. Rachel V.M.Baumer (Honolulu: Univ. of Hawaii Press,1976), 200-43, 213.

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Bhandaris, the Panchkalshis, the Agris and the Kolis, as its oldest existing social groups. Of these, the Palshikar Brahmins were notable not only for their long association with the city but also for the privileges granted to them by the East India Company. They were given the right to act as priests and as medical attendants to the sick. In addition to these social groups, Parsis also constituted a fair proportion of the general community in Bombay. Initial efforts to educate the local population were made by the missionaries who arrived in India in the early nineteenth century. The establishment in 1815 of the Hindu Boys’ School in Bombay, the first school operating in accordance with the style of education in Europe, was followed by a Girls’ School in 1824. Further encouragement to provide education to girls was provided by the Church Missionary Society, which opened another school in 1826 and in 1835 founded an Anglo–vernacular school in memory of Robert Cotton Money, secretary to the government in the Education Department in Bombay. Between 1829 and 1830, six schools for girls were established by Dr. John Wilson of the Scottish Missionary Society. While efforts were made by missionaries to educate the indigenous population in the English language as part of their missionary activity, education in Indian vernaculars also came to the fore. Although Mountstuart Elphinstone, the first Governor of Bombay, established the Elphinstone Native Education Institution in 1827, its quality was determined much later when Charles Morehead, member of the Bombay Medical Service and Secretary of the Board of Education (created in 1840), demanded inspection of all schools in the Bombay Presidency. Local elites, in the meantime, organized the establishment of the Bombay Native School and Book Society, which was eventually merged with the newly created Board of Education, hence taking charge of educational administration in Bombay. A redeeming feature of the education policy of the 1840 Board of Education was the supply in abundance of books in Indian vernaculars, in addition to new translations into the local languages. Local magnates and influential men in the Bombay Presidency actively supported all efforts to promote and expand education in the Presidency; needless to say, they were also the main patrons of medical education in later years. In Bengal, the proposal to expand subordinate medical services resulted in the foundation of the Native Medical Institution (hereafter, N.M.I.) in 1822. The school was the first of its kind in India and attracted popular interest by instituting medical classes (in Indian medicine) in the Indian vernaculars, although instructions in Western medicine were added in 1827. The review of the progress of the N.M.I. by the Court of Directors

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in 1828, revealed dissatisfaction among members of the Political and Military Committee.11 The N.M.I. was, however, short lived, with the reformation strategies employed by William Bentick, the then Governor General of India, resulting in its abolition in 1835. The abolition of the N.M.I. and its replacement by the Calcutta Medical College in 1835 marked the end of the very first attempts at “a peaceful amalgamation of indigenous and western medical education.”12 It was also a turning point in the history of medical education in India as well as a benchmark for the way medical knowledge was to be taught, practiced and disseminated in colonial India. In the Bombay Presidency, attempts to expand education continued unabated. It is possible to identify three phases in the spread of medical education. It started with hospital education in the year 1821, which included a three-year apprenticeship under the supervision of a surgeon and a five-year attachment to different hospitals for acquaintance with the practical details of hospital duty, qualifying those who completed the program as hospital assistants able to serve both indigenous troops and the regiments arriving from England. Dressing wounds, sores and fractured limbs and performing minor surgical operations under the guidance of the accompanying medical officers constituted an essential part of the practice of medicine learned in hospital education. Regular attendance on the sick wards provided further insight into individual cases of the indigent poor, their disease conditions and the prescription of remedies. In the next phase, hospital education was expanded by the establishment in 1826 of the Native Medical School (hereafter, N.M.S.) in Bombay, an institution that would follow the school of native doctors in the Bengal Presidency and provide a medical education on the principle that, as Charles Morehead, a member of the Bombay Medical Service in the 1820s, put it, the education of natives should fit them for the useful and safe practice of surgery and medicine and not the training of the hospital servants of the State.13

Medical instruction at the N.M.S. was imparted through Indian 11

India and Bengal Despatches, Public Letter, 1835. For a detailed discussion on the Native Medical Institution, See Poonam Bala, Imperialism and Medicine in Bengal: A Socio-Historical Perspective (New Delhi,London: Sage, 1991), chapter 2. 12 Bala, Imperialism and Medicine in Bengal. 13 H.A.Hanes, ed., Memorandum of the Life and Work of Charles Morehead (London: W.H. Allen, 1884), 18.

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vernaculars and the entire funding for the school came from the government, its expenses amounting to 8,383 rupees by 1831. Anatomical instruction was communicated by means of plates, casts and preparations, as opposed to the use of scalpel for medical investigation. The school was, however, abolished in 1833 when the Medical Board Committee decided to remodel it on the basis of providing practical knowledge of pharmacy, surgery and “physic” for the improvement of both the theory and practice of medicine. During its brief existence from 1826 to 1833, the N.M.S. trained 70 pupils, of which 21 were employed in military hospitals, while others were either discharged on account of lack of attendance, failure to perform well, or lack of professional etiquette. The final phase in the expansion of medical education witnessed the foundation of the Grant Medical College (hereafter, G.M.C.) in 1845. Successful attempts in bringing Western medicine and medical education to the Indian population in the Bengal Presidency were a factor in inspiring the colonial administrators to adopt similar measures in the Bombay Presidency. The establishment of the G.M.C. clearly reflected the pedagogical focus of Robert Grant (for whom the new medical college was named) on the study of anatomy, instruction in the English language and clinical teaching and practice in a hospital. The period that saw the most changes in the profession and practice of medicine as well as in the State itself commenced toward the end of the nineteenth century, when two issues emerged as a consequence of the changes in the nature of the State after 1857. The first was the matter of encouraging an independent medical profession, or a “profession of Indian doctors,” to extend medical relief through hospitals and dispensaries manned by hospital apprentices. The second was the fact that when the Crown assumed power in 1857, several feudal states were liquidated and new land revenue measures were imposed, both of which actions led to impoverishment of the Indian peasantry. The provision of medical services and their expansion in the mofussil areas where European Civil Officers were stationed, nonetheless, remained a priority for the British government; it also followed upon the colonial “necessity to ensure the continued efficient economic exploitation of the empire’s natural resources.”14 By the late nineteenth century and especially “from the 1870s tropical medicine, its ideology European, its instrument the microscope, its epistemology the germ theory of disease, served the interests of dominant 14 Margaret Jones, Health Policy in Britain’s Model Colony Ceylon, 1900-1948 (Hyderabad: Orient Longman, 2004) 5.

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economic groups and obscured the relationship of disease to the social structure.”15 While new ideologies were central to new perceptions of disease on the part of the medical community, the nationalist movement at the same time acquired prominence with the shifting social and political practices of imperative ideologies. The foundation of the G.M.C., for instance, with the aim of qualifying “a class of practitioners of medicine to displace the hakeems (practitioners of Unani medicine) and vaids (practitioners of Ayurveda) whose ‘ignorance’ was such as to render them rather injurious than useful to the people”16, proved inimical to the professional base of Indian medicine. The Mutiny of 1857 also became a matter of central concern for the medical department when the issue of strengthening the subordinate medical service came to the fore. Moreover, the opening of the Suez Canal in 1869 expanded commerce and trade activities, thus opening up new routes for accessing the interior regions and facilitating an increase in cotton cultivation. With the expanding economic benefits of successful trade, the Native Opinion was prompt enough in recording that the “course of lecture existed….but the spirit seems to be gone.”17 In addition, in order to meet the increasing medical needs, the imperial State actively sought to deploy practitioners of Indian medicine. The impact of these policies was best seen in the government employment schemes between 1887 and 1898 that employed hakeems and vaids trained at the Lahore Medical College.18

New Visions and the Political State The onset of epidemics in colonial India provided one major impetus to the way in which the prospects of health policies were to be determined, yet at the same time, in the Western world, it was shaped by the trajectory of development in the interwar years. Moreover, its contribution to and engagement in creating a wide gulf between Western medicine and Ayurveda, cannot be overlooked. The enforcement of measures to prevent the spread of the plague, for instance, making quarantine measures necessary in the nineteenth century, widened this gulf. Perceived threats of professional exclusion and marginality prompted advocates of Ayurveda 15 Roy MacLeod, “Introduction” in Disease, Medicine and Empire: Perspectives on Western Medicine and the Experience of European Expansion, ed., Roy MacLeod and Milton Lewis (London:Routledge, 1988), 7. 16 Grant Medical College, Bombay: Annual report of the Grant Medical College, Bombay, 1859/60-1861/62. 17 Native Opinion, 4 June 1868. 18 Proceedings of the Government of Bengal, Medical Branch, 1919.

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to seek possibilities of bridging this gap and saving it from a complete fall from grace. In a similar vein, public health measures were often necessitated by the “global spread of epidemic” that “transformed modern medicine and led to the birth of modern public health.”19 As an example, when under these circumstances much of Uganda, the Congo Free State, the French Congo and the Portuguese territories, among others, were faced with one of the most noticeable and unprecedented health crises of the era, with their populations ravaged by human trypanosomiasis (sleeping sickness), “the policies chosen were influenced not just by individual scientists’ recommendations or the national priorities of their governments but also by the transnational community of tropical medicine specialists who exchanged ideas, reinforced each other’s positions and pushed their own agendas.”20 The Indian Contagious Act, promulgated in 1868, also had the effect of stirring anticolonial feelings among the Indian masses. Similarly, the mandatory registration of brothels and prostitutes and the examination and treatment of women afflicted with venereal diseases drew sharp criticism from nationalists, for the intervention was widely seen as “inappropriate and interfering with women’s private lives.”21 Toward the end of the nineteenth century and well into the early twentieth century, the economic conditions prevalent in India became a cause of concern for several nationalists. Prafulla Chandra Ray, with his nationalist outlook and patriotic sentiments, founded the first indigenous pharmaceutical company in the year 1901. Hailed as the father of the chemical industry in India, Ray pioneered the manufacture of drugs and chemicals in the country; his work also reaffirmed the significance of scientific knowledge in the establishment of the drug industry there. With a nationalist outlook and a keen sense of India’s indigenous traditions, he was influenced by Gandhi22 in seeking to employ indigenous technology

19

Pratik Chakrabarti, Medicine and Empire, 1600-1960 (Basingstoke:Palgrave Macmillan, 2014), 96. 20 Deborah J. Neill, Networks in Tropical Medicine: Internationalism Colonialism and the Rise of a Medical Specialty, 1890-1930 (California: Stanford University Press, 2012)135. 21 Blair D. Brown, “The Pros and Cons of the Contagious Diseases Act,” Transactions of the Medical and Physical Society of Bombay, n.s., no. 11 (1887): 91-4. 22 “Viewing the advance of modernity (industrialism and globalization) with trepidation, Gandhi saw the potential impact of capitalism on the body as both a health and a moral issue.” Mark Nichter provides a detailed overview on Gandhi’s views on health. See Mark Nichter, “The Political Ecology of Health in India: Indigestion as Sign and Symptom of Defective Modernization” in Healing Powers

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and raw materials in addressing the economic needs of the Indian population. In this respect, nationalism was not always about attempting to modernize or reform medical tradition; it also had to do with cultivating and reclaiming indigenous skills, knowledge and practices and making these indispensable to the medical profession. Ironically enough, this perspective places less emphasis on the diffusion of “modern medicine” as an ontological entity beyond the West and more on how medicine in colonial India was reconstructed to give it the character that continued in postcolonial times.23 In explaining disease causation, the 1901 Census acted as a precursor to later explanations of ‘caste-disease associations’ by the colonial policy makers. The Census not only reified social and religious hierarchies but also enabled new ideas on political and administrative control of the Indian population through a meticulous numerical grouping of social divisions. As anticipated, explaining diseases through caste and social divisions was disfavoured by the Indian masses and fueled nation- wide anti-colonial sentiments and nationalistic anxieties. Quite clearly, the establishment of Arya Vaidya Samajam in 1901-2 by Vaidyaratnam (jewel among physicians) P.S.Varier, emerged as a successful venture in popularizing drugs manufactured according to indigenous methods for effective treatment of diseases; rich elites, princes and local influential patrons used the success of Arya Vaidya Samajam to favourably explain various notions and debates around professionalism in Ayurveda in later years. Secondly, several events “that took place between 1905 and 1909 altered the political situation in the country with a spur in general disbelief and hostility toward the British rule.”24 The nationalist movement was, thus, also a consequence of the various policies that governed India. The partition of Bengal in 1905 by George Curzon, the then Viceroy of India, divided the Presidency into a Hindu and a Muslim nation-state; the effects of a “religious divide” of the population were far reaching and later reinforced religious consciousness among the people of India. In addition, the Morley–Minto Reforms, through the Indian Councils Act of 1909, while allowing Indians more power and presence in various legislative and Modernity: Traditional Medicine, Shamanism and Science in Asian Societies, eds. Linda H. Connor and Geoffrey Samueln (Westport, Connecticut, London: Bergin and Garvey,2001), 85-106, 86-7. 23 Hormoz Ebrahimnejad (ed.), The Development of Modern Medicine in NonWestern Countries: Historical Perspectives (London: Routledge, 2009). 24 Poonam Bala, “‘Nationalising Medicine..’” in Contesting Colonial Authority, ed., Poonam Bala.

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councils, clamped down on any attempts at establishing a colonial selfgovernment. Not surprisingly, the Calcutta Medical Society’s plans to register medical practitioners in Calcutta were abandoned as a result of “perceived hostility from the vaids and hakeems.”25 It was not until the Montague–Chelmsford Reforms of 1919 (passed through the Government of India Act) that a system of dual government, or “dyarchy,” was introduced. This had larger repercussions on the indigenous medical systems and their practice, for it introduced the categories of “transferred” and “reserved” subjects; the former, which included education, health, industry and agriculture, came under the Indian ministers, while the latter, including finance, irrigation, revenue and law and order, came under the jurisdiction of the governor. The new move accorded with the “diseasespecific” priorities of the Medical Research Council, newly created in 1919 and the foundation of an autonomous Ministry of Health in the same year.26 While most of these negotiations were based on an assumption of the scientific authority of Western medicine, they were never, wholly, accepted by Indian medical practitioners, even though claims of universalization of the West as history had driven “the Hindu intelligentsia to negotiate the relationship of classical knowledge with Western science and to represent their traditions as scientific.”27 Renewed interest in claims of reassertion of the scientific élan of indigenous medicine also meant indigenizing the power of Indian medicine, the main proponents of which were the Westerneducated intelligentsia. Being fully cognizant of Western thoughts and practices and providing a cogent force behind the reformation of Indian medicine, they had perhaps begun to believe that it was the Indian scientists’ breakthrough to the “world of science” that proved more powerful for the cause of science in India and its nationalist perspective than any colonial impediments or “troublesome political 25

Poonam Bala, Imperialism and Medicine in Bengal: A Socio-Historical Perspective (New Delhi, London: Sage, 1991). Government control of medical education led to what Roger Jeffery calls “de-professionalisation” of Western medicine. See Roger Jeffery, “Allopathic Medicine in India: A Case of DeProfessionalisation?,” Social Science and Medicine II (1977): 561-73. 26 Joan Austoker and Linda Bryer (eds.), “Preface” in Historical Perspectives on the Role of the MRC: Essays in the History of the Medical Research Council of the United Kingdom and its Predecessor, the Medical Research Committee, 19131953, eds., Joan Austoker and Linda Bryer (Oxford: Oxford University Press, 1988). 27 Gyan Prakash, Another Reason: Science and the Imagination of Modern India, Princeton: Princeton University Press, 1999), 118.

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questions.28

The Montague–Chelmsford Reforms were followed by a rapid Indianization of medical services. This ensured increased support to indigenous medicine. Similar events took place in other colonial empires. For instance, in discussing the “civic vision of medicine and science in a specific colonial setting” in the Philippines, Anderson characterizes these transfers as being linked with “corporeal and cultural transformation” and “the establishment of hygienic identities in the colonial laboratory.”29 By the end of the nineteenth century, a series of bureaucratic status of practitioners of indigenous practitioners with knowledge of European medicine could be discerned—these came to be predominant in the growing dissatisfaction within the medical professions, which was caused by several factors. Much of this had to do with changes in the medical profession and in the legislation and rules regulating medical practice in Britain at the same time. The most notable of the latter was the 1858 Medical Act, which sought to institutionalize medical practice and was in itself a major breakthrough in the way such practice was to be conducted, for it led to conflicting assertions among practitioners in their efforts to claim superior status; vaids (practitioners of Ayurveda) and hakims (practitioners of Unani) predicated their claims on the knowledge they had gained by “virtue of their acquaintance with Western medicine, while traditional Brahmins, who practiced Ayurvedic medicine ‘as a philanthropic avocation’ and adopted it as an occupation, were at the center of these professional conflicts. Amidst this situation, the foundation of the “Native Medical Society in Calcutta channelized medical practice to members of the Vaidya caste.”30 In discussing the social and political conditions shaping the dissemination of medical information, which also enabled new negotiations of social and intellectual authority, Rachel Berger (Chapter Three in this volume) discusses these changes and new incorporations of modern medicine in the light of Yashoda Devi’s (a successful Ayurvedic practitioner) negotiations of medical information within the public sphere. By the late nineteenth century, while the strength of indigenous medical 28

Uma Das Gupta, “Introduction” in Science and Modern India: An Institutional History, 1784-1947, ed., Uma Das Gupta (Delhi: Pearson Longman, 2011), XV, no.4, xxxix- lxxvii, liii. 29 Warwick Anderson, Colonial Pathologies: American Tropical Medicine, Race and Hygiene in the Philippines (Durham, London: Duke University Press, 2006), 2-3. 30 See D.G,Crawford, A History of the Indian Medical Service,1600-1913 (London: W.Thacker, 1914), Vol.2, 453.

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groups had become noticeable, at the same “hostility towards indigenous medicine within the medical bureaucracy had become apparent.”31 This also led to new visions of an independent medical profession in 1907, which was best expressed in making provisions for practitioners trained in Western methods.32 One of the provisions focused on founding new medical institutions that could be affiliated with existing universities or, alternatively, by increasing the number of government schools. Since by this time, the medical profession was already well-established in the Bengal and Bombay Presidencies, with a large and willing clientele, handing over the charge of providing steady institutional support for medical education and practice to private practitioners was not an arduous task to accomplish. Elsewhere, in the United Provinces and the Central Provinces, medical practice was expanded through long-term affiliations of private practitioners with government hospitals as honorary physicians or surgeons. While the medical community was occupied with issues of strengthening an independent medical profession in India, renewed interest in medical research opened up new vistas for legalizing medical practice, which further prompted new directions for medical policies. The Medical Research Council (hereafter, MRC) established in 1920 under the National Insurance Act in Britain, acted as the main body governing these new directions. In addition to its important role in promoting and overseeing research, it continued to maintain relations with the Colonial Office and the Royal Colleges of Physicians and Surgeons as well as with various pharmaceutical companies.33 Laboratory research, as opposed to clinical trials, observes Cantor, became so important that “only one of the 12 members of the MRC possessed any adequate knowledge of scientific and clinical surgery; one practices medicine and his very able mind, sways rather to the laboratory than to the wards.”34 The end of the First World War witnessed one of the deadliest natural disasters in medical history: the pandemic of influenza that spread across the globe, claiming between 24.7 and 39.3 million lives,35 with almost 21 31

Poonam Bala, Imperialism and Medicine in Bengal, 82. East India Correspondence, 1914. 33 David Cantor provides a detailed and informative overview of the role of the MRC in the first half of the twentieth century. See David Cantor, “The MRC's Support for Experimental Radiology during the inter-war Years” in Historical Perspectives on the Role of the MRC, eds. Joan Austoker and Linda Bryder, 181– 204. 34 See details in David Cantor, “The MRC’s Support….”. 35 David K Patterson and Gerald F Pyle, “The geography and mortality of the 1918 influenza pandemic,” Bulletin of the History of Medicine 65 (1991): 4-21, 19. 32

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million deaths claimed to have taken place in India alone.36 This event reinforced further changes in medical practice in India, with an increase in professionalism and professional regulation being an obvious outcome. The threat of economic loss and colonial instability could not be overlooked by the colonial government. In Bombay Presidency, a bill was prepared for the purpose of regulating medical qualifications as well as the registration of practitioners of “Indian Systems of Medicine”37 (hereafter, ISM). The bill stated that registered practitioners of ISM should be regarded as legally qualified or duly qualified medical practitioners and certificates granted by them shall be recognized by law.38

The prerequisite for registration was, however, passing the qualifying examination, the course of training for which was designed by the Board of ISM. The bill also stated that if the Provincial Government is, on the report of the Board or otherwise satisfied that the course of study and examinations prescribed by any of the institutions are not such as to secure persons obtaining such qualifications requisite knowledge and skill for the efficient practice of their profession, it shall be lawful for the Provincial Government to direct the removal of the name of such institution from the list of institutions authorized to hold a qualifying examination. No person other than a practitioner registered under the aforesaid Bill or under the Bombay Medical Act of 1912 shall be eligible to practise any system of medicine, surgery, or midwifery but the Provincial Government is authorized to direct that this provision shall not apply to any person or class of persons or in any specified area.39

Under these circumstances, it is little surprise that the provision of medical relief to rural areas became a central concern for the medical community. More specifically, the issue attracted considerable attention from the provincial public health and medical departments; in 1934-35, the government of India allocated a sum of one crore rupees to this end.40 In accordance with this scheme, a new system of subsidizing vaids and

36 Ian Mills, “1918-1919 Influenza Pandemic- The Indian Experience,” The Indian Economic and Social History Review 23, no. 1 (1986) : 1-40, 2. 37 These include Ayurveda and Unani. 38 Ernest William Charles Bradfield, 1938, An Indian Medical Review (Delhi: Manager of Publications,1938), 33. 39 Ernest William Charles Bradfield, An Indian Medical Review,34. 40 This is equivalent to 10 million rupees.

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hakims was introduced through the local boards of medicine and health.41 The development of an Ayurvedic college at Poona42 and its subsequent de-recognition and eventual closure following political unrest in the country, illustrates the politicization of medical revival in the postwar period. The wider consequences of these events, coupled with the intensification of political and nationalistic fervor inspired by the civil disobedience or noncooperation movement, were seen in boycotting the educational institutions throughout India. The Bengal Medical Act of 1914, the Bombay Medical Act and the Madras Medical Registration Act further curbed any prospects of association of practitioners with indigenous medicine. For instance, Dr. Krishnaswami Iyer’s name was struck from the Medical Register because of his association with the management of Calavala Cunnum Chettiars Free Dispensary, an Ayurvedic dispensary in Triplicane;43 this affiliation was considered by the Council to be highly “unprofessional conduct.44 Similar warnings of permanent exclusion from the Medical Register were conveyed to Dr. Praburam Popatram, a renowned Ayurvedic doctor, for his institutional affiliation with Praburam Ayurvedic College, founded and named after his father, also a vaid of repute. This led to much public criticism. In Poona, political leaders founded a university named after the nationalist hero Lokamanya Tilak and included Ayurveda in the list of courses. In 1932, however, the institution was derecognized and students of the university were imprisoned for participating in the second Civil Disobedience campaign (1930-34), which was fought more intensely.45 The intensity of political agitation served to provide a high-profile platform for some Ayurvedic practitioners who used public lectures as a forum for expression of their reverence for and allegiance to India’s medical past. The most prominent of these was Kaviraj Mahamahopadhyaya Gananath Sen Saraswati, who delivered lectures on Ayurveda in various parts of the country, often dwelling on its scientific essentials “as Hindu medicine (in 1916)” or defining its pristine heritage by looking at its 41

Ernest William Charles Bradfield, An Indian Medical Review, 34-7. For a detailed discussion on this, see Poonam Bala, “Indigenous Medicine and the State in Ancient India,” Ancient Science of Life 5, no.1 (July-September 1985). With its beginnings enmeshed in politics, the College was affiliated with Poona University by 1955, eventually becoming one of the best-equipped Ayurvedic colleges in the country. 43 Report of the All India Ayurvedic Conference and Exhibition held in Madras, 44 Bombay Samachar, 12 November 1915. 45 Background information for this part has been drawn from Contesting Colonial Authority, ed., Poonam Bala. 42

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“Glory.”46 In this context, discussions on creating a healthy population for India were grounded in various nationalistic debates on Hindu identity. Rachel Berger (Chapter Three in this volume) and Srirupa Prasad (Chapter Six in this volume) address these issues in terms of Gandhi’s advocacy of brahmacharya and the construction of reproductive behavior in the domestic sphere. Elsewhere, in British colonial Punjab, the broader agenda of Hindu cultural and political mobilization was intercepted by the various encounters and conflicts taking place within the emerging social, cultural and political alignments.47 The All India Ayurvedic Mahasammelan, established in 1907 as the leading organization of vaids in India, provided a platform for the nationalist project to support Ayurveda for its scientific and cultural associations. Premised on the links between India’s cultural past and the established Ayurvedic knowledge, the move to reform indigenous medical systems is to be seen as part of the rising national consciousness.48 Needless, to say, Ayurveda also existed as a force of change affecting India’s medical ideas and practices; the drive to attain power, authority and professional autonomy was one expression of this change. Shiv Sharma, one of the presidents of the All India Ayurvedic Congress, argued in support of Ayurveda precisely for this reason.49 In Africa, on the other hand, British colonization of Africa and colonial attempts to apply scientific knowledge in “solving African problems” were subverted by the “local and vernacular expressions.”50 In India, indigenous knowledge provided an equally convincing platform for negotiations and claims for professional authority, power and autonomy. Yet, it existed as a site that was to be desired—a site that could be understood, experienced and accommodated within the imperial project. It was also a cultural force 46

Shivangi Jaiswal, “To be ‘Modern’ and ‘Hindu’: Mobilising Ayurveda for the Nation,” Mainstream LII, no. 39 (September 20, 2014): 9-16. 47 Kavita Sivaramakrishnan discusses this in the light of colonial engagements, political ideologies and Ayurveda in British colonial Punjab. See Kavita Sivaramakrishnan, “The Languages of Science, the Vocabulary of Politics: Challenges to Medical Revival in Punjab, Soc. Hist. Med., 2008, 21 (3): 521-39. 48 See Bala, Imperialism and Medicine in Bengal; B.T. McCully, English Education and the Origins of Indian Nationalism, (Gloucester: Peter Smith, 1966). 49 Jean Langford, 2002, Fluent Bodies: Ayurvedic Remedies for Postcolonial Imbalance, Durham and London: Duke University Press. See also Guy Attewell, 2007, Refiguring Unani Tibb: Plural Healing in Late Colonial India (New Perspectives in South Asian History, no.17), New Delhi: Orient Longman, p.191. 50 Helen Tilley, 2011, Africa as a Living Laboratory: Empire, Development and the Problem of Scientific Knowledge,1870-1950, (Chicago: Univ.of Chicago Press).

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that initiated new visions of the engagement of Western medicine with indigenous ideas. By the end of colonial rule, Indian medicine successfully had created its own modernity in order to serve the health and medical needs of the Indian population.51 Medicine in colonial India can, thus, be seen “as a broader enterprise than” what John Farley52 calls “Imperial Tropical Medicine in missionary activities, modernization and protection of the health of the indigenous peoples.”53 In conclusion, within the broad paradigm of the nationalist project, various developments marked by the emergence of institutional alliances, new networks and engagements within the medical community and attempts at understanding Ayurveda as a ‘national’ symbol, were manifestations of locating indigenous medicine knowledge within popular perceptions of cultural heritage and of scientific and medical knowledge.54 Nevertheless, situating modern cultural constructs within regional intellectual history, as Alter remarks, would also mean “reproducing and reinforcing nationalism and imposing the logic of nationalism on history in general and on intellectual and social history in particular.”55 Finally, the competing claims, with regard to medical thoughts and ideas and professional identities, served as formidable expressions of the nationalist project in colonial India—formidable because they were instrumental in spearheading the various reforms initiated by the nationalists, advocates of Ayurveda and rich and influential Westerneducated patrons; formidable also because they were important agents through which negotiations on localized and indigenous medical knowledge could be carried out, comprehended and disseminated under British rule.

51 David Arnold, Science, Technology and Medicine in Colonial India (Cambridge: Cambridge University Press, 2000), 17. 52 John Farley, Bilharzia: A History of Imperial Tropical Medicine (Cambridge: Cambridge University Press, 1991), 293. 53 Michael Worboys, “The Colonial World as Mission and Mandate: Leprosy and Empire, 1900-1940,” Osiris, Vol. 15, no.1 (2000): 201-18, 207. 54 I have discussed this at length in Poonam Bala, Medicine and Colonialism: Historical Perspectives in India and South Africa (London: Routledge, 2016), ch.2. 55 Joseph S. Alter, Yoga in Modern India: The Body between Science and Philosophy (Princeton: Princeton University Press, 2004), xiv.

CHAPTER THREE INDIGENIZING POPULATION CONTROL: YASHODA DEVI AND THE CONSTRUCTION OF POPULATION POLITICS IN LATE COLONIAL INDIA͒ RACHEL BERGER

The history and historiography of culture and society in colonial North India emphasizes the growing rigidity of disciplinary and professional forms of public participation, mediated in most cases by more notions of class, caste, region and nation.1 The ordering of information into specific forms of knowledge in this period was characterized by the involvement of newly emergent societies, regulatory boards, sophisticated trading networks and communal affiliations, all of which had a role in determining relevance and meaning. However, despite the measures of social and political control exercised over the production and dissemination of information and services in this period, there is ample evidence of individuals working outside of existing power structures while still making significant contributions within it. One such individual was Yashoda Devi, a traditionally trained Ayurvedic doctor and writer, who ran several private clinics with her husband and had a very long and active publishing career beginning in 1910 and lasting until the late 1930s. As a self-proclaimed Ayurvedic practitioner, Yashoda Devi existed on the periphery of the medical establishment, separate from practitioners who adopted biomedical approaches to medicine.2 At the same time, 1

See, for example, S. Joshi, Fractured Modernity: Making of a Middle Class in Colonial North India (New Delhi: Oxford UP, 2002) on the emergence of a discourse of class and S. Bayly, Caste, Society and Politics in India (Cambridge: Cambridge UP, 1999) on caste. 2 For examples of historical work on the history of medicine, see P. B. Mukharji, Nationalizing the Body: The Medical Market, Print and Daktari Medicine

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cadres of traditional practitioners, once ostracized by the colonial state, were now governed by regional Boards of Indian Medicine, which required them to obtain licenses and to register their services.3 Registered practitioners were actively forming professional associations and publishing tracts on their findings and by 1930 there were dozens of journals dealing with Ayurvedic medicine.4 Similarly, the Hindi publishing industry was also controlled by complicated networks reliant upon social, cultural, economic and religious patronage.5 While recent work on the advent of women’s publishing has identified it as constituting a substantial proportion of Hindi printing, those women able to publish came from influential backgrounds and social circles, most notably those of the Nehru family and others.6 Although Yashoda Devi was marginalized from both the professional circles of certified vaids and the social circles of the uppermiddle class, she managed to accomplish a major literary and medical intervention. She produced and sold more books than any other female

(London: Anthem Press, 2009); Guy Attewell, Refiguring Unani Tibb (Hyderabad: Orient Longman, 2007); Seema Alavi, Islam and Healing: Loss and Recovery of an Indo-Muslim Medical Tradition 1600–1900 (Delhi: Permanent Black, 2007); Rachel Berger, Ayurveda Made Modern: Political Histories of Indigenous Medicine in North India, 1900–1955, Cambridge Imperial and Postcolonial History Series (Basingstoke: Palgrave Macmillan, 2013); M. Harrison, Public Health in British India: Anglo-Indian Preventive Medicine 1859–1914 (Cambridge: Cambridge UP, 1994); D. Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: Univ. of California Press, 1993); A. Kumar, Medicine and the Raj: British Medical Policy in India, 1835–1911 (New Delhi: Sage, 1998). 3 See Berger, Ayurveda Made Modern, chap. 5. Documentation of the creation of these boards can be found in various archival collections and most notably in the United Provinces State Archives, Medical 131/1933 box 59. For similar issues in the Unani medical community, also see Seema Alavi, “Unani Medicine in the Nineteenth-Century Public Sphere: Urdu Texts and the Oudh Akhbar,” Indian Economic and Social History Review 42, no. 1 (2005): 102–29. 4 The Kala Bhavan library in Varanasi still holds the majority of these journals. 5 See F. Orsini, The Hindi Public Sphere, 1920–1940: Language and Literature in the Age of Nationalism (Delhi: Oxford UP, 2002), esp. chapters 2 and 3. 6 The relationship between class and the consumption of literature is evident in critical commentaries on the history of literature in the subcontinent. See, for instance, C. Gupta, Sexuality, Obscenity, Community: Women, Muslims and the Hindu Public in Colonial India (Delhi: Permanent Black, 2002); Luzia Savary, “Vernacular Eugenics? Santati-ĝƗstra in Popular Hindi Advisory Literature,” South Asia: Journal of South Asian Studies 37, no. 3 (n.d.): 381–97.

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author, became one of the most famous women writers of her day and was considered a medical authority by thousands.7 In this chapter, I argue that it was her keen understanding of both the relevance of medicine to society and the form in which information could be most appropriately disseminated that enabled her rise to fame, a rise that at the same time testified to the complicated social, political, cultural and economic relationships that constituted and informed the dissemination of information and knowledge in the Hindi public sphere. Yashoda Devi began her career writing journal articles and fiction, in line with the writing of the day addressing the challenges that obstructed the living of “moral” lives. As her writing developed, she moved on to cookbooks and health guides, taking part in the scientific writing revolution in the vernacular languages and promoting the ideals of self-discipline and healthy living. She finally moved on to population control pamphlets and elaborate guides to sexual health and sexual practice, creating illustrated medical books to which her readers could refer if experiencing illness or interested in anatomical accuracy. It is in this evolution from fairy tale to recipe book to pamphlet that we see the discourse of the reproductive body unfold, moving the discursive terrain of “wife” from the space of the home to the center of public debate, the language shifting from euphemisms to medicalized terminology and the prescience of the matter shift from one of general interest to pressing concern for the health of the nation.

Erasing Pleasure, Imposing Purpose: Jeevanshastra and the Ordering of the Reproductive Body Yashoda Devi first came to the attention of contemporary historians as a side note in Gyan Prakash’s work on science and nationalism in colonial India, an interesting figure whose works appeared frequently in the literary archive but were given very little attention beyond a cursorial reference.8 The project of uncovering her life was initiated by Charu Gupta, who has conducted the most in-depth study of Yashoda Devi’s work and personal life, based not only on critical readings of her texts but also on meetings with her family; she has also given the most thought to what her life meant in relation to the perception of Ayurvedic medicine, the postcolonial space 7

See Charu Gupta, “Procreation and Pleasure Writings of a Woman Ayurvedic Practitioner in Colonial North India,” Studies in History 21, no. 1 (February 2005): 17–44. 8 See G. Prakash, Another Reason: Science and the Imagination of Modern India (Princeton: Princeton UP, 1999).

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of Allahabad and the broader study of sexuality.9 This latter work has carved out the lifeworld of the practitioner, situating her in the time and space of a society in flux, where the introduction of women’s education by Arya Samaj had set a precedent for uplifting women and where this wife and daughter of Ayurvedic practitioners was empowered to participate and eventually run the family business. Gupta also notes that Devi’s story is dramatic but pared-down versions of it were common, with women acting as the traditional dispensers of medical care of all kinds.10 My contribution to the life story of Yashoda Devi is to situate her back into the larger project of crafting the reproductive body in the subcontinent, gauging the evolution of her work in order to consider the shifts in discourse concerning the conception of population in early twentieth-century India. Yashoda Devi’s writings constitute a clear effort to include in a Sanskritic intellectual tradition a social group marginalized from it in two ways. Her work was written for women, whose participation in that tradition had, for much of its history, been scanty. Moreover, it was written for women belonging to a newly emerged section of the middle class: for those who were literate but only or primarily so in Hindi and who could afford to choose their diet carefully but who might have prepared their food themselves. Yashoda Devi’s work guided women who wished to display the taste, discrimination and education of the rich, not merely through conspicuous consumption but rather through the systematization of household life guided not simply by family convention but rather by scholarly wisdom. Moreover, she was able to capitalize on both the complicated politics of Hindi-language scientific writing and the boom in publishing for women and turned her writings into a successful venture that fitted both agendas. Her insistence on “suddh” (pure) Hindi in her work and its scientific focus, helped her lay claim to producing medical writing in the Sanskritic “tradition,” while the centrality of the domestic sphere and the “appropriate” role of women to her arguments made her extremely accessible to middle-class female consumers of popular printed materials. Her attempts to establish continuity between past, present and future and so to stabilize an “essential” Hindu identity, were molded by the intellectual traditions to which she was linked. At the same time, some of her interpretations focusing on the appropriate role of women, both in the family and in building a new India from succeeding generations of families, were distinctively her own.

9

See Ibid. Ibid., 5.

10

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The growing popularity of the vernacular language press in North India in the early twentieth century ushered in a new era of women’s writing, in which Indian women were both authors and readers. By the beginning of the twentieth century, several monthly or bi-monthly journals and pamphlets for women had appeared in North India and by the 1910s, publishing for women had taken off in a major way.11 Grhalakshmi and Stri Darpan, both published in Allahabad from 1909, started what was to become a North Indian trend. They addressed the management of the domestic sphere, cementing this theme as being of “principal” concern to newly literate women. The popularity of these subjects spread by the 1920s into mainstream journals such as the Lucknow journal Madhuri (1922-1950), which ran a women’s column and also ensured the success of the women’s magazine Chand, founded in 1922, which at one point was the most widely circulated Hindi language publication.12 As Francesca Orsini has argued, women’s journals in Hindi played as large a role in educating women as did more formalized outreach strategies.13 The content of these journals provided information on the minutiae of running the household and maintaining an appropriate lifestyle for one’s family. Moreover, familiar and engaging subject matter in journals, pamphlets and newspapers could compensate for and help to overcome, limited literacy, while the affordability of such publications made them accessible to lower-middle-class families. Within the family, women of divergent status, generation and educational attainment could enjoy the magazines. However, these journals cannot be assumed to have been unregulated; although they existed for the most part outside the frame of interest of the state and, therefore, outside the disciplinary gaze of the governing forces, they were highly monitored by the cultural powers of the day. Various texts of Shastric philosophy, erotic literature and medical tracts discuss the human reproductive system. For instance, the idea of the fertile body as textual trope dates as far back as the compilation of the Kama Sutra by the scribe Vatsyayana in the fourth century.14 Among these 11 See Lal, “ ‘The Ignorance of Women Is the House of Illness’: Gender, Nationalism and Health Reform in Colonial North India,” on the discussion of women and healthcare in Hindi-language journals and magazines. 12 Orsini, The Hindi Public Sphere, 245. 13 Ibid., 260–62. 14 See W. Doniger and S. Kakar, Introduction to Vatsyayana’s Kama Sutra (Oxford: Oxford UP, 2002). A scholarly synthesis linking notions of pregnancy, fertility and health from all these genres is still awaited; however, Kenneth Zysk attempts it in K. G. Zysk, Conjugal Love in India: Ratisastra and Ratiramana (Leiden: Brill, 2002).

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genres, erotic literature, with its attention to the association between reproduction and pleasure, was particularly prominent. The Kama Sutra put pregnancy at the center of the pleasure encounter, stating that the goal of Kama when entered into with an appropriate partner should be the creation of suitable offspring and is mostly taken up with the idea of conception rather than that of gestation.15 A later text called the Ratamanjari, written in the twelfth century and itself constituting a later version of erotica, discusses the reproductive cycle at length and details the appropriate times at which to conceive—but makes no other comments on the health of the woman in question, or the role that the reproductive cycle plays in her general well-being.16 Similarly, the Susruta Samhita and the Caraka Samhita, the two major volumes of Ayurvedic medicine, go into great detail about the process of conception but offer no commentary on the gestational period or the birthing procedure; while the Ayurvedic ideal of the humoral balance is discussed at length, along with the development of the child’s qualities and his/her gender, very little instruction is given to the reader about the particulars of the birthing process. Yashoda Devi’s intensive understanding of the mechanics of reproduction was, therefore, a significant departure from the traditional literature to which she alluded. This could be attributed to her possible encounters with modern medicine as practiced in the subcontinent but most probably is derived from her experience running an Ayurvedic clinic with her husband.17 The tension between tradition and modernity was elided in Yashoda Devi’s hybrid medical advice which tried to marry one to the other. While the content of her medical analysis was grounded more in Ayurvedic practice than in European anatomical knowledge, her willingness to make this advice available to women in written form is reminiscent of the priorities of contemporary women’s health reformers in the Western tradition. It is significant to note that much of her advice had its roots in folk medicine and popular culture. She advises her readers that a man should not impregnate “a woman who is in Ritu [her season], who has illness of any kind, genital illness or is dirty, hungry or thirsty, or who does not desire it at that time. Those who do not keep these rules will

15

See Doniger and Kakar, Vatsyayana’s Kama Sutra. See Zysk, Conjugal Love in India. 17 For the broader history of Ayurveda in twentieth-century India, see Berger, Ayurveda Made Modern. At the same time, because Yashodadevi left no record of her experiences running her clinic, it is difficult to derive anything about her experiences running a clinic beyond what her remedies and recipes reveal. 16

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always be ill.”18 These comments seem to have more cultural than “Shastric” resonance. At the same time, though some of her methods of determining the gender of the child do conform to the passages in the Susruta Samhita, they stem more from cultural than from traditional understandings of gender.19 The Ayurvedic samhitas as well as other traditional Indic texts that deal with the question of reproduction, note that a female results from the strength of the raaj (female ejaculation) being greater than that of the viry (semen) and vice versa and have nothing more to say on gender and pregnancy. Yashoda Devi concurred with this but went on to explore the ways in which the parents can detect evidence of pregnancy, as well as evidence of the gender of the child. “First of all, if the front part of the breast becomes black, there is drowsiness in the eyes, vomiting, there is no desire for good smells, there is saliva, there is stiffness in the body,” then pregnancy has resulted from the encounter.20 Furthermore, “in the second month, if it is a boy, it appears like a lump. The pregnant woman’s right eye appears a bit bigger and milk can be seen first in the right breast.”21 However, “if she desires feminine-gendered things in her dreams, one should understand these to be signs of a girl.” One of the most interesting things to note about the new movement in publishing about pregnancy and health care was the conception of audience held by those who wrote about these topics. Whereas nineteenthcentury guides to childbirth, though few and far between, were written for midwives and for lady doctors, the new writing on pregnancy and childbirth was directed at the same women who were enthusiastic about printed knowledge concerning birth control and child-rearing; middleclass mothers comprised a majority. Traditionally, the midwife would have been the authority on popular understandings of the reproductive system. However, this relationship had been undermined by the involvement of the colonial state in the regulation of reproduction.22 This 18

“Garbhdan ke Niyam (Regulations for Conception),” Yashodadevi, Dampati Arogyata Jivanshastra arthat Ratishastra Santantitshastra (1924): 236 19 See P. Ray and H.N. Gupta, Susruta Samhita: A Scientific Synopsis (Delhi: Indian National Science Academy, 1980), esp. chap. 1. 20 From “Garbhdaran ke Niyam (Signs of Pregnancy),” Yashodadevi, Dampati Arogyata Jivanshastra, 239. 21 “Putr ke Lakshan (How to tell if it’s a son),” Yashodadevi, Dampati Arogyata Jivanshastra, 237. 22 See M. Kasturi, “Law and Crime in India: British Policy and the Female Infanticide Act of 1870,” Indian Journal of Gender Studies 1, no. 2 (1994): 169– 94, on the role of midwives in the infanticide process. C. A. Bayly also remarks on the importance of the midwife as an informal informant with regards to the spreading of information in colonial India, in C. A. Bayly, Empire and

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led to the training, licensing and professionalization of dais from the 1880s, provided they trained at one of the courses set up to educate them in the ways of modern medical science.23 This paralleled the regulation of other groups who held knowledge useful to the imperial state, as hakims, vaids and pandits similarly came to be acknowledged as professionals once they became associated with emerging institutional bodies. The emergence of a public discussion of reproductive health in the printed form, therefore, written in vernacular languages and intended for popular consumption, was innovative. Older guides for midwives had been laid out in very specific ways, detailing the process of birthing step by step and focusing on what a birthing attendant could do to help a laboring mother.24 While there was some concern about the overall gestation period, the majority of the information contained within the nineteenth-century midwifery guides focused on birth and the potential problems that might occur at the time of delivery. However, Yashoda Devi drew attention away from the actual birth and instead focused on the gestation period, devoting chapters to the process of determining the gender of the child, the dangers of engaging in intercourse throughout the pregnancy and specificities of the diet throughout the gestation period. For instance, in a revision of Dampati Arogyata Jeevanshastra, she detailed the development of the fetus in each month in a section called the “Cures for Illness in the Womb.”25 The birthing process is not ignored here but is discussed in medical terms, with explanation of the way in which the baby turns in the womb and descends through the vagina. She also provides twenty pages’ worth of visual diagrams depicting the different stages of a birth, beginning with the turning of the child and ending with its final descent. What Yashoda Devi failed to offer was a guide to complications, or suggestions about how to manage birth, since this new mode of writing about pregnancy assumed that a birth attendant of some sort would be present, probably in the form of a traditional midwife, now newly trained

Information: Intelligence Gathering and Social Communication in India, 1780– 1870 (Cambridge: Cambridge UP, 1996). Furthermore, the testimony of the midwife was solicited, especially in Bengal, in cases ranging from rape allegations to infanticide, which once again highlights the importance of the dai as medical informer; see S. Sen, “Motherhood and Mothercraft: Gender and Nationalism in Bengal,” Gender & History 5, no. 2 (Summer 1993): 231–43. 23 See G. Forbes, Women in Modern India (Cambridge: Cambridge UP, 1996). 24 See Chattopadhyay, Garbhraksha (1886). 25 ‘Garbh-Pira ka upay,’ Yashodadevi, Dampati Arogyata Jivanshastra (1931), 219.

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and registered by the State.26 The construction of reproductive knowledge divorced from the act of delivering the child, especially in light of the anxiety about the conditions of the delivery, suggests that information about the reproductive body was being compartmentalized, with different knowledge being marketed to specific audiences. What emerges in this division is the line drawn between health-care consumer and health-care practitioner, despite the focus on the holistic body and its functioning. This division also needs to be located within the context of class and caste antagonism; dais would conventionally have been expected to be poor and their routine encountering of ritually impure materials would have ranked them at the bottom of the social scale. However, dais were fully aware of this and higher-caste dais in this period argued that their medical knowledge and role in the maintaining of praan should be considered to mean that their touching of unclean materials did not compromise their ritual purity.27 The focus on the consumer of the material was emphasized by the importance to Yashoda Devi’s Dampati Arogyata Shastra of information about disease gleaned from the results of a survey completed by her readers.28 It was divided into two sections, one addressed to men and the other to women, each consisting of over fifty questions. Underlying these questions was a very sophisticated and well-developed model of what Yashoda Devi believed marriage and domesticity to be, represented in both the order of questions and the content within them. Women were asked primarily about their reproductive health and only peripherally about their general health, suggesting that their primary role as embodied beings was to procreate. Even when women were asked about their general health, including the color of the nails, the size of the body, the smell and color of the urine, how they felt when eating and lumps on their feet, other questions distinguished between their health at the current time and at the time of the marriage and then asked about the health of their husbands at both times and about the process of leaving the familial home for the father-in-law’s home. Many of the questions about their general health were related to their overall menstrual health, further affirming their positions as mothers first and humans second. Yashoda Devi asked about menstruation in great detail, covering the menstrual cycle, the color and quantity of the blood, the experience of menstruation during the summer 26 See S. Guha, “From Dais to Doctors: The Medicalisation of Childbirth in Colonial India,” Understanding Women’s Health Issues: A Reader (Delhi: Kali for Women Press, 1998). 27 Gupta, Sexuality, Obscenity, Community, 177–86. 28 See Yashodadevi, Dampati Arogyata Jivanshastra, 8–14.

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months and the amount of time between giving birth and the return of menstruation. Overall knowledge of health and health care was assumed to be greater in women than in men; women were constructed in this survey as keepers of extensive medical knowledge. It was women who were asked to write about how they detected disease, which medicines had previously worked for them and their husbands and which diseases and conditions had not gone away. While women were asked very specific, detailed and lengthy questions about their own and their family’s health and given lengthy counsel on the necessity of sending in their answers, written in clear Hindi, by registered post, men were asked short, direct and general questions, which were often followed by a secondary question, “Ya malum nahin hoti hain [Or do you not know]?” Nor did she ask about men’s perceptions of their wives’ health. Clearly, the burden of securing reproductive health fell mostly upon the shoulders of women. The questions for men principally concerned their general health. Yashoda Devi asked about their jati, color, the various illnesses they experienced and their eating and digestion; very little time was spent dealing with their reproductive health, though the guide would eventually be about the sexual health of the couple. At the same time, she tempered the threat of giving women agency as health-care providers by reasserting the traditional structure of marital domesticity. Interestingly, reproductive success, a term she uses often in her work, was the responsibility of both partners because it encompassed not only reproductive health but sexual and moral health as well. Whereas in much of the traditional literature, women were faulted for problems during conception and pregnancy, Yashoda Devi recognized the contribution of men to the process. While she maintained that the entrance of pure semen into the womb and its mixing with the pure fluid of the raaj constituted the only condition under which pregnancy could result, she also listed several other possible reasons why pregnancy might not result even if the couple had seemingly engaged in the proper process of insemination: “Because of any bad habits if some bad thing like mucous or crookedness has affected the penis, instead of going in it goes here and there, because of this fault of man, the woman does not become pregnant.”29 She ends by referring readers to certain sections of her book dedicated to “the faults in men that prevent conception.” Indeed, Yashoda Devi’s representation of the male anatomy in the reproductive process invoked a morality and conjugality which differed from the Ayurvedic 29

“Garbh rehne ke Samay” (The Time to Become Pregnant), in Yashodadevi, Dampati Arogyata Jivanshastra, 236.

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representation. She suggested that “conception takes place when there is strong desire, the female and male discharge and pure semen produces an offspring; however, if both fluids are pure, the result is children with seven good qualities.”30 In compiling a work that reflected the needs and experiences of her readers, Yashoda Devi claimed yet another form of authority. In an era of state-imposed health policy based on Western medicine and considering the heightened anxieties of the colonial machine with regard to sanitation and public health, the voice of the patient, especially if Indian and female, was erased from the dialogue. This is not to imply that Indian women were represented in precolonial discussions of medicine, or that they were being newly silenced. It also does not imply that Yashoda Devi’s inclusion of their stories gave them any real power, even within informal medical spheres. However, by creating a body of knowledge based on the experiences of the average middle-class Indian, she was able to win the trust of her readers through means by which women could see themselves in the text, at a time when the institutionalized systems of medical practice were becoming more and more alien to the average Indian. In her guides to marital health, she could claim two sorts of legitimacy in order to justify her writings: on the one hand, her claim of Vedic and “Shastric” insight; on the other, her claim that passages that might have appeared risqué or immoral were simply the experiences of her readers, which she was merely reporting.

Suyogy and swaraj: Reproductive Health and the Health of Nations Yashoda Devi’s nuanced analysis of modern domesticity inspired her to adopt a distinctive position in the increasingly prominent national discussion of population control. The topic permeated every aspect of her writing and was, in turn, the subject of at least one pamphlet-length publication. Yashoda Devi’s understanding of population shared certain ideas with the eugenicist approach which, during the interwar years, popularized the belief that some individuals produced better offspring that others. However, she was largely divorced from the eugenics movement itself. From the movement’s inception in the 1880s up until the First World War, eugenicist discussions were restricted to elite intellectuals, mostly male, mostly literate in English and mostly located in urban

30

“Garbhdan ke Niyam” (Regulations for Conception), in Yashodadevi, Dampati Arogyata Jivanshastra, 236.

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centers.31 However, as the colonial state’s growing concern about population manifested itself through various sanitation and public health policies, the issue came to pervade the realm of popular culture. Moreover, the construction of an exponentially growing population of uneducated and unsanitary masses that could be controlled only through strict discipline by those of a superior moral quality held its own social currency within both the caste and class contexts of North Indian society. At the same time, popular nationalist leaders were writing about these issues in the public sphere, with opinions ranging from the Gandhian take on celibacy, to Premchand’s socialist take, to the emerging voice of the national women’s movement. The nationalists’ attention to Hindu and Indian identity ensured that their political program for the first time shared some common ground with Yashoda Devi’s own concerns. In the context of this national discussion of India’s future population, her demand that individuals be suyogy (competent) can be understood as a construction of normative Hindu reproductive behavior in the domestic sphere that took on national resonance; at a time when Gandhi was advocating brahmacharya as a means to liberation, suyogy was easily articulated as swaraj. Although linked through individuals and texts with eugenicist movements around the world, debates on population control in India expressed a distinctively national flavor during the late nineteenth century. Interest in demography is conventionally associated with the British government in India, which had, since 1901, collected census data to quantify and plan for the nation.32 The Raj, however, refrained from taking an official stance 31

Sarah Hodges writes extensively on the self-improvement societies of Madras, in which elite men used discourses around birth control to stage conversations about Indian masculinity in modern times. See S. E. Hodges, Contraception, Colonialism and Commerce: Birth Control in South India, 1920–1940 (Aldershot: Ashgate, 2008). Exploring another route, Sanjam Ahluwalia’s work on the role of Indian sexologists in the international eugenics movement points again to the use of this discursive terrain to reflect more prominently on the role of men and masculinity— and the lives of elite people in urban centers—than on the concerns of women of any class. See Sanjam Ahluwalia, “Scripting Pleasures and Perversions: Writings of Sexologists in the Twentieth Century,” in Sexuality Studies, ed. Srivastava, Sanjay (London: Oxford UP, 2013). 32 See A. Appadurai, “Numbers in the Colonial Imagination,” in Orientalism and the Postcolonial Predicament: Perspectives on South Asia, ed. P. Van de Veer and C. Breckenridge (Philadelphia: Univ. of Pennsylvania Press, 1993) on the rising importance of quantitative research and the emergence of demography and other mathematically based sciences in the early twentieth century and the limits of representation inherent to data collection.

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on population control, even though individual administrators, especially in the medical services, may have supported it.33 Over the years, population control became an important issue in national debates; the foundation of the Hindu Malthusian League in 1882 in Madras and the stabilization of national population categories after the 1901 census provided data for subsequent eugenicist organizations dominated by administrators, statisticians, social scientists and economists.34 Their views culminated in P. K. Wattal’s The Population Problem in India. By the mid- to late 1920s, the notion of birth control was being contentiously debated in both the English and the vernacular press. Dr. Bhimrao Ambedkar and Subhas Chandra Bose were both supporters of population control and birth control.35 As the nationalist movement evolved, elite Indian eugenics writing in English gave way to an increasing prominence for population control in the Hindi press and a greater emphasis on local and regional population concerns. Gandhi was the most prominent critic of the mainstream eugenicist approach to population control generally articulated in English and those who disagreed with him risked being considered anti-Gandhian. The Gandhian ideal of brahmacharya advocated complete self-control and abstinence for both spouses but especially for men. He developed this into his own understanding of the oppression of women within marriage and the necessity of their own swaraj: “Man has regarded woman as his tool. She has learned to be his tool and found it easy and pleasurable to be such, because when one drags another the descent is easy…if I can drive home to women’s minds the truth that they are free, we will have no birthcontrol problem in India.”36 Nonetheless, Gandhi was quick to refer to the Hindu tradition of Brahmacharyic practice, pulling on the same heartstrings 33

See D. Arnold, “Official Attitudes to Population, Birth Control and Reproductive Health in India, 1921–46,” in Reproductive Health in India: History, Politics, Controversies, ed. S. E. Hodges (Delhi: Orient Longman, 2006). 34 See C. Hirschman, “The Meaning and Measurement of Ethnicity in Malaysia: An Analysis of Census Classifications,” Journal of Asian Studies 46, no. 3 (1987): 555–82; Hodges, Contraception, Colonialism and Commerce; Sanjam Ahluwalia, Reproductive Restraints: Birth Control in India, 1877–1947 (Champaigne: Univ. of Illinois Press, 2007); M. John and J. Nair, A Question of Silence? The Sexual Economies of Modern India (Delhi: Kali for Women, 1998); B. Ramusack, “Embattled Advocates: The Debate Over Birth Control in India, 1920–1940,” Journal of Women’s History 1, no. 2 (1989): 34–64; Mridula Ramanna, “Indian Attitudes Towards Western Medicine: Bombay, A Case Study,” Indian Historical Review 27, no. 1 (2000): 44. 35 Ahluwalia, Reproductive Restraints, 62–63. 36 Gandhi, Harijan, January 25, 1936, from the Collected Writing of Mahatma Gandhi, vol. 26.

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plucked by earlier thinkers wishing to recall a glorious Hindu past.37 Premchand, the most popular of the Hindi writers of the colonial period and an active Socialist, was also critical of eugenics and condemned the elitism of popular leaders interested only in eradicating the working class. Eugenicists say that unworthy men and women in the country should be sterilized. Only those strong in heart and those who are well to do in body and brain and who are educated, should have the right to produce children. They will have to produce children and take care of them; otherwise the country will be filled with unworthy children.38

Though Premchand was critical of this sentiment, his language is an accurate portrayal of the rhetoric put forth by the mainstream population control movement of the late 1920s and 1930s. Indeed, many middle-class Indian advocates of population issues were linked to national women’s organizations that emphasized voluntary birth control, influenced by international campaigners like Margaret Sanger and Marie Stopes. Such individuals had a strong sense of both their own superiority and their right to reproduce. They visualized problematic issues with both Gandhian principles of celibacy and the skepticism with which Indian women approached the often-foreign technology. The Gandhian popularity of all things Swadeshi, matched with the utter foreignness of items like condoms and pessaries, made some women doubtful about these precautions but led writers to create a new synthesis of Indian versus “alien” elements in population control. One exasperated follower of Marie Stopes wrote in Hindi in 1931: “If you are only in favour of natural things, why don’t you go on foot from Bombay to Calcutta? During the monsoon, why do you go out with an umbrella? Why do you go to the doctor when you have a fever 37 However, as Gyan Prakash argues, Gandhi’s promotion of brahmacharya divorced the act from its philosophical roots by decontextualizing it. Brahmacharya was traditionally a practice adopted by saddhus (ascetics), devoted students and younger men engaged in studies, all of whom existed in a purposely celibate context. Gandhi, however, transformed the marital context to make it one that accommodated sexual celibacy by declaring sex to be evil and wasteful, except for the purpose of procreation. See also J. Alter, Gandhi’s Body: Sex, Diet and the Politics of Nationalism (Philadelphia: Univ. of Pennsylvania Press, 2000). Vinay Lal has dissected the pragmatics of Gandhi’s sexuality vis-à-vis the goal of brahmacharya and the lure of desire; see V. Lal, “Nakedness, Non-Violence and the Negation of Negation: Gandhi’s Experiments in Brahmachary and Celibate Sexuality,” South Asia 22, no. 2 (1999): 63–94. 38 Premchand, “Mahila-sabhaon mein santan-nigrah ka prastav,” November 1932, in Premchand, Vividh Prasang (1962), 252.

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and why does it stop when you take quinine?”39 These advocates always straddled the gap between the local and the global by writing for local and regional audiences in a particular vernacular but contextualizing the struggle through the larger eugenics movement. Yashoda Devi’s approach to population control differed greatly from those who took hold, once birth control became a popular issue of national concern; the debates about artificial birth control and the imposition of technology were irrelevant to the eugenic message she promoted among the women of her class, as the act of reading her works suggested that the reader was both wealthy and educated enough to be capable of producing suyogy offspring. Although her views on political economy remain unknown, she certainly purveyed the same message of elitism that Premchand attempted to ridicule. This left her at odds with both Gandhian thought and the feminist movement. She advocated the brahmacharya that Swami Dayananda, the leader of the Arya Samaj movement, made popular. It differed from Gandhian brahmacharya in that it was promoted primarily during youth, especially during the period of education, in order to ensure the concentration of the student.40 Dayananda believed that men and women were put on earth to create healthier children and hence accepted the necessity of the sexual encounter.41 Nevertheless, Yashoda Devi held no firm views on birth control technology and expressed little or no interest in the debate between Gandhi and the feminists. Her views differed from those of the women’s movement as she advocated refraining from organizing women at the local and national levels. In addition, her concern was in no way international; she was simply concerned with “bharatvarsh mein ki striyon (the women of the Indian region),” which constituted the main theme of her books. Despite these differences, Yashoda Devi’s work nonetheless shared with the population control movement several of the themes underlying the latter. Her concern with producing healthy individuals led fluidly to a preoccupation with the development of a healthy, strong nation, evident in all her projects from the beginning of her career. Indeed, most of her guides emphasized reproduction and almost all her books delineated characteristics that made individuals learn to be suyogy parents and members of society. While the creation of superior offspring was portrayed as the most effective means of creating a strong and successful nation, self-discipline—the importance of which was reflected in her 39

“Santan-Vidhi Nigra” Sushiladevi, Dampatya Jeevan (1930), 139–40. Y. Arya, Arya Samaj and Freedom Movement (Delhi, 1988), 63–65. 41 M. Kishwar, “The Daughters of Aryavarta,” Indian Economic and Social History Review 23, no. 2 (1986): 151–86. 40

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detailed writings on how to properly run a household and live a healthy life—also played a significant part in attaining this goal. Responsible procreation was at the center of the struggle but clean living was just as important. In this respect, Yashoda Devi differed from those social reformers advocating population control as a self-contained subject with a single solution. The link between Yashoda Devi’s work and the population control debate was the discussion of sexuality. Her sole direct contribution to that debate was her 1924 pamphlet, “Ideal Spouses and the Improvement of Offspring,” published the same year in which she stopped writing cookbooks and focused her work on jeevanshastra and sexual health. Her participation in the emerging debates about birth control and sexuality caused her work to actively seek and explain new and altered meanings in the 1920s and 1930s. Her writings, which earlier had focused so much on ordering domesticity, began to address a larger audience. Although still targeted at women, the message contained in these was one of interest at all levels of government and also to different factions of the nationalist movement. The emergence of a national discussion of population control gave Yashoda Devi’s work increased legitimacy and significance by justifying her studies of health as dwelling on a subject of central importance to the future of the nation. She became increasingly concerned that her work might be misinterpreted as a guide to sex, leading her to explain why her writings constituted guides to marital health rather than pleasure. In her denunciation of the novel, she was careful to note that her reservations were not about discussing sexuality but about discussing sex outside a reproductive context, while in her discussion of “Ayurveda or Kamashastra,” she denied that her book was a Kamashastra of the traditional sort and reemphasized teaching men and women about their sexuality so that they could become responsible parents of superior offspring.42 She ended the passage by saying that “reflections of the Vedic shastras inform us that women and men who are defective will have inadequate children but on the other hand, sensual men and women who are not concerned about their children and let their desire take over, will have defective children because they only thought of their desire.”43 In this statement, in marked contrast to eugenicists, Yashoda Devi suggests that to be born suyogy is not enough to produce children who are themselves suyogy; instead, quality ought to be maintained through self-discipline and education. 42

“Ayurveda or Kamashastra,” in Yashodadevi, Dampati Prema aur Ratikriya Guptarahasya (viveh vjhan kamshastra) (1935), 149 43 Ibid., 79.

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Yashoda Devi’s central concern continued to be largely the producing of strong, worthy citizens who would make up a suyogy nation. This fueled her interest in health and it was the ferocity of this belief that caused her to become so active a writer and publisher. Her emphasis on the glories of the past bore the most fruit: her writings on the problem of overpopulation, which was understood as fundamentally modern, were couched in the language and values of the ancient past, when sages were wise and people were pious. The population problem, therefore, could be solved by educating Indians in traditional practices. In particular, followers of the Arya Samaj would have been familiar with this argument of improvement.44 As with her domestic guides, her writings on this topic assumed that the middle classes needed to be educated, in this case in appropriate reproduction, lending credence to Sanjay Joshi’s suggestion that the North Indian middle class was more a project than an established entity.45 Moreover, in her discussion of both the preparation of food and the delivery of children, working class laborers emerged as the “other” in relation to which Yashoda Devi and others like her constructed their position in the economic hierarchy of North Indian society; to consider the significance of food itself instead of its preparation or to consider the particulars of conception and gestation above and beyond the process of delivery, was to demonstrate prosperity sufficient to allow families to concentrate on social significance rather than survival. Yashoda Devi’s articulation of class distinctiveness was not explicitly socially divisive, as she stressed the improvement of the individual over control of the population. She argued that ignorant parents produce ignorant offspring and that “women who have too many babies bring ignorance upon themselves;”46 but her conception of intelligence was an Arya Samaji one, based on education and self-discipline and not specifically on caste or class. However, her reliance on the written word, especially as purchased commodity, necessarily limited her audience and demonstrated a shrewd understanding of the workings of status in the emerging middle class.

44

Though originally a Hindu construct and tradition, caste as a determinant of employment and social status was closely tied into the class structure of North India and caste-based affiliations often included non-Hindus. For this reason, we can speak of a low-caste Muslim. 45 S. Joshi, Fractured Modernity: Making of a Middle Class in Colonial North India (Delhi: Oxford UP, 2002). 46 Yashodadevi, Adarsh Pati-Patni Sur Santati-Sudhara (1924).

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Conclusion Yashoda Devi’s work presented a coherent understanding of the role of the ideal Indian woman in her family and received a wide readership among middle-class women. The emergence of the debate about population control gave Yashoda Devi a way out of the world of women’s publishing and an entrance into the wider public sphere. However, the potential for a wider audience did not inhibit her style, which continued to be driven by the desire to provide educative materials for women relevant to their daily lives but grounded in Hindu values. A focus on worthy children, responsible parenting, detailed knowledge of the reproductive system and the importance of maternal healthcare was the stock-in-trade of Yashoda Devi’s earliest works, despite the seemingly innovative deployment of such themes by mainstream writers publishing in popular magazines. If anything, the new focus on birth control in the public sphere was something that she could exploit to strengthen her own message with her initial readers. At the beginning of her career, the authority she claimed with her readers came from her firm rooting in traditional Ayurvedic practice and her familiarity with local, informal knowledge; at the end of her career, however, her authority came from the relevance of her arguments to the larger political process. As its concerns shifted to meet her own, the modernity from which she had been sure to shy away in the early 1910s was the one that she happily appropriated in the late 1920s and 1930s. Besides, her emphasis on purity, both lexical and moral, remained consistent but found an echo in the population debates of the 1930s. When she began in the 1910s, she wrote solely about appropriate behavior of the Hindu wife in the narrative style, grounding her fictional stories in the accepted notion of traditional morality. She also used short, easy sentences and a limited, if innovative, vocabulary to accommodate women who had lower levels of literacy and were not well-versed in the standardized suddh Hindi that was beginning to be enforced as the lingua franca of the Hindi public sphere. As her career developed, she moved from fiction to domestic guides, beginning with diet and moving on to reproductive health and developing a model of healthcare that understood disorder and desire to be at the root of disease, at the same time promoting strict selfdiscipline over both body and mind as a guide to control one’s life. In creating philosophies of food and disease and dubbing them shastras, she laid claim to the authority bestowed on traditional Hindu texts; ultimately, she used this claim to scriptural authority to put forth radically innovative notions of reproductive functioning that went far beyond the Ayurvedic

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texts dealing with these topics. In so doing, she codified aspects of popular and Western-influenced medical knowledge as Hindu shastra. As her career spanned vast social and political changes, Yashoda Devi had to renegotiate her claims to social and intellectual authority, particularly among her core readership. Yashoda Devi’s work consistently addressed the same audience and her shifting point of reference—from past to present, from fiction to fact and from family life to marital relations—sheds light on the social and cultural referents upon which this class of women depended when ordering their intake of information from the public sphere. Moreover, her continued popularity, represented in reader response and also in the large number of books she sold, indicates that her claim to knowledge was accepted, as was her message. Ultimately, it was her careful adherence to normative understandings of gender, culture and identity in her writings that allowed her to put forth innovative understandings of health and the body and that accounted for their consumption by a wide audience. By working within the framework of an appropriate domesticity, Yashoda Devi was able to relay to women radically new information about their individual health and that of their families; in so doing, she provided them with new hopes and visions with regard to imposing a new order upon their domestic lives for the procreation of a better and superior nation.

CHAPTER FOUR TOWARD A TRANSNATIONAL MODERNITY: MANAGING FEMALE SEXUALITY, CONJUGALITY AND REPRODUCTION IN THE BENGALI MAGAZINE, NARA-NAREE (1939-1950) SUTANUKA BANERJEE

During the early twentieth century, worldwide interest in modern sexual reform spurred critical debates on the female body and sexuality within “medical” discourses by Western sexologists as well as by several expert writers in Bengal, who conceptualized conjugal happiness as synonymous with the rhetoric of a healthy family and a modern nation. This growing preoccupation with sexual reform emerged out of transnational connections as the Bengali experts started propagating “modern” sexual science by adhering to Western biomedical discourses. Global sexology thus established the foundation of a modern, scientific concept of sexual compatibility and “marital happiness.”1 But in the intersection between the local and global dialectics, female sexuality and desire were almost invisible subjects in the vernacular journals. Sexual science acquired great prominence in Europe in the early decades of the twentieth century, a trajectory that also led to the internationalization of sexual reform and the development of transnational networks.2 Scientific discourses challenged the taboos in Victorian society and paved the way for the greater openness of the modern era. While 1

Douglas E. Haynes, “Selling Masculinity: Advertisements for Sex Tonics and the Making of Modern Conjugality in Western India, 1900–1945,” South Asia: Journal of South Asian Studies 35, no. 4 (2012): 787–831. 2 N. Matte, “International Sexual Reform and Sexology in Europe, 1897-1933,” Canadian Bulletin of Medical History 22, no. 2 (2005): 253–70.

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debates on marital and sexual reform were not limited to Western countries, sexual reform in the European and American settings remained predominant at the time, as its well-charted history attests.3 In studying the Indian context, various works have dealt with the complex nuances that became evident with the introduction of Western medicine in a colonial setting; these have examined how scientific discourses brought about multiple challenges in the process of adapting and contesting Western modernity. A number of scholars and historians have contributed extensively in this domain, exploring the intricate dynamics of the colonial encounter and examining indigenous responses to the popularization of Western medicine.4 The colonial engagement, as discussed in these works, required re-appropriation of the discourses of modernity that influenced the history of medical practice; the emergence of new ideas of sexual reform, however, has rarely been addressed in this respect. Sanjay Srivastava’s critical works on sexual culture in South Asia underscored the engagement with reformulation of the notions of modernity and expression and/or regulation of desire.5 More recent studies place new emphasis on 3

Michel Foucault, The History of Sexuality: An Introduction, vol. 1, trans. R. Hurley (New York: Vintage Books, 1990); Jeffrey Weeks, Sexuality and Its Discontents: Meanings, Myths and Modern Sexualities (London: Routledge and Kegan Paul, 1985). 4 David Arnold, Imperial Medicine and Indigenous Societies (Delhi: Oxford UP, 1989); David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: Univ. of California Press, 1993). Poonam Bala, Imperialism and Medicine in Bengal: A Socio -Historical Perspective (New Delhi: Sage, 1991); Poonam Bala, Medicine and Medical Policies in India: Social and Historical Perspectives (Lanham: Lexington Books, 2007); Poonam Bala, ed., Biomedicine as a Contested Site: Some Revelations In Imperial Contexts (Lanham, MD: Lexington Books, 2009); Poonam Bala, ed., Contesting Colonial Authority: Medicine and Indigenous Responses in Nineteenth and Twentieth Century India (Plymouth: Lexington Books, 2012); Poonam Bala, Medicine and Colonialism: Historical Perspectives in India and South Africa (London and New York: Routledge, 2016); Pradip Kumar Bose, ed., Health and Society in Bengal: A Selection from Late 19th-Century Bengali Periodicals (New Delhi: Sage, 2006); Mark Harrison, Public Health in British India (Cambridge: Cambridge UP, 1994); Biswamoy Pati and Mark Harrison, eds., Health, Medicine and Empire: Perspectives on Colonial India (Hyderabad: Orient Longman, 2001); Biswamoy Pati and Mark Harrison, eds., The Social History of Health and Medicine in Colonial India (London: Routledge, 2008). 5 Sanjay Srivastava, ed., Sexual Sites, Seminal Attitudes: Sexualities, Masculinities and Culture in South Asia (New Delhi: Sage, 2004); Sanjay Srivastava, Passionate Modernity: Sexuality, Class and Consumption in India (New Delhi: Routledge, 2007); Sanjay Srivastava, Sexuality Studies (New Delhi: Oxford UP, 2013).

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transnational linkages in non-Western medical sources but female sexuality has not received adequate critical attention. Exceptions existed; the link between birth control and patriarchy in the debates on women’s autonomy and reproductive rights has been explored in the context of colonial Tamil Nadu.6 In addition, Charu Gupta and Sanjam Ahluwalia have addressed significant issues of female sexuality, sexual desire, pleasure and contraception, as discussed in medical treatises in North and South India, respectively.7 Although sexual reform in colonial Bengal was a highly contested topic, almost no research has been done in this area. This chapter will examine the articles published in the Bengali magazine, Nara-Naree [Man-Woman], during the years 1939–1950, with a focus on the discourses and transnational dialogues on the emerging ideas of female body, sexuality, conjugality and contraception, as expressed by certain expert Bengali writers and the way in which these discourses affected gender roles in heterosexual relations. Since global sexual reform challenged traditional ideas about chastity, conjugality and female sexuality, it generated discussion of highly debated issues centered on sexual agency and permissible sexual behavior for Bengali women. In the magazine, Bengali women’s sexual autonomy constituted the topic of much critical contention among male and female Bengali experts. In a male-dominated field, women became increasingly interested in the right to control their own bodies and to freely discuss the crucial issues, such as contraception, marital reform and sex education that became an indispensable part of social reform. On the one hand, Western sexual science was used to popularize the notion of women’s sexual emancipation and autonomy, while on the other, scientific sexology was deemed to be useful in forwarding the national interest, with the espousal of the ideal of a happy conjugal family as part of the project of nation building. This chapter will also analyze the way in which Western science was used to justify and 6

Anandhi S. “Reproductive Bodies and Regulated Sexuality: Birth Control Debates in early 20th Century Tamil Nadu,” in A Question of Silence, ed. Mary E. John and Janaki Nair (New Delhi: Kali for Women, 1998), 139–66. 7 Charu Gupta, Sexuality, Obscenity, Community: Women, Muslims and the Hindu Public in Colonial India (New Delhi: Permanent Black, 2001); Charu Gupta, “Procreation and Pleasure: Writings of a Woman Ayurvedic Practitioner in Colonial North India,” Studies in History 21, no. 1 (2005), 17–44; Sanjam Ahluwalia, Reproductive Restraints: Birth Control in India, 1877–1947 (Chicago: Univ. of Illinois Press, 2008); Sanjam Ahluwalia, “Scripting Pleasures and Perversions: Writings of Sexologists in the Twentieth Century,” in Sanjay Srivastava, ed. Sexuality Studies (New Delhi: Oxford UP, 2013), 24–45.

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sustain traditional conceptions of marriage and motherhood with a view to women’s “biological fulfillment,” perhaps reflecting an inherent gender bias among both Western and native sexologists.

Nara-Naree: The Only Bengali Magazine on Health, Hygiene and Sex The magazine Nara-Naree was launched in Paush [December-January] 1346 [1939-1940]8 by a group of Bengali intellectuals, experts and distinguished physicians who had received their medical degrees from Indian medical colleges and foreign institutes; their intercultural expertise added a sharp edge of intellectuality to the magazine. The first volume indicated that the magazine was edited by Sunil Kumar Dhar and published by Sukanta Kumar Halder, with the assistance of an honorary advisory board of physicians consisting of Dr. D. R. Dhar, Dr. Benoy Sinha, Dr. B. K. Goswami and Dr. Sudhamadhab Sengupta. Later, Sukanta Halder and Panchanan Halder became editors and Srikanta Halder, the associate editor. These individuals were well versed in Western technological developments in the field of medical science and combined transcultural competence with professional specialization. Some of the women who wrote for Nara-Naree were associated with well-known male contributors to the publication at the time (Image 4-1). For instance, Bani Halder was the wife of the publisher, Sukanta Halder and Monika Debi was the wife of Dr. D. R. Dhar; both women gained prominence in the magazine. Other female writers who were professionally acclaimed and had articles featured in the magazine included champion Bengali swimmer Lila Chattopadhyay, midwife Srimati Sarojrekha Dutta, dancer Monika Desai and actress Chandrabati Debi as well as Shrimati Manjari Debi, Shrimati Tripti Roy, Maya Gupta, Bani Halder, Sudhira Sengupta, Mrinalini Dasgupta, Aparna Basu, Bela Bhattacharya and Kamala Goswami; they focused on social issues, sexuality, beauty and health columns of the magazine.

8

The Bengali calendar is completely different from the English calendar; in every Bengali month, two English months overlap, as do the English years at the end of the Bengali annual cycle. January 1900 started in Paush 1306.

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Image 4-1: The Editorial Board and the Management Committee of the magazine, Nara-Naree, 1347 [1940].

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During the colonial rule, Nara-Naree was widely circulated in undivided Bengal; however, following partition in 1947, the readership was divided between Bengali communities in West Bengal (India) and East Bengal (which was then part of Pakistan). Hindi versions of the magazine also began to be circulated, due to the huge popularity of the magazine.9 This popularity is also evident from the demand for circulation agents and the number of postal orders accepted from various parts of India, Pakistan and Myanmar; a reader noted that an office of the magazine had also been established in London.10 Besides disseminating ideas of scientific sexology, the significance of vernacular magazines can also be gauged by the proliferation in scientific writings and the growth of vernacular languages that enabled the promotion of emerging ideals of general healthy living and self-discipline. Srirupa Prasad (Chapter Six in this volume) elaborates this in her discussion on the engagements of Gandhi’s spiritual, moral and self-discipline ideals of body with ensuing political concerns at the time. In an attempt to engage with global scientific modernity, contributors to the magazine engaged in a transnational approach by incorporating stories and articles about different countries and cultures. In this respect, Nara-Naree was particularly significant for popularizing sexual science outside of the elite and Western circle and producing a lucid form of knowledge presented by the non-Western expert to the non-expert public in order to guide readers toward a better understanding of conjugal life.

Marriage as a Prescription In Nara-Naree, companionate marriage and the new understanding of the “scientific” management of sex were conceived as central sites and the markers of a modern society. Discourses on “conjugal happiness” aimed at inculcating a sense of marital responsibility in spouses, who were provided valuable tips for leading an informed sexual life. To this end, Nara-Naree quoted extensively from Marie Stope’s Married Love (1918), Bertrand Russell’s Marriage and Morals (1929) and Havelock Ellis’s Studies in the Psychology of Sex (1897-1928); this also implied a fair degree of openness toward gathering and imparting knowledge through crossing national and cultural borders.11 It is not surprising that with the popularization of 9 “Sharadiya Nara-Naree [“Autumn Issue of Man-Woman],” Nara-Naree [ManWoman] 10, no. 9 (Bhadra [August–September] 1356 [1949]): 239. 10 Manmatha Kumar Adhikari, “Alochana [Discussion],” Nara-Naree [ManWoman] 9, no. 4 (Ashar [June–July] 1355 [1948]): 203. 11 Santoshkumar De, “Bangla Bhasai Yauna Vigyan Alochana [Sexual Science in

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Western sexual science and global sexology, Marie Stopes’ Married Love (1918) was accepted as a handbook of sexual knowledge for both men and women.12 In Nara-Naree, male advocates often borrowed views from Western writers and argued that sex is a biological instinct that is also profoundly affected by cultural and moral notions.13 With the advent of global sexology, abstinence was considered unnatural and the idea that conjugal compatibility was of importance gained favor. The institution of marriage was considered to be the sanctioned social mode for sexual expression and any repression of sexual activity was considered to have far-reaching manifestations. The adverse effects of repression were regarded as “Nature’s retaliation” and sexual stimulation without reaching the “natural end” through marriage was often deemed to cause nervous disorders, with the possibility of creating critical medical circumstances and jeopardizing sexual health.14 In accordance with Bengali cultural norms, during the early years of Nara-Naree adult men and women in love were advised to avoid sex before marriage. But soon physical attraction and intimacy in premarital relations began to be highlighted in different stories.15 The “Prescription” section also received a number of questions from readers about their premarital experiences and the advisors often asked lovers to restrain their sexual desire until after marriage; other questions raised by readers concerned the character of the wife and indications of premarital affairs. In reply to such a question about the chastity of the wife, the advisor described various types of hymens that could be ruptured without

Bengali],” Nara-Naree [Man-Woman], 9, no. 7 (Ashwin [September–October] 1355 [1948]): 390. 12 Dwijendranath Maitra, “Dadur Chithi [Letter from Grandfather],” Nara-Naree 10, no. 1 (Poush [December–January] 1355 [1948–49]): 28. 13 Bimalendu Chattopadhyay, “Niti o Samaj [Morality and Society],” Nara-Naree [Man-Woman] 9, no. 7 (Ashwin [September–October] 1355 [1948]): 384. 14 Sarojkumar Nandy, “Parinata Boyose [Sexual Maturity],” Nara- Naree [ManWoman] 1, no. 6 (Jaishtha [May–June] 1347 [1940]): 281; Sudhamadhab Sengupta, “Bigyaner Chokhe Prem [Love in the Eyes of Science],” Nara-Naree [Man-Woman] 1, no. 5 (Baisakh [April–May] 1347 [1940]): 174; Vatsayan, “Valobasar Bighno [Travails of Love],” Nara-Naree [Man-Woman] 1, no. 8 (Shraban [July–August] 1347 [1940]): 364. 15 Sukantakumar Halder, “Parinay [Marriage],” Nara-Naree [Man-Woman] 1, no. 12 (Agrahayan [November–December] 1347 [1940]): 543–47; Sudhamadhab Sengupta, “Bigyaner Chokhe Prem [Love in the Eyes of Science],” Nara-Naree [Man-Woman] 1, no. 5 (Baisakh [April–May] 1347 [1940]): 174–76.

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intercourse.16 Different shapes and structures of the hymen were also dealt with in detail in “Yauna Jiban” [Sexual Life] (1355 [1948]) to ease moral panic.17 Thus, sexual outlets outside the ambit of marriage were frowned upon and the sexual behavior of unmarried couples was often monitored by their parents and society. In this regard, marital compatibility and conjugal fidelity were held to be a way to control sexual extravagance and prevent sexually transmitted diseases.18 Therefore, desire was considered natural in premarital relations but it was only within marriage (especially in the case of women) that the sexual act was considered to be socially acceptable or moral. In this context, Nara-Naree referred to Ellen Key’s observation: Never do greater possibilities exist for the happiness of both of the individuals and of the race than in a love which begins so early that the two can grow together in a common development; when they possess all the memories of youth as well as all the aims of the future in common, when the shadow of a third has never fallen across the path of either.19

This argument was elaborated in “Valobasar Bighno” [Travails of Love], in which sexual desire prior to marriage was argued to generate various physiological problems and jeopardize sexual health.20 Marriage was promoted by the doctor as the “prescription” to cure the psychological excitement caused by love. The critical condition of a love-struck Bengali girl was compared with the story of an American girl named Betty, who suffered from abdominal pain and for whom doctors advised marriage as the remedy. Repression was also believed to lead to barrenness or impotence and marriage was cited as the medical cure. Monogamous marriage was also hailed as the principal and permanent solution for curbing the irresistible desires of the new generation of youth, who easily gave in to material temptations and it was declared that marriage had been scientifically ascertained as important for keeping the

16

“Prescription,” Nara-Naree [Man-Woman] 9, no. 6 (Bhadra [August– September] 1355 [1948]): 314–20. 17 Jyoti Bachaspati, “Yauna Jivan [Sexual Life],” Nara-Naree [Man-Woman] 9, no. 3 (Jaishtha [May–June] 1355 [1948]): 122. 18 Nandy, “Parinata Boyose [Sexual Maturity],” 281–83; Vatsayan, “Valobasar Bighno [Travails of Love],” 363–64. 19 Shyamaprasanna Sen, “Bangalir Sasthyonasher Karon [Reason of Bengali’s Health Loss],” Nara-Naree [Man-Woman] 1, no. 2 (Magh [January–February] 1346 [1940]): 53. 20 Vatsayan, “Valobasar Bighno [Travails of Love],” 363.

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social structure from crumbling.21 The “medicinal value” of marriage and its “natural” and scientific implications were endorsed by Western references, such as Dr. Wench’s “Healthy Wedded Life,” which highlighted the necessity of marriage: Marriage is a condition the time for which is indicated by Nature and if Nature is disregarded and marriage is delayed, a certain amount of punishment will surely follow.22

The idea that there was a proper marriageable age for both boys and girls was scientifically endorsed, as the prolonged repression of natural urges was believed to affect the psychophysical health of both.23 Love was treated as a private affair that was considered to properly take place only between a husband and a wife; sex outside these confines was repressed, with the institution of marriage claiming exclusive rights to the discourses on sexuality. Society tried to regulate the sexuality of modern women by placing it firmly within marriage, which was deemed to be the only appropriate institution for sexual intimacy. Another article also referred to Havelock Ellis, who observed in Studies in the Psychology of Sex: It is recognized that a girl becomes sexually a woman at puberty, at that epoch she receives her initiation into adult life and becomes a wife and a mother.24

Companionate marriage and conjugal life became the best prevention against emotional and physical complications, “immorality,” sexual extravagance, promiscuity and sexual diseases.25 The process of taming “wild” sexuality also led to comparisons between the prostitute and the chaste wife. So naturally all other forms of intercourse, except that within monogamous heterosexual marriage, came under a strict regime of surveillance. During the initial years of Nara-Naree, issues related to love outside marriage and premarital physical intimacy became highly debated. Gradually, love marriages became predominant and socially acceptable. Yet, in another article, one finds a reference to premarital relations declaring that these should not be considered sinful; the writer based this 21

Mukhopadhyay, Debdas, “Prajapatir Mrityu [Death of the Butterfly],” 328–31. Sen, 55. 23 Nandy, “Parinata Boyose, [Sexual Maturity],” 281–83; Vatsayan, “Valobasar Bighno [Travails of Love],” 363–64. 24 Sen, 55. 25 Mukhopadhyay, Debdas, “Prajapatir Mrityu [Death of the Butterfly],” 328–31. 22

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on Ellen Key’s observation, “those who love each other are husband and wife.”26 There were also questions from readers to the advisors about managing problems in one’s love life. Women and men started to profess marital commitment through letters such as “Keno Ami Amar Swami K Valobasi” [Why Do I Love My Husband?] and “Keno Ami Amar Stri ki Valobasi” [Why Do I Love My Wife?].27 It was evident that the idealization of compatibility and companionship took on a major role in Nara-Naree, with conjugal love considered to be the necessary and basic foundation of marriage. Modernity was, thus, interlinked with the ideals of romantic love and monogamous companionate marriage, which centered around intimate needs such as that to love, to be loved and to experience a fulfilling sex life.

Combating Conjugal Displeasure To the Bengali public, Nara-Naree became an encapsulated form of Western sexual knowledge and private life became a public concern. Readers were very enthusiastic about the scientific analysis of sexual issues, which acquainted them with a global sexual culture. Readers also acknowledged the important contribution Nara-Naree made in promoting “conjugal science,” as the silence about sex education in the public space contributed to marital dissatisfaction caused mainly by “ignorant” husbands.28 Western and Bengali experts focused on ways of consolidating and stabilizing the conjugal relationship, with the wife’s sexual satisfaction 26 Bimalendu Chattopadhyay, “Niti o Samaj [Morality and Society],” Nara-Naree [Man-Woman] 9, no. 7 (Ashwin [September–October] 1355 [1948]): 385. 27 Sukumari Bhattacharya, “Keno Ami Amar Swami Ke Valobasi [Why Do I Love My Husband],” Nara-Naree [Man-Woman] 7, no. 6 (Jaishtha [May–June] 1353 [1946]): 212–13; Kamala Debi, “Keno Ami Amar Swami Ke Valobasi [Why Do I Love My Husband],” Nara-Naree [Man-Woman] 7, no. 8 (Shraban [July–August] 1353 [1946]): 294–95; Mina Maitreya, “Keno Ami Amar Swami Ke Valobasi [Why Do I Love My Husband],” Nara-Naree [Man-Woman] 7, no. 7 (Ashar [June–July] 1353 [1946]): 254–55, 287; Sarojkumar Nandy, “Keno Ami Amar Stri k Valobasi [Why Do I Love My Wife?],” Nara-Naree [Man-Woman] 11, no. 9 (Bhadra [August–September] 1357 [1950]): 342–44. 28 Chakrabarty, “Nara-Naree ki Amar Jibonke Sushtho o Sundar kore Tuleche? [Did Nara-Naree Make My Life Beautiful?],” Nara- Naree [Man-Woman] 11, no. 9 (Bhadra [August–September] 1357 [1950]): 370-373; “Prescription,” NaraNaree [Man-Woman] 10, no. 9 (Bhadra [August–September] 1356 [1949]): 241– 48; Nirupama Sengupta, “Adbhut Aggyata [Strange Ignorance],” Nara-Naree [Man-Woman] 10, no. 10 (Ashwin [September–October] 1356 [1949]): 274-75.

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regarded as a prerequisite for reinforcing her commitment to the relationship. This involved an increasingly explicit concern for a wife’s right to pleasure, which found expression in the discursive formation of the ideal of “companionate marriage.”29 Contributors to Nara-Naree provided a wide range of advice to married couples while continuing to stress the importance of the husband’s role in providing sexual satisfaction to his wife. Here, the wife’s sexual contentment was linked with marital happiness and a successful conjugal life. In this context, Diganta Roy explained the functioning of the female sexual physiology while Mukul De pointed to knowledge about “preparatory tenderness” and the art of lovemaking as being essential for attaining marital bliss.30 Various prescriptions and techniques were issued for ensuring the provision of complete pleasure to one’s wife; this was assumed to be a marker of true modernity. This theme resonates with Douglas Haynes’ findings on the popularity in western India of global sexology, which highlighted the modern husband’s need to arouse and satisfy his wife sexually.31 Moreover, the husband was treated as a teacher who could not only guide the wife in sexual matters but was also expected to initiate the sexual act.32 In this respect, the emergence of the gendered model of the male as the initiator and tutor and the female as the responsive student remained remarkably persistent throughout the twentieth century.33 Thus, the reasoning of global sexology emphasized the centrality of a husband’s ability to provide his wife pleasure in both the physiological and emotional acts, which together constituted the basic foundation upon which the marriage rested. While marriage manuals stressed the importance of marital responsibilities, the wife was universally assumed to be a virgin and sexually inexperienced. So even though attention to female sexual pleasure became a characteristic of modern sexual culture, women were considered to be the receivers of secondhand knowledge from their 29

Erin Connell and Alan Hunt, “Sexual Ideology and Sexual Physiology in the Discourses of Sex Advice Literature,” The Canadian Journal of Human Sexuality 15, no. 1 (2006): 23–45. 30 Diganta Roy, “Yoni Srab [Vaginal Secretion],” Nara- Naree [Man-Woman] 9, no.1 (Poush [December–January] 1354 [1947-48]): 25–31. Mukul De, “Yauna Aparagata [Sexual Impotence],” Nara-Naree [Man-Woman] 7, no. 12 (Agrahayan [November–December] 1353 [1946]): 476–77. 31 Douglas E. Haynes, “Selling Masculinity: Advertisements for Sex Tonics and the Making of Modern Conjugality in Western India, 1900–1945,” South Asia: Journal of South Asian Studies 35, no. 4 (2012): 787–831. 32 Prabha Basu, “Jigyasa [Query],” Nara-Naree [Man-Woman] 9, no. 3 (Jaishtha [May–June] 1355 [1948]): 162. 33 Connell and Hunt, “Sexual Ideology,” 23–45.

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husbands. Furthermore, women were often advised to master the art of lovemaking in order to please their husbands because it was believed that women had as much responsibility to be responsive to their husbands— breaking down the barriers of fear, shame and unwanted pregnancy—as husbands had to satisfy their wives. Sexual harmony and mutual gratification were considered to be the key concerns of modern conjugality. Thus, sexual performance became a critical social space, within which male and female sexuality were constructed. Female desire was, thus, accorded much importance; this simultaneously raised anxiety about male sexual performance and manhood. For example, Shailen Bhattacharya’s “Kuntalar Chithi” [Kuntala’s Letter] (1347 [1940]) suggests that medical scrutiny of sexual health should take place before marriage.34 In the form of a personal letter, the leading character, Kuntala unveils the “problem” of her married life to a friend. Her husband’s premarital passivity was discovered to be the result of impotence, leading to futile consultations with sexologists for therapeutic solutions. Citing her own unfortunate experience, Kuntala implored her friend to persuade her physician husband to begin a movement promoting sex education: In today’s era every developed nation has a system of scientifically testing the health of the spouses to declare them as fit for marriage by issuing a medical certificate […] If Mr. Sen initiates a movement on sexology, it would be really beneficial for the womenfolk of our society.35

This also opened up a world of female conversation for the readers, where women talked openly about conjugal disharmony, infertility and male impotence. Even though sexologists now conceptualized women as sexual beings, breaking away from the traditional patriarchal notion of female passivity and submissiveness, writers in Nara–Naree still linked sexual pleasure with marriage and motherhood; a number of articles measured the fulfilment of a woman’s conjugal life in terms of attaining motherhood. In the article, “Gorilla,” a female Bengali writer, Manjari Debi, narrated the plight of a dissatisfied housewife named Lila, who would scream in her dreams as she visualized intimate scenes with a gorilla.36 Her suppressed sexual desire had evidently been imprinted in her subconscious, appearing 34 Shailen Bhattacharya, “Kuntalar Chithi [Kuntala’s Letter],” Nara-Naree [Man Woman] 1, no. 12 (Agrahayan [November–December] 1347 [1940]): 521–23. 35 Ibid., 523. 36 Manjari Debi, “Gorilla,” Nara-Naree [Man-Woman] 1, no. 2 (Magh [January– February] 1346 [1940]): 45–52.

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through repetitive dreams that defied moral policing and repression in the actual social space. While Lila tried to hide her latent dream-thoughts, with her transgression occurring in the form of “unnatural” fantasy, repression of desire and failure to obtain pleasure took a toll, which became evident through the deterioration of her physical health. Unable to endure this silent suffering any longer, she confided in her “happily married” friend, seeking a remedy that would help her sustain her difficult marriage. Her friend’s husband, a psychologist, interpreted her dream as symbolizing her despair and discontentment in conjugal relation and recommended that her husband consult a sexologist. The story ends on a happy note, with Lila achieving satisfaction in married life after her husband regains sexual vigor following consultation with the sexologist and she becomes a mother. The best proof of conjugal satisfaction was thus deemed to be the experience of maternal joys. As exemplified in such writings, “scientific sexology offered the potential of a highly-sexualised partner, a wife whose libido could be potentially unleashed in the context of ‘sex love’ without threatening the destruction of the conjugal relationship or the larger social order.”37 At the same time, articles in Nara-Naree provided a space where women poured out their desperation and dissatisfaction in conjugal life to their married female friends, a space where women characters broke the conspiracy of silence that had existed around married women’s bodies and sexuality. Women were, thus, participating directly and indirectly, through face-to-face conversation or epistolary confession, as trusted empathizers for their female friends and assisting them in finding scientific solutions with the help of their specialist husbands. The changing social sciences, which created a platform where women could openly discuss personal matters and intimate issues, contributed to the gradual emergence of a changing social space for women as well as to ideas of modernity. In this new social milieu, divorce was also suggested as a much-needed alternative solution, while abstinence within marriage became “unnatural” for both male and female partners.38 In “Dorokha Niti” [Double Standard of Morality], Bertrand Russell’s Marriage and Morals (1929) was discussed, with the writer indicating that issues of morality hindered women from expressing their minds and desires.39 He also noted that those 37

Haynes, 825. Bhattacharya, 521–23; Debdas Mukhopadhyay, “Shipra, Bijoy ar Ami [Shipra, Bijoy and Me],” Nara- Naree [Man-Woman] 1, no. 9 (Bhadra [August–September] 1347 [1940]): 382–87; Panchugopal Mukhopadhyay, “Kuhelika [Enigma],” NaraNaree [Man- Woman] 1, no. 7 (Ashar [June–July] 1347 [1940]): 301–5. 39 Diganta Roy, “Dorokha Niti [Double Standard of Morality],” Nara-Naree [Man38

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who criticized divorce rates in Europe and applauded their own chastity, were unmindful of the silent sacrifices that were being made and the suicides that were taking place in the context of preserving the institution of marriage. It was argued that higher rates of divorce did not necessarily reflect lack of commitment or the decline of moral character; instead, they indicated that the institution of marriage had evolved to respect individual autonomy, particularly for women, instead of functioning within a rigid, confined framework.

The Construction of Female Frigidity Scientific discourses that focused on “good sex” and conjugal compatibility often looked at female frigidity as a medical concern. In “Kuhelika” (Enigma), Shri Panchugopal Mukhopadhyay related a man’s personal experiences concerning both his wife and his mother.40 The mother was said to have exhibited a sexually passive, terrified and cold approach toward the father’s advances; the son then encountered the same attitude in his own wife. Her panic-stricken appearance, antipathy and indifference increased with the birth of the couple’s second child. The man categorized his wife’s unresponsiveness and detachment as frigidity, “mental disease,” or a “complex;” the “cold woman” was dubbed as “mad.” Physical issues, such as menstrual problems, chronic appendicitis and deformities in the uterus or ovaries, were cited as causes of this “psychological anomaly.” The medicalization of the wife’s sexual unresponsiveness was influenced by global sexology and based on the work of the early twentieth-century Western sexologists, who associated female sexual passivity with psychiatric deficiency and pathology. Thus, some among both Western and native sexologists constructed the “truth” about orgasm and frigidity by making women’s bodies a legitimate site for medicalization. In contrast, some contributors in Nara-Naree pointed to a lack of sexual knowledge as the reason behind the high frequency of sexual dissatisfaction among women.41 These writers cited ample references and noted that female frigidity was much less common than believed and was often merely a consequence of the man’s inability and selfishness. The main reason for frigidity was often not an anatomical anomaly but the

Woman] 9, no. 7 (Ashwin [September–October] 1355 [1948]): 386–89. 40 Mukhopadhyay, Panchugopal, “Kuhelika [Enigma],” 301–5. 41 “Prescription,” Nara-Naree [Man-Woman] 10, no. 9 (Bhadra [August–September] 1356 [1949]): 246; Mukhopadhyay, Panchugopal, 301–5.

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insensitivity of the male; lack of sexual education and disgust or fear regarding the sexual act might also create anxiety about issues related to sexuality. Various writers also observed that men readily indulged in extramarital affairs with or without reason. If any difficulty arose in conjugal happiness, some men slept in separate beds and developed liaisons with other women or prostitutes, while others isolated themselves, expecting the wife to realize her own “mistake,” and still others suspected other men to be behind their wives’ “abnormal” sexual behavior, instead of analyzing their own domineering and autocratic aggression.42 A number of articles in Nara-Naree, in fact, dealt with the sensitive issue of sexual pleasure and frigidity and noted that the overbearing attitude of the partner could heighten psychological pressure, apathy, mental distress and hysteria.43 In the article,“Shipra Bijoy ar Ami” (Shipra, Bijoy and Me), Debdas Mukhopadhyay depicted the husband Bijoy’s insensitivity and hypersexual aggressiveness toward his wife Shipra after the marital night; this was accompanied on several occasions by physical torture and mental abuse.44 Later, the woman was drawn toward an empathetic friend whom she married after divorce from her first husband. Their conjugal harmony pointed to the threatening pattern of behavior and unwanted sexual advances that she received from her husband as having been the cause of her sexual passivity in the face of mounting stress. Her failure to reciprocate and her objection to his continued demands for sex indicated that women did not always yield to quench male sexual desire. In this context, Sheila Jeffreys has noted that the popular assumption about the “normal” woman was that she would enthusiastically embrace sexual intercourse.45 The woman who failed to respond with enthusiasm was classified as “frigid” and deviant. But in this case, the traditional idea of a “normal” woman, who readily responded to male stimulation, was overturned. The “Prescription” section of the magazine included some questions about unhappy married life. One reply suggested that if a man had some patience and empathy, he could solve conjugal problems, as women 42

“Prescription,” Nara-Naree [Man-Woman] 9, no.2 (Baisakh [April–May]) 1355 [1948]): 107-–12. Mukhopadhyay, Panchugopal, “Kuhelika [Enigma],” 301–5; Mukhopadhyay, Debdas, “Shipra, Bijoy ar Ami [Shipra, Bijoy and Me],” 382–87. 43 Vatsayan, “Briddhassya Taruni Varja [Young Wife of the Old],” Nara-Naree [Man-Woman] 1, no.7 (Ashar [June–July] 1347[1940]): 316–20. 44 Mukhopadhyay, Debdas, “Shipra, Bijoy ar Ami [Shipra, Bijoy and Me],” 382– 87. 45 Sheila Jeffreys, The Spinster and Her Enemies. Sexuality and the Last Wave of Feminism, 1880-1930 (London: Pandora Press, 1985).

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needed some time for preparation to achieve ease in the marital relationship, especially in arranged marriages.46 Promoting the ideas of global sexology, the advisors pointed to compassion as the foundation for conjugal happiness and emphasized the modern concept of love between spouses. The magazine’s contributors expressed support and respect for a woman’s desire and her right over her own body, while also trying to foster mutual understanding. Following are examples of questions on the part of an advisor, who aimed to clarify the various factors that made a marriage happy and sexually fulfilling:47 a) What is the age of the wife? How is her health? [implying that a suitable age and good health were criteria for marital happiness]. b) Did you consummate the marriage? c) When did you make love for the first time after the marriage? d) Was it consensual or forced? e) Did you discuss the conjugal relation with your wife? What was her opinion? f) Were both of you satisfied in the sexual union? To drive home the point of their discourse on conjugal bliss, contributors cited the fact that scores of women had been mothers despite which had not attained pleasure in the sexual union owing to the ignorance or disregard of men who were mainly concerned with their own satisfaction. Many women were also frightened of becoming pregnant, hence were reluctant in sex. Nonconsensual sex and women’s inability to refuse their husbands’ sexual demands were two factors that most frequently led to unwanted pregnancy. Some other contributors opined that forced sexual relations within marriage could be termed rape.48 Men were given the responsibility to be sensitive, friendly, open to discussion, empathetic and compassionate. Various articles highlighted the need to seek the wife’s consent, asking the husband to value her emotions. Thus, scientific discourses suggested various mechanisms through which a better sexological understanding could be incorporated into the complex, hybrid conceptions of sexuality. The assumption of maternal and marital duties by the woman was not sufficient for marital bliss; the right to personal satisfaction became equally significant.49 46

“Prescription,” Nara-Naree [Man-Woman], 1355a [1948]: 112. “Prescription,” Nara-Naree [Man-Woman] 9, no. 7 (Ashwin [September– October] 1355 [1948]): 398–401. 48 Diganta Roy, “YoniSrab [Vaginal Secretion],” 25–31. 49 Connell and Hunt, “Sexual Ideology,” 23–45. 47

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Looking at the issue from a different perspective, Nara-Naree reported that the number of “frigid” women was not small in the West. Various examples of frigid women were quoted from A Marriage Manual by Abraham Stone and Hannah Stone and Sexual Truths by W. J. Robinson to indicate that a huge number of women were not sexually responsive. Katherine Davis listed the reasons in her book, Factors in the Sex Life of Twenty-Two Hundred Women; these were incorporated into an article by Nirmalchandra De.50 The Bengali sexologists tried to draw conclusions from the responses of Western women to apply to the native context. De provided various reasons that could lead to sexual frigidity in association with the insensitivity of the partner; prominent physical causes included lack of desire, physical weakness, pain, repeated coitus, pregnancy, menopause and lack of sexual harmony, besides far-ranging psychological reasons. Inhibition and feelings of degradation made sexual intercourse distasteful. It was also found that frigidity could be temporary or “situation-specific.”

Contraception, Motherhood and Problematics of Choice The significance of Nara-Naree was also evident from the various records of global discourse on the modern model of conjugality and reproductive sexuality that characterized and influenced the changing ideas about the female body. Both global and local practices relevant to the discourses on birth control and conjugal science propagated by Western sexologists were repeatedly referred to by Bengali advocates. Contraceptive information served as a legitimate platform for the articulation of new discourses on sexuality and conjugality. Sarah Hodges has noted that the late-colonial contraceptive commercialism was rooted in the pursuit of pleasure and cultivation of the self.51 The discourses surrounding domestic science focused on the simultaneously “forwardthinking” and pleasure-seeking nature of the modern public, a combination made possible by virtue of their adoption of new forms of technology.52 In Nara-Naree, contraception was claimed to enhance pleasure in sexual life; in this context, women’s health was considered primarily in terms of the circulation of birth-control information.

50 Nirmalchandra De, “Narir Kamshitalata [Women’s Sexual Frigidity],” NaraNaree [Man-Woman] 9, no. 2 (Poush [December–January] 1354 [1947–48]): 2–6. 51 Sarah Hodges, Contraception, Colonialism and Commerce: Birth Control in South India, 1920–1940 (Aldershot: Ashgate, 2008). 52 Ibid., 128.

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Bengali men initiated a sustained public discussion on birth control and attempted to establish institutions to provide information on contraception, with women quickly joining the public discourse. The ideology of limiting the family size and the declining birthrate were symptomatic of a larger questioning of women’s role in procreation as well as in marriage. The analysis of Nara-Naree showed that women were aware of different procedures of birth control and were inquisitive about sexual health, desire and pleasure. Thus, female scholarship about contraception and sexual knowledge promoted both direct and indirect participation by women, instead of them being merely passive recipients of information through their husbands: With the root of prejudices being destroyed “moral burden” is declining. They (women) are learning to think differently, explore new things and live healthily and scientifically. They do not become embarrassed and reddened with shame while listening to the information regarding birth control.53

Several writers and contributors to Nara-Naree realized that as long as married women were subject to their husband’s sexual desires and as long as there was no way to regulate fertility, women would be forced into repeated childbirth and the managing of a large household; such writers often projected a positive representation of women as subjects of knowledge. In the article, “Nischit Nirnoy” (Confirmed Detection) by Tripti Roy, the female protagonist, Ela, attempts to dissipate the secrecy, shame and silence surrounding women’s bodies and to make women active participants in creating and sharing knowledge to reclaim their bodies from hierarchical control.54 In her discussions on new discoveries and scientific inventions relevant to women’s health and sexuality, she represents the cosmopolitan modern woman who had an understanding of the world outside the home. She argues, “I cannot agree on the issue that marriage is the final conclusion of a woman’s life, rather it is the beginning,”55 and establishes a school for circulating birth control information. Ela explains various strategies of birth control like Ogino-

53

Panchugopal Mukhopadhyay, “Jonmoniyontron o Adhunik Manush [Birth Control and Modern Man],” Nara-Naree [Man-Woman] 1, no.1 (Poush [December–January] 1346 [1939–40]): 6. 54 Tripti Roy, “Nischit Nirnoy [Confirmed Detection].” Nara-Naree [Man-Woman] 1, no. 8 (Shraban [July–August] 1347 [1940]): 337–40. 55 Ibid., 337.

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Knaus method56 to calculate the “safe” period. She also discusses modern scientific discoveries such as confirmation of pregnancy through the Aschheim-Zondek test,57 highly praising this “European-American technique.”58 Such articles drew a distinction between procreation and pleasure by portraying women as active, knowledgeable agents who could make their own decisions about conjugal satisfaction and procreation. Many readers asked about contraception and expressed a desire to delay childbirth. In replying to such questions, Bengali advocates presented an array of modern contraceptive and family planning options, such as birth control tablets, pessaries, sponges, condoms, calculating the safe period, barrier methods, coitus interruptus, application of spermicidal jelly or cream, the diaphragm or cervical cap and sterilization, with elaborate discussions of their usage, method of application and advantages and disadvantages.59 This new knowledge of contraception highlighted the impact of global sexology on conjugal and sexual practices in Bengal and hence offers insight into aspects of transnational modernity. Looking back in the past, an article by Maya Gupta quoted Norman Haire and delineated various strategies of birth control dating from the very beginnings of civilization in Greece, Rome, Egypt, Japan, Arabia, Asia, Africa and Australia.60 With the rise of transnational modernity and the loosening of moral prejudices, Bengali women’s eagerness to learn more about sex and birth control continued to increase and they became comrades in a movement to promote sexology, sex education and contraception; sexual reforms were, thus, focused on and directed toward modern women. Women were represented as ideal subjects for receiving, circulating and controlling contraceptive knowledge. Their conscious choice to embrace birth control was evident in the questions that appeared in the 56 The Ogino-Knaus Method (named after Kyusaku Ogino, a Japanese gynecologist and Hermann Knaus, from Austria) is a calendar-based method for estimating the fertile and infertile phases during the menstrual cycle. To use it, a woman tracks the days of her periodic cycle and thereby determines the apparent likelihood of pregnancy on particular days of the month. This method was intended to be used either to conceive or avoid pregnancy. 57 This test was used to determine pregnancy in a laboratory by injecting concentrated urine from the woman into the body of a mouse. 58 Roy, Tripti, “Nischit Nirnoy [Confirmed Detection],” 336 59 “Prescription,” Nara-Naree [Man-Woman] 11, no. 9 (Bhadra [August– September] 1357 [1950]): 382–86. 60 Maya Gupta, “Prachin Samaje Janma Niyantran [Birth Control in Ancient Society],” Nara-Naree [Man-Woman] 9, no. 6 (Bhadra [August–September] 1355 [1948]): 274–76.

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“Prescription” section: I have been married for one month. I don’t intend to have children right now….I would be obliged if you could prescribe some medicine and explain its application. But I would be happier if you could suggest some other natural methods instead of medical potions as I am afraid that a negative reaction might create other complications or ailments….I am looking forward to your recommendation for medicine or any other natural method in this regard.61

This eagerness to learn about contraception gradually strengthened with the growing popularity of Western biomedicine and the individual assertion of women’s sexuality which demarcated the institution of motherhood from conscious reproductive choice. Many articles focused on improving the quality of life and upgrading the standard of living for a modern lifestyle. Becoming modern in this respect was linked with women’s contraceptive choices within the conjugal sphere. Western and Bengali birth control activists made repeated attempts to persuade women to exercise their own choice regarding the method of contraception instead of depending on their husbands to manage reproductive sexuality. The idea of controlling their own bodies, sexuality and fertility in a patriarchal domain was linked to issues of sexual compatibility and birth control, as in such case married women would no longer be defenseless vis-à-vis the sexual demands of their husbands: Women’s natural hesitation is mostly responsible for their plight and misery. One kind of women endures the untoward and overbearing demands of her husband for fear of displeasing him and there is another type of woman who does not take recourse to scientific measures for fear of jeopardizing her physical and psychological health and even religious or after-life repercussions.62

Although the use of contraceptives was advised in order to retain autonomy in sexual activity, some articles put forward apparently scientific claims that marriage and motherhood were highly beneficial for women’s health.63 Motherhood was championed as “Nature’s law” to 61

“Prescription,” Nara-Naree [Man-Woman] 7, no. 12 (Agrahayan [November– December] 1353[1946]): 491. 62 Mukhopadhyay, Panchugopal “Jonmoniyontron o Adhunik Manush [Birth Control and Modern Man],” 6. 63 Sarojkumar Nandy, “Janmo-Niyontron o Swasthyo [Birth Control and Health],” Nara-Naree [Man-Woman] 8, no. 3 (Falgun [February–March] 1353 [1947]): 81–

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benefit the woman’s body which was said to be best suited for this purpose as a complementary physiological necessity. It was presumed that motherhood paved the way to sexual maturity and cured sexual anomalies; several Western references were cited in this regard. Thus, even though discourses surrounding scientific sexology emphasized birth control, the link between motherhood and biological fulfilment was found to be indispensable in both the Bengali and Western contexts of sexual reform. Myriad instructions were provided to women for good births and good living, highlighting the link between domesticity and fertility. Women were considered as the mothers of future progeny, required to produce strong leaders for the nation.64 Bio-politics was woven into the project of social and national welfare where images of the healthy mother and courageous children were interlinked with scientific discourse. Bengali reformers, both male and female, encouraged the employment of new methods for the maintenance of maternal and child health and abandonment of the traditional midwifery practices of the dhais and “unscientific” ways of childrearing for the Western standard in these areas. It was recommended that women depend on specific scientific measures to ensure the birth of healthy babies: Science should reign over the mother’s mind and she should be instructed to be careful during the menstrual period, pregnancy and postpartum stages, keeping the thoughts about the unborn baby which she would deliver.65

Scientifically-conscious women were persuaded to learn healthy methods of scientific mothering. There were apparently no such conditions and guidelines regarding fatherhood and the father’s responsibility which highlighted the traditional sexual divisions of labor and power relations. The impact of the private domain on the public life of the nation came to be seen as crucial as time progressed and, thus, could not be left unsupervised. Besides, the relationship between health and governance necessitated engagement with a global scientific modernity which also facilitated recognition of the importance of a healthy lifestyle. Advocates of birth control wanted to ensure the propagation of a “fitter” race of people, expressing their concern with the quality rather than the number of 84. 64 Mukhopadhyay, Bamondas, “Matrittyo o Sishumongol [Motherhood and Child Welfare],” Nara-Naree [Man-Woman] 1, no. 8 (Shraban [July–August] 1347 [1940]): 349. 65 Ibid., 349.

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people. In a prayer on New Year’s Eve, one author proclaimed: May we be exhilarated with the birth of “balaban” (vigorous) babies in the household. May our race thrive with the renewed glamour of eternal vitality and vivacity.66

The objective of such advocates was to reformulate the norms and functions of middle-class family life as a site for moral and cultural restructuring of the nation and to create educated compatriot–wives who would bring discipline, order and hygienic practices to middle-class homes. Most of them opined that prolific pregnancy was a curse in the lives of middle-class women while illiteracy and superstition prevented their emancipation. Additionally, some contributors to Nara-Naree indicated that women from working-class families suffered from producing more children than the family could properly maintain.67 This was how women’s bodies came to be considered appropriate sites for directing attention to national uplift and revitalization. The increasing demand for wider dissemination of birth control information and technology allowed educated men to speculate upon the intimate domain of procreation and conjugal relations. This highlighted a complex understanding of Western biomedical discourses on birth control and its influence on the debates on the size of the population size and the health of the people. The elite and the middle class became suspicious of the prolific way in which the working class and the poor produced progeny, thus giving eugenic and hygienic discourses a definite class character, with the copulation of the less affluent classes deemed to be devoid of emotional satisfaction.68 Sexual relations among these socioeconomic groups were regarded as a mere monotonous physical act incapable of capturing expressions of “real” intimacy and hence, in the emerging discourse of birth control, sexual pleasure was attached to a hegemonic and hierarchical interpretation. The promotion of birth control strategies, thus, could not be linked in an unproblematic way with the expression of progress, development and women’s autonomy in the context of Bengal; instead, it was associated with various paradoxes and problematic notions regarding conjugal happiness and the national cause.

66 Kumar, “Naba-Barsho [New-Year],” Nara-Naree [Man-Woman] 1, no. 2 (Magh [January–February] 1346 [1940]): 67. 67 Roy, Tripti, “Janmo Niyontron [Birth Control],” Nara-Naree [Man-Woman] 1, no. 4 (Chaitra [March–April] 1347 [1940]): 137–41. 68 Ahluwalia, Reproductive Restraints, 43.

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Conclusion The contributors to Nara-Naree adapted scientific theories from Western sexologists for conjugal reform in Bengal and encouraged women to express their own opinions about their desires and pleasure within heterosexual relations. This was coeval with claims of Bengali writers and sexologists regarding understandings of the scientific management of sexuality and the gendered nature of sexual reform both of which were constructed by Bengali as well as Western writers. Like Western sexual reformers, Bengali sexual reformers in their writings were not unanimous about women’s sexual independence. Some were preoccupied with women’s sexual fulfillment as wives and mothers and some championed women’s pleasure and desire in unambiguous terms with the promotion of contraceptive choice. Women participated as trusted friends, companions and confidants amidst the male monopoly of sexual reform and operated as agents of social change; their engagement ensured as well as indicated a major shift in the male-oriented reform movement within the overarching expressions of sexuality within marriage and motherhood.

Note Sections of the chapter have been published as a part of the PhD thesis Unbinding Bodies and Desires: Researching the Home, the World and the In-Between in Nara-Naree, the Only Bengali Journal on Health, Hygiene, Sex (1939-1950). Aalborg: Aalborg UP, 2015.

CHAPTER FIVE FEEDING EMPIRE: WET NURSING AND COLONIAL DOMESTICITY IN INDIA ͒ NARIN HASSAN

In her travel narrative, Scenes and Characteristics of Hindostan (1835), Emma Roberts notes the vulnerability of European families in India and the particular struggles of mothers and young infants: Infant life in the torrid zone hangs upon so fragile a thread, that the slightest ailment awakens alarm; the distrust of native attendants, sometimes but too well founded, adds to maternal terrors and where the society is small, the social meetings of a station are suspended, should illness, however slight, prevail amongst the baba logue. Where mothers are unable to nurse their own children, a native woman, or dhye, as she is called is usually selected for the office, Europeans being difficult to be procured; these are expensive and troublesome appendages to a family; they demand high wages on account of the sacrifice which they affect to make of their usual habits and the necessity of purchasing their reinstatement to caste, forfeited by the pollution they have contracted, a prejudice which the Mussulmans have acquired from their Hindoo associates. Their diet must be strictly attended to and they are too well aware of their importance not to make their employers feel it: in fact, there is no method in which natives can so readily impose upon the European community as that in which their children are concerned.1

 1

Emma Roberts, Scenes and Characteristics of Hindostan, with Sketches of AngloIndian Society, vol. 2. (London: Wm. H. Allen and Co., 1835), 121. NOTE: This chapter reprints material from a previously published essay. A version of this chapter was originally published in Nineteenth Century Contexts in 2016 (Vol. 38, No. 5, 353-63).

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Roberts presents India as a tropical space where the management of homes and children requires discipline and cautious planning, particularly on the part of European women. She introduces her readers to the Indian dhye or wet nurse, highlighting the entry of this figure within the homes of British families and her role in supporting the health of infants abroad. Roberts presents the dhye as a potentially troublesome, demanding and yet necessary figure who requires constant management and demands a special space and importance within the household. Referring to both Muslim and Hindu women and the value of their milk for European families, Roberts suggests that the wet nurse represents the co-mingling of peoples and evokes the tensions of varying religions, castes and classes. Thus, this account introduces readers to the dhye as a boundary-crossing figure who has the potential to pollute and muddle clear demarcations between European and native bodies. This depiction of the dhye reflects some common perceptions of colonial child-rearing overseas and British interactions with local servants. As Roberts suggests, the relationship between the European family and the “amah” or “dhye” (sometimes spelled “dhaye” or “dai”) was particularly vexed. By the middle of the nineteenth century, the increased migration of European families overseas to British colonies shifted the dynamics of domestic life, bringing more and more women and children into the tropics and increased exchanges between native servants and their “memsahibs.” As Nupur Chaudhuri, Alison Blunt, Elizabeth Buettner, Durba Ghosh and many others have discussed, the inclusion of British women within domestic spaces shifted and sometimes complicated the nature of colonial exchanges. Chaudhuri notes that servants were often the first figures British memsahibs had to interact with and on the most sustained basis.2 Cross-cultural relations evoked particular anxieties and depictions of colonial experiences and women often bore the burden of recreating the home and positioning British values abroad while negotiating relationships with native servants. The question of how to protect and care for infants and children in the “torrid zone” and how to manage servants was increasingly a topic of debate and the subject of many texts. While travel accounts depicted relationships between dhyes and European families, manuals for women in India, such as Flora Annie Steel and Grace Gardiner’s The Complete Indian Housekeeper and Cook (1888), included sections on the hiring of servants and suggestions for addressing and managing wet nurses and other local domestic workers. Further, the

 2

Nupur Chaudhuri, “Memsahibs and their Servants,” Women’s History Review 3, no. 4 (1994): 549–62, 550.

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“science” of infant management was becoming established in the period by the authoritative voices of doctors who suggested remedies for infants and young mothers and distributed their advice in texts. By the middle of the nineteenth century, manuals by Edmund Hull, Henry Pye Chavasse, William Moore and others became available in the publishing market and helped to shape a culture of household management based upon medical and scientific expertise. By the 1870s, many of these manuals targeted and addressed the needs of families in India and doctors became increasingly concerned with how “the tropics” affected the pregnant or lactating body as well as the health of infants. For example, medical doctors including Edward Tilt, R. S. Mair and William Moore published books that focused upon the health of Europeans in India and highlighted the nature of illnesses in the region. By the end of the century, female doctors such as Mary Scharlieb produced manuals for British and Indian women, providing guidance on topics such as healthy childbearing and infant feeding. Thus, the opinions of doctors became available in the publishing market and helped to shape a culture of household management based upon medical and scientific expertise. Women received information from multiple “experts,” all of whom promulgated various notions about the norms and conditions of infant feeding and management. Furthermore, depictions of the wet nurse and information regarding child-rearing found in numerous travel narratives, novels and other texts, produced notions of cultural difference and helped to establish guidelines for families abroad to navigate their experiences and relationships. This essay examines representations of the wet nurse in India in order to consider how shifting depictions and practices of breastfeeding and wet nursing can help us interpret and analyze colonial relations. As Ann Stoler and others have argued, within the spaces of empire, domestic relationships provide particularly rich and fruitful opportunities to study the complexities and variances of imperial power and “domains of the intimate figured so prominently in the perceptions and policies of those who ruled.”3 Further, Philippa Levine reminds us that by the middle of the nineteenth century, images of colonial domesticity were already forged: “By the 1850s, the image of colonizing as a rough and ready frontier practice was beginning to give way to an insistent demand for white settler areas to look more like Britain and, in particular, more like a domesticated Britain of both natural and familial order.”4 Analyzing the advice manuals

 3

Ann Laura Stoler, Carnal Knowledge and Imperial Power: Race and the Intimate in Colonial Rule (Berkeley: Univ. of California Press, 2002), 7. 4 Philippa Levine, Gender and Empire (New York: Oxford UP, 2004), 8.

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and representational exchanges between infants, mothers and native women reveals the nature of colonial relationships within the domestic sphere and the dependencies of European families abroad as well as colonial anxieties and notions of the boundaries of the body. The exchange of bodily fluids and particularly of milk as a nourishing and sustaining substance for infants, is symbolic and tied to notions of generational bloodlines and successful reproduction. Further, I will discuss how wet nursing and the exchanges it produced could challenge boundaries of race, religion, ethnicity and class and simultaneously reinforce and reshape roles for European and native women in colonies. Since emerging nineteenth-century technologies such as milk bottles and artificial formulas did not easily reach imperial spaces and since the “tropics” were viewed as a space where European women were imagined to be strained by nursing (and, therefore, encouraged to hire wet nurses), the native wet nurse was a crucial domestic worker.5 While, as Emma Roberts notes, the wet nurse was a figure to be managed and contended with, her intimate relationship with and access to British babies revealed the ways that the future of the empire depended upon servant women, their bodily transactions with European children and the exchange of breast milk. Reading the wet nurse within the colonial context broadens our notions of both the culture of milk sharing in the Victorian period and relations between Indian and British women within the colonial context. Further, the wet nurse can be read as a potent marker of colonial exchange and a reflection of colonial anxiety and guilt; her place within the English household in India reveals both a dependence upon and disciplining of the native woman’s body and reflects fears of the imperial project’s participation in the neglect of native children and the preference for Anglo-Indian familial structures. I suggest that the female lactating body was a site of both fear and fascination and that the figure of the wet nurse shifted notions of colonial order within the domestic realm. My project concurs with Indrani Sen’s analysis of the “ambivalences in the interactions between the middle-class

 5

Multiple accounts, including those by Tilt and other doctors, emphasized how the climate of the tropics could be unhealthy for European women and suggested that breastfeeding could put an additional strain on women’s bodies. See for example, R. S. Mair in his Medical Guide for Anglo-Indians. Some texts claimed that European women were often unable to breastfeed in the climates of India and other tropical regions. The anonymous English woman writer of A Domestic Guide To Mothers in India (Bombay:American Mission Press,1836) wrote that “no infant thrives so well than those fed by these women” (72) asserting that native women would have richer and more nutritious milk than European mothers.

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memsahib and low class/caste/’native’ female servants inside the colonial home” and her suggestion that the nursery was a “contested” space.6 Within the space of the nursery, the wet nurse also functioned as a complex boundary figure and her exchange of milk for consumption presented a challenge to notions of “pure” British bodies. I examine contradictory responses to the wet nurse—some that position her as a dangerous and deviant figure to be carefully monitored and managed and others that emphasize her role as a highly necessary inclusion within the household. What all of these representations uncover, however, is the vulnerability of English reproduction and child-rearing and the wet nurse as a figure to confront within colonial and familial relations. Finally, I suggest that a reading of wet nurses and child-rearing practices in India allows us to see the complexity of domestic relations between natives and their European employers—the figure of the wet nurse reveals colonial spaces as sites of negotiation and reordered familial organization. While dominant images of the wet nurse pose her as a challenge to English memsahibs, her presence within the household contributed to the shaping of a culture of domestic management and maternal care for families in India. Further, the dhye’s important role within the household could potentially challenge binary assumptions about submissive and victimized Indian women and the empowerment of English women abroad.

Reading the Figure of the Wet Nurse Notions of the wet nurse as a complex and yet necessary figure were sustained throughout the nineteenth century, across the British Empire and within the metropole as well. When Emma Roberts is writing her narrative in 1836, she suggests the need for the wet nurse in tropical environments and establishes her as a figure requiring surveillance and supervision. By the middle of the nineteenth century, depictions of the wet nurse would become more common in a range of texts including fiction, travel narratives and domestic guides. Victorian literary texts such as Dickens’ Dombey and Son (1848) featured the wet nurse as a figure marked as lower class but essential for the reproduction and success of the upper classes. In the novel, Dickens emphasizes the economic transaction of milk sharing through the wet nurse Polly (who he renames “Richards”). She is the critical figure who keeps Dombey’s male heir alive and thriving

 6

Indrani Sen, “Colonial Domesticities, Contentious Interactions: Ayahs, Wetnurses, and Memsahibs in Colonial India,” Indian Journal of Gender Studies 16 (September–December 2009): 299–328), 300.

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and she feeds the young child in “a little glass breakfast-room” situated at the end of Dombey’s dark private office, where she can be viewed at any moment by his secretive gaze.7 Dickens’ account represents the ways that the wet nurse’s body was monitored, interpreted and displayed as a boundary site for the intersection of various classes. When Polly enters the household after the death of Dombey’s wife, she is subjugated to an elaborate doctor’s examination of her breasts and overall health and asked to leave her own children in order to focus solely upon nourishing and nurturing the child she is employed to feed. By the end of the nineteenth century, the wet nurse figure became sentimentalized in texts such as George Moore’s Esther Waters (1894)—a novel that traces the struggles of the wet nurse, especially those arising because of her separation from her own offspring. Forced to become a wet nurse, Esther leaves her own child in the hands of a “baby farmer,” but eventually leaves her post because she cannot bear to be at such a distance from the child and subsequently discovers the deplorable conditions in which he lives. Both Dickens and Moore describe the cultural tensions of the wet nurse’s absence from her own family as she is encouraged, or forced because of her circumstances, to prioritize the feeding of the upper classes. Horrific stories of stark Victorian “baby farms” and images of impoverished poor children aside, wet nursing was sometimes a lucrative occupation for women in the nineteenth century and one that sustained itself through much of the period. However, it was increasingly represented as dangerous, dirty, or unnecessary as the nineteenth century progressed, particularly as new technologies allowed for the development of artificial formulas and bottles. Critics such as Valerie Fildes and Janet Golden focus on the elimination of the wet nurse by the twentieth century in the context of European and American history, tracing how “wet nursing became particularly problematic in the nineteenth century” and “the development of scientific infant feeding eliminated wet nursing by the beginning of the twentieth century.”8 Wet nursing has been a subject of analysis by Rima



7 For an important close reading of the qualities of surveillance at play in the wet nursing scenes of the novel, see Melisa Klimaszewski’s essay, “Breasts, Power, and Penetration in Victorian England, Women’s Studies 35, no. 4 (2006): 323–46. Early chapters of the novel feature several scenes that highlight Mr. Dombey’s surveillance of the wet nurse’s body from his study when she is with the young infant. In the descriptions, Mr. Dombey rings for the wet nurse with his bell and asks her to walk with her young charge in his glass study where he can view her feeding. 8 Janet Golden, A Social History of Wet Nursing in America. From Breast to Bottle (Columbus: Ohio State UP, 2001), 2.

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Apple, Jacqueline Wolf, Valerie Fildes and others in recent years and the history they convey, reveals the popularity of the practice, although the archive itself is limited. Golden and Wolf both convey the fact that historical records are slight and narratives from wet nurses themselves are limited—or practically unavailable. Thus, many critics turn to texts that represent the wet nurse, or to medical guides and domestic manuals that reveal how medical professionals advised young mothers and families. With the limited research available, critics come to different conclusions about wet nursing as a practice and how it was placed within the hierarchy of options for infant feeding. For example, while Apple, in her reading of infant feeding in the United States, suggests that by the late nineteenth century, wet nursing was often dismissed by doctors in view of advances in artificial foods and bottles, Wolf argues the opposite—suggesting that “physicians, medical charities and government health and welfare agencies consistently recommended, well into the 1920s, the use of the wet nurse when a mother did not breastfeed despite wet nurses’ foibles.”9 Fildes argues that the British Medical Journal “waged a long campaign against both baby farming and wet nursing during the 1860s and 1870s”10 and yet, doctors including Mary Scharlieb and Henry Pye Chavasse continued to advise families on the hiring of wet nurses beyond this period. Scharlieb, writing at the beginning of the twentieth century, emphasized the importance of breastfeeding and the difficulties of alternative forms of infant feeding: No effort should be considered too great and no perseverance too obstinate, to enable a woman to suckle her child. Still, some cases will always exist where the infant is inevitably deprived of its natural nourishment. It is therefore necessary to consider possible substitutes. In some respects nursing by another woman would appear to be the obvious solution…it is a solution but is never satisfactory and sometimes is disastrous….the young woman is taken from her home, her husband and her children; the baby she has abandoned in favor of the rich woman’s child is very likely to die because it is not only deprived of its natural food and its mother’s personal

 9

Wolf, “‘Mercenary Hirelings’ or ‘A Great Blessing’?: Doctors’ and Mothers’ Conflicted Perceptions of Wet Nurses and the Ramifications for Infant Feeding in Chicago, 1871–1961,” Journal of Social History 33, no. 1 (Autumn 1999): 97–120, 115. 10 V. Fildes, Wet Nursing: A History from Antiquity to the Present (Oxford and New York: Blackwell Publishing, 1988), 196.

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Scharlieb goes on to discuss how the quantity and quality of a wet nurse’s milk may be weakened by her separation from her own child and she emphasizes the importance of seeking a healthy nurse with a good temper and disposition.12 Chavasse made similar claims: “If a mother be blessed with health and strength and if she have a good breast of milk, it is most unnatural and very cruel for her not to suckle her child” and “even the milk of a healthy wet nurse acts differently and less beneficially upon the child than the mother’s own milk.”13 Writing in the late nineteenth and early twentieth centuries, these doctors promote the value of “mother’s milk” and establish breastfeeding as a necessary duty for good mothers but also assume that if the mother is unable to nurse, the next option—and one more beneficial than using a bottle—is establishing a relationship with and carefully selecting, a wet nurse. The wet nurse would be, however, a symbol of the comingling of classes and bodies within the household. Depicting the class tensions with the wet nurse, Scharlieb writes, “Her position in the household is a difficult one: her intimate relation to the nursling and the care that is necessary in her diet and general surroundings bring her much in contact with the family; at the same time, she is really of the servant class and her sympathies will probably be with them.”14 While the history and representation of the wet nurse is varied and sometimes unreliable within the context of Western histories, reading the wet nurse within the broader scope of the British colonies is an even more complex task with a limited archive. And yet it seems that within the context of empire, the issues surrounding infant care and feeding become even more critical and necessary to analyze. Moving beyond the class exchanges that occurred in wet nursing scenarios within Britain, in colonies like India, cultural, religious and racial barriers could be imagined as crossed through the exchange of milk. Further, intimate relations

 11

Mary Scharlieb, The Seven Ages of Woman: A Consideration of the Successive Phases of Woman’s Life (London, New York, Toronto, and Melbourne: Cassell and Co., 1915), 180. 12 Ibid., 181. 13 Pye Henry Chavasse, Advice to a Mother on the Management of her Children: And on the Treatment on Some of the Complaints Incidental to Pregnancy, Labor, and Suckling. Revised by Fancourt Barnes, 14th ed. (New York: Routledge, 1898), 317–18. 14 Scharlieb, Seven Ages, 181–82.

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between European babies and their native nurses would signify a shifting or disruption of familial structures. Milk was within Britain, as it would be in the colonies, a symbolic bodily substance and one that not only nourished an appetite but also created intimacy and dependency. As Jules Law has argued, milk and other fluids such as blood and water had a social and ideological weight in the nineteenth century, particularly in terms of bodily boundaries: “What emerges in the Victorian period, then, is an intensification of the opposition between the science of fluids out of the body and the fetishization of fluids within.”15 Further, “milk is imagined by the Victorians as a necessarily trans-individual fluid, a fluid whose telos— unlike that of blood—is to pass out of the body and into the body of another. And yet, it is a fluid whose circulation—it is imagined once again—outlines relatively intimate circuits of sociality and a relatively strict conception of the natural units of sociality.”16 In her reading of Linnaeus and his use of the term “mammalia,” Londa Scheibinger notes, “The female breast evoked deep, wide-ranging and often contradictory currents of meaning in Western cultures.”17 Reading breasts as iconic and potentially powerful, Scheibinger also reads breast milk as a traditionally regenerative and at times nationalistic substance that has been idealized in Western culture.18 What social order is implied, then, when the network of human milk is a transnational or colonial one, or when the productive breasts that sustain British infants are racially, ethnically and religiously marked? What notions of kinship are challenged and how is the order of colonial relations and representations shifted when milk is transferred from the body of a native woman to the English baby and how does this transfer perhaps subvert our notions of native women and colonialism? Like the analysis of food, which Arjun Appadurai has connected to the politics of nation and empire, a reading of human milk within the context of India can offer a way to analyze the ambivalent and shifting notions of colonial relations and the disruption of social orders.

 15

Jules Law, The Social Life of Fluids. Blood, Milk, and Water in the Victorian Novel (Ithaca: Cornell UP, 2010), 4. 16 Ibid., 5. 17 Londa Scheibinger, Nature’s Body: Gender in the Making of Modern Science (Boston: Beacon Press, 1993), 41. 18 Ibid., 61–62.

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Depictions of Wet Nursing in Colonial India Emma Roberts’ account of child rearing in India in the 1830s emphasizes the potential loneliness and “maternal terrors” for Englishwomen abroad but the culture of life in the colonies was soon to change with the increased inclusion of women in India and the development of “compounds” and clubs where English families could gather. Writing during a period when the “memsahib” as a figure was more integrated within colonial India and when larger numbers of women and children resided in the colonies, Florence Marryat depicts increased anxieties surrounding the wet nurse and the tensions between the nurse and the European family—particularly in regard to the nurse’s own family. In her 1868 memoir, Gup Sketches of an Anglo-Indian Life and Character, she writes, ….an “amah” also, or native wet-nurse, offended by some word or action of her mistress will revenge herself by causing her milk to dry up, or “backen” as it is technically termed, in a few hours and what is more extraordinary, will, when perhaps in possession of the dismissal she coveted, bring the draught back in again almost as quickly. “Just look at that woman” a doctor said to me in reference to a similar case in Madras; “she has done, with apparently the greatest ease, what we English would give anything to know, how to quickly disperse a mother’s milk without risking an injury to her system; and though I’ve tried every means by which to find out their method, they won’t disclose it.”19

She then writes, “I have known several cases in India, where English children have been lost from the desertion, or constant change, of their ‘amah’; and my only wonder is that Englishwomen can ever prefer the use of them to that of a cow.”20 Here, Marryat identifies the wet nurse as a figure of suspicion. She is assumed to have “hidden powers” but also to use her influence to control the household. In this depiction the wet nurse’s abilities confound the British doctor and also challenge the scientific methods and knowledge available to him. Marryat alludes to the potentially harmful and disruptive long-term effects of infant dependency upon wet nurses and the powerful position they hold by controlling their bodies and milk production with methods unknowable by British parents and doctors.

 19

Florence Marryat, “Gup,” in Sketches of an Anglo-Indian Life and Character (London: Richard Bentley, 1868), 165. 20 Ibid., 166.

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Other narratives, such as Steel and Gardiner’s authoritative Complete Indian Housekeeper and Cook, continued to establish notions evincing suspicion of the wet nurse and to guide readers to carefully monitor their relationships with these women. It describes the dilemmas of European families overseas in the case of infant feeding: The horror of native wet nurses universally expressed, even by missionary ladies, in the answers received from their correspondents, have impressed the authors so deeply that they feel bound to call special attention to it. No good purpose would be served by quoting the actual expressions used but it must certainly rouse surprise and regret that even those who profess to love the souls of men and women should find the bodies in which these souls are housed more repulsive than those of a cow or donkey or a goat? The milk from all these it is true—to the shame of humanity be it said—is free from a certain specific contagion; but it is a contagion from which, alas! the West is no more immune than the East. Therefore, the objection cannot be on this ground. What remains, therefore but race prejudice to account for the fatuity of fearing lest the milk of a native woman should contaminate an English child’s character, when that of beasts which perish is held to have no such power? The position is frankly untenable. Therefore, if the Western woman is unable to fulfill her first duty to her child, let her thank heaven for the gift of any one able to do that duty for 21 her.

Emphasizing the precept that “all mothers should persevere in nursing their children,” Steel and Gardiner also claim that “most babies in these days are bottle children and that the cause of half the deaths among young babies and the delicacy of many who survive is due to the growing objection of mothers to nursing their children, ‘they seem to consider it trouble.’ Another accounts for the unwillingness by saying that the mothers prefer amusements.”22 Ultimately, Steel and Gardiner recognize that Indian wet nurses are sometimes necessary additions to the “household machine,”23 yet, as they note above, the inclusion of wet nurses into the home and the comingling of her fluids with infants can also “taint” or change the nature of an English baby’s character. Along with fears of the wet nurse transmitting aspects of her own character to the nursing child, Victorian representations revealed anxieties about the wet nurse introducing children to other substances and

 21

Flora Annie Steel and Grace Gardiner, The Complete Indian Housekeeper and Cook, rev. ed. (London: Heinemann, 1904), 176. 22 Ibid., 163. 23 Ibid., 7.

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commodities such as opium and thus exposing the child more broadly to the assumed habits of natives. In his Medical Guide for Anglo-Indians (1874), R. S. Mair writes, “But perhaps the most pernicious of habits of these amahs is that of administering narcotic drugs to infants with the object of inducing sleep and thus relieving them of some part of their duty. The bazaars of India and even the gardens round European houses offer facilities for offering any quantity of the most dangerous drugs and it is astonishing how well their noxious qualities are known to natives generally.”24 Like other doctors, Mair suggests that the “amah” be carefully examined by doctors prior to being hired and continually monitored by the child’s mother: “In all cases the amah should be asked to draw off half a wineglassful of her milk at her first examination in the presence of her mistress every attention at the time being paid to the nature of the flow.”25 This sense of suspicion regarding native servants and particularly wet nurses, would linger into the twentieth century. Elizabeth Buettner shows, in her reading of early twentieth-century handbooks, that such depictions were sustained. She writes that servants were imagined to have low standards of health and to be the source of dangerous habits: “Ayahs as well as dais were also said to try to put their charges to sleep using opium.”26 Emphasizing the continued demarcations of European and native homes, Buettner notes that handbooks would describe bungalows to be situated “at least half a mile from any Indian homes to decrease the possibility that ‘infected natives’ would transmit their own ailments to British offspring.”27 And yet, while texts would highlight the dangers posed by dhyes and emphasize the need to separate young children from native servants, medical texts of the period also represented English bodies as being in need of local care and produced contexts for establishing what practices were healthy and normal within imperial spaces. Critics including Nupur Chaudhari have noted how Indian servants were viewed as a necessary addition to British homes and many doctors depicted European bodies as weakened in tropical environments. R. S. Mair wrote that “the concurrent testimony of many distinguished medical men, attests most clearly, then, that the climate does deteriorate the human system.”28 Much of Edward



24 R.S. Mair, Medical Guide for Anglo-Indians (London: Henry S. King and Co., 1874), 113. 25 Ibid., 112. 26 Elizabeth Buettner, Empire Families: Britons and Late Imperial India (Oxford: Oxford UP, 2004), 38. 27 Ibid. 28 R.S. Mair, Medical Guide, 215.

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Tilt’s research on the tropics corroborated this notion that the climates of tropical spaces like India were dangerous and debilitating for European bodies. While numerous accounts would note the dangers of climate to European families and especially to children, narratives of the wet nurse would reveal other fears, for instance, that the wet nurse would produce indulgent children—and children who reflected the wet nurse’s own habits and negative traits. Edmund Hull notes the “invariable overindulgence by servants and the frequent was of judgment shown by parents”29 but also suggests the imitative qualities of children as being particularly dangerous: Indian servants are naturally very subservient to their employer’s children; and yielding to every whim, however unreasonable, in a short time turn the youngster into a self- indulgent and capricious tyrant on a small scale. Nothing can be worse for children than this premature experience of mastery…but there is another danger: by being constantly with native servants, children pick up the “ways” of those who often belong to all but the lowest class of natives. Human nature is highly imitative; child nature especially so; the tendency being always greater to copy what is bad than what is good.30

Other and more substantial, fears that the Indian caretaker could influence a child through the transference of milk echoed anxieties in Victorian Britain about the possible “taint” and influence of lower-class women. But, regardless of these warnings and fears, the wet nurse continued to be an established inclusion within the English household. As an anonymous “lady resident” would write in The Englishwoman in India, Containing Information for Ladies…, “almost all infants in India are brought up by amahs or native wet nurses and these are very expensive luxuries, as they are fed, clothed and highly paid.”31 If the inclusion of white women in colonies produced stronger racial divisionsííStoler notes, for example, that “their presence was encouraged precisely to enforce the

 29

Edmund Hull, The European in India, or Anglo-India’s Vade-Mecum A Handbook of Useful and Practical Information for Those Proceeding to or Residing in the East Indies Relating to Outfits, Routes, Time for Departure, Indian Climate, and Seasons, Housekeeping and servants, etc. (New Delhi and London: H.S. King, 1871), 131. 30 Ibid., 135. 31 “A Lady Resident,” The Englishwoman in India, Containing Information for the Use of Ladies Proceeding to, or Residing in the East Indies, on the Subject of their Outfits, Furniture, etc (London, 1864), 96.

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separation between Asians and whites”32—then, the wet nurse figure toppled efforts to create stronger distinctions by her very presence as an intimate member of the household who occupied a position within the children’s nursery and also transgressed boundaries of race and class through her mediatory role as the person assigned to ensure the future health of the family. So, while she may have been maligned as a figure in many texts—particularly texts from the mid-Victorian period and the years following the Indian rebellionííand surveilled by doctors and mothers, she held a symbolically powerful position and one that endured through various stages of colonial history.

Sentimental Scenes: The Case of Sherwood’s Lucy and Her Dhaye Literary and cultural critics have examined the complex position of British women in colonial spaces and the ambivalent nature of their representations. As we have seen in the case of Emma Roberts, Steel and Gardiner, Florence Marryat and others who produced advice manuals and travel accounts, women had access to greater and more varied encounters with native servants and subjects and therefore produced authoritative descriptions of the nature of relationships with them. Sara Suleri has described the nature of the female gaze and the position of the British woman in India as an “amateur ethnographer,” while other critics such as Antoinette Burton have shown that British women played pivotal roles in shaping the notion of the Indian female subject and supporting particular projects of reform. My readings of the manuals and texts discussed earlier in this chapter are shaped by Nancy Armstrong’s reading of conduct manuals and domestic novels as genres that helped to shape cultural norms and establish particular “normal” roles for middle-class women and for families.33 Thus, I suggest that texts describing the nature of the wetnursing relationship within the colonial context of India helped to create and integrate certain norms about the behaviors of dhyes and the families who employed them. The repeated pleas to monitor and supervise dhyes, manage their diets and behaviors and limit their access to their own children, facilitated a “normalized” sense of what a dhye’s role would be and established particular notions of English motherhood in the tropics. Through the extensive advice offered to women on how to manage dhyes, these texts also produced idealized visions of the Englishwoman abroad.

 32 33

Stoler, Carnal Knowledge, 33. See Armstrong, Desire and Domestic Fiction, particularly chap. 2.

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The extensive and detailed way in which the mistress of the household is told to manage the dhye and her other servants, reveals a particular shaping of colonial motherhood at a time when women were often given mixed messages about the nature and practices of childrearing. While families were encouraged to carefully consult with medical men when selecting a dhye, it was often the mistress of the house who was required to survey and manage her. As the examples in the previous section illustrate, manuals would encourage mothers to keep a watchful eye on the dhye’s behaviors, food habits and interactions with infants. While many of the texts discussed so far address the nature of the dhye’s role within the household and provide guidelines for her management, in this final section, I turn to a short story published earlier in the period, “The History of Little Lucy and Her Dhaye” (1823) by Mrs. Mary Sherwood, to consider a contrasting but potent narrative about the nature of a dhye’s relationship with her charge. This sentimental fictional story creates a narrative that reflects many of the anxieties and ambivalences we see in manuals and travel accounts but also represents a deep linkage between the dhye and her charge, which assumes a bond as deep as one the child would have had with her mother. In the story, the child’s mother is absent and thus the dhye is her primary source of care. Nineteenth-century manuals articulated concerns that a dhye could overshadow the mother and create a potentially troubling bond that would be hard to break. This early nineteenth-century story addresses this kind of a relationship but in so doing also creates a sympathetic account of the dhye and her love for an English child—thus challenging notions of the dhye as an antagonistic figure. Mrs. Sherwood accompanied her husband to India in 1805and both her children, Henry, born in 1805and Lucy, born in 1807, died within a few years of birth. She created children’s stories with characters that alluded to her own children. “Lucy and Her Dhaye” tells the story of young Lucy, “the only and beloved daughter of a man high in rank and influence”34 whose father has hired a local dhye after the death of his wife. Lucy develops an intense bond with the dhye who is brought in to feed her. Focusing upon this intimate relationship, Sherwood describes the crucial role of the dhye in Lucy’s life and the ways that Lucy becomes embedded within Indian culture as a result of this attachment. Her “dhaye” enchants her with stories of “fairies and genii”35 and takes her out on daily

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Mary Sherwood. “The History of Little Lucy and her Dhaye,” The Works of Mrs. Sherwood, vol. 3 (New York: Harper and Bros. 1836), 42. 35 Ibid., 47.

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excursions and visits to the bazar with other servants. The dhye relationship extends beyond the infant years; and as Lucy matures, Sherwood depicts the child as “encouraged to prattle in Hindoostanee, the only language she could speak,” and “terribly mismanaged” and idle.36 Lucy is also accustomed to Indian dress, along with being “unable to speak English.”37 Sherwood’s depiction of Lucy’s attachment to Indian servants and their shaping of her childhood reflects anxieties that would emerge in later nineteenth-century manuals depicting the dangers of raising children in India. Lucy is, in some ways, a model of the English child who has suffered the “invariable overindulgence” of servants toward children that Edmund Hull described.38 Such warnings often led to the pattern of AngloIndian children being sent to England and separated from their parents at an early age. At age seven, Lucy is forced to leave India when her father makes the decision to return to England. She has, until this point, learned very little English and is completely immersed within the culture of the Indian servants she spends time with. The narrative takes a dramatic turn as the dhye, who is determined to follow the child to England, is left behind. Holding the child to her bosom, the narrative describes the intense scene as the two are torn apart, as well as Lucy's tearful journey to England: The dhaye begged to be permitted to accompany her beloved child…and bitter with the lamentations which the poor woman made over the child during the whole of the last night which she spent with her onboard the vessel. At sight of the ship, which was lying at anchor in the roads, she renewed her cries; while Lucy hung upon her with all the feelings of a daughter about to be separated forever from a tender mother.39

Sherwood notes how Lucy’s father “was almost compelled to use force” to separate Lucy from “the poor black woman” who treated her as her own child.40 Within the text, Sherwood appeals to her readers’

 36

Ibid., 45. Ibid., 47. 38 Hull, The European in India, 131. Numerous other writers would depict the dangers of childrearing in India and the sustained closeness of English children with their servants. R. S. Mair wrote, “Surrounded by native servants, and in too many instances, almost entirely left to their mercy and control, the European child, unless carefully watched by the parents, cannot fail to be contaminated to a serious extent” (124). Steel and Gardiner describe Indian children as “proverbially captious, disobedient, and easily thrown out of gear” (87). 39 Sherwood, 48–49. 40 Ibid., 49. 37

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emotions to enable them to imagine the deep, affectionate and intrinsic bond between these characters and to subvert the image of the dhye as a temporarily negative influence upon children. On the journey to England, Lucy and her father meet an English lady, Mrs. Courteney, “who could speak the Hindoostanee language with fluency and elegance”41 and therefore prepare Lucy for her immersion into England, the English language and Christian values. Lucy develops a bond with Mrs. Courteney—one that nurtures her through her separation from her dhye but comes nowhere close to the intensity of her feelings for her nursemaid: “not that she yet felt by any means the same regard for her which she did for her poor dhaye, of whom she continuously spoke with the greatest affection, dwelling with fondness upon the days and scenes that were past and declaring, that as soon as she was grown up, she would go back to India and have her dhaye and her bearer to live with her again.”42 The story is ultimately a conversion narrative in which the dhye is sacrificed at the end. After Lucy is settled in England, she is determined to find her dhye and teach her about Christianity so they can meet in heaven. She asks Mrs. Courteney, who eventually becomes her stepmother, to write to “some kind lady and ask her to look for my poor dhaye; and beg her to talk to her about the Saviour.”43 Mrs. Courteney does eventually send a letter to a friend in Bareilly, India, with details about Lucy’s dhaye, in the hope that she can be found and converted to Christianity. Sherwood writes that “once the letter to Bareilly was written and duly dispatched, the mind of the little girl seemed for a while to be laid at rest upon the subject of her dhaye and she soon regained her usual cheerfulness.”44 However, in a dramatic turn of events, Lucy falls ill six months later, “with a violent inflammation of the chest, owing no doubt to the cold of the English climate.”45 In a reversal of mid-nineteenth-century depictions of dangerous tropical climates, in Sherwood’s tale it is the damp, cold English weather that attacks the Anglo-Indian child. After a period of waiting to hear news of the whereabouts of her dhye and many assertions of her desire to become a missionary in order to convert her, Lucy, at the age of twelve, is struck once again with “the same disorder that had formerly threatened her life and which now was so rapid and alarming in its progress.”46 On her deathbed, Lucy declares, “My dhaye will be in heaven with my first

 41

Ibid., 51. Ibid., 53. 43 Ibid., 55. 44 Ibid., 57. 45 Ibid. 46 Ibid., 68. 42

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mamma…I feel assured of my dhaye’s salvation.”47 Lucy dies and the story ends with the dhye eventually hearing about Lucy’s fate and converting to Christianity on her own deathbed. In the final paragraph of the story, Sherwood writes, “Some of you, my young readers, may have been nursed by heathen women in foreign lands and others by women who are as utter strangers to their Saviour as Lucy’s beloved dhaye. May I not hope that the example of Lucy will induce you also to seek the spiritual good of those persons to whom you owed the comfort of your early years?”48 Presenting readers with a tragic and sentimental tale of childhood, intimacy and loss, Sherwood depicts the wet-nursing relationship as one of potentially productive hybridity and redemption. While the dhye is clearly marked as a racially and religiously “other” figure who influences the young child with Indian ways, the story presents her as a mother figure who can provide sustained comfort for the English child. Although this is ultimately a conversion story in which both Lucy and her dhye are sacrificed at the end (but promised an eternal bond), Sherwood asks her English readers to remember the efforts of the nurses who may have fed them. Thus, she alludes to the fluidity of the wet-nursing relationship— implying a milk bond that is far-reaching and powerful. Finally, she represents the wet nurse and the English child as boundary figures—both have the potential to reshape and realign colonial relationships and both challenge neat distinctions among races and religions. Catherine Hall, Lata Mani, Antoinette Burton and numerous other critics have noted the ways in which nineteenth-century texts presented India as a space of degradation in need of reform and Indian women as the marker of that society’s need for progress and improvement. 49The notion of the British travelers—particularly British women—of saving Indian women from the primitive and unhealthy practices their cultures imposed is one that

 47

Ibid., 69. Ibid., 73. 49 For example, Catherine Hall writes of “colonial discourses which constructed India as a degraded place in need of civilization, and which utilized figures of the Indian woman, and particularly the Hindu woman, as the index of Indian society’s desperate need for help” (52). Lata Mani’s reading of practices of sati, and colonial responses to Indian religious rituals, presents a similar reading of how British reforms were imagined to save Indian women from the barbaric practices of their cultures. Finally, historians such as Antoinette Burton have shown how the emancipation of British women and the development of women’s reform movements were often a response to notions of victimized Indian women (see for example, Burton’s Burdens of History). 48

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permeates nineteenth-century colonial discourses and representations. I suggest that representations of the dhye reflect stereotypical notions of victimized and backward Indian women—indeed, depictions of her as a potentially harmful or lazy servant reinforce popular stereotypes from the period and she is often mapped as a figure of difference and one symbolic of the dangers of the “torrid zone”—but I also suggest that she can be read as a potentially powerful and subversive force who inverts and complicates any kind of simple reading of colonial relations. Instead of being the vulnerable victim, she is often the necessary force that maintains the health of the vulnerable English child. The fact that depictions of wet nurses and the advice given to British women in texts and manuals were so varied and sometimes contradictory tells us how charged the subject of infant feeding was during this period and how layered and nuanced relationships between European families and their servants were. While the numerous travel narratives, domestic guides and medical manuals produced by or written for women offered strict rules and terms regarding how to manage the wet nurse, it is clear that the intimacy of her task could not be easily controlled or contained. While the dhye may have inspired texts that emphasized the need for boundaries between Indian women and the English families they served, the physical and metaphorical nature of her transactions challenges any sense of clear delineation between races and peoples, necessarily calling for a consideration of the powerful ways in which the future of colonial expansion and reproduction lay at the breast of the Indian woman.



CHAPTER SIX GANDHI’S MORAL POLITICS AND PLAGUE IN SOUTH AFRICA SRIRUPA PRASAD

The cup of woe of the Indians in South Africa evidently does not appear to have as yet become full; and the bubonic plague promises to fill that cup well to the brim. (Times of India, 1899) Jealousy of Indian enterprise is having full play without let or hindrance and under cover of plague precautions, Indian trade is being ruined and all kinds of inconveniences are having put in their way. (Indian Opinion, 1904) We cannot agree with The Natal Mercury that “it is due to the action of certain Indians that the plague is still with us”. (Indian Opinion, 1905)

In 1899, Gandhi expressed his foreboding about a plague rumor that was circulating in South Africa. He was deeply worried about the hardships that could befall Indians if it were in any way proven true. Between then and 1905, Gandhi wrote extensively on the distress and anguish that plague control measures caused Indians settled in South Africa. The newspaper Times of India published those writings by Gandhi as a series. Later, as the plague made an appearance in South Africa, the Indian Opinion became the vehicle, carrying Gandhi’s strong views against the anti-plague measures of the British colonial government. At a particular phase of the plague outbreak in South Africa, one could see weekly updates and reflections by Gandhi, who became a trenchant critic of the colonial sanitary establishment and its discriminatory policies toward Indians. This paper explores the history of Gandhi’s engagement with the South African plague epidemic between 1899 and 1906. His role as a vociferous advocate of the rights of the Indian community during the outbreak constitutes an important moment in his legal advocacy work for Indians settled in South Africa. I have chosen this period because while

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1899 marked the beginnings of the tenure of plague in South Africa, Gandhi consistently wrote about the outbreak, taking to task the British colonial government, until 1905. Even in The Story of My Experiments with Truth, Gandhi reminisced about the “black plague” and his relief work with Mr. Madanjit, the publisher of the Indian Opinion. The plague outbreak in South Africa was a productive moment for Gandhi both politically and morally. Not only was this an occasion for him to articulate some of his politics with regard to the economic, political and social rights of diasporic Indians in South Africa; it was also a time when he enunciated some of his ideas on purity and contamination and the relationship between socioeconomic status and physical/moral purity. This chapter argues that Gandhi’s involvement in matters related to the bubonic plague in early twentieth-century South Africa (in the relief work he organized and participated in as well as through his writings) was a critical phase in his political career. It highlighted the deep ambiguity of his opinions about the racist South African colonial state. On one hand, Gandhi was vocally critical of its negligence in failing to maintain adequate sanitary standards in Cape Town, where the plague first broke out. He was also very critical of quarantine measures imposed by the colonial state, especially those affecting Indian residents. On the other hand, he exhorted the Indian community to be “patient” and “realize their responsibility by suffering,” urging them not to be hostile to the state by staging protests that could hamper colonial administration. He repeatedly asked Indians to be model citizens—patient and law abiding. The plague epidemic in South Africa also revealed some of the paradoxes in Gandhi’s politics of race and respectability, I argue in this paper. While Gandhi was emphatic about the respect that Indians deserved from their white rulers, he justified it on the ground that Indians were a superior people when seen in comparison to Africans. This paper is based on an analysis of Gandhi’s writings on the plague outbreak in the Indian Opinion between 1899 and 1905 and his essays on the bubonic plague in The Story of My Experiments with Truth. It explores three main issues: a) Gandhi’s plague relief work as a formative episode vis-à-vis his later politics of Satyagraha and b) his ideas on the contamination, transmission and containment of plague, which functioned “as deeply resonant metaphor for the circulation of social, moral or political dangers through a population and as visceral, horrible infection.”1

 1

Alison Bashford and Claire Hooker, eds., introduction to Contagion: Historical and Cultural Studies (Abingdon: Routledge, 2001), 5.

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This chapter is divided into four sections. The first section is called “Contagion and Culture.” Gandhi’s medical relief efforts not only comprised a set of hygienic and journalistic practices but constituted an episode with deep social and political implications as well. How do ideas of contagion, appropriation, borders and citizenship inform his work and writings on the plague outbreak in colonial South Africa? This section focuses on some of the debates that have become prominent in the last twenty years in cultural and historical studies of contagion. The second section, “Gandhi’s Body Politics,” locates my arguments in the context of the scholarship on Gandhi’s passionate engagement with matters of the body as being intrinsic to his politics. The third section is called “Plague in South Africa and the Indian Opinion” and chronicles the outbreak of the 1901 plague and Gandhi’s coverage of it in the Indian Opinion. This section highlights the centrality of this newspaper in documenting Gandhi’s reflections on the South African plague. From being a moderate newspaper, the Indian Opinion went on to become a vocal mouthpiece for Indian workers’ rights in South Africa. It represented the trajectory of Gandhi’s politics—from those that were defined on the basis of rightful conduct of Indians as model citizens of a colonial state to those based on the legitimate legal rights of the Indian community in South Africa. The last section, “Gandhi’s Politics of Respectability,” explores his ambiguous response to the plague, most particularly with regard to issues of race and respectability.

Contagion and Culture Epidemics and contagious diseases are not merely zoonotic entities. They are vehicles of signification. Paula Treichler called the AIDS epidemic in the United States “simultaneously an epidemic of a transmissible lethal disease and an epidemic of meanings of signification.”2 While the reading of contagious diseases as densely metaphoric is hardly a new concern among cultural and medical historians, the AIDS epidemic, anxieties about bioterrorism and the explosion of various strains of the flu onto the global scene have led to an energized field of studies of infectious diseases using literary-historical-cultural frameworks that have specifically focused on the element of contagion and its manifold implications. Peta Mitchell rightfully commented that the early years of the new millennium saw an



2 Paula Treichler, How to Have Theory in an Epidemic: Cultural Chronicles of AIDS (Durham: Duke UP), 11.

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impressive growth in “interdisciplinary cultural studies of contagion.”3 A few warrant mention here: Contagion: Historical and Cultural Studies (2001), edited by Alison Bashford and Claire Hooker; Imagining Contagion in Early Modern Europe (2005), edited by Claire Carlin; Contagion: Health, Fear, Sovereignty, edited by Bruce Magnusson and Zahi Zalloua (2012); Contagious Metaphor (2012), by Peta Mitchell; and Confronting Contagion: Our Evolving Understanding of Disease (2015), by Melvin Santer. The journal American Literary History published a special issue on “Contagion and Culture” in 2002 and in 2003, Literature and Medicine printed a special issue called “Contagion and Infection.”4 Priscilla Wald’s Contagious: Cultures, Carriers and The Outbreak Narrative (2008) contends that even American popular culture became infected with the contagion bug in the 1980s and 1990s, when there was a spate of literary and film productions on contagious diseases and fears of a global epidemic. Academic areas as diverse as economics, psychology, history, literary studies and global public health have used contagion as an analytical concept. The metaphoric dimension of contagion, infection and contamination is something that has been explored in literary, historical and cultural studies in recent years. As Wald, Tomes and Lynch write, “The relationship between the medical and the social is at once particularly evident and especially important in discussions of diseases that are contagious or infectious among human populations, such as AIDS. Cultural meanings and national borders are often summoned, if not articulated, through the figure of specific contagious diseases.”5 Cultural studies have focused on the “figurative language” of contagion.6 The reason behind this, as Cynthia Davis argues, is that culture

 3

Peta Mitchell, Contagious Metaphor (New York: Bloomsbury Publishing, 2014), 11. 4 Bruce Magnusson and Zami Zalloua, eds., Contagion: Health, Fear, Sovereignty (Seattle: Univ. of Washington Press, 2012); Bashford and Hooker, Contagion; Melvin Santer, Confronting Contagion: Our Evolving Understanding of Disease (New York: Oxford UP, 2014); Claire Carlin, ed., Imagining Contagion in Early Modern Europe (Palgrave Macmillan, 2005); Mitchell, Contagious Metaphor. See also “Contagion and Culture in American Literary History,” Literature and Medicine, 14, no. 4 (Winter 2002): 617–867 and “Contagion and Infection” Literature and Medicine, 22, no. 1 (Spring 2003). 5 Priscilla Wald et al., Contagious: Cultures, Carriers and the Outbreak Narrative (Durham: Duke UP, 2008), 617. 6 Mitchell, Contagious Metaphor, 13.

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is “transmitted” in the same way that disease is.7 She also argues that contagion is itself both a “content and a method.” 8 Moreover, as Wald shows, in particular contexts “contagion and culture become synonymous, used interchangeably to connote interchange, communication, contact.”9 Contagion is also suffused with ideas of morality. Diseases like syphilis and AIDS have always had strong moral connotations. Sexual desire could breed the most dangerous contagions. For example, modernity-created uncontrolled desires for consumption led to all kinds of physical and moral contamination. Bashford and Hooker catalog a list of “potent signifiers with which contagion is connected— resistance, immunity, colonisation, hygiene, blood, plague, hysteria,” each of which gained moral weight depending upon the contexts in which they were played out.10 In order to appreciate Gandhi’s writings on the bubonic plague in South Africa, dwelling on the idea of moral contagion will be helpful. While metaphors of disease causation, spread and containment were often used to debate about the state, family, social order and modern subject, the household or the national borders became the physical space within which a set of concrete practices around the body/bodies were ordered in order to prevent and/or contain contagion. Mary Poovey and Andrew Aisenberg analyze the prevalence of ideas on contagion in the social, economic, political and cultural thought of Britain and France respectively.11 For example, Aisenberg argues in the case of France, “Most important (and what made the preceding formulations possible), officials made contagion into the basis for objectifying the social ties and moral duties that bound together free individuals in a republic.12 Gandhi’s writings on the plague in South Africa were much than more bulletins on the progress of the disease. They were a series of journalistic essays, which, in tandem with his other writings on medicine, health and the body, constituted a

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Cynthia Davis, “Contagion as Metaphor,” American Literary History 14, no. 4 (Winter 2002): 828–36. 8 Ibid., 830. 9 Priscilla Wald, “Communicable Americanism: Contagion, Geographic Fictions and the Sociological Legacy of Robert Park,” American Literary History 14, no. 4 (Winter 2002 ): 653–85. 10 Bashford and Hooker, Contagion, 4. 11 Mary Poovey, Making a Social Body: British Cultural Formation, 1830-1864 (Chicago: Univ. of Chicago Press and Aisenberg, Andrew, 1995); Andrew Robert Aisenberg, Contagion: Disease, Government and the ‘Social Question’ in Nineteenth-Century France (Stanford: Stanford UP, 1999). 12 Aisenberg, Contagion, 3.

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statement of what he thought were the rights and responsibilities of the citizen and the state. As Joseph Alter commented with respect to Gandhi’s attitude to scientific knowledge, Science was a means by which to translate the traditional roots of charisma, as well as experiments with Truth, into modern public health for “the whole of [his] kind.13

If seen through the lens of medical history, Gandhi’s plague communiqués read like an eighteenth- and early nineteenth-century sociomedico-moral narrative, in which the contagious dangers came from both inside and outside. For Gandhi, one had to be as careful against external contagion (read plague, racism and empire) as one had to be vigilant against one’s own (desire, weakness and poverty). Any political or social crisis for Gandhi was always a condition to be become keenly aware of, one “relational of the self, an awareness of the self’s exposure to otherness.”14 And these were for him moments of deep introspection (read: truth). He writes in “Sanitary Reform and Famine Relief,” Thus, service of the Indians in South Africa ever revealed to me new implications of truth at every stage. Truth is a like vast tree, which yields more and more fruit, the more you nurture it.15

Gandhi’s Body Politics Engagements with ordering and disciplining the body were central to Gandhi’s political practice. His notion of self-rule or swaraj was as much self-government of a nation as it was mastery over the corporeal-moral self. Two of his key texts, Key to Health and The Story of My Experiments with Truth, address this concern, which Gandhi thought of as vital to his politics—management of one’s physical and moral self. While Key to Health is a compendium of what he considered the “rules” of health, in his autobiography, The Story of My Experiments with Truth, Gandhi details his trials with bodily practices—fasting, experimenting with particular diets and body cleansing. Joseph Alter rightly stated,



13 Joseph Alter, Gandhi’s Body: Sex, Diet and the Politics of Nationalism (Philadelphia: Univ. of Pennsylvania Press, 2000), 22. 14 Magnusson and Zalloua, Contagion, 15. 15 Mahatma Gandhi, An Autobiography: The Story of My Experiments with Truth (Ahmedabad: Navajivan Mundranalaya, 1927), 218.

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Thus, an engagement with Gandhi’s nationalist politics remains incomplete unless one attends to his bodily and “biomoral” experiments.17 His experiments with vegetarianism or cutting down on the number of meals were initiated in South Africa, long before he had become the embodiment of a lean-bodied, astute saint in the thick of the Indian nationalist movement. This was a period when he was actively involved with sanitary work in the wake of epidemics of diseases like plague and smallpox and outbreaks of noninfectious diseases like malaria, as well as with famine relief work. My paper owes a great deal to two strands of scholarship on Gandhi in recent years: one that looks into the somatic and material dimensions of Gandhi’s politics and another that delves into the trajectories of Gandhi’s life and political career while he was in South Africa. Here I focus on the first body of work and emphasize the importance of a few studies within it. The first is Joseph Alter’s influential Gandhi’s Body: Sex, Diet and the Politics of Nationalism. In this book, Alter shifts attention from the usual issues around which Gandhi’s politics have commonly been studied— nationalism, nonviolence and peace. Instead he focuses on a few of the more overlooked aspects of his life—sexual abstinence, dietary experiments and naturopathy practices. Alter states that [a] distinction cannot be made between his personal experiments with dietetics, celibacy, hygiene and nature cure and his search for Truth; between his virtual obsession with health, his faith in nonviolence and his program of sociopolitical reform.18

Alter’s contribution lies in his delineation of the powerful ways in which Gandhi’s health- and body-related practices signified broader debates about health, power and truth in the transnational world. The other text is Parama Roy’s provocative Alimentary Tracts: Appetites, Aversions and the Postcolonial—an analysis of the political,

 16

Alter, Gandhi’s Body, xi. Alter uses the word “biomoral” to signify the way in which, for Gandhi, being morally chaste was the basis of good health and meaningful life. See Gandhi’s Body. 18 Altler, Gandhi’s Body, 4. 17

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cultural and affective trajectories of food, feeding, hunger and famine in colonial and postcolonial India. Through analysis of a variety of themes like flesh, famine and vegetarianism, Roy studies certain emotions and sensibilities associated with each—disgust, dearth, abstinence and appetite, among others. In one of the essays, “Abstinence: Manifestos on Meat and Masculinity,” Roy explores the linkages between consumption of flesh, masculinity and vegetarianism in Gandhi’s personal and political life. She argues that Gandhi’s experiments with alimentation were no less central than his trials with celibacy. Roy comments on the shifting terrain of Gandhi’s practices around vegetarianism—from reading meat consumption as a distinctly modern practice, to making a promise to his mother about giving up meat consumption when he went to study law in Britain, to, finally, vegetarianism being an indispensable political element of his nonviolence. Roy also comments on the “gendered character” of Gandhi’s vegetarianism which, she says, cannot be understood without invoking a large, inescapably gendered cast, including his mother, his male friends, his wife, his sons and his female and male disciples. In particular, the consistently familial contexts of Gandhi’s alimentary practices must be highlighted in any consideration of the gendered character of vegetarianism, nonviolence and sacrifice, including self-sacrifice.’19

Another engaging essay on Gandhi’s perspectives on health and illness is Sandhya Shetty’s “The Quack Whom We Know: Illness and Nursing in Gandhi.”20 Shetty explores Gandhi’s deep resentment toward modern allopathic medicine. While Gandhi was skeptical about the efficacy of biomedicine, he was opposed to the philosophy of modern medicine at a much deeper ethical level. As Shetty argues, “shaped by a bioethical commitment to self-liberating forms of ascesis, a far more deeply rooted antagonism frames the latter’s critical stance on the professional practice of medicine.”21 According to her, Gandhi especially disapproved of one of the fundamental “axioms” of biomedicine: “that ‘Life’ and its preservation at all cost stands as a self-evident good.”22



19 Parama Roy, Alimentary Tracts: Appetites, Aversions and the Postcolonial (Durham: Duke UP, 2010), 76. 20 Sandhya Shetty, “The Quack We Know: Illness and Nursing in Gandhi,” in Rethinking Gandhi and Nonviolent Relationality: Global Perspectives, eds. Debjani Ganguly and John Docker (Abingdon: Routledge, 2008). 21 Ibid., 38. 22 Ibid.

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Leela Gandhi offers another reading of Gandhi’s vegetarianism in her article, “Ahimsa and Other Animals: The Genealogy of an Immature Politics.”23 She emphasizes that the moral and political impetus to his experiments with vegetarianism needs to be excavated from the context of the early years of his life as a student of law in England. According to her, the discourse of “fin de siècle” animal welfare in Britain played a formative role in Gandhi’s politics of vegetarianism and nonviolence. I have alluded to this body of works because all of them underscore the central role of bodily practices in articulating and constituting Gandhi’s politics. What all of these scholars have collectively argued is that each and every corporeal experimentation (that Gandhi undertook) was based on an ethical and/or moral justification, which subsequently took on a fuller and political, shape. It is within this scholarship that my arguments are squarely located.

Plague in South Africa and the Indian Opinion and An Autobiography Gandhi’s regular critical opinion pieces in the Indian Opinion on the plague in South Africa from 1901 onward emphasized issues of the duties of the colonial state, the rights of the Indians in South Africa, the belligerent nature of the government’s anti-plague measures and the responsibilities as an ideal citizen on the part of every Indian in South Africa. In early 1899, a concerned Gandhi wrote in the Times of India, “The cup of woe of the Indians in South Africa evidently does not appear to have as yet become full; and the bubonic plague promises to fill that cup well up to the brim.”24 Rumor of a plague in Lourenco Marques worried him about the potential impact on Indian residents in terms of the “stringent measures” that could be imposed in its wake. Based on extremely thin evidence, this putative outbreak of plague led the Transvaal Government to issue a decree barring the entry of Indians, even from adjacent states. Gandhi commented on the “mischief” created by unreliable reporting regarding a plague outbreak: a “hysterical scare throughout South Africa” and Indians “suffering seriously.” Gandhi then goes on to reflect on the “two conflicting interests” at Natal. I will quote him at length, as the passage brings to the fore the complex politics involving

 23

Leela Gandhi, Rethinking Gandhi and Nonviolent Relationality: Global Perspectives (Oxford: Routledge, 2008). 24 Mahatma Gandhi, “The Plague Panic in South Africa,” The Times of India, March 20, 1899.

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European racism, communal jealousy and issues of the class and commercial interests of Indians. On the one hand, the farmers and the planters, who are, all over the Colony, entirely dependent on the indentured Indian labour, cannot afford to do without a continuous supply of such labour; on the other, the people in the towns and the cities, such as Durban and Maritzburg, having no such interests at stake, would gladly see the entire prohibition of Indian immigration, indentured or otherwise. It is interesting to note that, throughout the whole controversy, the people of South Africa have not once allowed themselves to think of Indian interests. It seems to have been tacitly assumed that the Indians who are at present resident in South Africa need not be taken into consideration at all. It does not appear to have struck them that these men, some of them very well-to-do and respectable, may have to bring their wives and children or servants from India. 25

Detailing the miseries of Indian merchants, Gandhi declared that the stringent restrictions clearly proved that such panic had its source “in the anti-Indian prejudice which is due chiefly to trade jealousy.”26 Maynard Swanson has called it the “sanitation syndrome”—viewing infectious diseases and other microbial menaces as a fallout of societal filth and infection. He writes, Overcrowding, slums, public health and safety, often seen in the light of class and ethnic differences in industrial societies, were in the colonial context perceived largely in terms of colour differences. Conversely, urban race relations came to be widely conceived and dealt with in the imagery of infection and epidemic disease.27

Swanson’s essay looks at the production of “urban apartheid” by exploring the “sanitation syndrome” in colonial South Africa during the time of the bubonic plague outbreak between 1900 and 1909. He argues that the plague epidemic gave the colonial authorities a solid justification to impose racist segregationist policies. He traces this to a longer history in Natal and Transvaal, where fears of epidemic cholera, smallpox and plague had instigated the segregation of Indians and Africans in distinct neighborhoods from the 1870s. The earlier quotation by Gandhi indicates

 25

Mahatma Gandhi, “The Plague Panic in South Africa” in Collected Works of Mahatma Gandhi, 3 (1899): 67-8. 26 Ibid., 69. 27 Maynard W. Swanson, “The Sanitation Syndrome: Bubonic Plague and Urban Native Policy in the Cape Colony, 1900–1909,” Journal of African History 18, no. 3 (1977): 387–410.

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how economic jealousy went hand in hand with the colonial authorities’ rationale of controlling disease and filth. In fact, in his view, this was the strongest motive behind such rabid segregationist policies. Indians were undoubtedly one of the main targets of these isolation measures but Africans were also brought within the ambit of segregation.28 Plague first appeared in Cape Town in early February 1901, as some dockworkers fell ill and died. But it took some time for the medical authorities to conduct tests and confirm with certainty that the deaths were indeed from the bubonic plague. The most readily available yet uncertain explanation was that ships carrying cargo from India, Argentina, or Australia had carried the plague bacillus to Cape Town. Swanson writes, “By December 1900, rats were seen dying in great numbers at the docks but the military officers in charge did not report this to the public health authorities. Early in February 1901, the first human cases of plague appeared in the city among Cape coloured and African dockworkers.”29 But as scholars such as Echenberg have convincingly argued, there was no way to prove beyond doubt that the bacillus was transported from Argentina. He notes that “Cape Town was a city bursting with wartime commerce and immigrants and the provenance of infection could equally have been ships from India, Australia, or Hong Kong. One point was clear. War had made Cape Town a prime target of Y. pestis.30 In an 1899 letter in the Times of India, Gandhi ruefully commented that India and Indians were being made synonymous with infection and disease and despite the fact that both the Natal and Cape governments were “anxious to avoid injustice being done during the panic,” the authorities gave in to public pressure, which was hostile to Asiatic interests in the colony. A reiteration of this may be seen in both The Story of My Experiments With Truth and in the writings in the Indian Opinion on the plague outbreaks between 1899-1905. Gandhi was at great pains to clear Indians of this “charge.” He writes, “the charge had often been made that the Indian was slovenly in his habits and did not keep his house and surroundings clean.”31 This was the same logic I discussed earlier in the paper, that is, the notion that one’s own internal afflictions had to be addressed before one responded to external ones. As Francis Dube argues, Gandhi’s main contention was that the segregation of Indians was

 28

Ibid. Ibid., 392. 30 Myron Echenberg, Plague Ports: The Global Urban Impact of Bubonic Plague, 1894-1901 (New York: New York UP, 2010), 271. 31 Gandhi, Autobiography, 217. 29

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implemented due to British and Boer fears of competition from Indian traders and sanitation.32 Yet, the above concern was expressed very differently in his Autobiography and his reports in the Indian Opinion. His writings in the former are much more expressive of his own turmoil, be it as a journalist, or a political advocate, or a seeker of truth. Gandhi’s chronicles of the plague, for example, disclosed scenes of suffering and affliction and the agony it caused him and his close associates. And these moments are crucial for his realization of the value of patience, asceticism and fearlessness. He writes on the Black Plague in Johannesburg, “It was a terrible night—that night of vigil and nursing. I have nursed a number of patients before but never any attacked by the black plague. But the whole incident, apart from its pathos, is of such absorbing interest and for me, of such religious value.”33 Critical times like these were for Gandhi also moments of making lasting allies and friends. His associations with Serjeants Kalyandas, Maneklal and Gunvantrai Desai, Dr. William Godfrey, Henry Polak and Albert West were all made during the outbreak.34 These are also episodes during which Gandhi most powerfully forges indispensable connections between personal and political servitude (empire, racism, poverty). Isabel Hofmeyr has called Gandhi’s Indian Opinion “one of the great intellectual archives of the world.”35 She explains how it provided an animated journalistic space in the “context of multiple diasporic intersections in southern Africa,” with the paper’s pages “woven from a variety of global intellectual filaments, drawn from larger trajectories of migration.”36 A periodical that became a vital sensor reflecting the ebbs and flows of the political tides between India, Britain and South Africa, the Indian Opinion is also valuable as a chronicle of the beginnings of Gandhi’s political life. In his autobiography, Gandhi commented on this



32 Francis Dube, “Public Health and Racial Segregation in South Africa: Mahatma Gandhi Debates Colonial Authorities on Public Health Measures, 1896-1904,” Journal of Historical Society of Nigeria 21 (2012): 21–40. 33 Gandhi, Autobiography, 292. 34 Ibid., 290–95. Also, in this context I would like to point to Joseph Alter’s exploration of how Gandhi “locates the discovery of celibacy’s power in the midst of the Zulu rebellion’s violent face-to-face carnage and his role as sergeant major in a voluntary ambulance corps assigned to provide medical services to the wounded rebels.” 35 Isabel Hofmeyr, Gandhi’s Printing Press (Cambridge, MA: Harvard UP, 2013), 73. 36 Ibid., 72.

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journal, saying that despite the financial hardships involved, he persisted with its publication and also noted that the changes the journal went through reflected the changes that took place in his own life. For Gandhi, the Indian Opinion experience served as “training for him in selfrestraint,” and was something without which “Satyagraha would probably have been impossible.”37 Given the centrality of the Indian Opinion, Gandhi’s regular discussions of and reflections on the plague epidemic in that forum therefore articulated issues that in future became crucial centerpieces of his social and moral politics. Gandhi’s writings on the bubonic and pneumonic plagues were a regular feature in the Indian Opinion as the plague made its first, relatively less lethal appearance in 1899-1900 in the Transvaal. The piece, called “The Plague Panic in South Africa,” describes the rumors and panic that triggered the prohibition of Indian immigration.38 Reporting on the successive waves of plague infection began in earnest in the Indian Opinion from 1903. Gandhi participated in the controversies surrounding the plague via discussion of a number of commercial, political, social and moral issues. For example, legal concerns surrounding indentured Indian laborers (permits and licenses, housing, commercial arrangements in the “Asiatic Bazaars,” petitions to the colonial state, appeals to the Indian National Congress) were some of the most frequently debated topics in the newspaper’s columns. As Hofmeyr argues, it was truly a “transnational” platform, collecting and printing news from across the globe and especially the British Empire.39 Eminent political leaders and statesmen (both British and Indian) were often written about. News about “the plague” epidemic was in the spotlight side by side with these concerns, especially in the period between 1903 and 1905.40 By 1905, Gandhi is writing, “Plague has come to stay. It is the annual messenger which, year after year, comes as a warning against darkness, filth and overcrowding. Wherever it has once appeared, it has hitherto unfailingly reappeared with more or less regularity. Leaders of the Indian community have in this

 37

Gandhi, Autobiography, 348. Mahatma Gandhi, “The Plague Panic in South Africa,” in Collected Works of Mahatma Gandhi, 3, (1899): 66. 39 Hofmeyr, Gandhi’s Printing Press. 40 Captions like “An Insanitary Report,” “The Plague,” “The Plague and Red Tape,” “A Political Medical Report,” “The Plague Havoc,” “The Plague in Johannesburg: The Great Work of the Indian Community,” “The Plague Regulations in Natal,” and “The Plague Peg” were frequent in those two years in the Indian Opinion. 38

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respect a clear duty to perform. Every educated Indian has a unique privilege; he can become a missionary in hygiene and sanitation.”41

Gandhi’s Politics of Respectability Gandhi’s serial essays in the Indian Opinion on the plague in South Africa chronicled the ordeals that the Indian community faced because of the stringent sanitary measures implemented by the white colonial government of South Africa. Throughout his coverage of the epidemic, Gandhi frequently comments on the patience and dignity with which members of the Indian community responded to the quarantine restrictions and financial regulations imposed by the government. He hails the “calmness” and “stoicism” of the Indians in the midst of the crisis and repeatedly denounces the white colonial government for causing Indians to undergo racist indignities. This section focuses on Gandhi’s “politics of respectability” in the context of the plague epidemic in South Africa.42 More specifically, I call attention to the paradoxes that constitute his politics of respectability. On the one hand, he admonished the colonial government for its unfair treatment of Indians in South Africa and strongly urged it to make amends for such racist arrogance. On the other, he made a categorical plea to the government that it ought to make a distinction between the racially superior Indians and the inferior “Kaffirs” in matters of sanitary administration.43 Here, however, one needs to be aware of the fact that in



41 Mahatma Gandhi, “The Bubonic Plague” in the Collected Works of Mahatma Gandhi, 5 (1905), 100-101. 42 I borrow the term “politics of respectability” from Evelyn Brooks Higginbotham’s work on the Women’s Convention of the National Baptist Church during the Progressive Era. Higginbotham focuses on the values (sexual purity, temperance, thrift and cleanliness) eulogized and promoted by the Convention to serve as bases for a respectable identity of African Americans. Higginbotham writes, “The black Baptist women’s opposition to the social structures and symbolic representations of white supremacy may be characterized by the concept of the ‘politics of respectability.’” See Higginbotham, Righteous Discontent: The Women’s Movement in the Black Baptist Church, 1880-1920 (Cambridge: Harvard UP, 1994), 186–87. 43 In an article in the Indian Opinion (February 25, 1905) called “The Plague,” Gandhi explains why some Indians might be concealing cases of plague rather than reporting them to the authorities. “We are informed that, at the plague hospital, no distinction is made between Indians and Kaffirs, all being herded together indiscriminately.” [See below for a more extensive quotation of this passage]. Collected Works of Mahatma Gandhi, 4, 362.

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no place does Gandhi use phrases like “superior race” or “inferior race,” when talking about “Kaffirs” or Indians. Gandhi reported in 1904 that the plague had finally broken out in Johannesburg. Despite the Indian community’s complaints to the colonial administration regarding the unhygienic conditions of residential settlements, the administration was slow to act, which delay had, according to Gandhi, caused the outbreak in the first place. The state of the coolie (Indian indentured laborer) settlement, the “Insanitary Area,” was found to be appalling, according to the Rand Plague Committee, which prepared a report in 1905.44 As a result of overcrowding and lack of ventilation and lighting, the residential arrangements for these Indian workers were havens for infectious diseases like plague and smallpox. Even before the officially announced outbreak in March of 1904, the Medical Officers of Health had identified a certain site for a plague hospital and a camp for suspect patients at Reitfontein as people started becoming ill with the disease.45 Progression of the outbreak suddenly intensified, with fourteen Indian patients being infected and soon “dying one after another,” as Gandhi wrote of a scene “at once ghastly and inspiring—ghastly because it was bleak and frightful and inspiring because the event showed the ability of the community to rise to the occasion and to organize.” He wrote,

 44

Tim Capon, Plague, Gandhi and the Parliamentary Clerk’s Daughter, accessed May 9, 2015, http://www.heritageportal.co.za/article/plague-gandhi-and-parliam entary-clerks-daughter-tim-capon. Capon cites the Rand Committee’s Plague Report in this essay. 45 It is important to mention in this regard that there was recently a huge outcry from historians and residents of South Africa when plans were unveiled to convert the site of the Reitfontein Hospital into a mixed-use development of residential units, offices, business and commercial units and restaurants. The Heritage Portal has served as a platform for discussion and for negotiating the tensions between the different stakeholders about the pros and cons of conservation and development; it has published several essays on different historical sites and their value for posterity. The Reitfontein site became the subject of an outcry bridging India and South Africa, with newspapers in both nations highlighting the necessity of preserving the building and adjacent graveyard because of their great historical value. Historians and residents alike have criticized the proposed structures, arguing that “they will be sited over the graves of thousands of people who died of bubonic plague and other highly infectious diseases.” See http://articles.economictimes.indiatimes.com/2014-0812/news/52728022_1_mahatma-gandhi-bubonic-plague-hospital-site and http://www.timeslive.co.za/local/2014/08/12/multi-billion-rand-project-plannedon-the-graves-of-thousands-in-johannesburg.

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While the patients were being looked after on one Strand, a very largely attended mass meeting was going on in another Strand. Nearly £1,000 were subscribed by the rich and the poor in order that a permanent hospital may be erected for the use of the community. The manner in which the poor men came forward with subscriptions reflects the greatest credit on them.46

Gandhi goes on to praise the Indian community for “bearing its troubles with a heroic patience worthy of its traditions.”47 In these commentaries, Gandhi expressed ire against what he perceived as jealousy of the colonial government toward the flourishing commerce that Indians were engaged in. According to him, much of the indifference and negligence on the part of colonial authorities could be attributed to this resentment. He wrote that “Indian trade is being ruined and all kinds of inconveniences are being put in their way” but compliments the Indian community for “bearing their troubles patiently and heroically.” “The European traders have got their chance. But if the Indians continue to preserve their calmness, the wind will be taken out of the sails of their detractors.”48 Gandhi asserted the value of such calm demeanor and laid down the idea of the moral fortitude of suffering, which would later become the core of his Satyagrahi politics. The beginnings of Satyagraha in South Africa can be seen in his discussions of virtues like “patient suffering”—for him, the ideal weapon on the part of Indians against the delinquent Town Council (which was to be blamed for the outbreak). The Town Council had committed a grievous crime by allowing yet more tenants to inhabit already overcrowded huts in the “Insanitary Area.” Many of the residents of this area were poor indentured laborers—the first casualties of the virulent plague. The plague epidemic was more than an occasion for Gandhi to fight for commercial and basic legal rights for Indians. It can be argued that the plague posed a deeper question for Gandhi, as it involved issues that were to him crucial in the definition of Indians as a people in colonial South Africa. This is evident in a question he poses in the Indian Opinion in April 1904. Have they, like the Public Health Committee, done anything to atone for the crime against nature? We are glad to be able to say emphatically, yes. They woke up when the Council was asleep. The moment they realised that the disease had commenced in its most virulent form, they began to

 46 Mahatma Gandhi, “Plague in Johannesburg,” Indian Opinion (March 24, 1904): 153. 47 Ibid. 48 Gandhi, “The Plague,” Indian Opinion (April 9, 1904): 155.

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Gandhi’s politics at that point were still defined by deference to colonial law and order, which to him were the rightful mark of any civilized society and being an ideal subject meant following such laws diligently. While he referred to all Indians in the statement quoted above, he later qualified this by commenting on the class dimension of such political morality. In 1905, he contended that the price that Indians paid during the plague outbreak was based on a misguided analysis by those in power. All Indians, he said, could not be held responsible for the faults of the community’s “most ignorant section.” For him, it was unfortunate that lower ranks of Indians did not appreciate or follow the diktat of hygiene and cleanliness. And he was proud that the higher-class Indians never cease, both by personal example and by precept, to impress upon their less-favoured brethren the necessity of cooperating with the authorities in order that the effort to stamp out the fell disease, that is now rife amongst us, may not prove abortive. Over and over again, we ourselves have, in our leading columns, both in English and in the vernacular tongues, done our best to point the moral that “Cleanliness is next to Godliness.” And yet we have foolish people asking why “the Indians” do not cooperate with the authorities.”50

Further on in the piece, he raised the issue of concealment of plague cases by poor Indians and argues that they were forced to do so in “selfdefence.” As mentioned previously, he questioned European representations of Indians as being prone to unlawful and dangerous behavior that exacerbated the epidemic and offered an explanation of why such behavior might occur. There is, however, one important reason why cases of concealment do occur. We are informed that, at the plague hospital, no distinction is made between Indians and Kaffirs, all being herded together indiscriminately. Anyone with even the slightest knowledge of Indian habits and prejudices

 49 50

Ibid., 156. Gandhi, “The Plague,” Indian Opinion (February 25, 1905): 362.

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will at once see how great a factor this negligence is in impeding the good work initiated by the authorities. We can only say that, so long as no separate accommodation is allotted to Indians as such and so long as no differentiations of creed and caste are made amongst the Indians themselves, with due regard to religious customs and traditional beliefs, so long will the authorities cope in vain with many of the difficulties that could, with a little foresight, be easily avoided.51

Conclusion The plague epidemic had created havoc in the British Empire, with its historic spread from India to China to South Africa over several years. It was the third bubonic plague pandemic, originating in China, advancing to India, developing into a killer outbreak (1896-1913/14) and appearing in South Africa in 1899. Historians like David Arnold have described it as being of mammoth proportions in colonial India not only because of the very high mortality rates but also its enormous political and social impact.52 It was an “assault on the body” that brought about unprecedented quarantine regulations and forceful inspections of Indians, creating deep resentment that finally led to the assassination of W. C. Rand, the chairman of the Plague Committee. Along with his writings in the Indian Opinion on the more serious plague outbreak in South Africa, Gandhi criticized some of the stringent restrictions that the colonial state had put in place in India. The plague in South Africa provides an interesting example of the ambiguous moral and social politics of Mahatma Gandhi. In this paper, I have explored some of the paradoxes that characterized his postulates about an Indian subject’s selfhood, respectability and rightful conduct. This was the pre-Satyagraha phase, when Gandhi was yet to formulate his explicit agenda of passive resistance against British colonial policies, epitomized in, for example, the protest against the Asiatic Registration Bill of 1906. On the one hand, Gandhi was voicing disapproval of the colonial state and its racist ideologies. At the same time, many of his writings, especially those on the plague control measures, express the desire (translated as the collective desire of all immigrant Indians in South Africa) that his community be ideal subjects of the British Empire. As I have discussed in this chapter, in his trenchant critique of the racist arrogance and discriminatory policies of the South African state, Gandhi

 51

Ibid., 362. David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: Univ. of California Press, 1993). 52

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often voiced an ambition (even if not explicit) for Indians to be ideal, lawabiding subjects. His ideas on the plague outbreaks, the government policies to check them and the acute plight of Indians (the commercial interests of Indians being hurt most badly, according to Gandhi) were couched in a deeply moralistic language. He frequently praised the patience and endurance of fellow Indians in South Africa who were respectfully obedient despite their ill treatment by the white colonial state. For Gandhi, such exemplary behavior distinguished immigrant Indians from the native South Africans, or “Kaffirs.” He was also clearly ambivalent in his approach to lower-class and “ignorant” Indians as opposed to Indians who were more educated. Gandhi also commented on the elevated standards of hygiene among Indians, which he attributed to the interrelationship between Hindu beliefs and physical cleanliness and purity. Regarding the accusations of Indians not reporting when their family members became sick with the plague, while admitting their lack of cooperation in this regard, he was quick to explain such omissions. Physical pollution was always avoided by upper-caste Indians, he declared, and in the plague hospitals of South Africa, Indian patients were put together with “colored” South Africans and, therefore, Indians naturally avoided sending their relatives to such contaminating places. Notions of racial, physical and moral distinctions were intrinsic to Gandhi’s moral politics of respectability, even if such articulations were muted. Contagion for Gandhi was, thus, a manifold opponent, with the metaphoric implications of his ideas on contagion being as significant as his efforts to care for plague patients and/or engage with the issue journalistically.



CHAPTER SEVEN BEYOND THE BROWN TICK: COLONIAL RACIAL HEGEMONY AND THE CONTROL OF EAST COAST FEVER IN SWAZILAND, 1902-1920 ESTELLA MUSIIWA

The difficulties in stamping out any contagious disease in a native territory are very numerous but with East Coast Fever two great difficulties have been in teaching the native that the disease is spread from animal to animal by means of ticks and that the ground over which sick cattle has been grazing remains infected for at least fifteen months after the death of the last tick animal.1

The above statement by W. A. Elder, who served as veterinary surgeon for Swaziland’s colonial government in the early twentieth century, sums up the binary colonizer/colonized conceptualization of East Coast fever that runs through some of the scholarly works on disease and empire in Africa. Scholarship on livestock disease in Africa has given attention to East Coast fever and its diseased environment counterpart but not necessarily from the hegemonic racial “disease and empire” perspective. For instance, Colin Bundy restricts her study on East Coast fever to the penetration of veterinary science into Transkei and underscores the African response through compliance and resistance.2 James L. Giblin 1

Swaziland National Archives (hereafter SNA), RCS 261/09, East Coast Fever, W.A. Elder, Government Veterinary Surgeon, Report on East Coast Fever in Swaziland, attached to letter from W.A. Elder, Government Veterinary Surgeon, to the Government Secretary, May 12, 1909. 2 Colin Bundy, 1987, “‘We don’t want your rain, we won’t dip”: Popular collaboration and social control in the anti- dipping movement, c. 1908- 1916”, in Colin Bundy and W. Beinert (eds.), Hidden Struggles in Rural South Africa, (London: James Currey).

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attributes the East Coast fever epidemic in Tanzania to colonial environmental imbalances that disrupted traditional African methods of livestock disease control.3 Similarly, Paul F. Cranefield links East Coast fever to the colonial agenda in Rhodesia but focuses on the efforts of the colonial state and veterinary scientists to control the epizootic.4 Likewise, Richard Waller’s work on East Coast fever in colonial Kenya highlights state efforts at controlling the epizootic,5 while Karen Brown moves a step further and devotes attention to the role of settler farmers and Africans in the co- production of veterinary knowledge on East Coast fever in South Africa.6 From an Africanist perspective, Mfanimpela Ishmael Thabede emphasizes the impact of East Coast fever on Africans, especially with regard to the loss of cattle, which resulted in male migration and the ultimate feminization of agriculture in Natal.7 In a similar vein, Lotte Hughes is preoccupied with the environmental impact of East Coast fever and the loss of cattle among the pastoral migratory Maasai in Kenya.8 With reference to the making of an East Coast fever epidemic in Rhodesia, Wesley Mwatwara argues that the conflict between the colonial state and the white farmers, which emanated from differences in diagnosis owing to ignorance concerning the nature of the disease, created time for the spread of the disease.9 Wesley Mwatwara’s work on African response to the introduction of the dip tanks implicitly points to the hegemony of colonial 3

James L. Giblin, 1990, “East Coast Fever in Socio- Historical Context: A Case Study from Tanzania”, The International Journal of African Historical Studies, (Vol. 23, No. 3), pp. 401- 421. 4 Paul F. Cranefield, 1991, Science and Empire: East Coast Fever in Rhodesia and the Transvaal, Cambridge: Cambridge University Press. 5 Richard Waller, 2004, ““Clean” and “Dirty”: Cattle Disease and Control Policy in Colonial Kenya, 190- 1940”, Journal of African History, (Vol. 45), pp. 45- 80. 6 Karen Brown, 2005, “Tropical Medicine and Animal Diseases: Onderstepoort and the Development of Veterinary Science in South Africa 1908- 1950”, Journal of Southern African Studies, (Vol. 31, No. 3), pp. 513- 529. 7 Mfanimpela Ishmael Thabede, 2006, “The Impact of East Coast fever on African Homestead Society in the Natal Colony, 1901- 1910”, MA Thesis, University of South Africa. 8 Lotte Hughes, “ ‘They gave me fever’: East Coast Fever and Environmental Impacts of the Maasai Moves”, in Karen Brown and Daniel Gilfoyle (eds.), Healing the Herds: Disease, Livestock Economies and the Globalisation of Veterinary Medicine, Series in Ecology and History, Ohio: Ohio University Press, pp. 146- 162. 9 Wesley Mwatwara, “‘The tick was not slow to take advantage’: Conflicts in the Struggle Against East Coast Fever in Southern Rhodesia (1901- 1920)”, South African Historical Journal, (Vol. 65, No.2), pp. 249- 270.

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veterinary science but falls short of demarcating clearly defined colonial livestock policies based on race.10 It is against the polarized colonizer/colonized backdrop that the current study attempts to spell out the relationship between colonial racial hegemony and the anxiety to control East Coast fever. In short, how did the colonial state institute racial hegemony through the vehicle of East Coast fever? What makes this study significant lies not in its appreciation of conventional veterinary biomedical encounters as it were but rather in its ability to evince the subtle nuances of the trajectory of multiple racialized colonial medical encounters through the lens of veterinary biotechnology. In that respect, the study marks a departure from the polarized “colony/resistance or colony/acceptance of Western biomedicine” kind of historiography, to an appreciation of the mutation of multiple African responses to colonial veterinary biomedicine. Through the prism of East Coast fever, this study sets out to demonstrate that veterinary science was not only a result of colonialism but constituted a veritable medium through which colonial racial hegemony was constructed. The lethal epizootic was perceived through the lens of a racialized colonial economic and ultimately, political hegemony. While both Swazi- and white-owned cattle succumbed to East Coast fever, livestock disease control facilities for Swazi cattle only became a priority when East Coast fever threatened the settler low-veld cattle ranches. In a situation where the Swazis were having their first experience of East Coast fever, it was imperative that the colonial state take the initiative in providing control measures to the “uneducated” Swazis. The veterinary department constructed veterinary knowledge as part of the colonizing process, where Africans were not only trained in the diagnosis of East Coast fever but adopted “top-down” East Coast fever control measures. In the process, Swaziland experienced the mutation of Swazi reaction as Swazis contested, negotiated and engaged racialized hegemonic western veterinary non-biomedical and biotechnological strategies to avert the East Coast fever epidemic over the course of almost two decades.

10

Wesley Mwatwara, 2014, “‘Even the calves must dip:’ East Coast Fever, Africans and the Imposition of Dipping Tanks in Southern Rhodesia, c. 19021930,” South African Historical Journal, (Vol. 66, No 2), pp. 320- 48.

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Racial Construction of the East Coast Fever Discourse and Swazi Response to Non-Biomedical Control Strategies, 1902- 1910 The British takeover in 1902 of Swaziland, which had been under the Transvaal since 1895, was against Boer imperial interests. Apart from British imperial control, there were the Cape Boers led by Louis Botha and Jan Smuts who supported Dutch expansion under British influence and the Boers in the Transvaal who advocated total annihilation of Swaziland and the allocation of the Swazi land to Boer farmers. The speed at which British settlers bought land in Swaziland was a cause for concern for Louis Botha, the Union prime minister, who nursed hopes of incorporating Swaziland into the Union specifically for the benefit of the Boers in the Transvaal. It was within the context of the competing British and Boer interests that efforts were made to develop Swaziland either under either British influence as a High Commission Territory, or under the proposed Botha-Smuts “Greater South Africa.” Between 1899 and 1902, Swaziland was free of the Transvaal administration. When the British took over in 1902, they administered the territory through a commissioner but implemented the policies of the former Transvaal government. In 1907, Robert Thorne Coryndon was appointed resident commissioner for Swaziland, being considered “admirably suited to the Swaziland post” on the basis of his reputation for “skilled handling of African problems.” Coryndon instituted a colonial structure based on piecemeal development projects that, presumably, partially protected Africans from total annihilation. It was within the context of Coryndon’s development policy that the East Coast fever control measures were conceived and implemented. Although white settlers had occupied large tracts of land by 1908, the Swazis had not yet been relocated. The majority were on the high veld and middle veld, where they practiced livestock farming, while settler ranching was still confined to the low veld. The grassy environment, hospitable to the brown tick’s reproduction cycle, accounted for the prevalence of East Coast fever among the cattle of the Swazis and the few white farmers who had settled on the middle and high veld. East Coast fever, which broke out in Southern Rhodesia, the Transvaal and Natal in 1901, had been brought in by cattle from Portuguese East Africa. The fatal sub-regional panzootic11 first appeared in Swaziland in 11 An enzootic is an animal disease endemic to a specific environment. An epizootic is a new animal disease that affects a specific animal population in a

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1902 when it was brought into the Territory by oxen carrying supplies from Komati Poort to Pigg’s Peak and Nomahasha in northern Swaziland.12 East Coast fever was not only alien to the sub-region but appeared at a time when veterinary biomedicine was nonexistent in Swaziland. By the time the government veterinary surgeon arrived in 1903, it had been confirmed that the disease was conveyed through the brown tick.13 Unknown to the Swazis as well as to the white settlers, the panzootic was mistaken for redwater, rinderpest, lung sickness and gall sickness and, consequently, spread rapidly on the high and middle veld because of a lack of appropriate and timely control measures. Citing the impact of East Coast fever on the cattle-based Swazi economy, Crush (1987) notes that Swazi herds were decimated by rinderpest and East Coast fever between 1898 and 1905. The situation was worse in the Peak District, where the cattle population decreased by between thirty and fifty percent between 1904 and 1908 (Image 7-1).14 The veterinary surgeon’s reference to the disease as either East Coast fever or Rhodesian redwater15 clearly indicated that as of 1908, veterinary scientists had not yet delineated the difference between East Coast fever and other tick-borne cattle diseases16 and, therefore, had not yet devised effective strategies to curb the spread of the disease in a timely manner.

specific geographical environment for a given period of time. When an epizootic affects a larger region, it becomes a panzootic. 12 SNA, RCS565/12 East Coast Fever, Report on the incidence of East Coast Fever amongst cattle in Swaziland, October 22, 1912, as enclosure letter titled “Report of the GVS on Eradication of East Coast Fever in Swaziland” from R. T. Coryndon, Resident Commissioner, to the High Commissioner for South Africa, October 23, 1912. 13 SNA, D09/78, Swaziland Annual Report 1907–1908, Report of the Government Veterinary Surgeon for the financial year ending March 31, 1908. 14 SNA, D09/78, Swaziland Annual Report 1907–1908, Report of the Assistant Commissioner, Peak District for the financial year ending March 31, 1908. 15 SNA, D09/78, Swaziland Annual Report 1907–1908, Report of the Government Veterinary Surgeon for the financial year ending March 31, 1908. 16 During that time, the East Coast Fever was referred to as Rhodesian Redwater in the Transvaal (see D. Bruce, “The Advance in Our Knowledge of the Causation and Methods of Prevention of Stock Diseases in South Africa during the Last Ten Years,” Science 22, no.558 (September 1905) :289-298, 290.

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Image 7-1: East Coast Fever in Swaziland, 1908

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Curbing the spread of the disease rather than decimating the vector was typically the way in which the authorities attempted to control East Coast fever in southern Africa, especially in Swaziland. Until 1908, the government resorted to quarantine methods and controlled cattle movements to stop the spread of the disease. Natural immunization became one of the control measures that the colonial state counted on in its endeavor to control the progress of the lethal epizootic. Cattle that had developed immunity to the disease were considered “salted cattle.”17 By the beginning of 1908, the government had indeed managed to control the spread of East Coast fever but only after considerable areas of the high and middle velds were almost denuded of cattle.18 As was the general practice within the British Empire, each colony was to shoulder its expenses while for Swaziland, funding the control of East Coast fever weighed heavily on the Swazi who bore the cost through the heavy annual tax of £2 per family head.19 The racially-constructed issues surrounding East Coast fever became evident when the blame for the spread of the epizootic was put squarely on the Swazis. Admittedly, political instability was at the core of the factors that militated against effective control of the disease. Having been released from Transvaal control during the 1899–1902 South African war, the Swazi were suspicious of any interference with their cattle, which constituted their currency and wealth. As they were encountering the epizootic for the first time, they were understandably averse to some of the measures adopted to control the disease. Moreover, they held to their cultural beliefs against cattle movement because the death of cattle was associated with witchcraft.20 Therefore, efforts to control East Coast fever were, at times, counteracted by Swazis who unknowingly contravened the controlled cattle movement regulations. Notwithstanding, with the resurgence of the disease in previously infected areas, the resident Commissioner blamed the Swazis and complained that it was difficult to enforce the laws controlling the removal of stock because they wantonly evaded the regulations, 17

SNA, D09/78, Swaziland Annual Report 1907–1908, Report of the Government Veterinary Surgeon for the financial year ending March 31, 1908. 18 SNA, D09/78, Swaziland Annual Report 1907–1908, Report of the Resident Commissioner for the financial year ending March 31, 1908. 19 Ibid. 20 SNA, RCS565/12 East Coast Fever, Report on the incidence of East Coast Fever amongst cattle in Swaziland, October 22, 1912, as enclosure letter titled “Report of the GVS on Eradication of East Coast Fever in Swaziland” from R. T. Coryndon, Resident Commissioner, to the High Commissioner for South Africa, October 23, 1912.

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resulting in several fresh outbreaks.21 In addition, there was evidence of preferential treatment based on race when it came to provision of veterinary services. For instance, in one case, a Swazi lost one of his five cattle and the other four were sick but were not quarantined to clean areas, while a white farmer who lost a bull had the rest of his cattle quarantined on a clean area.22 By August 1908, there were more outbreaks in infected areas, especially in the Pigg’s Peak district where one of the chiefs brought infected cattle from the Transvaal and was ultimately reprimanded for that.23 In an effort to control East Coast fever and other stock diseases, the new Stock Diseases Regulations were promulgated under the High Commissioner’s Notice of 1908.24 Legislating stock disease control was one of the processes leading toward imperial veterinary hegemony; this was later reported to be of great interest for the Swazis for whom livestock disease regulations were promulgated.25 By the end of 1908, the Veterinary Department had managed to arrest the spread of the disease southward. In fact, nationwide, there were over 100,000 registered cattle in 1909, compared to 37,432 in 1904.26 East Coast fever had ravaged cattle herds in various parts of southern Africa but it was not until January 1909 that a pan-African veterinary conference was held in Pretoria to map out strategies for eradicating the disease.27 At that conference, Swaziland was granted £10,000 to finance the fight against East Coast fever. The principal veterinary surgeon of the Transvaal Department of Agriculture recommended a scheme that included the following non-biomedical strategies: (a) compulsory branding of all cattle, (b) concentration of all infected herds, (c) slaughter of calves 21 SNA, D09/78, Swaziland Annual Report 1907–1908, Report of the Resident Commissioner for the financial year ending March 31, 1908. 22 SNA, D09/125, Annual Report 1908–1909, Office of the Government Veterinary Surgeon, July 6, 1908. 23 SNA, D09/125, Annual Report 1908–1909, Swaziland Administration, November 13, 1908. 24 SNA, RCS D09/125, Annual Reports 1908/9, Report of the Government Veterinary Surgeon for the year ending March 31, 1909. 25 SNA, RCS414/1911, Annual Reports of Swaziland for the year, 1910–1911; Annual Report of the Assistant Commissioner for Police, Swaziland, for the financial year ending March 31, 1911. 26 SNA, RCS261/09, East Coast fever, W. A. Elder, Government Veterinary Surgeon, Report on East Coast fever in Swaziland, attached to letter from W. A. Elder, Government Veterinary Surgeon, to the Government Secretary, May 12, 1909. 27 SNA, RCS D09/125, Annual Reports 1908/9, Report of the Government Veterinary Surgeon for the year ending March 31, 1909.

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of immune parents born in infected areas and (d) fencing off the bush veld that was free of disease.28 Such measures constituted the basis of East Coast fever control strategies pending the introduction of biomedical technology. The geographical position of northeast Swaziland rendered that region susceptible to East Coast fever incursions. Proximity to the Transvaal meant that any movement of infected cattle from the Transvaal would result in a resurgence of the outbreaks. The year 1909 was marked by the resurgence of the disease in previously infected areas, especially among Swazi cattle in Pigg’s Peak (Image 7-2). The prevalence of the disease in Pigg’s Peak was a result of the reinfection of clean areas by the illicit movement of cattle from the Transvaal.29 In the isolated centers of infection the disease was kept alive by the calves that were born before the ground was clean, thus contracting the disease and renewing the infection for another eighteen months. Complaints were made about difficulties in controlling the disease because the Swazis were not accustomed to stopping cattle from breeding as a result of which calves were born in infected areas, reactivating the epizootic. Geographical zoning became the alternative strategy. However, this measure was also ineffective which was blamed on the traditional Swazi seasonal grazing practices. The veterinary surgeon complained that winter was the most dangerous time for the spread of East Coast fever because the Swazis did not keep their cattle herded or in kraals at night at that time of the year, since there were no gardens to be protected.30 The proposed solution was to zone grazing areas by preventing any two herds from feeding over the same area.31 Additional preventive strategies included slaughter of sick animals and the first generation of calves after the disease ceased as well as prevention of breeding for one year; to encourage compliance on the part of the Swazis, compensation was paid for the animals that were killed.32

28

SNA, RCS 414/1911, Annual Reports of Swaziland for the Year 1910–1911, Report of the Government veterinary Surgeon for the year ended March 31, 1910. Office of the Assistant Commissioner. 29 SNA, RCS D09/125, Annual Reports 1908/9, Report of the Government Veterinary Surgeon for the Year ending March 31, 1909. 30 Ibid. 31 Ibid. 32 Ibid.

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Image 7-2: East Coast Fever in Swaziland, 1909

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Racial colonial hegemony was evident in the superiority/inferiority complex embedded in what constituted veterinary knowledge. That the Swazis were blamed for reinvigorating and spreading the disease was explicit in the veterinary surgeon’s statement that the difficulties in stamping out any contagious disease in a native territory are very numerous but with East Coast fever two great difficulties have been in teaching the native that the disease is spread from animal to animal by means of ticks and that the ground over which sick cattle has been grazing remains infected for at least fifteen months after the death of the last tick animal.33

The racial implications surrounding East Coast fever became apparent in the surgeon’s assumption that the disease could only be stamped out if the Swazis appreciated the dangers associated with the movement of sick cattle. The latter were encouraged to prevent cows from breeding for the first year after the disease had ceased. Colonization through veterinary science was explicit in the veterinary surgeon’s appreciative observation that after almost six years of teaching, the Swazis were beginning to realize the dangers of moving sick cattle, which would help in controlling the disease.34 On another note, it was suggested that control over cattle movement could be effective if the infected areas were fenced off.35 Meanwhile, cattle removal permits were issued in a bid to control movement of cattle, while culprits were incarcerated, with the effect that illicit movement of cattle was greatly reduced. Some of the Swazis had started to accommodate colonial strategies of controlling the spread of East Coast fever.36 These strategies were explained to the Swazis through their chiefs. Initially, there was fear that they might not work because it was assumed that it would be difficult to convince the Swazis to have their cattle branded.37 The branding method provided a way of marking livestock with a specific identity, as explained below: The system of branding is similar to that employed in other parts of South Africa and is known as the “three piece system.” The brand consists of an italic letter and two Roman numerals, this arrangement being confined to Swaziland. Each district was allotted a distinctive letter and was divided 33

Ibid. Ibid. 35 Ibid. 36 Ibid. 37 Ibid. 34

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Chapter Seven into ten wards each ward being shown in the brand as turned to the right. By an arrangement of these letters and numerals a separate brand was allotted to each herd so that no two herds of cattle in the territory have the same brand. After branding a herd the Stock Inspector makes out a list of the cattle at the kraal, which is given to the headman of the kraal and which must be produced for inspection when demanded. By this means, all illicit movements of cattle can be traced.38

Branding was the first step that left a colonial mark on the physical appearance of both the Swazi and European cattle. Most of the Swazis responded positively to cattle branding and the zoning of grazing areas so that in the event of an outbreak, it would be easy to identify the infected ground. However, the assumption that the Swazis had taken a “sane” and “reasonable” view about cattle branding39 carried racial superiority/inferiority connotations. The Swazis who resisted cattle branding had their reasons, having experienced seizures of their cattle by the Boers. There were rumors in some districts that the government was branding in preparation to rob the Swazis of their cattle.40 In one instance: Chief Mtshengu in the Mankaiana District refused to allow us to commence on the grounds that he had had no message from the Chief Regent giving her approval. I refrained from pushing the matter and returned to Mbabane immediately and reported the matter to the Resident Commissioner who sent to the Chief Regent requesting her to send out messengers immediately, this she did and since then the work has gone on without a hitch.41

Thus, in some cases, the Swazis defied colonial authority, taking orders directly from their Queen Regent. East Coast fever-oriented environmental science was yet another body of “top-down” knowledge that the Swazis as well as the white settlers had to contend with. Although some Swazis complied with the branding 38

SNA, RCS565/12 East Coast Fever, Report on the incidence of East Coast Fever amongst cattle in Swaziland, October 22, 1912, as enclosure letter titled “Report of the GVS on Eradication of East Coast Fever in Swaziland” from D. T. Coryndon, Resident Commissioner, to The High Commissioner for South Africa, October 23, 1912. 39 SNA, RCS 414/1911, Annual Reports of Swaziland for the Year 1910–1911, Office of the Assistant Commissioner, Hlatikulu, Monthly Report, August 1910. 40 Ibid. 41 SNA, RCS 414/1911, Annual Reports of Swaziland for the Year 1910–1911, Office of the Government Veterinary Surgeon, Mbabane, Swaziland, East Coast Fever Eradication- Report for December 31, 1910.

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system, they did not take readily to the notion of quarantine camps, as they always preferred to have their cattle in the kraals.42 Even though compensation was promised for cattle that died in the camps, the strategy met with stiff resistance.43 The alternative was to continue to slaughter calves in infected areas where immune cattle were grazing on infected ground. Fifteen months were allowed to elapse between the time of the last death and that when the area was designated free of infection. 44 When it was noted that the calves of salted cows were dying, it was realized that this was clear-cut evidence that the ground was infected. To counter the problem, the Swazi cattle owners were informed that the calves that had already been or were about to be born would be killed in order to prevent the spread of East Coast fever—a control measure to which some of the Swazis objected.45 Another measure adopted to curb the prevention of East Coast fever was fencing. A fence was erected from the Komati River to the Usutu River, cutting off the infected area from the clean area (Image 7-3). It also prevented straying cattle from passing from the clean to the infected area and vice versa; this was done with the Swazis in mind because during winter and spring, it was difficult to prevent cattle from straying long distances.46 Although fencing did not entirely prevent the spread of East Coast fever, it was successful to a considerable extent. To prevent the spread of the disease southward, a fence was erected from the Transvaal border on the northeast along the Komati River to the Bremersdorp-Pigg’s Peak wagon road with the assistance of the Swazis.47

42

Ibid. SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Office of the Government Veterinary Surgeon, Mbabane, Swaziland, East Coast Fever Eradication- Report to December 31, 1910. 44 Ibid. 45 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Office of the Assistant Commissioner, Peak, Monthly Report, May 1910. 46 Ibid. 47 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Report of the Government Veterinary Surgeon for the year ending March 31, 1910. 43

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Image 7-3: Fence erected to control East Coast fever in Swaziland, 1912

The concept of a “Greater South Africa” was entrenched with the promulgation of the Union of South Africa in 1910. The inextricable link between the subtle Botha-Smuts “Greater South Africa” sub-imperial motive and the efforts at eradicating East Coast fever, was unequivocally evinced in Botha’s statement that: a considerable portion of the land in Swaziland belongs to residents in the Transvaal, many of whom continually trek to and fro… A very determined effort will now be made by the Union government to eradicate stock

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diseases—and in view of the constant trekking of farmers…this aspect of the question alone is of greatest importance and warrants the immediate incorporation of this Territory, which is, by its relation, placed in a very different position to other territories adjoining the Union. Swaziland, too, has a fairly large white population which promises to increase rapidly and from this point of view it also differs considerably from the other native Protectorates.48

The sub-imperial discourse became the focal point around which development policies in High Commission territories revolved and constituted the context in which the colonial state dealt with livestock diseases, including East Coast fever. Not only were cattle the backbone of the settler economy during the period in question, they were economically and culturally important among the Swazi. According to Jonathan Crush: “The country acquired a reputation as the ‘stockyard of southern Africa’ in the years before rinderpest as Swazis disposed of large numbers of cattle to white and black buyers.”49 The value of cattle among the Swazis and the white settlers undoubtedly accounted for the haste with which East Coast fever had to be eradicated. In the early months of 1910, East Coast fever was on the increase in different parts of the country, especially among Swazi cattle in the northwest. The majority of the Swazi kraals that were infected were in areas within which the disease had been rampant for several years and where surrounding cattle kraals were already infected;50 the problem was worse in Pigg’s Peak where the disease was prevalent in most parts of the district.51 As cattle died in large numbers, some of the chiefs assisted in the measures adopted to control East Coast fever. For example, the native chiefs of the Hlatikulu district were called up by the Assistant Commissioner who explained to them the proposed measures. These chiefs were quite satisfied with what they were told and assented to assist in the carrying out of the measures.…At the meeting of chiefs of the Mbabane district Chief Malunge, who had heard before the proposed measures and had explained them to the Chief Regent and himself were quite satisfied 48

Ronald Hyam, 1972. The Failure of the South African Expansion, 1908- 1948. London: Macmillan Press Ltd. 49 Jonathan Crush, 1987. “Tin Mining in the Valley of Heaven”, African Studies Seminar Paper No. 205, presented at the African Studies Institute, University of Witwatersrand. 50 Ibid. 51 SNA, D10/67, Annual Reports 1909–1910, Report of the Assistant Commissioner, Peak, for the year ending March 31, 1910.

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Chapter Seven with what was proposed and that they had to thank the Government for what they had done in the past to try and attempt to stop the spread of the disease. Other chiefs signified their assent in similar terms. At Ubombo District, the natives were anxious that anything shall be done to prevent the disease spreading to the bush veld.52

However, some chiefs contested the proposed East Coast fever control measures. It was noted that the chiefs of the Mankaiana made a great point of the fact that they had not received any information from the Chief Regent on the matter and also the proposed killing of the calves of immune parents in infected areas. On the first point I told them that no doubt they would hear from the Chief Regent and on the second when it was thoroughly explained what was intended and I was able to give them several examples of how calves at certain kraals died every year in the Mankaiana district and cases of which they were aware themselves they became satisfied. At Peak district, the chiefs made the same complaint about not having heard from the Chief Regent, Chief Lomncayi stating that he thought the whole scheme useless and that he would not consent to anything even if they did hear from the Chief Regent.53

Despite overt resistance by some of the Swazi chiefs, most of the meetings bore fruit in facilitating implementation of the methods devised by the colonists to control East Coast fever. However, the colonial authorities were aware of their inability to completely subjugate the Swazis because the peculiar ideas about the branding of cattle could not be dispelled immediately, even though efforts had been made to assure them that cattle dipping was not harmful.54 Although there were no fresh outbreaks and few cattle died of East Coast fever during the beginning of 1910,55 the disease was prevalent in many parts of the country. In that year, ninety Swazi cattle kraals and two white farms were affected by the disease. As noted above, most of the infected Swazi cattle kraals were in areas where the disease had been rampant for some years and where almost all the surrounding cattle kraals were already infected. In a bid to control the spread of the disease, 300 52 Colonial Reports- Annual, No. 697, SWAZILAND, Report for 1910–11, Report on Swaziland for the financial year ending March 31, 1911. 53 Ibid. 54 Ibid. 55 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Office of the Assistant Commissioner, Stegi, Ubombo District, Monthly Report, January 1910.

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inter-district and 2,749 intra-district cattle removal permits were issued.56 The state enforced non-biomedical control measures such as branding, fencing and, in some cases, slaughter of cattle.57 Evidence of the hegemonic colonial racial mark was reflected in changes in attitude among some of the chiefs. For instance, it was noted that the chiefs of the Mbabane district who heard about the proposed measures informed the Chief Regent that they appreciated government efforts to curb the spread of the disease.58 Between March 1910 and March 1911, Swaziland experienced numerous outbreaks of East Coast fever among Swazi cattle.59 In response, several strategies were employed to control the spread of the disease. The branding of their cattle took place on a larger scale than before. Some of the Swazis expressed concern over intentions of the government in the efforts to combat the epizootic, while others gave as much support as they could.60 The latter participated in the efforts to prevent illegal movement of cattle by assisting the police force.61 The promulgation of the Proclamation for the Prevention and Eradication of East Coast Fever Amongst Cattle in 191062 was evidence of the extent to which the colonial state entrenched its hegemony through disease-control legislation. On the basis of that legislation, 703 inter-district and 2,135 intra-district cattle removal permits were issued between March 31, 1910 and March 31, 1911.63 The increase in the number of cattle removal permits was therefore 56

SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Report of the Government Veterinary Surgeon for the year ending March 31, 1910. 57 SNA, D10/67, Annual Reports 1909–1910, Report of the Resident Commissioner for Swaziland the year 1909–1910. 58 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Office of the Assistant Commissioner, Peak, Monthly Report, May 1910. 59 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Yearly Report of the Assistant Commissioner, Mbabane, together with that of the Assistant Commissioner, Mankaiana, for the year ending March 31, 1911. 60 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Report of the Assistant Commissioner, Ubombo, for the year ending March 31, 1911. 61 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Annual Report of the Assistant Commissioner for Police, Swaziland, for the financial year ending March 31, 1911. 62 SNA, RCS 414/1911, Annual Reports of Swaziland for the year 1910–1911, Report on Swaziland for the financial year ending March 31, 1911. 63 SNA, RCS 414/1911, Annual Reports of Swaziland for the Year 1910–1911, Office of the Government Veterinary Surgeon, Mbabane, Swaziland, Report for the year ending March 31, 1911.

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another indicator of the hegemonic nature of colonial East Coast fever control strategies. Funding of the East Coast fever eradication measures was not only a financial burden for the colonial government but demonstrated the extent to which sub-imperial motives were played out in the process. The fact that in 1910, of the total abnormal expenditure of £95,463, a sum of £5,390 was spent on the eradication of East Coast fever,64 pointed to the magnitude of the problem and the swiftness with which the disease had to be eradicated if cattle ranching was to be preserved. The High Commissioner in South Africa provided loans while Basutoland advanced £20,000 Peter Duignan to finance measures to control the epidemic.65 It was in the context of the ensuing financial constraints that in 1911, Coryndon accommodated Queen Regent Labotsibeni’s proposal to set up the Swazi National Fund from which he obtained the greater proportion of the money used to finance the control of East Coast fever.

Race, Veterinary Biomedical Technology and Swazi Response to the Dip Tank, 1911–1920 Although there was no medication for the infected cattle, the introduction of a dip that killed the vector was a major biomedical veterinary scientific measure that was not only invented in colonial laboratories but was extended to the Swazis. Swaziland introduced compulsory dipping of cattle in conjunction with the ongoing nonbiomedical strategies. Necessary funds were raised by the imposition of a permanent yearly tax of 2/- on every adult male Swazi and 2/- per annum for two years and 1/- per annum for three years, thereafter, on every head of cattle owned by Europeans.66 The first cattle dip tank was constructed on the White Mbuluzi River in the Ubombo District in 1911 with the support of both white and Swazi cattle owners.67 Thereafter, the government, in conjunction with individual settler farmers, constructed 64

Ibid. Peter Duignan, 1978. “Sir Robert Coryndon: A Model Governor 91870- 1925)”, in L.H. Gann and Peter Duignan, African Proconsuls: European Governors in Africa, (New York/London/Stanford: The Free Press/Collier Macmillan Publishers and Hoover Institution, p. 32. http://www.weafriqa.net/library/african_proconsuls/contents.html. 66 SNA, RCS 146/13 Blue Book and Annual Report, 1912–1913. Annual Report for the year ending March 31, 1912. 67 SNA, RCS 146/13 Blue Book and Annual Report, 1912–1913. Annual Report for the year ending March 31, 1912. 65

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additional dip tanks where the latter allowed the Swazis to dip their cattle (Image 7-4). By that time, the Swazis had submitted to the dipping regulations and it was anticipated that cattle dipping would check the spread of the disease, because experience had shown that: “regular dipping of cattle was the best method of dealing with East Coast Fever.”68 Control of the vector was one of the most successful colonial biomedical technologies used to subjugate the Swazis. Coupled with dipping was the continuation of branding, which minimized illicit movement of cattle. Even though in some cases, the brands could not be provided, the Assistant Commissioner of the Peak District took note of the great psychological effect of the brand on the Swazi.69 Nonetheless, there was an increase in illicit movement of cattle when ten Europeans and one hundred and ten Swazis were convicted.70 Regardless of such cases, some of the Swazis cooperated with the government in its endeavor to stamp out East Coast fever. To encourage cattle owners to comply with the eradication measures, compensation was paid for all cattle that were brought under government control. Efforts at controlling the spread of East Coast fever succeeded because most of the funding came from the Swazi National Fund.71 The report that East Coast fever had retarded the economic development of Swaziland, which was considered an exceptionally good country for raising cattle,72 succinctly summed up the type of thinking that informed British Empire discourse, where political hegemony hinged on the structure and nature of the colonial economy. As of 1912, East Coast fever was under control; however, isolated outbreaks were blamed on the Swazis. Since some of the outbreaks took place in clean areas where they could not have been caused by the movement of sick cattle, with the fence

68

SNA, RCS 44/12, Annual Reports for the year ending March 31, 1912, Office of the Assistant Commissioner, Hlatikulu, Swaziland, Annual Report for the year ending March 31, 1912. 69 SNA, RCS 44/12, Annual Reports for the year ending March 31, 1912, Report of the Assistant Commissioner, Peak District, for the year ending March 31, 1912. 70 SNA, RCS 44/12, Annual Reports of for the year ending March 31, 1912, Office of the Swaziland Police, Mbabane, Swaziland, Annual Report for the Assistant Commissioner for Police, Swaziland, for the financial year ending March 31, 1912. 71 Ibid. 72 SNA, RCS 44/12, Annual Report for the year ending March 31, 1912, Report for Swaziland for the financial year ending March 31, 1912.

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Image 7-4: Dip Tanks in Swaziland, 1914

having deterred such movement, the Swazis were assumed to be the vehicle by which infected ticks were carried from one place to another.

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Although outbreaks of East Coast fever have occurred on the east of the fence in previously clean areas, that is I think, explained by the fact that infected ticks are carried on the clothes of the natives, there is no doubt whatever that this fence has been of very great service in checking the spread of the disease in an eastwardly direction and I am strongly of the opinion that had this fence not been erected the disease would have much more widely spread than it is today.73

Within the first four years of his service as resident Commissioner, Coryndon and not the Swazis, was credited for the effective control of the disease.74 The extent to which East Coast fever had been used to construct racial domination was expressed in the veterinary surgeon’s report that the veterinary department experienced problems in their effort to convince the Swazis to adopt the recommended East Coast fever control strategies. In fact, he gave credit to veterinary officials for convincing the Swazis to assist the government in the eradication of the disease. Government success was further proved in that the Swazis understood the regulations and did not evince their past fears that the measures were designed by the white government primarily to dispossess them of their cattle.75 Changes in Swazi attitudes toward colonial East Coast fever control measures were reflected in an increase in the number of cattle that were dipped. By March 1913, there were twenty dips in Swaziland, at which 31,000 head of cattle were regularly dipped. Apparently, the Swazis had come to appreciate the value of dipping, as it was reported that: the natives are now taking readily to the dipping of their cattle and place no obstacles in the way. Several natives living too far away from a tank have asked for tanks to be built near their kraals. In some cases, natives have voluntarily assisted in the erection of tanks with free labour. Everyone in the country, both European and native, are now giving every assistance in stamping out East Coast Fever.76 73

SNA, RCS 44/12, Annual Reports for the year ending March 31, 1912, Report for Swaziland for the financial year ending March 31, 1912. 74 SNA, RCS 44/12, Annual Reports for the year ending March 31, 1912, Swaziland. 75 SNA, RCS565/12 East Coast Fever, Report on the incidence of East Coast Fever amongst cattle in Swaziland, October 22, 1912, as enclosure letter titled ‘Report of the GVS on Eradication of East Coast Fever in Swaziland’ from D.T. Coryndon, Resident Commissioner to The High Commissioner for South Africa, October 23, 1912. 76 SNA, RCS 146/13, Blue Book and Annual Report for 1912–1913, Office of the Government Veterinary Officer, Annual Report for the financial year ending March 31, 1913.

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However, as Mwatwara has noted, one should not rule out instances of resistance because it was common for Africans to have one cattle kraal for colonial dip records and another cattle kraal that was not taken to the dip.77 In fact, there were occasional outbreaks of the disease between 1913 and 1920 attributable to the spread of East Coast fever through undipped cattle. Such outbreaks were blamed on the Swazis who were frequently accused of carrying the ticks in their blankets from infected to clean sites.78 The effectiveness of the dip tank, coupled with the positive Swazi response to this biomedical solution, was reflected in the marked decline in loss of cattle to East Coast fever. From 1913 to 1919, loss of cattle, especially among the Swazis, declined by half the 1902 figure. The low veld, a portion of the country heavily stocked by white farmers, was free from the disease.79 By 1920, the department had managed to control East Coast fever through the use of dip tanks (Image 7-5) in conjunction with other control measures but still had not entirely eradicated the disease.80

77

Mwatwara, 2014. “‘Even the calves must dip’… SNA, RCS 146/13, Blue Book and Annual Report 1912–1913, Report on Swaziland for the financial year ending March 31, 1913. 79 SNA, RCS565/12 East Coast Fever, Report on the incidence of East Coast Fever amongst cattle in Swaziland, October 22, 1912, as enclosure letter titled ‘Report of the GVS on Eradication of East Coast Fever in Swaziland’ from D. T. Coryndon, Resident Commissioner, to The High Commissioner for South Africa, October 23, 1912. 80 East Coast fever was eradicated in Swaziland in the 1960s. 78

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Image 7-5: Dip Tanks in Swaziland, 1916

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Conclusion Framed within the context of hegemonic racial “disease and empire” discourse, the above discussion addressed colonial racial hegemony in the context of a stock disease. Through the prism of East Coast fever and the related diseased environment, it highlighted the subtle racial imperial politics of stock disease whereby veterinary medicine was not simply a “side effect of colonial projects” but constituted “a necessary apparatus of the imperial project” that entailed the construction of a hegemonic colonial veterinary regime within racial ideologies. The British/Boer imperial interests in Swaziland did not end with the defeat of the Boers in 1902. The continued anxiety of the latter to wipe out the British Empire as soon as possible was reflected in the manner in which they dealt with Swaziland. Up to about 1908, Swaziland experienced widespread infection of cattle for various reasons, chief among which was lack of scientific knowledge on the part of government veterinary personnel. The spread of East Coast fever was attributed partly to negative Swazi response to some of the measures adopted to control the disease. White-owned cattle brought the disease to Swaziland but the Swazis were blamed for spreading and reinvigorating it. A few of the white farmers whose cattle were affected were associated with compliance, while the Swazis were considered the most “arrogant” victims. Control measures were either accepted by the Swazis, or where they were rejected, the Swazi were considered ignorant or rebellious, even though they shouldered the greater proportion of the funding through taxes and the Swazi National Fund. Beyond the brown tick were the fence and the dip tank—significant permanent fixtures that not only constituted the poignant features of colonial racial hegemony but served to inform Swaziland’s racialized hegemonic “disease and empire” discourse.

CHAPTER EIGHT INIMITABLE COLONIAL ANXIETY: AFRICAN SEXUALITY IN UGANDA’S MEDICAL HISTORY, 1900- 1945 ͒ NAKAKYIKE MUSISI AND SEGGANE MUSISI ͒

This chapter is dedicated to H. J. Nakityo, R.N. (1957-1990), a missionaryeducated nurse whose interest in the history of medicine in Uganda inspired the writing of this chapter.

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The casual observer often views and interprets the introduction of Western medicine in the British colonies as “good, philanthropic, and humanitarian” work to save “benighted people” from the ravages of disease and pestilence. Indeed, most memoirs of European doctors who worked in colonial Africa were written from this perspective. This chapter sets out to examine both missionary and lay medical practitioners’ discourses within the British imperial project in colonial Buganda, Uganda, with a focus on demonstrating how these discourses expose deeply entrenched suppositions of gender, sexuality, and race in a colonial setting. Examining in particular the discourses generated by Dr. Albert Cook and his wife Catherine, Colonel Lambkin, J. P. Mitchell and R. Y. Stones, we argue that in as much as European doctors were for the most part engaged in “good, philanthropic, and humanitarian” work in colonial Buganda, they nonetheless produced discourses that epitomized and embodied a series of beliefs about race, gender, and sexuality. Through these discourses, their role in Buganda went beyond straightforward simple acts of healing and reducing suffering of the sick. In their discourses, the Baganda were imagined, institutions set up, and racist remarks espoused. More specifically, these discourses demonstrate how medical interventions and information, and the regulations they prompted, were simultaneously used in a colonizing project and as vehicles for general surveillance of and intrusive intervention into the lives of the Baganda. In essence, such medical discourses signified organizational, partisan/prejudicial, and at times dogmatic and radical realities for the Baganda. They left behind a legacy that continues to reverberate even in the post-/neocolonial period, influencing not only how an African people, disease, and sexuality are talked about but equally so Uganda’s health, education, and politics today. We start from the premise that these discourses cannot be understood outside the historical context within which they were articulated and espoused—that is, in the context of colonial power over and production of knowledge about “natives.” These discourses were part of a larger history of domination, control, and accommodation as practiced in the British imperial project. The chapter is organized in four parts. The first section gives a brief background of Buganda and its early missionary and lay colonial medical doctors. The second part explores early missionary and lay colonial medical doctors’ discourses on the subject of race, while the third part deals with discourses on gender. In the fourth part, we take up the crucial issue of sexuality in these discourses. In reality, the discourses related to these categories (race, gender and sexuality) were not as neatly demarcated as

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is attempted here; more often than not, the three would be implied in a single proclamation.

Colonial Buganda and Its Early Missionary and Lay/Colonial Medical Doctors Uganda lies astride the equator to the west of the East African region, at the very heart of the continent of Africa. In the precolonial period, the southern, central, and western parts of the geographic area that was to become Uganda were inhabited by kingdoms of Bantu-speaking peoples, central among which were Buganda and Bunyoro (Image 8-1).

Image 8-1: Colonial Ethnic Districts of the Uganda Protectorate under British administration. (Source: Google maps)

When the first European explorers arrived in Buganda in the 1860s, they were struck by the kingdom’s “obvious prosperity, high population density and the seemingly benign environment of such a large, complex and ordered kingdom located at the source of the Nile.” They noted the

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large caravans of Arab traders from the coast that meandered through Buganda’s villages over several months, carrying with them beads, guns, and cotton cloth but also “a host of bacteria and viruses” and the Islamic religion.1 The diseases of note were cholera, smallpox, gonorrhea, yaws, and later, syphilis. In 1884/5, at the Berlin Conference, Uganda was ceded to Great Britain and subsequently governed as a British protectorate until 1962, when it attained its independence.2 The first appearance by a European medical doctor was that of J. Smith of the Church Missionary Society (CMS), at Kabaka (King) Mutesa’s court in 1877. Physically exhausted by an arduous and lengthy journey from the East African coast, Smith arrived in Buganda very ill and soon died. Before the CMS could dispatch Smith’s replacement, a doctor by the name of Edward Schnitzer, also known as Emin Pasha, arrived in Buganda via the kingdom of Bunyoro. In fact, Emin Pasha’s interests there were not in medicine but rather in military and administrative matters. He had been dispatched to Buganda as an emissary by Colonel Gordon, the governor general of Sudan.3 Throughout his stay, the Baganda remained quite suspicious of his intentions, and though the Kabaka was quite ill at the time, he refused to be treated by this foreign doctor. Soon after this, the CMS posted Dr. R. W. Felkin to Buganda. And although Felkin quickly established a good rapport with the king and was the first European to study and treat disease in Uganda, the king still remained wary of the Europeans’ intentions and would refuse to take their medicine unless they and some of his chiefs first tasted it.4 Thus the early European doctors in Uganda started by occupying themselves with not only treating their own (fellow Europeans in Buganda)but also trying to win the confidence of Buganda’s nobility by showing them the power of Western medicine. Once settled in his job, Felkin soon noted that the Baganda were infected with a variety of venereal diseases including gonorrhea and syphilis, both of which they blamed on the presence of Arab slave traders in their country. Yaws was also common. While noting a whole host of

1

G. Hartwig, “The Economic Consequences of Long Distance Trade in East Africa: The Disease Factor,” African Studies Review 18, no. 2 (1975): 63–75. 2 John Darwin, The Empire Project: The Rise and Fall of The British WorldSystem, 1830–1970 (Cambridge: Cambridge UP, 2009). 3 William D. Foster, The Early History of Scientific Medicine in Uganda (Nairobi: East African Literature Bureau, 1970). 4 Ibid.

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other diseases,5 Felkin recorded epidemics of smallpox, dysentery, and cholera, which followed caravans of traders from the coast. He also noted some very advanced practices of medicine by the Baganda native doctors. This included seeing a woman, who had failed to give birth, being operated upon under “alcohol anaesthesia and a red hot knife” in what Felkin recorded as a caesarean section.6 He noted with surprise that both the woman and the baby survived, with hardly any infection.7 According to Felkin, the Baganda treated malarial fever with a bitter herb called omululuuza (Vernonia amygdalina). They also practiced “vaccination/immunisation” for syphilis by inoculating young women with exudate from pustules of infected individuals. Newborns were given special protective herbal baths, called ekyogero. Felkin also noted “cases of insanity” that were being handled by the native doctors without prejudice or stigma. They enjoyed the same “cultural explanatory model” as physical illnesses, and the approaches to their treatment were similar: herbal medications, divinations, spiritual consultations, incantations, exorcism, and spiritual appeasement of ancestors with prayers to them for healing and protection. Skin conditions were treated with various baths and herbal smears. Water, minerals, earth, and clay were mixed with herbs to make huge tablets (mumbwa) and were dispensed as the medium to administer to the afflicted. While Felkin was for the most part impressed by the traditional medical regimens of the Baganda doctors and their potential to acquire new medical knowledge, he was not free from the racist prejudices of his times. About the possibilities of training the Baganda in Western medicine, he wrote: “Africans undoubtedly possessed the innate capabilities of education better than Europeans till the age of fourteen but thereafter would never equal the European.” He concluded: “It would take at least three generations to develop the Negro to our mental standard.”8 Following Felkin, many other missionary doctors came to Uganda. They served three main functions in the British imperial project: i) offering medical treatment to European explorers, missionaries, colonial administrators, and their families (for example, Dr. Albert Cook and Dr. Mitchell); ii) providing treatment to those injured in wars of colonization and/or religious wars (for example, Dr. Moffat); and iii) employing medicine as a means to disseminate and ensure conversion to Christianity 5

Ann Beck, A History of the British Medical Administration of East Africa, 1900–1950 (Cambridge, MA: Harvard UP, 1970). 6 Foster, The Early History. 7 Ibid. 8 Ibid. 9.

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(that is, medical evangelism; for example, Dr. Cook). Thus, in every colonial post they established a church, a school, and a health center/hospital. This triadic practice has persisted up to today, such that private universities in Uganda are now mushrooming along colonially entrenched religious lines, e.g., Mukono and Ndejje Christian Universities (Anglican), Kisubi and Nkozi Catholic Martyrs’ Universities, and Mbale Islamic University. In colonial India, there is much to be discussed about missionary efforts in reaching the indigent and sick. Sam Nesamony highlights this in his discussion in Chapter Ten in this volume. He argues in favour of the role of medical missions as close “allies” of the colonial State rather than as “contested” rivals in providing health care. As more missionaries of various persuasions came into Buganda and settled at the Kabaka’s court, religious wars broke out as missionaries scrambled to influence the royalty and gain converts.9 Impressively curing the diseases and injuries that befell the royal army and the royal family thus became a basis for who was to be favored in the various groups’ (Catholic, Muslim, and Protestant) attempts to monopolize political power in Buganda. Medicine was thus thrust into the middle of the British imperial project, finally paving the way for the establishment of the first European medicine hospital (Image 8-2) at Mengo Hill by the missionary doctor (cum soldier in times of war) Albert Cook (later Sir Albert Cook) in 1897.10 The hospital, as seen in the image below, had a very humble origin. Built of mud, wattle, and thatched with grass, it nonetheless had a larger role to play in the grand scheme of the British imperial project. Unfortunately, in 1902, the building was burnt to the ground by lightning during a thunderstorm.11 Given the significant evangelical role that the hospital had played and continued to play, with the keen support of Buganda’s leading chiefs “a bigger and better” hospital was built.12 Work on the new hospital began in July 1903 and was completed for the grand opening in November 1904, an occasion attended by all the colonial and African notables of the day.13 The now more durable Mengo Hospital (Image 8-3) had many innovations. For example, its architects, sensitive to a hierarchy based on class and racial divisions, incorporated in its design a “private wing” exclusively for Buganda royalty, Europeans, and wealthy Indians. The 9

Ibid. 14. William D. Foster, The Church Missionary Society and Modern Medicine in Uganda – The Life of Sir Albert Cook, K.C.M.G. 1870–1951 (Newhaven: Newhaven Press, 1978). 11 Foster, The Early History, 59. 12 Foster, The Early History, 62. 13 Ibid., 64. 10

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hospital was established where the first Christian church stood, and where the nation’s biggest Christian church, Namirembe Cathedral, would also be built. Soon the first school in Uganda was constructed on the same hill, and thus the triad of church, hospital, and school was born. It is this triad that played a central role in the colonizing efforts of the British imperial project. Once the Mengo hospital project gotten underway, it enabled Albert Cook to demonstrate the power of Western medicine and mount a sustained battle against any other forms of healing—particularly those of a traditional nature. Using Western medicine to treat people, needless to say, became the cornerstone of the effort to win over the Baganda to British colonial rule, religion, and education, and its acceptance became a mark of higher social class and standing. Prior to Cook’s medical revolution in Buganda, Drs. Moffatt, J. Ford and other military missionary doctors had concentrated their efforts on combating the epidemics of sleeping sickness (trypanosomiasis), cholera and smallpox.14 Cook was the first to clearly articulate the role of a medical mission in Buganda. He wrote: “The most urgent claim to the opening of a medical mission was preaching the gospel and affording special evangelistic opportunities including…amongst Indians, Mohammedans and Roman Catholics.” CMS Archdeacon Walker concurred: “I regard the medical work merely from its missionary aspect....

Image 8-2: Picture of the First Mengo Hospital, 189715

14 15

Foster, The Early History. Foster, The Church Missionary Society.

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I consider how far it is likely to aid our work not how much suffering will be relieved...we could not consider our mission work complete without a hospital or some such institution in which we might show this side of Christian life.16 Thus, although Mengo Hospital was open to all irrespective of religious creed, attending religious instruction was a condition of medical treatment.17 Today, Mengo Hospital (Image 8-4) stands out as a leading hospital in Uganda. It is one of the top five missionary hospitals, the others being Rubaga, Nsambya, Lachor and Kibuli hospitals. There also exists a Mengo Nursing and Midwifery School as well as the Ecurei School of Radiology. Currently under serious discussion is the establishment of a Mengo Christian Medical School, to carry on the work of the “civilizing triad,” as this legacy has continued to influence Uganda’s health policy and planning. Albert Cook has been immortalized by the naming of the hospital’s newer, modern building after him, while the discourses he initiated some hundred years ago continue to haunt Uganda’s medical establishment.

Image 8-3: The New Mengo Hospital of 1904, as renovated and repainted in recent years,2015 (Source: From Personal Collections)

16 17

Ibid. Foster, The Church Missionary Society, 63.

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Image 8-4: Mengo Hospital today, 2015: The Sir Albert Cook Wing (Source: From Personal Collections)

It is against the backdrop of this long history that we now turn to the discussion of the missionary and lay medical doctors’ discourses in colonial Buganda. Central to these was the colonial establishment’s concern for the “quality” (in terms of physical and spiritual well-being) and “quantity” (in terms of numerical strength) of the Buganda population. The vital statistics issued in each Medical and Sanitary Annual Report gave an alarming picture, and colonial administrators soon realized that Buganda’s population was in serious danger.18 This disquieting realization was followed by cataclysmic prophecies that the once-powerful Baganda would disappear in the same way indigenous populations in North America had been decimated by new diseases brought in by Europeans. Because of this concern, mortality and fertility rates had primacy of place

18 Sir Harry Hamilton Johnston, The Uganda Protectorate, vol. 1 (London: Hutchinson, 1902); Foster, The Church Missionary Society; Foster, The Early History; Beck, A History; Shane Doyle, Before HIV: Sexuality, Fertility and Mortality in East Africa, 1900–1980 (Oxford: Oxford UP, 2013); J. Caldwell, Theory of Fertility Decline. (London: Academic Press, 1982); J. Caldwell, P. Caldwell, and I. Oruboloye, “Fertility Decline in Africa: A New Type of Transition?” Population and Development Review 18, no. 2 (1992): 211–42.

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in all colonial statistics, especially the Annual Reports.19 Missionary and lay doctors took it upon themselves to promote the nurturing of healthy bodies that would guarantee population growth. Out of this concern, they painstakingly monitored and scrutinized the Baganda as a people, their culture, and their bodies, and commented on their sexuality. From this outlook materialized discourses that the doctors repeatedly aired and vigorously defended. Out of these discourses emerged, in turn, significant measures, some of which were no doubt proved beneficial of the Baganda; for example, the founding of maternity training schools. These not only increased women’s restricted employment opportunities but also prompted girls’ schools to include some basic science subjects in their curricula. The nursing and midwifery profession became a reserve of female students, a legacy that continues today (Image 8-5).

Image 8-5: Female missionary-trained nurses continue to dominate Uganda’s nursing and midwifery profession, 1995 (Source: From Personal Collections)

19

Albert Cook, “The Influence of Obstetrical Conditions on Vital Statistics in Uganda,” The East African Medical Journal 9 (1932–33): 316–17; Albert R. Cook, Uganda Memories: 1897:1940 (Kampala: Uganda Society), 329–30. Also see R.R. Kuczynski, Demographic Survey of the British Colonial Empire (London: Oxford UP, 1949), 230–24.

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Saving a “Race”: Anatomy, Culture and the Racialized Discourse The entire Ugandan medical structure developed from one concern: that the Baganda as a “race” would be extinct within a few years.20 The medical establishment, particularly through Cook’s work, set out to do two things. The first was to engage in scientific observation and classification of the reasons behind the “imminent catastrophe” and the factors influencing health and mortality rates in Buganda. The second, emerging out of the first, would be to devise and implement solutions to the problem. Cook became the first to accomplish the first mission. He concluded that the causes for the unfortunate situation fell into three categories: “harmful native customs and behaviour, sexually transmitted diseases (syphilis), and the absence of skilled help in abnormal cases.”21 Committed to scientific and empirical observation, Cook also set himself the task of systematically observing, measuring, and noting the varying sizes of most of his Baganda women patients’ (both living and dead) pelvises.22 He came to the conclusion that the Baganda practiced “harmful customs” that caused severe biological deformity in women, seriously hampering the successful delivery of babies. He pontificated that Baganda girls were victims of a cultural burden: because they carried heavy loads, they were likely to suffer from “degenerate,” “flattened,” “deformed” and “contracted” pelvises and reproductive organs.23 Based on this conviction, Cook embarked on a lifetime career of propounding in medical journals and at regional conferences a discourse that linked the size and shape of women’s pelvises and reproductive organs to the level of civilization. Within the ambit of this argument, maternal problems were regarded as being rooted in culture and heathen customs. This “scientific” discourse reversed the long-held conviction that anatomy was destiny. Instead, culture became destiny.24

20 Albert R. Cook, Uganda Memories, 329; Colonel Lambkin, “Syphilis in Uganda,” The Lancet, (October 3, 1908): 1022. 21 Albert Cook, “The Influence of Obstetrical Conditions on Vital Statistics in Uganda,” The East African Medical Journal 9 (1932): 327. 22 See Clinical Notes and Files, ACMLA; Cook, “The Influence of Obstetrical Conditions,” 321–22. 23 Cook, “The Influence of Obstetrical Conditions,” 327; also, see Albert Cook “Notes on Dr. Mitchell’s Paper on the Causes of Obstructed Labour in Uganda,” The East African Medical Journal 15 (1938–39): 190–92. 24 See Cook, Uganda Memories, 328.

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Lay doctors in the colonial government’s service vehemently disagreed with Cook. For instance, Dr. J. P. Mitchell, superintendent of Mulago Hospital and principal of its medical school, called Cook’s theory “mere guesswork.” Writing in the East African Medical Journal, Mitchell revealed his thoughts on the matter: I know that much can be said in favour of clinical observations against laboratory tests. Nevertheless, in our own early records, I find many examples of credibility and loose thinking in relation to this subject (native medicine, culture re: obstructed labor). Fixed convictions of any kind have undoubtedly a perverting effect upon one’s clinical honesty and acumen....I have refrained for some years from discussing this subject publicly in the hope that by private endeavor the teaching of what I believe to be a myth would cease. I do so now because I find that it continues.25

Cook refused to relent, calling upon the medical community to have trust in his training and meticulous observations.26 Those such as Dr. Mitchell who were skeptical of his ideas called for further scientific investigation into what was being propagated as a medical truth regarding the relationship between “culture and obstetric tragedies.27 Dr. R. Y. Stones, for one, was incensed by Cook’s obstinacy in continuing to blame native customs and medicine for Baganda women’s antenatal and obstetric difficulties. To Stones, this was “not only unfortunate” but also “dangerous,” for such insistence had the potential to foil further investigation.28 Calling for further enquiry, he wrote: If the Baganda women are peculiar in having a contracted pelvis the girls are certainly not peculiar among Africans in alone carrying heavy head loads....There is undoubtedly room for further investigation in these matters....The Baganda…are availing themselves of the opportunities of safe delivery that these examinations afford their women. It is to be hoped that, thus, early causes of obstruction...will be revealed and the reasons for the many still births among this people be brought to light.29

Cook failed to recognize that colonial government doctors such as Mitchell and Stones were not disputing his observations but rather his 25

J.P. Mitchell, “On the Causes of Obstructed Labour in Uganda, Part 1,” The East African Medical Journal 15 (1938–39): 188–89. 26 Cook, “Notes on Dr. Mitchell’s Paper,” 213–17. 27 Ibid. 28 R.Y. Stones, “On the Causes of Obstructed Labour in Uganda,” letter to the editor, The East African Medical Journal 15 (1938–39): 218. 29 Ibid.

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interpretation and analysis of them. Yet the significance of Mitchell’s and Stone’s critiques lies in their demand that Cook come to terms with differences and with that which was not palatable to him—that is, native customs. The two colonial doctors were willing to accept the way in which birth took place as a product of the interaction of cultural and medical preferences. Stones, in particular, retorted: “The custom of giving these drugs can hardly have been so long accepted if their effect were only detrimental…It is very reasonable to suppose that some parturient women are helped by these drugs.”30 In refuting and correcting what they saw as medical misconceptions and misrepresentations, Mitchell and Stones unfortunately became drawn into a discourse framed in racist and evolutionist language. Mitchell in particular refused to accept the classification of Baganda women’s pelvises as “deformed.” To him, they were simply small, and it was this inherent smallness, rather than cultural factors, that was the cause of women’s antenatal difficulties. Lamentably, he stated his argument in a racialized and evolutionist manner, asking, Who has not been struck by the extraordinary narrowness of the Negroid hip? Viewed behind in the erect position at the level of hips the female Negroid body is narrow and round as compared with the “broad beam” of the average European woman, and when the dried pelvises of each are placed alongside each other the explanation is obvious, the Muganda’s bone looks like that of a child in size and in the fineness of its structure....The Negroid races have a shape of pelvis which is intermediate between the protomorphean races and those of the higher civilised types....The brim, as in the apes, is long-oval in shape.31

He continued, “With the development of races the long-oval brim changes to the round or cordate type and the pelvis as a whole becomes more upright and compact.”32 To support his position, Mitchell compared a collection of local female pelvises with those held by the museum of the Royal College of Surgeons. His conclusion again exposed the racialized, evolutionist underpinnings of his approach: “It will be seen that the inlets of the pelvises of the blacks are not only smaller but they are also round and not reniform as in the whites.”33 Mitchell was convinced that “some of the black races...appear to be living still in the transitional period.” He was even more precise in his racialized argument when it came to the Baganda: 30

Ibid. Mitchell, “Obstructed Labour, Part 1,” 181–83. 32 Ibid. 33 Ibid., 183. 31

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“From the evidence provided by the bones of these unfortunate young mothers, and from the story of the high incidence of obstructed labour in Uganda, one cannot but suggest that the Baganda are afflicted with a hereditary stigma.”34 This unfortunate likening of Baganda women’s pelvises to those of apes closely echoed earlier anatomical categorizations of African women developed in Europe and in the United States. Cook also discussed sexuality and sexual diseases in his public lectures and conference papers, succeeding in conjuring up images of the natives’ sexuality as “irresponsible and everywhere”; yet his discourse concealed the truth about race and disease in colonial Buganda. As with other colonial and missionary discourses, we gain only partial historical truth from Cook’s discourse on disease, sexuality, and race. For instance, although no one else in the colonial period wrote as extensively on sexually transmitted diseases in Buganda as did Cook, the extent to which these diseases were not only a “native” problem or a problem of the “immoral Arabs” but a European colonial problem is concealed in his public lectures and writings. Yet his correspondence files are full of letters from Europeans asking for treatment of and advice about their venereal diseases.35 Cook exhibited his racial biases when he failed to either deduce from these letters and his meticulous patient medical notes, or make public pronouncements concerning, the high percentage of Europeans in the colony infected with such diseases in the way that he did with regard to his “native” patients; nor did he comment on the sexuality of the Europeans in Buganda. Cook’s suppression of this knowledge created an overall racialized perception that “immorality” was an exclusively “native” problem.36

Gender (Maternal and Child Care) The approach to saving the Baganda from dying out as a race hinged on how the missionaries and colonialists perceived gender relations in Buganda and the role each gender played in the rejuvenation of the nation. Within a holy patriarchal alliance, missionaries, elite Baganda men, and 34

J.P. Mitchell, “On the Causes of Obstructed Labour in Uganda, Part 2,” The East African Medical Journal 15 (1938–39): 210–11. 35 See, for example, letters marked “Cook Box 10” in box “Mengo Hospital Incoming Correspondence (from CMS London) (Including M.T.S), 1919–1921, 1925–1930 (Including Some Apolo Kagwa Correspondence)” at ACMLA, especially letters from J.G. Nunes and J.W. Braganza. 36 See, for instance, The Crewe Memorandum, 1909. Marriage Files, Mill Hill Fathers’ Archives, Bishop’s House, Jinja, Uganda.

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the colonial state all agreed that whereas men could play a role in this area, the greatest onus with regard to the regeneration of the Baganda and their extrication from this abyss rested upon women. Nonetheless, the view of women as potentially embodying the virtues of fecundity and life was conceived and propagated within an essentialist discourse in colonial medical circles. Women became not only the representation and icon of the continued existence of the nation but equally, its lifeline, a measure of the level of civilization, and an embodiment of a Christian order. Missionary and colonial doctors assumed that this image captured the “natural” role society assigned to women in Buganda.37 Women’s delineated role as an index of progress and the guarantor of stable mortality rates and strong Christian morality meant that their productive and reproductive capabilities were put under continued, controlling, and at times very patronizing microscopic scrutiny. Their situation was not made any easier insofar as they were concomitantly viewed as “ignorant” and “diseased,” and perceived as genetically deficient in their anatomic composition. With Baganda women envisioned and essentialized in this manner, a well-orchestrated discourse developed around them and the way in which they could be assisted in fulfilling their role. This discourse justified a number of medical practices and policies.38 For instance, in tandem with an all-encompassing concern over the quality of the Buganda “race,” the colonial medical establishment was compelled to wage a vigilant crusade to monitor and reform birthing practices and also initiate Western medical training. The positive value of this intervention lay in the establishment of maternal and child welfare centers, maternity training schools, Mulago Hospital, Makerere Medical School, and several other treatment and training centers in up-country areas. Yet, entries in the colonial archives demonstrate that medical intervention was highly specific, ideologically informed, and very intrusive.39 These institutions significantly reordered life for political purposes, demonstrating clearly that the welfare of women and infants had become a matter of national concern, rather than an issue primarily for individuals, clans, and families. To train female health-care workers, Cook’s wife Catherine established the Mengo School of Nursing and Midwifery in 1917 (Image 8-6). 37 See Herbert G. Jones, Uganda in Transformation, 1876–1926 (London: S.C.M. Press, 1926), 340. 38 See Carol Summers, “Intimate Colonialism: The Imperial production of reproduction in Uganda, 1900–1925,” Signs: Journal of Women in Culture and Society 16, no. 4 (1991): 787–807. 39 Ibid.; Megan Vaughan, Curing Their Ills: Colonial Power and African Illness (Stanford, CA: Stanford UP, 1991).

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Image 8- 6: Mengo School of Nursing and Midwifery, as it appears today, 2015 ((Source: From Personal Collections)

Commissions of inquiry such as one such headed by Colonel Lambkin in 1907 and by Colonel Spark, Captain Keane, and Lieutenant Traves in 1908 not only made pronouncements about women’s bodies but focused equally on their behavior and the customs pertaining to their freedom.40 All of this would be justified in the cause of protecting the “fine and virile race.” Any form of resistance on women’s part to participating in this grand and “noble” plan led to counteraccusations and desperate appeals from missionaries and colonial agents that women’s freedoms be curbed. For instance, in 1908, Lambkin bluntly asserted that it was premature for missionaries to consider freeing Baganda women from centuries of control. Comparing Baganda women to Western “liberated women,” he blamed Christian missionaries’ teaching and practices for facilitating the establishment of “a system of promiscuous sexual intercourse and immorality.” He charged that at the core of the problem was: the suppression by Christianity of the tribal laws and customs which formerly prevailed, under which the liberties of women were greatly restricted and the unchaste were severely punished. Christian teachers have 40

Albert Cook, “The Medical History of Uganda, Part 2,” The East African Medical Journal 13 (1936–37): 99.

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brought about the abandonment of polygamy and of a control over female liberty which was formerly exerted, and under which immorality and promiscuous intercourse did not exist...the chiefs of the Baganda tribe, the majority of whom had become Christians, decided to remove such restrictions as being contrary to Christian teaching, and to set the women free. This was done, and the women were left at liberty to roam about as they liked, with the result of establishing a system of promiscuous sexual intercourse and immorality.41

The Church Missionary Society’s Bishop Tucker vehemently refuted this, retorting, It is a fundamental principle of our work to interfere as little as possible with tribal laws and customs. The breakdown of the feudal system has been due not to Christian teaching—for Christian teaching had no controversy with it—but to government legislation. In saying this I do not wish in the very least to reflect upon the policy of administration, which I am sure has been actuated by the highest and best motives.42

Cook likewise refused to accept Lambkin’s assertion, writing, “I must give emphatic denial to the assumption that Christianity has been the chief cause of this epidemic. It has been all the other way. Read ‘civilization’ for ‘Christianity’ and there may be some amount of truth in it.” He added, “Christianity from the very beginning acted as a deterring and restraining force and when intelligently accepted it would be the only true prophylaxis to this terrible scourge.”43 Apart from accusing Christianity of undermining Buganda cultural restrictions on women, Lambkin also was convinced that as members of an inferior race, Baganda women did not deserve to be freed. Comparing them with European women, Lambkin justified restricting the former’s freedoms thus: The freedom enjoyed by women in civilized countries has gradually been won by them as one of the results of centuries of civilization, during which they have been educated; and women whose female ancestors had for countless generations been kept under surveillance were not fit to be treated in a similar manner.…They were, in effect, merely female animals

41

Lambkin, “Syphilis in Uganda,” 1023. Bishop Alfred R. Tucker, “Syphilis in Uganda,” letter to the editor, The Lancet (October 2, 1908): 1246. 43 Albert Cook, “Syphilis in Uganda,” The Lancet (December 12, 1908): 1771. 42

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Thus, the bid to halt the effects of the syphilis epidemic and to curb what medical colonialists saw as Baganda women’s immorality led not only to these unfortunate and highly racialized counteraccusations regarding the emancipation of women; these discourses also resulted in the passage of strict laws regarding marriage, divorce, and the movements of women.45 These largely misogynist laws prohibited women from traveling without male escorts or living in town alone, and were very prohibitive of divorce.46 Police arrested and harassed many of those they saw as “redundant” women, the so-called bakireereese women.47 Nonetheless, implementation of the laws led to many Baganda women being awarded large settlements for damages caused to them by their husbands, whom they accused of infecting them with sexually transmitted diseases.48 In such cases, women could even be granted custody of the children in case of divorce.49 Although these laws pertained to the whole of colonial Uganda, they were not uniformly enforced, being more rigorously applied in Buganda, the seat of the colonial establishment. For instance, in the west (Ankole, etc.), adherence to these laws was more lax, with age-old sexual attitudes and practices—regarding such matters as premarital sex, ritualized sex, wife-sharing, wife inheritance, and culturally sanctioned extramarital sex, as well as children’s inheritances and other issues— persisting up to independence and beyond.50 44

Lambkin, “Syphilis in Uganda,” 1023. Foster, The Church Missionary Society; Foster, The Early History; Doyle, Before HIV; Albert Cook, “An Urgent Need In Uganda,” Mercy and Truth 12 (1908): 44–53; Megan Vaughn, Curing Their Ills: Colonial Power and African Illness (Cambridge: Polity Press, 1991); Marjinez Lyons, “Medicine and Morality: A Review of Responses to Sexually Transmitted Diseases in Uganda in the 20 Century,” in Histories of Sexually Transmitted Diseases and HIV/AIDS in SubSaharan Africa, ed. P. Setel, M. Lewis, & M. Lyons (London: Greenwood Publishers, 1999), 97–117; Marjinez Lyons, “Sexually Transmitted Diseases in the History of Uganda,” Genitourinary Medicine 79 (1994): 138–45. 46 Doyle, Before HIV. 47 Foster, The Church Missionary Society; Foster, The Early History; Beck, A History; Doyle, Before HIV. 48 Foster, The Church Missionary Society; Foster, The Early History; Beck, A History; Doyle, Before HIV. 49 Grace Bantebya Kyomuhendo and Marjorie Keniston McIntosh, Women, Work and Domestic Virtue in Uganda -1900–2003 (Kampala: Fountain Publishers, 2006). 50 Doyle, Before HIV. 45

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Disease and the Paranoid Fantasy of the “Native’s Uncontrolled Sexual Drive” Inquiries into the reasons as to why the Baganda were unable to reproduce themselves came to revolve around a central and paranoid European fantasy, which was unceasingly repeated in Cook’s correspondence: that the “uncontrollable sexual drive of the Baganda which was combined with disease and ignorance damaged their fertility.”51 Thus, concern regarding population decline led to the medical and colonial establishment’s preoccupation with Baganda sexuality and practices around reproduction.52 Yet for the most obvious reasons, the missionaries’ bid to attack sexual “immorality,” which was considered to be the primary cause of venereal diseases and high maternal mortality rates, was connected to the semantics of sin.53 Nonetheless, through their discourse and medicine, missionaries like Cook problematized the Buganda’s sexuality, particularly that of women, not only as a religious concern but equally so as a secular one, which needed to be regulated by the colonial state. Initially, the initiatives depended heavily on controlling female sexuality but after World War I, there was also considerable colonial concern over male sexual behavior, as the rates of syphilis and gonorrhea and their complications were recorded at high levels in Buganda and the Buhaya kingdom to the south.54 What was perceived as low male sexual morality was especially blamed. However, there were significant arguments and disagreements among the colonial administrators and missionaries concerning this issue.55 For example, the codification of customary laws on marriage that had been attempted failed to impose monogamy as the ideal form of marriage as promoted by the missionaries. In the view of the 51

Cook, “The Medical History of Uganda, Part 2,” 105; Foster, The Church Missionary Society; Foster, The Early History; Cook, “An Urgent Need In Uganda”; A. Cook, “Syphilis in The Ugandan Protectorate,” British Medical Journal 2 (1908): 2502; Lyons, “Sexually Transmitted Diseases,” 138–45. 52 Albert Cook, “The Medical History of Uganda, Part 2,” 105; Cook, “An Urgent Need In Uganda”; Albert Cook, “Syphilis in The Ugandan Protectorate,” British Medical Journal 2 (1908): 2502; Lyons, “Medicine and Morality”; Lyons, “Sexually Transmitted Diseases.” 53 Foster, Early History, 81. 54 Foster, The Church Missionary Society; Beck, A History; Doyle, Before HIV; Cook, “An Urgent Need in Uganda”; Cook, “Syphilis in the Ugandan Protectorate”; Lyons, “Sexually Transmitted Diseases.” 55 Beck, A History; Doyle, Before HIV; Lyons, “Sexually Transmitted Diseases”; Summers, “Intimate Colonialism.”

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colonial administrators, restricting men to monogamous marriages would culturally undermine among the “natives” the institutions of marriage and family, which they so wished to see as stable.56 In this way, church and state discourses lacked coherence with regard to the control of male sexuality. Nevertheless, because the sexually transmitted disease epidemic in Buganda was blamed for causing “subfertility” in women, it provoked a series of interventions aimed at reforming marriage, gender relations, and sexual behavior. The medical goal was to control the high rates of miscarriage and stillbirth, while the religious goal was to transform and “heal” souls.57 The medical and sociopolitical project of managing births, children, and mother’s lives required that sexual morality come under colonial surveillance. To be more explicit, this meant that Baganda women’s sexuality needed to be controlled by the state rather than by clan and kinship groups as had previously been the case.58 It is also important to note that in their efforts to rescue the Baganda from extinction, missionary and colonial establishments believed that educational and medical interventions would be more acceptable to the Baganda and more widely disseminated if they began with the dominant stratum of society, comprising the chiefs, the economically privileged, and the royal class. Through various means, this group’s sexuality was targeted and individuals were recruited into a moral campaign. The ruling elite were persuaded to devise a rational body of laws that would control as well as monitor sexual immorality.59 It was believed that the lower strata would then be eventually and uncompromisingly brought into line through such laws as well as public hygiene and sanitation laws.60 Although not fully successful, the results were not disappointing to the colonial establishment. As treatment rooms and maternity and child welfare centers were opened up in different places throughout Buganda, the decrees and pronouncements of the Buganda Lukiiko (parliament) 56

Foster, The Church Missionary Society; Foster, The Early History; Beck, A History; Doyle, Before HIV. 57 Foster, The Church Missionary Society; Foster, The Early History; Beck, A History; Doyle, Before HIV. Also see Cook, “Syphilis in The Ugandan Protectorate”; Lyons, “Sexually Transmitted Diseases.” 58 Nakanyike B. Musisi, “Transformation of Baganda Women: From the Earliest Times to the Demise of the Kingdom in 1966” (PhD Diss., University of Toronto, 1991). 59 Lambkin, “Syphilis in Uganda,” 1023; Cook, “The Medical History of Uganda, Part 2,” 100. For a fuller discussion of the development of laws to curb immorality in Buganda, see Musisi, “Transformation of Baganda Women.” 60 Cook, Uganda Memories, 335–36.

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obliged chiefs in rural areas to provide housing and food for medical assistants and midwives in their areas.61 These centers became individual community projects with direct missionary and colonial government participation in their staffing and surveillance.62 To help in staffing these centers, maternity training schools began to be opened in the early 1920s.63 Through such initiatives, a re-moralization of the Baganda through Christian ethics and a general acceptance of Western medical practices spread more broadly throughout the entire social body of Buganda. This was with the active contribution and involvement of the Buganda governing elite. From their perspective, missionary and lay doctors had much to be proud of, in terms of the success of both their medical enterprise and in the setting up of surveillance and compliance measures. For instance, Albert Cook boasted about the fact that men were now going to considerable efforts to secure Western medicines for their pregnant wives: “Husbands often make a journey of many miles to obtain the valued drug for their wives who are unable to walk the distance—they would not do that if they did not see the result in healthy families.”64 Upon departing from Buganda, Lambkin boasted of leaving behind a “network to handle the situation.” Through this network, persons afflicted with sexually transmitted diseases were reported to the medical authorities and forced, with the help of chiefs, to receive treatment. In recent times, the legacy of the misconceived and racist view of African sexuality has resurfaced with the HIV/AIDS epidemic.65 Indeed today, as in the days of the discourse on syphilis, much of the debate in the Western medical discourse regarding ways of combating the HIV/AIDS pandemic in Africa seems to center on controlling African sexual behaviors. Yet the usefulness of this approach is often not supported with concrete scientific evidence to back up the assertions made. Thanks to the 61 Lambkin, “Syphilis in Uganda,” 1023. Also see Cook, Uganda Memories, 342; Letter from the secretary of the MTS Committee, Mengo Hospital, to the provincial commissioner, 1920. Luganda version. AMLA, box, “Mengo Hospital Incoming Correspondence (including MTS) 1919–1921, 1925–1930.” 62 Cook, “The Influence of Obstetrical Conditions,” 329, and “The Medical History of Uganda, Part 2,” 101–2. 63 Cook, “The Medical History of Uganda, Part 2,” 102. 64 Albert R. Cook, “The Treatment of Ante-natal Syphilis,” Kenya and East African Medical Journal 6 (1929–1930): 15. 65 Doyle, Before HIV; B. Ahlberg, “Is There a Distinct African Sexuality? A Critical Response to Caldwell,” Africa 64, no. 2 (1984): 220–42; Summers, “Intimate Colonialism.”

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work of medical historians, it is becoming increasingly clear that the causes of epidemics such as syphilis or HIV/AIDS are more complex than merely a matter of sexual immorality. This new body of literature points to factors such as poverty, inadequate public health systems, and the breakdown of social norms and infrastructure (as happens in conflict/postconflict situations) to explain the high prevalence of HIV/AIDS in developing countries, including Uganda.66 The HIV/AIDS epidemic has also reawakened discussion of another controversial aspect of sexuality in Uganda: the subject of homosexuality. While the colonial medical doctors discussed in this chapter were silent on the matter, colonial law prohibited homosexuality. This silence in their discourses is intriguing in that homosexual practice was known to exist in Uganda even before the advent of the Europeans or the Arabs.67

Conclusion Empowered by their Eurocentric and religious ideological convictions, and notwithstanding whatever else missionary and lay colonial doctors did and wrote, Europeans perceived themselves as people on a mission. They considered this mission to be “noble,” with an ultimate goal of benefiting the Baganda. At the core of this conviction was their belief that they were assisting in “uplifting” and “saving” a “race” that was in danger of becoming extinct. On this matter, the ruling elite in Buganda agreed with them and listened to and facilitated their discourses, although these were sometimes laden with insidiously racist connotations and gender biases. This chapter has, thus, illustrated how discourses around race, gender, and sexuality developed around a universally humanistic endeavor—the practice of medicine for healing and to relieve suffering. These discourses generally had far-reaching consequences; Uganda’s health systems are rooted in this colonial heritage. Ironically, the continuation of the “civilizing triad” of hospital, church, and school continues to be upheld as the ideal in Uganda today. Universities and medical schools are still being established on the basis of this colonial anachronism. Indeed, to a large extent the interpretation of politics, education, medicine/diseases, gender, and sexuality in Uganda continues to follow this colonial legacy. 66

M. Tuck, “Syphilis, Sexuality and Social Control: A History of Venereal Diseases in Uganda.” (PhD diss., Northwestern University, 1997). 67 Carol Summers, “Subterranean Evil and Tumultuous Riot in Buganda: Authority and Alienation in King’s College, Buddo, 1942,” The Journal of African History 47, no. 11 (2006): 93–113.

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The chapter has also argued that the prevalent ideas of the Baganda as in danger of becoming extinct, became a guiding force to such medical discourses. Through them, both missionary and lay colonial doctors depicted the Baganda as ignorant, childlike, immoral, and diseased; they became triumphantly and staunchly convinced that the Baganda could be uplifted only through social engineering projects (that is, the reorganization of societal values) based on medical and scientific knowledge. Yet, the visible and, undoubtedly, strong presence of cultural, racist, and ideological colonialism in medical discourses and practices in Buganda cannot be denied. From these ideological positions, doctors such as Albert Cook relentlessly pontificated, lectured, and published in learned journals, as they sought to transform what was simply different and unpalatable to “Western/modern” medicine. No wonder, then, that medical historian W. D. Foster characterizes Cook’s epidemiological notions as being “led astray by his missionary keen nose for sin.”68 Cook looked at Baganda women’s illnesses in terms of what Christianity and civilization could beget and perfect. In this equation, backwardness, sin, and racial difference appear as the actual causes of “deformed,” “flattened,” “contracted,” and “childlike” pelvises as well as of high maternal and child mortality rates. There is no doubt that missionary and colonial doctors’ disquiet about population decline shaped their enterprise in Buganda but their preoccupation with women’s anatomy in particular cannot be understood outside of the larger context of scientific assumptions during this period, namely, the triumph of Darwinism in colonial medical thought. Through their use of evaluative language, doctors reinforced their power to judge and classify. In characterizing Buganda prenatal practices as dangerous and backward and Baganda women’s pelvises as less- or underdeveloped, they maintained Western white women’s bodies as the norm; set within this binary approach to cultural and anatomical progress, Baganda women’s pelvises continued to be classified as anomalous.

68

Foster, Early History, 81.

CHAPTER NINE BUILDING A ‘HEALTHY’ EMPIRE: WHITE WOMEN, RACE AND HEALTH IN COLONIAL ZIMBABWE USHEHWEDU KUFAKURINANI

There has been a growing interest in the study of white/Western women (sometimes called colonial women) in colonial societies, contributing to the emergence and expansion of the field of gender and empire. Scholarship has examined the complicity and resistance of Western women to colonialism, their status and roles as victims and victimizers, among other binaries. The growing interest in Western women in the colonies stems, in part, from their ambivalent position as an oppressed category within the category of “oppressors.” Their experiences illuminate, among other things, the “tensions of empire” and demonstrate that colonial spaces were platforms of racial, gender and class negotiations and compromise even among the colonizers. This chapter builds upon the growing studies on gender and empire by analyzing the contribution of white women in colonial Zimbabwe to the endeavor of creating a healthy population for both Africans and the white community. I argue that their interest in health, even where Africans were involved, was largely influenced by their determination to safeguard the health of the dominant white race. However, ending the analysis here would be an oversimplification of the reality of white women’s experience regarding health. Their personal health encounters and their involvement with issues concerning others, including African health on the farms or noncommunicable health conditions such as mental illness, demonstrate how much more complex white women’s experiences with health in the colonial era were. In the interest of unraveling this complexity, this chapter discusses white women as agents of the health crusade in colonial Zimbabwe as well as victims of threats (real or potential) to health.

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As “mothers of empire,” white women felt obligated to keep the health of the white populations in good condition. Even when they extended their efforts to Africans and pressured the government to act swiftly and effectively in its health policies toward the latter, this was primarily for the safety of the white population. However, when it came to noncommunicable conditions such as mental health, race played a lesser role. It appears that the white women who took interest in these conditions were influenced by a genuine concern for the welfare of Africans facing such issues. However, on the whole, the degree of commitment offered to Africans and Europeans by both state and non-state organizations exhibited the racial disparities at play in colonial Zimbabwe. Such discrepancies were in fact themselves not healthy for the survival of British rule. Although the motives behind white women’s involvement with African health remain a subject of debate, the significance of that involvement in improving the welfare of Africans should not be downplayed. This chapter also examines the personal health experience of white women in the colonies. As mothers and as individuals, white women had changing and different health experiences, particularly as victims of threats to health. From the establishment of colonial rule, one of the dominant fears that colonial society harbored was that concerning maternity and reproductive health. The combination of a tropical environment and poor health facilities rendered the settler community vulnerable to disease and death. Women’s role as mothers was critical to the survival of the family as well as the settler society at large. Findings in the chapter are based on archival documents, which include correspondence of the state and women’s organizations, minutes of the meetings of women’s organizations, newspaper articles and women’s magazines. In some ways, the discussion in this chapter cautions us against overstretching Helen Tilley’s thesis of Africa as a living laboratory, which suggests that experimentation and research on Africans defined the nature of the involvement of the British with their empire.1 Reducing Africa to a “laboratory” assumes the absence of relationships and engagements governed by anything other than experimentation. This study demonstrates how white women participated in efforts focused on the health of Africans, not as part of a grand experiment but rather as part of an endeavor to save both the settler and indigenous populations. On a similar note, Seggane Musisi and Nakanyike Musisi (Chapter Eight in this volume) provide critical insights into the ensuing colonial “concerns” about population 1

Helen Tilley, Africa as a Living Laboratory: Empire, Development and the Problem of Scientific Knowledge, 1870–1950 (Chicago: Univ. of Chicago Press, 2011).

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decline amongst the Baganda which led to their preoccupation with Baganda “sexuality and reproductive practices.” The motives for saving the indigenous population may not have always been benign. But to a great extent, white women’s actions were governed less by a desire to experiment with African health and more by the need to extirpate the menace of disease. In other words, the involvement of white women and their interest in health issues in Southern Rhodesia was complex and did not necessarily reduce Africa to a living laboratory in the sense described by Tilley; in this context, it is interesting that Tilley excludes Southern Rhodesia in her choice of case studies.2

Elasticity in Domesticity: White Women, White Femininity and Colonial Health In the colonies, white women were expected to play certain roles and behave in a certain manner.3 White femininity in colonies such as Southern Rhodesia4 was clothed in a racial etiquette that defined the dos and don’ts for white women. These included appropriate behavior in public and in relation to men, especially African men. In the words of Raka Shome, white femininity is “an ideological construction through which meanings about white women and their place in the social order are naturalized.”5 The author notes that as symbols of motherhood, as markers of feminine beauty,…as translators (and hence preservers) of bloodlines, as signifiers of national domesticity, as sites for the reproduction of heterosexuality, as causes in the name of which narratives of national defense and protection are launched, as symbols of national unity and as sites through which “otherness”—racial, sexual, classed, gendered and nationalized—is negotiated, white femininity constitutes the locus through which borders of race, gender, sexuality and nationality are guarded and secured.6

2

Ibid., 6. For a discussion of how manners shape a nation, see Allison K. Shutt, Manners Make a Nation: Racial Etiquette in Southern Rhodesia, 1910–1963 (Rochester: Univ. of Rochester Press, 2015). 4 Southern Rhodesia is one of the colonial names of what is today called Zimbabwe. From 1965 to 1978 the country was called Rhodesia and from 1978 to independence in 1980 it was called Rhodesia-Zimbabwe. 5 Raka Shome, “White Femininity and the Discourse of the Nation: Re/membering Princess Diana,” Feminist Media Studies 1, no. 3 (2001): 323. 6 Ibid. 3

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As an ideological construction, domesticity was central to white femininity, as it placed limits on the roles and status of white women. The configuration of domesticity within the colonial setting interacted with other factors such as class and race. In terms of their roles, white women were expected to embrace Victorian domesticity, which confined their space to the home. In reality, women in the colonies carved niches beyond private domestic spaces. As Ann Laura Stoler observes, “Colonial cultures were never direct translations of European society planted in the colonies but unique cultural configurations, homespun creations in which European food, dress, housing and morality were given new political meanings in the particular social order of colonial rule.”7 Thus in colonies such as Southern Rhodesia, white women moved into the public space, reconfigured domesticity and on some occasions assumed a domesticity whose boundaries shifted from the home front to coincide with those of the nation (i.e., the colonial state). At the national level, these women became “mothers of empire.” “In Africa,” read a 1938 article in Home and Country, a popular women’s magazine of the time in Southern Rhodesia, “European women have a responsibility to the white race as a whole, as well as to the African natives themselves.”8 Domesticity was thus elastic, stretching beyond the confines of the home. It is within this context that white women’s participation in ensuring the health of the colonies must be appreciated.

White Women and the Health of the Settler Community Southern Rhodesia, particularly Kenya in East Africa, was developed as a settler colony and having a healthy and self-reproducing population was critical to the scheme of establishing such a colony. White women in their different organizations took it upon themselves to monitor and assist in maintaining the health of the settler community. These organizations thus pressured the government to improve various aspects of the health of this community. As I will demonstrate, even their increased interest in African health was itself born out of white women’s interest in safeguarding the health of the white community. Africans were believed to be reservoirs of disease and it was, therefore, believed that the best way of 7

Ann Laura Stoler, “Rethinking Colonial Categories: European Communities and the Boundaries of Rule,” Comparative Studies in Society and History 31, no. 1 (1989): 136. 8 “Advice to European Women” (reprinted with acknowledgement to the East Africa Woman’s League), Home and Country 1, no. 3 (1938): 43.

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protecting the white community was to deal with the perceived source of disease.9 Women’s organizations lobbied the government for the improvement of health standards for white children in schools and, at times, took the initiative to investigate health conditions and make the necessary interventions. The health of children in the schools was, in fact, one area that white women’s organizations closely monitored. Unfortunately, because of the nature of the available documents, relatively little is to be found from organizations other than the Federation of the Women’s Institutes of Southern Rhodesia (FWISR). It is possible that this organization developed its interest in schoolchildren’s health as early as its inception in 1927, or around that time. In my research, the earliest reference to this issue was found to be in 1936, when the convener of the Federation’s public health committee, O. Gumprich, wrote (under the instruction of the FWISR) to different boarding schools, boardinghouses and other institutions where the young were housed, making enquiries on the health standards and practices in these institutions. This arose “out of the apprehension of a large number of mothers who have been very alarmed by the Medical Directors Report on the Health of the Colony.”10 The inquiry was “purely unofficial and confidential.”11 Most institutions responded to the inquiry by the FWISR with discomfort and reluctance to divulge any information. The headmistress of Evelyn High, for example, wrote to the director of education, “While not having any desire to withhold the facts from the department or anyone entitled to know, I do not feel that outside organisations have any right to approach us directly for this information.”12 The headmaster of Umtali High displayed similar reservations, noting that he did not think the matter “should be discussed at a general meeting of Women’s Institutes where the large majority of those present will have no experience of running a Hostel.”13 Thus, the lack of cooperation from members of the white society sometimes compromised the effectiveness of women’s organizations. 9

See also Glen Ncube, “The Making of Rural Healthcare in Colonial Zimbabwe: A History of the Ndanga Medical Unit, Fort Victoria, 1930–1960s” (PhD diss., University of Cape Town, 2012). 10 NAZ, S824/198/1, From O. Gumprich, Convener of the Public Health Committee, FWISR to Gwelo, July 22, 1936. 11 Ibid. 12 NAZ, S824/198/1, The Headmistress (S.L.T. Blackway) to the Director of Education, July 1936. 13 NAZ, S824/198/1, From the High School Umtali to Assistant Director of Education, September 23, 1937.

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It is not clear whether the information requested by the FWISR was eventually provided but the director of education clearly indicated to the schools that he had no objection to the request. The marked resistance by the institutions to have their “dirty linen” exposed did not dissuade the FWISR. In 1946, it passed a resolution that was presented to the director of education, asking the government “to appoint full-time schools Medical officers in Bulawayo and Salisbury or wherever the number of school children warrants an appointment.”14 In the same year, FWISR also passed a resolution that in the interest of stamping out “the prevalence of Bilharzia in the colony all school children should be periodically examined for Bilharzia.”15 The state, however, was not prepared for the extra cost that would be incurred by implementing these resolutions, given the unstable postwar economic environment. The FWISR and other women’s organizations continued to be watchdogs of children’s health throughout the colonial period, offering alternatives and challenging poor health standards. Their show of interest and persistent inquiries were likely to have kept service providers in the education sector on their toes, knowing there were people keeping a close eye on the situation. The FWISR also played an important role in educating its members and also non-members, on issues of good health and hygiene. The significance of the organization in this respect was recognized by the Department of Education which requested Women’s Institutes to cooperate with them on this matter. A report by the FWISR Standing Committee of Education in 1942 indicated that Miss Williamson, the woman inspector of school hostels, was most anxious that the Federation through its Institutes should co-operate with the Educational Department in contacting women in outlying districts and especially Afrikaner women, so that any information or lectures on diet, sanitation, child welfare etc. may be available to them. She feels that many women come to the colony and settle into groups living in isolated parts and are thus cut off from helpful information.16

Owing to the war, the government, through its Social Hygiene Council, was being overwhelmed and hence its request for assistance from the FWISR. Throughout the colonial period, the FWISR continued to take an interest in health and education matters. Vital information on diseases and 14 NAZ, S824/198/2, Resolutions passed at the 1946 Congress of the Federation of Women’s Institutes of Southern Rhodesia, September 4, 1946. 15 Ibid. 16 NAZ, S824/198/2, Report of the Standing Committee for Education of the FWISR, 1942.

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healthy nutrition, among other, related subjects, was disseminated to members and other women in the colony through its Home and Country magazine.

White Women and the Health of Africans Until the 1930s, the Rhodesian government had shown little interest in the health of Africans, especially outside the towns. Even when the state finally began to pay greater attention to African health, its efforts did not sufficiently address the issue.17 In an attempt to fill the gap, different women’s organizations became increasingly involved in programs and projects aimed at improving Africans’ health, especially after 1930. The obsession that white women had with African health is reminiscent of, what Maynard Swanson terms, the sanitation syndrome in South Africa where colonial authorities became uncomfortable and obsessed with African presence in urban spaces as these Africans were believed to be reservoirs of disease.18 Several other factors triggered white women’s interest in the health of Africans, over and above the belief in their mandate to ensure the welfare of Africans. The involvement of white women in African health and education can be appreciated in the context of the following remark by the chairperson of the FWISR on the perceived high incidence of disease among Africans: Surely self-interest, if no higher motive, should make us fight this “overwhelming incidence of disease!” How can we hope for ourselves and our children if our foodstuffs and clothes are handled by the diseased? Members of the Federation [FWISR] have frequently urged that native 17

See Glen Ncube, “The Making of Rural Healthcare in Colonial Zimbabwe”; G. Ncube, “‘The Problem of the Health of the Native’: Colonial Rule and the Rural African Healthcare Question in Zimbabwe, 1890s–1930,” South African Historical Journal 64, no. 4 (2012): 807–26. In these works, Ncube notes that the colonial state had little interest in the health of Africans before 1930, which explains its lack of commitment to the construction of rural hospitals, except for Ndanga and Belingwe hospitals in 1912, with the latter not lasting beyond 1914. It was only after 1930, he argues, that the state made a dramatic shift and took an unprecedented interest in African health. 18 Maynard W. Swanson, “The Sanitation Syndrome: Bubonic Plague and Urban Native Policy in the Cape Colony, 1900–1909,” Journal of African History 18, no. 3 (1977). For a discussion of the obsession of the colonial state and society with African hygiene in Southern Rhodesia, see Timothy Burke, Lifebuoy Men, Lux Women: Commodification, Consumption and Cleanliness in Modern Zimbabwe (London: Leicester UP, 1996).

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women employed in domestic service should be medically examined but we have been informed that this was almost impossible.19

Blanche Gordon, one of the founding members of the National Council of Women of Southern Rhodesia (NCWSR), made a similar remark in the 1950s, which betrayed the self-serving motive behind much of white women’s interest in the health of Africans: Perhaps, the most important field of work to Rhodesians today is that of the African life, health and education. The African people number roughly 30 to 1 compared with the European population. It will, therefore, be readily realised what an enormous influence African health has on European health and what a heavy drag their lack of education and mental development can have on the growth and progress of this country. Add to this the fact that their civilisation is entirely different from our own and by whatever standards you assess it, far behind our own.20

Thus, the “benevolence” shown by some white women to Africans was often rationally calculated, a cost-benefit analysis in which settler society saw that they had more to gain from a healthy African population than from one that was diseased. Indeed, especially in the pre-Federation period,21 correspondence on and discussions about the health of Africans are closely intertwined with mention of the health of the European family, which was a priority for the colony’s white population. Africans were seen as the source of diseases that could potentially be transmitted to the European family. A resolution made at the 1939 FWISR Annual Congress read, “the native being the reservoir of infections, tropical diseases, from which the European and his family are subject to invasion, this congress urges the vital importance of attacking these diseases without delay at their source.”22 In 1951, the NCWSR echoed similar sentiments: “It is from the urban natives that many of the Infectious Diseases are spreading to Europeans.”23 It is within this context that the NCWSR displayed grave

19

W. I. Notes, “Comment on Some Current and Important Subjects,” Vuka 1, no. 11 (June 1944): 65. 20 Blanche, “National Council of Women of Southern Rhodesia,” 72. 21 This refers to the period before the establishment of the Federation of Rhodesia and Nyasaland in 1953. 22 “Congress Agenda,” Home and Country 1, no. 4 (1939): 21. 23 NAZ, F242/400/4/1, National Council of Women of Southern Rhodesia Biennial Congress 1950, The Secretary of Health (R. M. Morris) to NCWSR, December 15, 1950.

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concern about the squalid conditions in which Africans were living in urban areas. The President of the organization, Mrs. O. Gumprich, wrote: Bilharzia is spreading alarmingly in the towns; the African can be seen polluting the rivers and the vacant stands and we still have the dreadful bucket system everywhere, even in the large towns where there is water sewage and we feel that is one of the first urgencies, that there should be enough latrines for natives employed in the towns. The National Building and Housing Boards are great offenders. The houses they put up for the boys near their work are just shanties; and the whole place is overcrowded and filthy and just a few bucket latrines for over a hundred boys or more.24

In light of the poor provision of sanitary facilities for Africans, in 1952 conference the NCWSR made resolutions on African health to be presented to the government.25 One of the resolutions urged “the government to bring in Legislation to make it compulsory for all employers to have sufficient sanitary arrangements for their natives outside the towns where there is no sewage.”26 Since the state seemed unable or unwilling to initiate a countrywide scheme of preventive measures, the NCWSR felt that control of the diseases believed to be endemic among Africans could be made possible by placing part of the burden on the shoulders of employers. In his response, the secretary of health described the resolution as laudable but also added that “adequate public health [however] cannot be enforced by mere resort to legal sanctions and prosecutions. It must come through education and persuasion of the public, leaving the legal proceedings to flagrant cases of non-compliance.”27 White women also drew attention to the potential impact that diseases could have on the African labor situation. At their 1950 Biennial Congress in Gweru, the NCWSR passed a resolution asking the government “to start without delay a Preventative Service for the Reserves,” adding that they “viewed with grave concern the rapid spread of diseases endemic amongst

24

NAZ, F242/400/4/1, The NCWSR National President (Mrs. O. Gumprich) to the Secretary of Health, January 29, 1951. 25 Other women’s organizations, such as the FWISR, also made resolutions at congresses and pressured the state to oversee the improvement of African housing in the urban areas. See The Rhodesia Herald, September 8, 1950. 26 NAZ, F242/400/4/1, The NCWSR National President (Mrs. O Gumprich) to the Hon. W. Fletcher, Ministry of Health, January 18, 1952. 27 NAZ F242/400/4/1, The Secretary for Health to the Resolutions of the NCWSR Congress of November 1951, Februrary 14, 1952.

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the Africans.”28 As a justification for their “grave concern,” the NCWRS made reference to the recommendations by one Mrs. Neville Rolfe, who had been mandated by the government to study the health of Africans in the reserves, farms and mines. In her report, she stressed the need for medical services without delay to tackle diseases “at their source.”29 “If you don’t,” she wrote, “I warn you that in fifteen years you will have no labour.”30 The NCWSR made reference to such reports in an attempt to convince the government to increase its involvement in matters relating to African health. It also believed that the poor health of Africans would only worsen the labor problem in the country. In its response, the government noted that it could not “afford a large scale prevention of disease.”31 This was not the first time that the NCWSR received a negative response on this subject. Earlier in 1951, Mrs. O. Gumprich had written to the secretary for health, expressing disappointment that the women’s resolutions on the improvement of African health that had been forwarded to the government “during the past fifteen years” had “met with so little success.”32 However, the lack of government intervention did not dampen the women’s interest in and pressure for the improvement of African health. Instead, women’s organizations, especially the conglomerated NCWSR, continued to be watchdogs of government policies on African health throughout the colonial period. Where the state seemed not to be taking sufficient action, the women were sometimes scathing in their criticism and where it was making a positive contribution, this was applauded. The following remark, made in 1944 by the FWISR Convenor for the Standing Committee on Public Health, reflects this watchdog role: Women’s Institutes are always keenly interested in matters of public health and the recent proposal for a native maternity hospital for Bulawayo financed jointly by government and the Municipality is one that we will

28

NAZ F242/400/4/1 The NCWSR, National President (Mrs. O. Gumprich) to the Secretary of Health, January 29, 1951. 29 Ibid. 30 Quoted in NAZ, F242/400/4/1, National Council of Women of Southern Rhodesia Biennial Congress, Gweru, September 1950; emphasis added. 31 NAZ F242/400/4/1, Mrs. O. Gumprich to Hon. W. Fletcher, Ministry of Health, January 18, 1952. 32 NAZ F 242/400/4/1, Mrs. O. Gumprich to the Secretary for Health, January 29, 1951.

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Women’s organizations were an important force in the social development of the colony and most were recognized as such by the state. On several occasions, state officials took time to respond to the organizations’ concerns, providing clarifications on the issues they raised. Where they could render assistance, this was given but where state response would require financial intervention, less expensive options were usually pursued. In 1950, for instance, responding to the NCWSR resolution urging the government to initiate without delay a preventive health service in the Reserves, the secretary for health, R. M. Morris, noted that such a service had already “started four years ago [1946] by the opening of a school for African Hygiene Demonstrators at Domboshava to work under the supervision of Health Inspectors and Government Medical Officers.”34 He also described other schemes that were already underway, adding that the government actually believed they should go beyond African Reserves as suggested in the resolution by NCWSR. It is possible that the Domboshava scheme was a consequence of mounting pressure on the government from various stakeholders, including women’s organizations such as the FWISR, which, in 1944, had passed a resolution on “the need for training African health advisors for the reserves.”35 The School of African Hygiene Demonstrators was opened in 1946. The health of African children in the schools also attracted the attention of women’s organizations. In 1951, the NCWSR began an investigation of African children’s nutritional standards in the schools. It wanted to provide a well-informed perspective on this subject as part of the oral evidence required by the Native Education Commission (Kerr Commission) of 1952. The NCWSR then wrote to the secretary of health in August, 1951, asking for the “existing figures on the malnutrition amongst African schoolchildren.”36 The NCWSR was “advocating a school feeding scheme for urban African children,” believing that “this information [was] necessary if [they were] to put a strong case before the 33

Convener for the Standing Committee for Public Health, “W.I. Notes: Many Interesting Subjects of National Interest,” VUKA, 1, no. 12 (August 1944): 69; emphasis added. 34 NAZ F 242/400/4/1, The Secretary of Health (R. M. Morris) to NCWSR, December 15, 1950. 35 Convener for the Standing Committee for Public Health, “W.I. Notes: Many Interesting Subjects of National Interest,” VUKA, no. 12 (August 1944): 69. 36 NAZ, F242/400/4/1, NCWSR to the Secretary for Health, August 6, 1951.

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African Education Commission”.37 The director of preventative services gave in to the pressure and provided a detailed nutritional survey for January 1950, covering schools in Highfield North and South. By and large, this survey established the need for nutritional intervention in African schools. The NCWSR, through its member associations, then began to assist with nutrition in African schools. A summary written around 1953 by the Union of Jewish Women (UJW) indicates that this association had, under the auspices of the NCWSR, been involved in activities intended to improve the health of African schoolchildren. Part of the summary read: “A soup kitchen was opened in the Native Location in Bulawayo for undernourished African school children and provided about 150 hot meals a day.”38 This service by the UJW typified “the activities of every branch of the Union of the Jewish Women in every town throughout Rhodesia.”39 The NCWSR also advocated the introduction of a compulsory medical scheme for Africans which was to be graded by income. The scheme was rationalized, at least in part, on the grounds that the African would be “made to realise he is paying for his health service and thus doing something to help himself and his fellow men.”40 The eventual introduction of medical schemes for Africans had its origins in such resolutions. As already indicated, the interest of white women in African health bordered on self-interest and was informed by the racial ideology of the time. On the farms, many white farmers’ wives were also involved in providing health services to Africans, as seen in the case of Margaret (Peggy) Bashford. Born in 1910 in Salisbury, Margaret was trained as a nurse but after marrying Pat Bashford (who became a farmer) in 1940, she left her profession and “embarked on her career as a farmer’s wife.”41 In 1954 they bought a farm in Karoi, where her training as a nurse became invaluable. The biographic note on Margaret reads: She ran a highly successful clinic on the farm and treated all manner of conditions. Snake bites were common—as were burns, malaria and bilharzia. She was an enthusiastic supporter of the Freedom from Hunger

37

NAZ, F242/400/4/1, NCWSR Standing Committee for African Affairs to the Mr. D. M. Blair, September 12, 1951. 38 Dora Lazarus, “Union of Jewish Women,” in Women in Central Africa, ed. O. Gumprich and E. Yates, 103. 39 Ibid. 40 NAZ F 242/400/4/1, M. L. William (Convenor of Public Health) NCWSR (n.d.). 41 Biographical note on Pat and Margaret (Peggy) Bashford (n.d.). C/O Irene Staunton. It is not clear exactly who wrote the biography.

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Margaret’s involvement with the health of Africans on the farms was not peculiar to her; a number of other white women on the farms engaged in similar activities. To a certain extent, the introduction of African clinics and farm schools constituted a “moral economy”43 on the farms, where some members of the settler society made some contributions toward the advancement and general welfare of Africans in order to negotiate the retention of African labor. It also kept in check diseases that had a potential to spread to the white communities in the area. Perhaps, the greatest vehicle that served to extend hygiene and health education to Africans was the home craft movement with emphasis on homemaking skills for African women.44 As early as 1938, the FWISR, through its mouthpiece magazine Home and Country, was already encouraging white women to be part of the Wayfarer movement, a precursor to the homecraft clubs that emerged beginning in the early l950s. The following passage from an appeal for the increased participation of white women in Wayfarer societies reflects on the obsession with disseminating Western practices and knowledge regarding health and hygiene: As regards home-making, the mass of native women who, unlike the native men, have not the advantage of close contact with Europeans, are ignorant: 42

Ibid. The term has assumed various meanings over the years and was first popularized by E. P. Thompson, “The Moral Economy of the English Crowd in the 18th Century,” Past and Present 50, no. 1 (1971). It received wide usage among anthropologists engaged in the study of peasant societies. In this case, I use the term to denote a just economy based on fairness and goodness. Also see James Scott, The Moral Economy of the Peasant: Rebellion and Subsistence in Southeast Asia (Princeton: Princeton UP, 1976). 44 For a detailed discussion of the homecraft movement, see U. Kufakurinani, “White Women and Domesticity in Colonial Zimbabwe, 1890 to 1980” (DPhil thesis, University of Zimbabwe, 2015); Kate Law ‘“Even a Labourer Is Worthy of His Hire: How Much More a Wife?’ Gender and the Contested Nature of Domesticity in Colonial Zimbabwe, c. 1945–1978,” South African Historical Journal 63, no. 3 (2011); Martin Shaw, “Sticks and Scones: Black and White Women in the Homecraft Movement in Colonial Zimbabwe,” Race/Ethnicity: Multidisciplinary Global Contexts 1, no. 2 (2008): 256–57; Sita Ranchod-Nilsson, “ ‘Educating Eve’: The Women’s Club Movement and Political Consciousness among Rural African Women in Southern Rhodesia, 1950–1980,” in African Encounters with Domesticity, ed. Hansen (New Jersey: Rutgers UP, 1992). 43

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they are unable to use their meagre material resources to the best advantage and are living and bringing up their children in appalling unhygienic conditions. Who has not felt sorry for the little piccanins with eyes encrusted by disease? Wayfaring is teaching African girls to avoid disease through greater cleanliness.45

The racial tone and stereotyping is overt, placing white women in the position of omniscient beings waiting to pass their knowledge of health and hygiene to Africans. The same appeal also clearly indicated that the white women were to assume leadership roles in their interactions with African women. It sought to persuade “the women citizens of Rhodesia” to provide “greater help towards Wayfaring, either by undertaking the leadership of Wayfaring detachments, or by serving on organising committees.”46 One of the pioneering homecraft undertakings in Rhodesia was initiated in 1942 by Catherine Langham and Freda Tully,47 a decade before the post-war Homecraft movement of the Federation of African Women’s Clubs (FAWC), which operated under the auspices of the FWISR.48 This early effort culminated in the Hasfa Homecraft Village, M’soneddi, which was run on a private basis from January 1943. Langham became the principal of this avowedly domestically oriented institution. Teaching was focused on four “aspects,” as indicated in a review on the village’s activities and curriculum, written in the 1950s. One of these aspects was “The Life of the Body:” Around this is grouped teaching hygiene, sanitation, sick nursing, simple first aid, care of pregnant women, child welfare etc....The women and girls take turns to work as orderlies in the little dispensary, cook for and look after all in-patients and maternity cases.49

45

Standing, “Wayfaring: An Explanation and an Appeal,” Home and Country 1, no. 3 (September 1938): 51–53. “Piccanins” is a derogatory word that was used to refer to African children. 46 Ibid. 47 Tully was responsible for investing capital in the project. 48 These two women’s organisations were different in that the FAWC derived its membership from African women and its top leadership from white women and the FWISR was entirely white in its membership. The former operated under the aegis of the latter. 49 “Hasfa Homecraft Village, M’soneddi: Southern Rhodesia,” in Women in Central Africa, ed. O. Gumprich and E. Yates, 106.

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The objective of the institution was that “the [African] women and girls may be able to build up happy and healthy homes and take their share in raising the general tone of the Reserve life.”50 The mandate and operations of the village school were thus clearly marked out for, among other things, the extension of Western perceptions and practices of health and hygiene to Africans. It would probably be inaccurate to assume that there were no white women with genuine concerns for African health and that their focus was always the safety of their own kith and kin. For example, their involvement in improving African women’s maternity care was surely driven not so much by a fear of disease contamination as by an interest in other health and hygiene issues raised by white women. The Gweru branch of the NCWSR, for example, ran a clinic for African mothers in the 1950s.51

White Women and Non-Communicable Health Conditions White women’s organizations also took special interest in the welfare of those who were vulnerable and/or disadvantaged in white society. These included those impaired either physically or mentally, children in general and the aged, as well as women themselves. Women’s organizations drew up resolutions aimed at the improvement of the welfare of these classes of people as well as their protection. The nature of the material evidence sometimes makes it difficult to trace the outcomes of resolutions on these subjects but the mere voicing of concern over these issues helps illustrate the wide range of interests that women’s organizations had and, to a certain extent, demonstrates the working of the domestic ideology. Documents from different women’s organizations show the concern of white women with regard to the welfare of the impaired/challenged (physically or mentally) within settler society. Depending on the nature of the impairment, organizations made references to those they termed “ineducable,” “mentally retarded,” and “physically handicapped,” among others. The major concerns of these organizations revolved around the provision of suitable accommodation and facilities and general welfare. For example, in 1954, the Women’s Voluntary Service helped establish the St. Francis Home for Ineducable Mentally Deficient Children and also

50

“Women’s Institutes Notes: Summary of year’s work by officers and conveners,” Vuka, 1, no. 2 (1943): 43; emphasis added. 51 Blanche, “National Council of Women of Southern Rhodesia,” 72.

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helped raise £1,300 from the public toward its construction.52 In the same year, the FWISR drew up a resolution to impress upon the Federal government “the urgent necessity for [it] to be responsible for the further finance required for the immediate establishment for the severely retarded child who is deemed ineducable.”53 In 1956, the NCWSR assisted in investigating the provision of facilities for the physically handicapped.54 The establishment of homes such as Hopelands (in 1959) for the mentally challenged owed much to pressure from different women’s organizations. In 1976, RAUW passed a resolution asking that “the Ministry of Local Government and Housing be requested to investigate architectural barriers to the handicapped in Municipal and public buildings.”55 A number of concessions were made, such as the establishment of disability centers for specific needs, as a result of the concerted efforts from women’s organizations and other pressure groups. As in the case of other matters in which women’s organizations expressed an interest, their involvement in promoting the welfare of the handicapped was driven in part by their conviction in their roles as mothers of the colony. White women’s organizations were also instrumental in improving the welfare of the aged, or at least presenting the case for improvement in the welfare of the elderly in society. Women’s organizations helped establish old people’s homes in the colony. The LWGC, for example, was responsible for the establishment of the Aged Women’s Home (Queen Mary House), started in Bulawayo in 1922 and rebuilt in 1928 on land provided by the Bulawayo Municipality and with the help of a grant from the government.56 In 1954, the FWISR passed a resolution that “the government be approached to provide accommodation for the aged requiring nursing and medical care.”57 Apparently, nothing positive came out of the 1954 resolution and in 1959, FWISR again pressed the government to look into the provision of a section within the hospital that 52

NAZ, F119/D52, From the National President, Central African Women’s Voluntary Services, Mrs. H. Shearer, to the Secretary to the Prime Minister, Federation of Central Africa, Salisbury, September 22, 1954. 53 NAZ, 3287/69/23, Federation of Women’s Institute of Southern Rhodesia: Resolutions passed by the 27 Annual Congress – Umtali, September 21–22, 1954. 54 NAZ, F122/400/30/2, National Council of Women of Southern Rhodesia, August 1955, Report on the Resolution Concerning Sheltered Employment and Rehabilitation adopted at Conference, September 1956. 55 RAUW Newsletter, no. 18 (July 1976): 10. 56 Mrs. Wilkins (Hon. Secretary), “Loyal Women’s Guild Council: Southern Rhodesia,” 75. 57 NAZ, 3287/69/23, Federation of Women’s Institute of Southern Rhodesia: Resolutions passed by the 27 Annual Congress – Umtali, September 21–22, 1954.

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would be reserved for nursing of the aged, chronically ill and bedridden.58 The rationale for this proposal was based on the grounds that home nursing entailed “extremely heavy expenditure” and also that some of the old did not have children or family to look after them.59 If, as in the case above, the government did not give a satisfactory response, the matter would be brought to their attention repeatedly. Women’s organizations were also instrumental in the establishment and improvement of the various pension systems. The FWISR, in particular, was vocal on this subject. At its 1954 annual congress it resolved that “representation be made to government on the extreme desirability of inaugurating a contributory Old-Age pension scheme.”60 The government stated that it was “investigating whether any scheme for contributory pensions [was] practicable and in this connection the resolution of the Federation [had] been noted.”61 The state might have been contemplating introduction of the scheme in any case but the contribution of women’s organizations was to demonstrate the urgency of the matter and give it more weight in attracting the attention of the government.62

White Women, Maternity, Reproductive and Children’s Health in the Colony As a result of poor access to advanced health facilities (and other basic necessities), either because these were not yet available in the country or simply because of the remoteness of the settlements, childbearing and rearing was, for instance, a different experience for the post-Second World War housewife in the town than for the housewife of early colonial days or for one who was remotely located. Indeed, in the early colonial period, the death of family members was common as a result, in part, of poor access to medicine. The stories of pioneering families are filled with saddening losses of infants and young children. A man named Walter Krienke 58

NAZ, 3287/69/23, The FWISR to the Minister of Health, October 30, 1959. Ibid. 60 NAZ, 3287/69/23, Federation of Women’s Institute of Southern Rhodesia: Resolutions passed by the 27 Annual Congress – Umtali, September 21–22, 1954. 61 NAZ, 3287/69/23, The Federal Treasury to the Department of the Prime Minister and cabinet, October 30, 1954. 62 For a discussion of the evolution of pension systems in colonial Zimbabwe, see Ben-Junior Chibhamu, “A History of Federal Public Service Pensions, C.1953 to 1964”MA Dissertation, Economic History Department, University of Zimbabwe, 2018. 59

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reflected on some of the experiences of his pioneering grandparents during the first decade of colonization: Whilst opening up this property [the Stoneridge farm] we all suffered many hardships and there was much sickness in the family. This period of sickness will serve general illustration of the wonderful pluck, bravery and stout heartedness, of the womenfolk. With the sole exception of my mother, every member of our family went down with fever at the same time. Day and night she toiled, nursing and tending eleven sick persons. Three were critically illand one, Othilia, died on the 11th February, 1892.63

Making reference to one Mrs. Clara Jane Tapsell, who came to Rhodesia with her husband in 1893, Folkertsen wrote, “Food was scarce and fruit and vegetables were not to be had. She (Mrs. Tapsell) lost three children in infancy through lack of medicine and malnutrition.”64 In the face of high death rates, Rhodesian families in the early periods tended to be relatively large.65 Mrs. Fox made reference to her grandmother, Noll Farmer, who had five daughters; the eldest, according to Mrs. Fox, “was the first person to die of cerebral malaria in Rhodesia.... Even the youngest daughter of my grandmother had four children and our mother had four children.”66 Having large families further complicated the life of a housewife. These complicated experiences affected housewives in a manner different from that of the later period, when medication, family planning methods and technology became relatively advanced and also available. In mentioning the challenges faced by white women, it is not suggested that these experiences were peculiar to these women in the country. In fact, African women experienced these difficulties and more, especially under colonial rule. Challenging the emphasis that scholars have placed on white women’s hardships as pioneers in South Africa, Dampier posits that “Black women on the frontier endured all these conditions at the same time, hence there are not hardships that can be used to single out white women settlers as special.”67 In the earlier period of colonization and even in later periods in the case of remote communities, housewives had poor access to basic 63 Walter Krienke, “Northwards to Mashonaland in 1891,” in Experiences of Rhodesia’s Pioneer Women by Jeannie M. Boggie (Bulawayo: Philpott and Collins, 1950), 51. 64 Beb Folkertsen, “Gwelo Central Group,” NHR Newsletter, December 1977. 65 Personal interview with Mr. and Mrs. Fox, Harare, March 30, 2012. 66 Ibid. 67 Dampier, “Settler Women’s Experiences of Fear,” 11.

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amenities and health-care facilities. As a result, housewifery became a complex undertaking, especially where issues like childbirth, bringing up children and even carrying out everyday household activities were concerned. In an archived interview, one Southern Rhodesian woman, Gertrude Mary Coghlan-Chennells, discussed her mother’s experience during the birth of one of her children, which indicates the difficult circumstances under which pioneer women had to give birth: My mother told me…that some man turned up at the wagon while she was in pain and in labour and she wished he would go away but hung on and he didn’t go away until after everything was over. When he heard the baby cry he jumped up and said, “What on earth is that?” And my father said, “I don’t know but I think my wife has got an infant.68

Without medical expertise or facilities to rely on, the woman gave birth in a situation where clearly no one had any idea of what was happening or what had to be done. This, of course, increased the health risks for both the baby and its mother. Maternity care remained a challenge in the colony. A contributor at the FWISR 1938 Congress pointed out that there was “yet a big part of the problem of rural maternity still untouched.”69 At this congress various suggestions were thrown out for discussion, including the establishment of a comprehensive maternity scheme, direct involvement of the government in providing the service and the conversion of sections of hospitals in outlying areas into maternity homes.70 Some of the suggestions, notably the first mentioned here, had already begun to be implemented with the assistance of private capital, particularly from the Beit Trust.71 But in the 1950s, the problem of maternity accommodation remained unsolved. “Expectant” wrote to the Rhodesia Herald in 1950, decrying the crisis of maternity accommodation in Salisbury, “I am Rhodesian by birth and in all my life I can only remember there being two government maternity homes, in Salisbury and Bulawayo. They are both upwards of 30 years old

68

Oral/CH 1- Gertrude Mary (“Petal”) Coghlan-Chennells (born 1902), Interviewer: D. Hartridge, Matopos, November 4, 1970. 69 NAZ, S824/198/1, Minutes of twelfth annual congress of the Federation of Women’s Institutes of Southern Rhodesia Held at Gwelo, July 5–6, 1938. 70 Ibid. 71 For further details on the activities of the Beit Trust see Jasmine Magunde, see “A History of the Beit Trust: 1906–1964,” (BA hons. diss., University of Zimbabwe, 2013).

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and crowded out all the year round; there is no accommodation at all for expectant and waiting mothers from farm and country.”72 In light of these challenges for expectant mothers, women’s organizations made significant contributions beyond just lobbying the government; they established their own maternity homes. Reporting on the activities of the LWGC, Mrs. Wilkins noted that its branches had “been instrumental in establishing or taking over maternity nursing homes, either in conjunction with other societies or operating on their own.”73 In 1950, for example, the FWISR and the LWGC organized a public meeting to discuss the project of having a maternity home in Bulawayo.74 Also, Mrs. L. M. Simmons, the chairperson of the Salisbury Women’s Institute, responded to “Expectant,” informing her that “a very comfortable double room” was available at the Women’s Institute branch but added that the facility was in frequent demand and “therefore bookings must be made well in advance.”75 The fact that bookings had to be made well in advance indicates that the problem of maternity accommodation had not really been solved by the existence of this facility. The new trend of family planning discourse that had begun in the nineteenth-century industrialized world came to Southern Rhodesia in the twentieth century. Family planning helped women gain control over their reproductive capacity and enabled them to channel more of their energy to activities outside the home, especially if they used such planning to have smaller families. Thus, in a way, the contraceptive pill had a potentially liberating effect on women. Most women’s organizations became involved in discussions on family planning, inviting international speakers and disseminating information to fellow white women. For example, the Salisbury branch of the NCWSR, at one of their meetings in 1955, invited one Miss Gates from New York, a representative of the International Family Planning Committee who was on a world tour. In the discussion, fears of family planning facilities being misused by African girls were voiced, even though the same concern was not raised with regard to white girls. Women’s organizations also submitted their ideas regarding the different but related matter of pregnancy termination to the 1976 Commission of Inquiry into the termination of pregnancy.76 Though the report of this commission of inquiry does not overtly indicate the nature of 72

The Rhodesia Herald, April 25, 1950. Mrs. Wilkins, “Loyal Women’s Guild Council: Southern Rhodesia,” 75. 74 The Rhodesia Herald, June 21, 1950. 75 The Rhodesia Herald, April 28, 1950. 76 Commission of Inquiry into the termination of pregnancy, 1976, [W. A. Pittman] (CMD R.R. 2 – 1976). 73

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the contributions by women’s organizations, there is evidence that white women would have liked to see the enactment of a more liberal law on abortion. The existing laws of Rhodesia criminalized abortion; the Termination of Pregnancy Act that became law on January 1, 1978, was viewed as more conservative than previous legislation.77 In a letter to the Rhodesia Herald, Jacquie Stafford, the president of the National Organization for Women, opined that the proposals made by the Commission “show nothing but contempt for the women of this country and make me wonder at the sanity of our parliamentary representatives. The recommendations of the Commission…were quite conservative…not going as far as many women would have liked.”78 Stafford argued that making abortion illegal, as recommended by the Commission, would eventually prevent it from being practiced.

Conclusion The chapter has discussed the health experiences of white women in colonial Zimbabwe as agents of health transformation as well as victims of health threats. It has demonstrated the interplay of race, gender and health in colonial Zimbabwe, arguing that white women’s participation in this arena was informed by the domestic ideology. As mothers of empire, white women were expected to oversee the health of the empire. White women’s transactions with Africans regarding health and hygiene were influenced, in part, by the dominant racial prejudices of the time and were primarily aimed at safeguarding the health of Europeans. This argument, however, must not be overstretched, as there is evidence of what may be perceived as genuine efforts by white women to assist in promoting African health, especially with regard to non-communicable health conditions and other threats to health faced by Africans. The chapter has also shown the complex nature of white women’s involvement with the health of both Africans and the white community; it has revealed the tensions that arose from their involvement, thereby supporting Fredrick Cooper and Anne Stoler’s thesis on the “tensions of empire.”79 Clearly, the colonizer was not monolithic and white women’s colonial encounters went beyond the binaries of complicity and resistance, victim and oppressor. In

77 For a brief discussion on the abortion laws and responses of the white community see Law, “Writing White Women,” 193–94. 78 Quoted in Law, “Writing White Women,” 194. 79 Fredrick Cooper and Ann Laura Stoler, eds., Tensions of Empire and Colonial Cultures in Bourgeois World (Berkeley: Univ. of California Press, 1997).

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the final analysis, I have also shown how white women navigated their own health experiences in relation to reproductive health.

CHAPTER TEN MEDICAL PHILANTHROPY: MISSIONARIES IN COLONIAL SOUTH INDIA SAM NESAMONY

Hospitals and primary medical education were the key tools with which missionaries sought to further their goals of healing both the soul and the body during the colonial era in India. Medical missions with the dual objectives of evangelism and humanitarianism were envisioned, deliberated on and even regarded as one of the missionary endeavors entailing the most indefatigable and zealous efforts. This chapter focuses on colonial south India and argues that in trying to address the urgent medical needs of the impoverished classes, medical missionaries ensured that they were the “valuable” and “beneficent” allies of the colonial state rather than “contested,” “alien” and “powerful rivals”; a situation that also ensured unconstrained partnership with the Raj and native rulers with regard to medical education and healthcare. In exploring this topic, the chapter focuses on how the “touring clinics” and itinerant medical practices of the missionaries, set up in rural and urban areas using bandis (bullock carts with a hanging lantern), formed an intrinsic part of the medical modernity of the missions. Describing the historic role played by missionaries in building up an efficient public health-care system in South India, it suggests that the missionary charity and philanthropy not only helped emancipate the underprivileged masses but left behind an ineffaceable imprint in the history of India’s health care at large. Western health-care practices gained much attention among the public across different faiths during the colonial period. This chapter discusses the role of Western missionaries, in general and medical missionaries, in particular; both played a crucial and historic role in disseminating the awareness and use of modern medicine to help save millions from disadvantaged classes as well as upper classes from recurring epidemics. Initially, the British rulers as well as medical missionaries identified “unfavorable environments” and “poor sanitary conditions” as plausible

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reasons for the high prevalence and epidemics of various diseases, including plague, in this “land of death,” which left most of the local “heathens” “unhealthy,” “sick,” and, thus, in “urgent need of improvement.”1 For instance, Buchanan, in his travelogue, A Journey from Madras through the Countries of Mysore, Canara and Malabar, notes that the sudden spread of epidemics like the plague and other communicable diseases in some places in the South, horrified the people at large.2 The London Missionary Society (hereafter, LMS) missionary, Samuel Mateer, who was an eyewitness to events during the worst famine and the resultant cholera in South Travancore in the 1870s, laments the cruel tragedy and the merciless visitation of death upon the masses.3 The close association between religion and medicine, and the fact that the process of evangelization was not especially successful, forced the missionaries to divert their attention toward health care and form medical missions, which offered a “divine method” of healing, as another way to forward their goal of evangelization.4 Accordingly, medical dispensaries, missionary movements against the four “demons” of dirt, disease, debt and drink, and charismatic campaigns against crime, mobilized a powerfully challenging social order that was clearly perceived by the disadvantaged masses as a response to their genuine needs, including those for the health of the body and the enlightenment of the mind.5 Deprecating the prevailing traditional healing practices of Ayurveda, Siddha, and Unani, Fitzgerald points out that people suffered under a 1 Mark Harrison, Climates and Constitutions: Health, Race, Environment and British Imperialism in India, 1600–1850 (New Delhi: Oxford UP, 1999), 153–203. Kristine Swenson, Medical Women and Victorian Fiction, (Columbia: Univ. of Missouri Press, 2005), 163. Also see, David Arnold, “Deathscapes: India in an Age of Romanticism and Empire, 1800-1856,” Nineteenth-Century Contexts 26, no. 4 (2004): 351. 2 Francis Buchanan, A Journey from Madras through the Countries of Mysore, Kanara and Malabar, I (London: T. Cadell and W. Davies, 1807), 336. 3 Samuel Mateer, The Land of Charity: Travancore and its People with Reference to Missionary Labour (London: John Snow and Company Ltd., 1870), 307–8. 4 Lyle L. Vander Werff, Christian Missions to Muslims: The Record: The Anglican and Reformed Approaches (California: William Carey Library, 1977/2000), 75. 5 Deepak Kumar, “Medical Encounters in British India, 1820–1920,” Economic and Political Weekly 32, no. 4 (1997): 166–70. See also Biswamoy Pati and Mark Harrison, eds., Health, Medicine and Empire: Perspectives on Colonial India (New Delhi: Orient Longman, 2001). Also see Susan Billington Harper, “The Dornakal Church on the Cultural Frontier,” in Christians, Cultural Interactions, and India’s Religious Traditions, ed. Judith M. Brown and Robert Eric Frykenberg (Cambridge: William B. Eerdmans, 2002), 187.

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“terrible burden of sickness” that could never be remedied by these archaic methods of indigenous healing.6 Even though there were many situations where Western medicine rivaled indigenous medicine, practiced by native doctors known as “vaidyars” through their “vaidyasalai” (medical clinics), the spread and popularity of these indigenous systems of medicines never ceased, as they were deeply embedded in the social and cultural fabric of India. Poonam Bala argues that modern medicine became indispensable at the cost of the indigenous medical practices after being assaulted by the State during the early days of independent India.7 Dhruv Raina, on the other hand, notes examples of the occasions when Indian science was deprecated by the Western voyagers, colonialists, and missionaries, while Sunita Nair explores the processes through which Western medicine gained hegemony over indigenous medical practices.8 These works shed light on the social and racial conflicts and colonial anxieties that resulted from colonial policies in addressing diseases of major concern. During the second half of the nineteenth century, the notion of Christ as the “great physician” became increasingly prominent in missionary discourse, along with Western medicine as its iconic representation; for this reason, the missionaries saw themselves as “healers of bodies” as well as “savers of souls,”9 moving into colonial quarters with the motto to “heal the sick”10; this process resulted in, what David Hardiman, calls a quintessentially “Christian Modernity.”11 Raj Sekhar Basu argues that it 6

Rosemary Fitzgerald, “‘Clinical Christianity’: The Emergence of Medical Work as a Missionary Strategy in Colonial India, 1800–1914,” in Health, Medicine and Empire: Perspectives on Colonial India, ed. Biswamoy Pati and Mark Harrison (New Delhi: Orient Longman, 2001), 89. 7 Poonam Bala, Medicine and Medical Policies in India: Social and Historical Perspectives (Lanham: Lexington Books, 2007). 8 Dhruv Raina, “French Jesuit Scientists in India: Historical Astronomy in the Discourse on India, 1660–1770,” Economic and Political Weekly 34, no. 5 (January 30–February 5, 1999): PE30–PE38. See also Sunitha B. Nair, “Social History of Western Medical Practice in Travancore: An Inquiry into the Administrative Process,” in Disease and Medicine in India: A Historical Overview, ed. Deepak Kumar (New Delhi: Indian History Congress and Tulika Books, 2001), 215–32. 9 John M. MacKenzie, introduction to Missionaries and their Medicine: A Christian Modernity for Tribal India by David Hardiman (Manchester: Manchester UP, 2008), xi. 10 G.H. Chao, “Heal the Sick” Was Their Motto: The Protestant Missionaries in China (Hong Kong: Chinese Univ. of Hong Kong, 1990). 11 David Hardiman, Missionaries and Their Medicine: A Christian Modernity for Tribal India (Manchester: Manchester UP, 2008).

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became imperative for the missionaries to adopt medical work as an essential “tool,” in order to emulate Christ.12 Similarly, Brian Stanley points out that from the very beginning, the physicians at mission stations had to “double up” to safeguard the health of the members of the mission as well as to employ the provision of medical care as an approach that would be successful in gaining the support of the local populace.13 Henry Scudder, a prominent missionary doctor who worked at Vellore, described a mission hospital as “a palace of pain,” and the most important facility for patients, particularly women and children.14 A typical medical mission in India, and also in other colonies, had a medical missionary, a central dispensary and a hospital, a medical school or class and a fund.15 Despite the severe criticisms leveled at the mission hospitals, their trained and semi-trained doctors, nurses, and dhais were caregivers who gave much hope to the public. In other regions under the colonial rule, as in Uganda, Nakanyike Musisi and Seggane Musisi highlight in their discussion (Chapter Eight in this volume) various concerns of the colonial establishment for the physical and spiritual well-being as well as maintenance of the numerical strength of the Buganda population.

Mission Hospitals in South India Though the colonial British brought some of the most important medical concepts and practices from the West to India, they were limited in their ability to offer immediate relief as indigenous medical practices continued to thrive and had large popular appeal.16 Colonial officials made a series of attempts to introduce Western medicines in their colonies, 12

Raj Sekhar Basu, “Healing the Sick and the Destitute: Protestant Missionaries and Medical Missions in 19 and 20 Century Travancore,” in Medical Encounters in British India ed. Deepak Kumar and Raj Sekhar Basu (New Delhi: Oxford UP: 2013), 187–207. 13 Brian Stanley, “Christian Missions, Antislavery and the Claims of Humanity c. 1813–1873,” in The Cambridge History of Christianity, vol. 8, ed. Sheridan Gilley and Brian Stanley (Cambridge: Cambridge UP, 2006), 468. 14 Henry M. Scudder, Second Annual Report of the Dispensary Connected with the American Mission, Dt. December 31, 1853, 4. Bangalore: UTC Archives. 15 Joyce Reason, Heights After Everest: Howard Somervell of India (London: Edinburgh House Press, 1954), 7. 16 Niels Brimnes, “The Sympathising Heart and the Healing Hand: Smallpox Prevention and Medical Benevolence in Early Colonial South India” in Colonialism as Civilizing Mission: Cultural Ideology in British India, ed. Herald Fisher-Tine and Michael Mann (London: Wimbledon Publishing Company, 2004), 191.

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where death due to the diseases encountered there was found to be “swift.”17 While the colonial masters failed to satisfactorily comfort the sick, the missionaries, with their hospitals and various medical missions, began to gain greater support from the public in general, and more so in the South for their noticeable presence and services to the dying. Western medicine was first introduced in India by the Portuguese governor Albuquerque, who in 1510 established the Royal Hospital for colonial officials in Goa.18 Fabrizio Speziale argues that the history of medicine dates back to the post medieval Muslim world, which he terms the “Avicennian period,” wherein there were hospitals in India, Iran, and some other countries of the East, while the first military and civil hospital of British India was established only in 1679 in Madras.19 C. D. MacLeon points out that the hospital, established together with the Madras Medical School by the government of Madras in early 1835, catered only to colonial employees and their immediate families;20 the Madras government also opened some dispensaries at Chittoor, Arcot, and Vellore in the early 1850s.21 The medical history of South India displays a continuous association with many missionary families but the most remarkable and memorable was that of an American trio, the three Scudder brothers – Henry, William, and Joseph. As representatives of the 17

David Arnold, “Deathscapes: India in an Age of Romanticism and Empire, 1800–1856,” Nineteenth Century Contexts 26, no. 4 (2004): 339–40. 18 Radha Gayathri, Female Medical Education in Colonial India (New Delhi: Ajanta Press, 2008), 47. 19 Fabrizio Speziale, ed., Hospitals in Iran and India, 1500–1950s (Leiden: Brill, 2012), 1–16. 20 C. D. MacLean wrote in 1885 that the Madras Medical College, established during the governorship of Sir Frederick Adam in 1835, was originally a school of medicine in which medical subordinates were trained, but it also educated students for medical degrees of Madras University as soon as the latter was established in 1857. The college consisted of two departments: Senior and Military Training. In the Senior or University department, students qualified for the technical M. B. (Bachelor of Medicine) and C. M. (Master in Surgery) degrees of Madras University by five years’ study. The qualification for entry to this department was that candidate for the former degree must have passed the First in Arts (F.A.) examination and those for the latter degree, the matriculation examination of Madras University. The Military department was to prepare military hospital apprentices to qualify for employ as military apothecaries. See for details C. D. MacLean, Manual of the Administration of the Madras Presidency: In Illustration of the Government, Government of Madras, vol. 3 (Madras: Government Press, 1885), 553. 21 The Annual Report (first) of the American Madura Mission [hereafter AMM], 1855 (Bangalore: United Theological College [hereafter UTC] Archives, 1855), 9.

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American Board Commission on Foreign Missions (hereafter, ABCFM), they belonged to the Presbyterian Church; they started their medical work in Arcot in the early 1850s. The Scudders had in fact originally begun their work in Sri Lanka but shifted their base to Arcot and finally settled down in Vellore near Madras, where Dr. Ida Scudder opened a hospital.22 The Scudders obtained medicines from Dr. John Coldstream and John MacKay of Edinburgh, who were supplying drugs at a discount for philanthropic purposes. Later, the Edinburgh Medical Missionary Society (EMMS) began to supply ample quantities of drugs and medical equipment at low cost.23 In Madras, Dr. Alexandrina Matilda MacPhail, representing the United Free Church of Scotland, set up a clinic, later known as the Rainy Hospital, in her own bungalow in 1890. The Madurai region soon gained the attention of the American medical missionaries. The pioneer was again one of the Scudders, John, who set up a dispensary in 1847. Dr. Charles Sheldon followed him, opening his first hospital in 1851 in a three-room building. In 1872, Dr. William Palmer built a hospital, which was later converted into a mortuary. Some years later, the medical missionary F. Van Allen built the Albert Victor Hospital in 1897 with money raised from the locals.24 This was done using pamphlets with quotes concerning health and the population of Madurai, and a request for one rupee from each citizen; the campaign succeeded in appealing to the upper castes as well as the general populace. During the early part of the twentieth century, American missionaries, most notably the Scudders, opened Willis F. Piece Memorial Hospital, a 100-bed facility especially for tuberculosis-afflicted patients, at Gudiyattam in the Tamil region and appointed a well-trained doctor, E. W. Wilder, as the medical officer. At this hospital, even Ida Scudder personally performed some rare operations and treated individuals with disorders including leprosy, asthma, scabies, epithalamia, ulcers, malaria, velar disorders, and heart disease. As per the hospital register, 90 percent of the patients were Hindus. A missionary committee granted Dr. Scudder an annual grant of rupees 450 toward her work at the Gudiyattam hospital.25 The presence of an army regiment with 1,000 native soldiers brought the American missionary, John Lawrence, to Dindigal. Known as 22 David Shavit, The United States in Asia: A Historical Dictionary (New York: Greenwood Publishing, 1990), 441. 23 Henry M. Scudder, Second Annual Report of the Dispensary connected with the American Mission, Dt. 31 December 1853, (Bangalore: UTC Archives, 1853), 5, 6. 24 F. Van Allen, Notes and Sketches in a Mission Hospital, Madurai, India (New York: Trow Press, 1916), 3. 25 AAM Reports, 1911, 1917

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the “apostle of Dindigal,” he set up a hospital and many other institutions in the area. During the 1860s, Dr. Edward Chester started an additional hospital in Dindigal. Due to his immense popularity, he was selected as the municipal chairman, which only helped him improve conditions in the town.26 Medical facilities in the western parts of the Tamil region were poor until the LMS missionaries opened a hospital in Erode in the early twentieth century. Though women and children were their initial targets, the missionaries also opened their doors to men and later carried out extensive medical work.27 The LMS missionaries also helped Amy Carmichael, a Church of England Zenana Missionary Society (hereafter, CEZMS) missionary to open a dispensary at Dohnavur in Tinnevelly (Tirunelveli) District in 1905.28 Established by her in 1929, Parama Suga Salai [Eternal Healing Center], served the economically less well-off segments of society; it is a colonial legacy that is still cherished for its provision of inclusive, egalitarian, and cost-free medical treatment. In Travancore, particularly in Neyyoor (a small town, now part of Kanyakumari District in Tamil Nadu), LMS missionaries contributed to the medical infrastructure by opening the South Travancore Medical Mission (hereafter, STMM) Hospital. The LMS sent its first medical missionary, Dr. Archibald Ramsay, a trained physician, to Neyyoor in 1838 followed by the establishment of the first LMS Hospital.29 In 1852, 26

A. Savarimuthu, A Short History of the Mission Work in Dindigal Station, unpublished twenty two-page handwritten copy (Bangalore: UTC Archives, dt. November 11, 1903), 2–3, 15, 17–18. 27 Minutes of the Madras Sub-committee of the South India Central Committee, 1923–45, handwritten and printed sources, file 44 (Bangalore: UTC Archives, 1945), 46. 28 Louis Hoadley Dick, Amy Carmichael: Let the Children Come (Chicago: Moody Publishers, 1984), 103. 29 As early as 1804, a medical missionary was appointed by the LMS to Surat, but for some reason he never entered upon his work. Ramsay, during the first three months of his practice, treated 1,500 people in Neyyoor, including even Brahmins. However, he moved away from mission work and became the personal physician of the Maharaja of Travancore in 1840. For details, I. H. Hacker, Memoirs of Thomas Smith Thomson: Medical Missionary at Neyyoor, Travancore, South India (London: Religious Tract Society, 1887), 52; John Charles Harris, Couriers of Christ: Pioneers of London Missionary Society (Westminster: Livingston Press, 1931), 89–90; Theodore Howard Somervell, Knife and Life in India: The Story of a Surgical Missionary at Neyyoor, Travancore (London: Livingston Press, 1940), 3. See also R. H. S. Boyd, A Church History of Gujarat (Madras: Christian Literature Society, 1981), 30–33. Also see Martin Daniel Dhas, Missionary Medical Work in

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C. C. Leitch, another LMS missionary, resumed medical work and sent home his first report describing how people from different castes were being treated in 1854. His report kindled the imaginations and aroused the consciences of missionary supporters and sponsors in Europe and America and helped create more medical missions in many fields. John Lowe, who became the secretary of the Edinburgh Medical Missionary Society (EMMS), was in the 1860s the third medical missionary to expand the mission and make Neyyoor the headquarters of the LMS Medical Mission branches in south Travancore. For a long time and, in particular, during the first decade of the twentieth century, Neyyoor, with 20 branch clinics, was one of the largest medical missions in the world in terms of the number of patients treated, as well the largest in the extent of its reach across the Madras Presidency. Meanwhile, the LMS started a free hospital at Attingal in central Travancore.30 The Anglican Church and the Church Missionary Society (CMS) also set up a dispensary along with the college they established in the early 1820s in Kottayam.31 Travancore (Marthandam: South India Press, 1981), 10; Dick Kooiman, Conversion and Social Equality in India: The London Missionary Society in South Travancore in the Nineteenth Century (New Delhi: Manohar, 1989), 46; Koji Kawashima, Missionaries and a Hindu State, 1858–1936 (New Delhi: Oxford UP, 2003), 114–22. 30 During the nineteenth century, the Neyyoor mission hospital of the LMS was the largest medical establishment of its kind in any mission field in the world. Besides this central hospital, there were ten branch hospitals and eight dispensaries distributed over the area of the mission by the year 1920. John Lowe, the medical missionary in the 1860s, treated 3,145 medical cases, performed 1,518 surgeries, and administered 2,021 vaccinations, for a total of 6,684 interventions. It is to be noted here that while the number of patients treated between the 1850s and 1880s in this hospital reached a few thousand, the period 1890–1900 witnessed an unprecedented increase to 8,659, largely due to natural calamities. During 1910–20 over a million patients were treated; the figure for 1920 was 110,154, with over 3,000 major operations being performed at the central hospital in Neyyoor. For details, A.T.S. James, Twenty-five years of the London Missionary Society, 1895– 1920 (London: London Missionary Society, 1923), 40; Koji Kawashima, Missionaries and a Hindu State, 126–27; Somervell, Knife and Life in India, 3. For details, see Christian Work, The News of the Churches, I, Magazine of Religious and Missionary Information (London: S.W. Partridge & Co, 1867), 351; Kawashima, Missionaries and a Hindu State, 117; A.T.S. James, Twenty-five Years of the London Missionary Society, 41 and Hacker, Memoirs of Thomas Smith Thomson, 52; Harris, Couriers of Christ, 91–92. 31 Prema A. Kurien, Kaleidoscopic Ethnicity: International Migration and the Reconstruction of Community Identities in India (New Delhi: Oxford UP, 2002), 135.

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Emily Berry examines the role of the Protestant missionaries within the British imperial endeavors. Through a case study of the missionary outfit the Salvation Army, which was commonly called Muktifauj in India, Berry illustrates the complexity of the relationship between the missionaries and the colonial government. Her work emphasizes the influence of the police commissioner Frederick Booth-Tucker on the Salvation Army’s complex interaction with the Raj. He led the Salvationists to alternately defy and support the Empire while continuously focusing on their prime goal of conversion. It should be noted that the Salvationists, who converted “criminals to caretakers,” opened a dispensary at Nagercoil in 1895 which later expanded and became the Catherine Booth Hospital, largely due to the efforts of Dr. Percy Turner; by the late 1920s, the dispensary had expanded to include six branch hospitals.32 The Malabar region, or the northern part of the present-day Kerala, gained popular acclaim for its indigenous medicine, particularly Ayurveda. With Christian missions being allotted specific areas for evangelization, the Malabar country was the province of the Basel German Evangelical Mission (BGEM) in the first half of the nineteenth century; the BGEM began medical missionary work in the second half of the nineteenth century. Snake bites were a perennial problem, and the patient population, be it upper-caste Hindus, members of lower castes including Tiyars and Pulayars, or the Mappilas or Muslims who came for treatment, cut across all faiths. The missionaries, in their reports to headquarters back home, complained that many patients came to them only after the failure of local treatments.33 The German missionaries set up mission stations in almost all the important cities and towns in the northern parts of Kerala and Karnataka. The German missionaries, Dr. Roberts and Dr. Ridings, were pioneers in medical missionary work, started hospitals in Calicut and Mangalore. According to the BGEM medical missionary Liebendorfer, their hospital in Tellicherry in Malabar was set up in 1891 and a “Leper Asylum Hospital” established in 1893 in Calicut, with financial support from Bailey, the secretary in charge of India.34 During the last decade of the nineteenth century, W. Stokes and his assistant, a Miss Hanhart, served in the Calicut hospital and were reported to have successfully treated as many as 28,915 patients in 1896.35 The LMS had a presence in Bellary 32 Emily A. Berry, From Criminals to Caretakers: The Salvation Army in India, 1882–1914 (PhD Diss., Northeastern University, 2008), 247–48. 33 BGEM Reports, 1869, 1896. 34 55th Report of the BGEM for 1895, 90-92. 35 Report of the BGEM for 1896, 56-57.

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too, where they established the Wardlaw Hospital. The Wesleyan Methodist Missionary Society had hospitals at Woriur, Madagadde, and Mysore, as well as hospitals at Medak and Karimnagar and a maternity hospital in Nizamabad, and Ramyanpett within Nizam’s boundaries. A number of other hospitals were established by various missionary societies during the second half of the nineteenth century, including the CEZMS, which opened mission hospitals in Bangalore, Trivandrum, Chennapatnam, and Khammamet; the Australian Presbyterian Mission (APM), in Shorlinghur in North Arcot; the Basel Mission, in Udupi and South Canara; the American Baptist Foreign Missionary Society (ABFMS), in Nellore, Udayagiri, Sooriaket, and Ganjam; and the Canadian Baptists, in Akidu, Voyeur, Pithapuram, Sompat, and Chiccacole.36 All of these played a significant role in the medical history of South India. Soon, Protestant missionaries’ attention turned toward Andhra and the present-day Telangana region, which was passed over by many missionary organizations owing to its dry and sultry climate. Indeed, the Telangana region was long a neglected part of the South, with appalling medical facilities both before and after independence. Anna Sunderman (later Mrs. Anna Bergthold), the first trained nurse of the American Mennonite Brethren Mission (AMBM), began her work at Malakpet in 1904. Another medical practitioner and missionary, Katherine Schellenberg, who was the AMBM’s first trained missionary doctor, joined the field work in Telangana in 1907.37 The missionaries of the Mennonite Brethren opened hospitals, dispensaries, and outdoor clinics in the Telangana region even after the 1950s. Dr. Anna Kugler, a graduate of the Women’s Medical College in Philadelphia (United States), joined the United Lutheran Church Mission to serve as a medical missionary and came to Guntur in 1883, thus 36 Margaret I. Balfour, The Work of Medical Women in India (London: Oxford UP, 1929); LMS Annual Report, 1945, London. 37 Medical missionaries served the Telangana region for more than a century. Anna Peters (1909), Mary C. Wall (trained nurse, 1915), Margret Sunderman (1929), Catherine Reimer (1931), Rossella Toews (1946–47), Frieda Neufeld (1957), Regina Sundarman (1951), Dr. Jack Friesen and Ruth Friesen (1952), Dr. and Mrs. G. J. Froese (1954), and Helen Dick (1956) all worked there. For reference, P. B. Arnold, “Medical Centre, Jadcherla,” Diamond Jubilee Souvenir, 1899–1974, (Mahabubnagar: MBCI, 1975), 64. Also see Y.D. Jeyakar, The Role of the Mennonite Brethren Church of India in the Upliftment of Telangana Region from 1958–2008 (MTh thesis, Senate of Serampore College, 2011), 52; H. T. Esau, The First Sixty Years of Mennonite Brethren Missions (Kansas, M. B. Publishing House, 1954), 91; Gerhard Wilhelm Peters, The Growth of Foreign Missions in the Mennonite Brethren Church (Kansas: M. B. Publishing House), 1952.

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becoming the first woman missionary physician in the Madras Presidency. The mission hospital for women that she opened in Guntur in 1883 is the oldest such facility in the country. She also established hospitals at Rajahmundry while Chirala continued her service until her death in 1930.38 The decision of the foreign and regional committees of the LMS to start a hospital at Kuvathalam in Andhra in March 1947 indicates the missionaries’ continued efforts to “serve mankind” and “heal the patients.” Having learned that their missionary Tedman was doing commendable preventive medical work, the committee recognized his service by appointing him as the doctor of the Kuvathalam Mission Hospital.39 In terms of the extent of their reach, the mission hospitals had reached their pinnacle by the mid-twentieth century, with over a hundred stations under the direction of the missionaries, in addition to a few hundred small dispensaries and clinics scattered across South India.40

Missionaries, Colonial Officers and Native Rulers: Philanthropic Patronships Many local rulers, government officials, landlords and even wealthy individuals were impressed by the sheer dedication of the missionaries and the charitable nature of the health-care work they were doing. Particular mention may be made of the king of Travancore and the rulers of Tanjore, 38

Alden H. Clark, India on the March (New York: Missionary Education Movement of the United States and Canada, 1922), 138–49. Also see, Margaret I. Balfour, The Work of Medical Women in India (London: Oxford UP, 1929), 81; Maina Chawla Singh, Genger, Religion and the “Heathen Lands”: American Missionary Women in South Asia (New York: Garland Publishing, 2003). 39 LMS Reports, 1946, 1947. 40 LMS Neyyoor Hospital, South Travancore; William F. Pierce Memorial Hospital, Madurai; United Free Church Mission Hospital, Conjeevaram; Danish Mission Hospital, Virudhachalam; I.A.M.C. Bangalore; St. Luke’s Hospital, Vengurla; Hospital for Women and Children, Madurai; Dayapuram Leprosy Mission Hospital; American Mennonite Brethren Mission; Mennonite Brethren Church of India; Russian Mennonite Brethren Church Missionary Society; Wesleyan Methodist Missionary Society; American Methodist Episcopal Church Mission; American Baptist Telugu Mission; Telugu Village Mission; Basel German Evangelical Mission and so on had hospitals in their respective mission stations. While the hospital at Nagarkarnool was completed in 1912, other hospitals were built at Devarakonda (1929), Shamshabad (1928), Wanaparthy (1933), Gadwal (1947), Jadcherla (1952), and Jeyakar (2011). For details, see Henry Fowler, A Directory of Medical Missions: Head Stations and Foreign Staff (Bangalore: UTC Archives, 1929).

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Pudukottai, and Mysore, who were especially appreciative of the medical services being offered by the missionaries. The LMS missionary in Parassala near Trivandrum, Samuel Mateer, described Travancore as the “Land of Charity,” noting the tremendous help that the Maharaja and his family in particular and officials in general had extended to him to promote the mission. These maharajas also invited the medical missionaries to their palaces to give treatments, and in addition honored them. The public munificence played a significant role in enabling the missionaries to obtain support, in the form of land and financial assistance, for setting up hospitals.41 It may be noted that the Travancore kings, known for their enlightened rule and social and educational reforms, did not take any direct steps on the health-care front until well into the mid-nineteenth century; but they provided financial support to the missionaries and relied on them to attend to all their medical needs. Throughout their time in the kingdom, the LMS missionaries had a cordial and mutually respectful relationship with the Travancore Maharaja personally, as well as with the kingdom’s officials. The Maharaja and his officials helped LMS missionaries to establish new hospitals and dispensaries. For the great help rendered by the then Diwan of Travancore, Nanoo Pillai, who was an alumnus of the LMS Seminary, Nagercoil, the medical missionary John Lowe wrote: Your straight forward, upright character and conduct, your intelligence and moral worth, have secured you an enviable reputation and made you a powerful influence….”42

The medical missionaries had influenced the local people and rulers by seeing to their medical needs, thereby inspiring the king to provide financial patronage for medical relief; under special circumstances, this also created an alliance between the missionaries and the Maharaja in Travancore. Thomas Smith Thomson, a medical missionary, received royal support to build a new hospital at Neyyoor, honoring this patronage by calling it the Maharaja’s Ward. While the Maharaja personally inaugurated the Tittuvilai dispensary in 1879, his Diwan, V. Ram Iyengar, opened the branch dispensary at Kulasekaram in 188143 and also laid the 41

Mateer, The Land of Charity 5–9, 311. Travancore Administration Report, 1865–1866 (Thiruvananthapuram: Government Press, 1866), Kerala State Archives, 68; K. R. Elankath, Dewan Nanoo Pillai: Biography with Selected Writings and Letters (Trivandrum, 1974), 29. 43 Hacker, Memoirs of Thomas Smith Thomson, 49, 58. Also see Harris, Couriers of Christ, 91–92. 42

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foundation stone for the Catherine Booth Hospital of the Salvation Army at Nagercoil; he made a generous donation of three hundred rupees toward its maintenance.44 The Maharaja also recognized the mission hospital at Marthandam by approving a monthly grant-in-aid of fifty rupees.45 The Neyyoor medical mission received liberal contributions not only from the Maharaja, his family and other nobles and gentry of the Travancore kingdom but also from a large number of individuals from England, Europe, America, as well as from many rich natives. A generous Englishman, E. D. Pochin, contributed three thousand rupees in 1904 for building a new hospital in Nagercoil. In 1907, an anonymous individual from Travancore gave 750 rupees to the mission to help open three new branches in the kingdom. An English widow, Mrs. George Cadell, sent a gift of one hundred pounds that helped the mission build a new hostel for the students in Neyyoor.46 It is evident that diverse motivations of Christianity, philanthropy and patriotism came together to support the overarching paradigm of what was considered the noble enterprise of the medical missions.47 The mission hospitals and dispensaries were known for their practice of admitting lower-caste untouchables and treating them with the latest equipment, as it was missionary policy to help the poor and needy.48 Surprisingly, this happened at a time when even the government hospitals were denying admission to untouchables; this was the case until the early twentieth century. Dismayed by the Travancore government’s policy of not admitting lower-caste untouchables to the wards, Salvation Army missionaries admitted Pulayars to their hospitals.49 As missionary work expanded, so did the support from the government, the local administrations, and philanthropic individuals from both within the region and overseas. The Calicut Zamorin, on learning that 44

Berry, From Criminals to Caretakers, 247–48. South Travancore Medical Mission Reports, 1901–1910 (Nagercoil: LMS Press, 1910), 13. 46 Mateer, Land of Charity, 5–9, 311. 47 Rhonda Anne Semple, Missionary Women: Gender, Professionalism and the Victorian Idea of Christian Mission (New York: Boydell Press, 2003). 48 Raj Sekhar Basu, “Medical Missionaries at Work: The Canadian Baptist Missionaries in the Telugu Country, 1870-1952” in Disease and Medicine in India: A Historical Overview, ed. Deepak Kumar (New Delhi: Indian History Congress and Tulika Books, 2001), 184; See also Basu, “Healing the Sick and the Destitute: Protestant Missionaries and Medical Missions in 19th- and 20th-century Travancore” in Medical Encounters in British India, ed. Deepak Kumar and Raj Shekhar Basu(New Delhi: Oxford UP, 2013),187-207, 203. 49 L.U.L. Fletcher, Brother of All (London: Salvation Army, 1956), 8; Kawashima, Missionaries and a Hindu State, 120. 45

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the German missionaries established a hospital and leper asylum, sent in food to the inpatients on his birthday in appreciation of the work of the missionaries and also asked the latter to take over the running of the government-established Vaniyankulum hospital. Some affluent wives of colonial officers came forward to support the extraordinary services of the missionaries by contributing oil paintings.50 The AMM missionaries thanked A. S. Alagannan Chettiar, the Zamindar of Kottagudi and a member of the Legislative Council (MLC), for his generous contribution of 750 rupees to the mission hospital, school and college building.51 The public health minister in the Madras Presidency, T. S. S. Raja, when opening the Willis F. Pierce Hospital, expressed appreciation of the efforts of the missionaries, particularly the octogenarian Willis F. Pierce, who donated a whopping $50,000, or 150,000 rupees at that time.52 The Madras government also contributed 1,00,000 rupees as a building grant, while the Madura Mills Company offered 50,000 rupees toward an endowment in addition to building a ten-bedded ward.53 Similarly, the nurses’ home at the AAM Hospital was constructed with a donation from Thirumalaiappa Mudaliar in 1931.54 Colonial and local officials of the Madurai municipality wholeheartedly agreed to increase the annual grant for the AMM-run Albert Victor Hospital to two thousand rupees.55 Missionary activities continued unabated along with the royal support; the Raja of Ramnad opened the Swedish Mission Hospital in Ramanathapuram in 1933. Some of the Raja’s senior ministers, including Khan Bahadur S. A. Naina Mahomed, also contributed generously to the hospital. On one occasion, the Raja said: I am glad that the Swedish mission hospital has done such excellent work not only for my people but also for the large number of patients who have thronged to it from all parts of the (Madras) Presidency.56 50

Basel German Evangelical Mission 55 Report for the year 1894 (Mangalore: Basel Mission Press, 1894), 99 and 1897:98. 51 Invitation, September 29, 1931, American Arcot Mission files, UTC Archives. See also, Thanks giving report of congregation at Kodangipatty, Bodynayakkanur Pastorate to Mr. A.S. Alagannan Chettiar, M.L.C (Bangalore: UTC Archives, 1936), n. p. 52 AAM Reports, 1917. 53 Madras Mail, 1937. Source: Nehru Memorial Museum & Library (NMML), New Delhi. 54 AAM Report, 1931. 55 Annual Report of Albert Victor Hospital, Madurai for the year 1925, (Madurai: Albert Victor Hospital, 1925), 1. 56 Madras Mail, 1933. Source: NMML, New Delhi.

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The missionaries came up with new ways of raising funds from the public. For instance, the American Madurai Mission appealed for funds by means of a pamphlet that, emphasizing the need for healthcare, asked for one rupee from each of the 1,50,000 people of the city.57 In the events surrounding the donation process, reciprocal arrangements were not unusual. For instance, in appreciation of his wife and son’s successful treatment by Anna Kugler of Guntur, the Ellore Rajah, Bhuyanga Rao Bahadur, offered land for a hospital and rest home, and also translated the New Testament, given him by Kugler, into Telugu; in addition, he renamed his youngest daughter “Annamma” in honor of the doctor and printed a depiction of Christ on his official letterhead.58 The recognition of the medical missions’ importance reached its pinnacle when the States, including the kingdoms, began inviting medical missionaries to participate in their official programs. For example, the LMS medical missionary Somervell was invited by Travancore University in Trivandrum to deliver lectures on health and family welfare.59

Touring Clinics and Medical Philanthropism Having established their services in the cities and towns, the missionaries began to move into the countryside, carrying drugs, medical equipments and accessories on bullock carts, generally called bandi, to attend to patients who could not reach the faraway mission hospitals. In the nineteenth century, this was a true innovation in health care. Since medical work had always been a part of their duties, the missionaries, and particularly their wives, were given chests loaded with medicines from London for emergencies. Martha Mault, wife of the LMS missionary Charles Mault and mother of Eliza Caldwell, had a “medical chest” when she reached Travancore with her husband in 1819; Archibald Ramsay, the first LMS medical missionary, also carried along such a chest when he met the Travancore Maharaja in 1840.60 The LMS missionaries made strenuous efforts to share the benefits of modern medicine in Travancore and other areas in order to provide immediate relief. They traveled on bandi to remote areas and launched several “touring clinics,” especially in places where public transportation did not exist until 1911-12.61 Both T. S. 57

AMM Report, 1930. Clark, India on the March, 141–45. 59 Somervell, Knife and Life in India. 60 Ibid., 15. 61 LMS Report, 1913. 58

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Thomson and William C. Bentall witnessed as participants the expansion of the medical missionary work in the early twentieth century. Recognizing Bentall’s indefatigable courage and conviction in serving the cholera-hit masses in the remote countryside of Travancore, the missionary in charge wrote, “He scorned the bullock-bandy travelling at two or three miles an hour, and preferred to cycle often over quagmires at 10-14 miles an hour.” The mission reporter added, “Our journeys are made partly on cycle, partly on bullock carts, partly in boats.… The main roads are very good but the side roads, especially in the rainy seasons, become very bad. Travelling at certain times of the year is not easy.”62 This “medical philanthropism” gained a considerable level of traction and public attention when Theodore Howard Somervell, a British mountaineer turned medical missionary, joined the South Travancore Medical Mission (hereafter, STMM) after his Everest expedition in 1922. A Rugby School product and an Olympic mountaineering champion in 1922, Somervell set his eyes on conquering Everest after gaining experience in the Alpines. A man of great personal integrity as well as professional qualifications, Somervell left a lucrative practice in London to join the LMS Hospital at Neyyoor on invitation from the medical missionary H. Pugh. Appalled by the sight of rampant cholera, malaria, and fever among the people, Somervell found the primary cause to be poor sanitary conditions and an absence of health-care facilities. He became involved in providing medical relief to the poor, and also developed strong ties with the Maharaja of Travancore as his personal physician. Braving incessant downpours, Somervell traveled by bandi to areas hitherto unreached, making him a popular medical missionary.63 His versatility was proven not only in Travancore, as a touring doctor but also in not-soclose Vellore, where he was active in the Christian Medical College, closely associated with Ida Scudder. The way in which Somervell transformed the Neyyoor hospital into one of the largest missionary hospitals in the world, with over twenty branch hospitals, during his three decades of service ending in 1953, left an indelible mark on the history of medical missions in the South. Along similar lines, the LMS missionaries offered support to the tea plantation workers on the Western Ghats by establishing some dispensaries in the foothills. The planters provided both personal and estate subscriptions to support these, and in one case the maharaja gave the LMS an unused salt store in Kulasekaram, which was converted into a 62 63

STMM-LMS Reports, 1901–1910, 13, 19. STMM Report, 1932.

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dispensary. The small hospitals and dispensaries in the foothills were of great service to the plantations, treating fever-afflicted workers, snake bites, estate accidents, and sudden and severe cases of dysentery, cholera, tuberculosis, and the like. Missionaries from many other missions likewise initiated medical work among the poor and the depressed in different parts of the Madras Presidency. The Mennonite mission in the Telugu region also reached remote villages, providing them with medicines through outdoor clinics. In addition, the service rendered by missionaries’ wives and women missionaries, and their presence among the local women, particularly in the South, greatly extended the missions’ reach and made a great impression on those they served. During cholera outbreaks and famines, medical missionaries responded quickly to help save the dying. According to Christhu Doss, the missionaries’ involvement in relief work during severe famines in the South was vital and far-reaching, with the philanthropic assistance being eagerly accepted by “rice Christians.” The drought-hit people appealed to the missionaries for more assistance, and the missionaries in turn asked the mission headquarters in Europe and America for help; they received an immediate response in the form of additional money and supplies.64 The manner in which Ida Scudder and her subordinate doctors developed a system of itinerant “roadside clinics” and “mobile clinics” and treated patients in the villages, constituted an important landmark in the history of medical missions in this part of the world.65 A gradual focus on addressing the health needs of women in India also developed, with a crucial role being played by British missionaries.

Medical Missions and Women British rule brought in a series of noticeable changes, especially in the lives of women. Of late, studies on women under the Raj have examined the centrality of medical education in modern constructions of the gender question. In South India, the question of women and medicine was identified largely with Christian missionaries. This later effected farreaching changes in discourses on space, mobility, sexuality, and 64

M. Christhu Doss, “Repainting Religious Landscape: Economics of Conversion and Making of Rice Christians in Colonial South India (1781–1880),” Studies in History 30, no. 2 (2014), 180, 194–97; Duncan B. Forrester, Caste and Christianity: Attitudes and Policies on Caste of Anglo-Saxon Protestant Missions in India (London: Curzon Press, 1980); Kooiman, Conversion and Social Equality, 1991; Henriette Bugge, Mission and Tamil Society: Social and Religious Change in South India (1840–1900) (Surrey: Curzon Press, 1994). 65 Shavit, The United States in Asia.

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respectability, radically transforming the nature of femininity to a subject of study with a different articulation. The transition from servitude to a “discourse of respectability”66 and liberation through education needs to be located in the specific historical context within which the question of women’s empowerment arose during the nineteenth century in South India. Female medical missionaries’ participation, including a direct engagement with the growing discourses on women’s empowerment, thus challenging social rigidity, contributed to historic transformation that the deep traditional ethos underwent. Even though women missionaries were initially subject to scathing attacks, they “silently and unassumingly” pioneered missionary work among women and children, and were later called “virtuous” and “valiant”; by the second half of the nineteenth century, “unmarried women with no specific home ties” were being invited to become missionaries to “work among the women.”67 Believing that educating women in the zenanas would gain converts who would then develop an interest in the outside world, British and American women missionaries, described by Rosemary Seton as “Western daughters in Eastern lands,”68 assisted and collaborated with the Raj to the end of “serving God to save souls” on one hand, and securing secular career opportunities on the other.69 Similar attitude prevailed in colonial Uganda when missionary activities of doctors and missionaries promoted the nurturing of healthy bodies. This was based, as Nakanyike Musisi and Seggane Musisi (Chapter Eight) portray, on the colonial perceptions of gender relations that saw these as a model for progress enabling population growth. The lack of provision for separately treating women that existed until 1877, with public hospitals and dispensaries limited in number and (for many people) far away, motivated the missionaries and other philanthropists to found the “National Association for Supplying Female Medical Aid” in 66

Eliza F. Kent, “Tamil Bible Women and the Zenana Missions of Colonial South India,” History of Religions 39, no. 2 (November 1999): 132. See also Eliza, F. Kent, Converting Women: Gender and Protestant Christianity in Colonial South India (New York: Oxford UP, 2004). 67 Rosemary Fitzgerald, “A ‘Peculiar and Exceptional Measure’: The Call for Medical Missionaries for India in the later Nineteenth Century,” in Missionary Encounters: Sources and Issues, ed. Robert A. Bickers and Rosemary Seton (Surrey: Curzon Press, 1996), 175–78. 68 Rosemary Seton, Western Daughters in Eastern Lands: British Missionary Women in Asia (California: Praeger, 2013). 69 Geraldine Forbes, “Medical Careers and Health Care for Indian Women: Patterns of Control,” Women’s History Review 3, no. 4 (1994): 515–30.

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the country. As a result, the Dufferin Fund was set up in 1885 to provide medical relief and education to women.70 Even the British government became indirectly involved with the Dufferin Fund, or what the Vicereine Harriet Georgina Blackwood, Marchioness of Dufferin and Ava, called “my female medical scheme.” Similarly, an auxiliary medical school was opened in 1877 in Royapuram to train sorely needed subordinate medical staff during the Madras famine; it was affiliated to the Medical College in 1879.71 Maina Singh argues that the increasing number of women medical missionaries instilled the idea of female employment among local women in the South as early as the early decades of the nineteenth century.72 Another advantage of the female medical missionary was that she could perform dual duty as both a doctor and a nurse.73 Besides, as Swenson points out, the British medical woman missionary was well respected in the country, as she represented, fundamentally, an “English lady upon whom is grafted the fortifying and empire-building power of medicine.”74 Ida Scudder’s valiant entry into medical practice inspired and propelled initiatives for medical education for women, which led to the setting up of the Christian Medical College, Vellore, in the early decades of the twentieth century. Missionaries also initiated the Madurai widows’ relief society and helped hundreds of widows during the late nineteenth and early twentieth centuries.75 Mention should be made of a leprosy patient, Annammal of the Dayapuram Leprosy Colony, who after treatment from the Leprosy Mission Hospital passed the necessary government exams and qualified for medical work with support from Francis Cardinal, who had built the first leprosy ward in the hospital from his personal savings. In the course of time, women missionaries began to assume responsibility for running missionary hospitals; the Leper Asylum at Dichpalli was run by a

70 Antoinette Burton, “Contesting the Zanana: The Mission to Make ‘Lady Doctors for India,’ 1874–1885,” Journal of British Studies 35 (July 1996): 368–97. 71 Forbes, “Medical Careers,” 516–18. 72 Singh, Gender, Religion and the “Heathen Lands,” 26. 73 Joy Gnanadason, A Forgotten History: The Story of the Missionary Movement and the Liberation of the People in South Travancore (Madras: Gurukul, 1994), 129–30. 74 Kristine Swenson, Medical Women and Victorian Fiction (Columbia: Univ. of Missouri Press, 2005), 169. 75 In 1904, the society assisted 65 widows among 243 members, both men and women; a total of 2,172 rupees was disbursed to them. See Widows Relief Society, AMM, 1903–4, n.p.

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woman missionary doctor.76 Missionaries adopted a peculiar system of appointing “Bible women” in hospitals, like those appointed to educate the inhabitants of the zenanas. The BGEM medical missionary Liebendorfer documents the appointment of Maria Herman as a Bible woman at the Calicut hospital in 1892.77 Similarly, the Organization of Women Missionary Societies created fundraising channels for women’s projects that existed separately from those of the male-dominated denominational missionary boards, allowing women missionaries to pursue their own philanthropic ventures,78 with further extension of medical activities to other parts of southern India.

Emergence of Native Medical Workers One of the most important achievements of missionary work in India was the creation of a large group of native inhabitants trained for medical work at mission hospitals. Giving medical training to local inhabitants by establishing medical schools and training centers for doctors and nurses students had a huge impact. Medical missionaries working in remote areas pushed for at least basic medical training for native Indians, as they felt that “half a loaf is better than no bread.”79 Though popular medical education institutions were established only in the twentieth century, the foundation was laid in the later half of the previous century, a period that saw some sudden changes in medical and nursing education. The LMS Scottish medical missionary John Lowe reported the admittance of a Hindu student to medical school, Govindan, a young Hindu student, supported by His Highness the first Prince of Travancore, has made satisfactory progress.80

This indicated that missionaries could demonstrate a generous attitude toward local non-Christians. Though aspersions were made that the missionaries used local medical school graduates as “medical evangelists,” the scheme of medical training remained hugely successful, as one of the 76

Pamphlet printed on behalf of the hospital for women and children and Willis. F. Pierce Memorial Hospital at Madurai, dated November 4, 1950, n. p. Bangalore: UTC Archives. For reference, see the AMM Report, 1950. 77 BGEM Report, 1894, 85. 78 Kent, Tamil Bible Women and the Zenana Missions, 132. 79 Harford-Battersby in Johnson, A Century of Missions, 1900. 80 Christian Work, London, IV, 1870, 182. John Lowe, Medical Missions: Their Place and Power (London: F. H. Revell Co., 1892).

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fundamental objective of the missionaries was to train and improve the condition of the lower castes.81 Equipping native individuals with medical knowledge, thus, became an obligation for missionaries, resulting in the establishment of some of the most popular medical and nursing schools in south India. John Lowe, who later became the secretary of the Edinburgh Medical Missionary Society, was instrumental in framing medical missionary work in 1864, and founded the Neyyoor Medical School which was one of the most significant achievements of the medical mission in Neyyoor. He recruited seven native young men, one of them an English-educated Hindu, from each of the mission districts for a three-and-a-half-year course in medicine and surgery. Lowe was helped by his friend, Dr. Burns Thomson of Edinburgh, who secured and forwarded the necessary funds and models. The trained medical students were then appointed as medical assistants or dressers and took charge of branch hospitals and dispensaries in their respective mission districts.82 Meanwhile, Ross of the Maternity Hospital in Trivandrum started a medical class for women; many girls from the Tamil region were also sent there.83 The period when the Scudder family was offering medical services to the poor and downtrodden during times of famine and epidemics, has often been described as the “golden era” of modern medicine in the South. Ida Scudder became an icon for millions in the early twentieth century. The medical school that she opened at Vellore was and still is one of the best institutions in its class;84 some of the most promising candidates were recruited and sent for medical courses to Vellore, Neyyoor, Bellary, Jammalamadagu, and other places; often some not-so-good locals were selected and paid stipends, thereby indicating a keen interest in promoting the natives.85 The development in the late 1920s of a four-year medical course for a Licentiate in Medicine and Surgery (LMS) at the Vellore 81

Sam Nesamony, Contribution of London Missionary Society towards Education in Madras Presidency, 1804–1908 (PhD thesis, Jawaharlal Nehru University, 2013). 82 Mateer, Land of Charity, 182 83 LMS Annual Report, 1866; John Lowe. Medical Missions: Their Place and Power (London: F. H. Revell Co., 1892). See also John Lowe, LMS Annual Report, 1870; John Abbs, Twenty-Two Years Missionary Experience in Travancore (London: John Snow & Co., 1870), 136; and also Esme Cleall, Missionary Discourse of Difference: Negotiating Otherness in the British Empire, 1840–1900 (New York: Palgrave Macmillan, 2012), 88. 84 Sharon Bahrych, Practical Disciplines of a Christian Life (Belfast: Ambassador Books, 2016). 85 AAM Report, 1911: 73, 86.

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Medical School, and the opening of a missionary dispensary and a medical training center in Black Town in Madras, exhibit a keen sense of the importance of educating and engaging the local population in medical science and practice.86 The training of local women in nursing and midwifery crystallized so that they might care for patients at hospitals and orphanages paved the way for the education of a large group of local young women as professional nurses; today over seventy-five percent of all nurses in the country are from south India. This advance occurred despite what Madelaine Healey has observed about nursing not having been a “publicly accepted” profession but instead a menial job that the influential sectors of society looked down upon.87 Following the initiation of a nursing course by the colonial government in 1871, there was an increasing demand for such training on the part of young people who wished to take up nursing as a profession. Over a period of time many nursing schools appeared, which were run on behalf of missionary societies. The LMS missionaries also started a nursing school to train local girls in midwifery in the late 1860s. In later years, however, owing to the paucity of female students, the missionaries started training local boys for nursing and midwifery; the first such course for boys was started by the LMS missionary, Edith Hacker, in the 1930s. The first five male students from the nursing college successfully qualified the norms of the Christian Medical Association of India; another nursing school was started in 1949, in Kundara.88 American missionaries also established a nursing school at Willis F. Pierce Memorial Hospital in Madurai.89 Gradually, nursing achieved professional status, with preparation going from a mere six-month training course to a oneyear program, and then to two and finally to three years of study for midwifery and four years for a degree course.90 During the nineteenth century, before the arrival of trained nurses, the local dhais were the accepted midwives. In the initial period of medical missionary work, many unmarried missionary women became dhais, or aayis, and cared for patients, particularly lepers. One notable example is that of Rosalie 86

CSMM Report, 1927. Quoted by Madelaine Healey, Indian Sisters: A History of Nursing and the State, 1907–2007 (London: Routledge, 2013), 52. 88 Norman Goodall, A History of the London Missionary Society, 1895–1945 (Oxford: Oxford UP, 1954); Joy Gnanadason, A Forgotten History, 129, 130. 89 AMM Report, 1937. 90 Most missionary organizations established nursing schools to cater to their followers in one way or the other through their small to big hospitals and dispensaries, though the trainers and trainees were few. 87

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Harvey, who became an aayi and established the Polwarth Home in Nasik for orphans, widows, children, and lepers.91 The bishop of Egypt, Llewellyn Gwynne, visited Harvey while on a tour to India and, impressed by her dedication, wrote: The whole atmosphere of the asylum is that of love and fearlessness and trust. I soon saw that under God, it was Miss Harvey from whom radiated that wonderful spirit of Christ which seemed to fill the whole compound… I saw that the poor lepers had a home where their disease was arrested, their wants supplied, their minds developed, and their souls inspired by her who in pitying love moves among them as the tenderest, kindest friend they ever had.92

In recognition of the services of local people, reports portrayed the success of missionary groups, both Western and Indian, in various places including Neyyoor, Calicut, Madras, Vellore, Madurai, and Erode, where native Indians had gained a larger presence as part of the missionary groups.93 The necessity of modernizing missionary work compelled the missionary societies to make some swift decisions, which would have long-lasting effects, regarding the running of their medical facilities, schools, colleges, and other institutions. One such decision, evincing the recognition that Indians were capable of running the hospitals, was the transfer of leadership to them.94 Christianity and medical philanthropy went hand in hand to a large extent by creating an amalgam that Fitzgerald has labeled “Clinical Christianity.”95 The benefits of mission hospitals and medical schools were recognized by the Raj, various local rulers, and the public at large. Many scholars claim that over half of the women’s hospitals in the country were under missionary supervision and control even in the first quarter of the twentieth century. The medical missionaries’ work can be credited with contributing to the reduction of the death rate in South India in the beginning of the twentieth century. E. A. Harlow, one of the managers at the Neyyoor medical mission, declared in 1931 that the death rate of our surgical cases is substantially less than it is in the 91

A. Donald Miller, “Aayi” (Mother): Glimpses of Rosalie Harvey of Nasik and her friends the Lepers (London: Mission to Lepers, 1930). 92 Ibid., 15–36; Forbes, Medical Careers and Health Care, 189–90. 93 BGEM Report, 1894, 85. 94 BGEM Report, 1910; John Friessen, Medical Report from India, CMBS/F (Bangalore: UTC Archives, 1970), 53. 95 Rosemary Fitzgerald, Clinical Christianity.

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large hospitals in London and in the Presidency towns in India.96

The country’s modern medical education system is also deeply indebted to the work of the missionaries during the nineteenth and early twentieth centuries. These accomplishments were due to the committed efforts of the missionaries in running their hospitals and dispensaries and providing medical relief to different strata of Indian society. In addition, as philanthropic agents, they built successful alliances with royalty, government officials, and progressive-minded individuals, which enabled a wider reach of their missionary agenda. Nevertheless, their healing centers were largely bound up with religious notions, a state of affairs that often attracted criticism from Hindu reformers for its questioning of the healing potential of indigenous medicine. Perhaps, somewhere amid the desire to learn the languages and cultures of the local populations, the value of local medical systems was overlooked, in the absence of the latter’s ability to offer a cure for epidemics. Nonetheless, the medical missionaries played an important role in engaging with members of the deprived classes who were suffering from venereal and contagious diseases, providing them with food and medicine, accommodating them in new villages, and bringing them into a new domain of change and a new culture of medical values. Health education helped free such members of the local population from the oppression and bondage imposed by their rigid society, while campaigns for vaccination, cleanliness, and hygiene proved beneficial in the long run. Alongside these efforts, local rulers placed medical assistance within the reach of all classes of society. The Maharaja of Travancore took the initiative by seriously looking into medical and nursing textual materials—he translated into Malayalam a medical paper by a missionary on “Sick Nursing”—and using his royal patronage to promote the message of medicine, an endeavor that would give him an image as a “charitable raja.”97 The importance of medical missions reached its zenith when both the Raj and the local rajahs showed an eagerness to invite medical missionaries to take part in their official programs. This was also a time when the British government showed little or no interest in promoting Western medicine in its colonies, including India, so that the medical care provided by the missionaries was the only viable alternative to that offered by indigenous systems of medicine; their work in advancing medical education by training young Indians was lauded. By making their medical mission a successful auxiliary in the dissemination of the gospel in South 96 97

LMS Report, 1932. Kawashima, Missionaries and a Hindu State, 120.

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India, missionary societies achieved considerable success in treating patients and training Indian nurses. Nonetheless, their avowed task of converting patients proved to be less successful, despite the fact that they performed their duties as doctors-cum-healing-evangelists. For the first time, the medical history of India witnessed a successful cooperation, collaboration, and coordination between the local rulers and medical missionaries in South India, facilitating recognition of the value of Western medicine to a degree greater than ever before.

CHAPTER ELEVEN TROPICALITY, RACE AND THE PRODUCTION OF MEDICAL KNOWLEDGE IN COLONIAL KENYA OSAAK A. L. A. OLUMWULLAH

Africa as “Nature” and as “Patient” In his presidential address to the Kenya Branch of the British Medical Association in 1958, K. V. Adalja made a series of sweeping observations on the medical changes that had taken place in the country since its constitution into a British Protectorate in 1895. Central to these observations was the argument that, with the exception of coastal towns, the East African area that would become the Colony and Protectorate of Kenya in 1920, had “very little, if any,” contact with “the outside world” before 1895. Mapping this invented isolation onto nineteenth- and early twentieth-century Western constructions of Africa as “raw nature” and as “patient,” Adalja maintained that before British colonialism, Kenya “was riddled with crippling and killing diseases”—infectious and noninfectious— that were “constant companions” of its inhabitants.1 What made it possible for Africans to continue to “exist despite these hazards,” Adalja concluded, was “the very high fertility of the African woman.”2 Almost a half a century later, this situation had been completely reversed in that diseases had not only “been controlled:” in developed areas like Nairobi and Mombasa, “their incidence [had] been reduced to a fraction of the former figure,” with population increasing “to such an extent that if the present rate continues the resources of the country may be outstripped.” 3 1

K.V. Adalja, “The Development of the Medical Services in Kenya,” East African Medical Journal 39, no. 3 (March 1962): 105. 2 Ibid. 3 Ibid.

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Adalja was a medical man, a man of science.4 However, it is noteworthy that the image of Kenya that emerges from the linkage established between geographical isolation, pestilence and the African condition on the eve of colonial conquest, was not the preserve of men of science: it was taken up with equal enthusiasm by many Westerners, among them explorers, missionaries, colonial administrators, anthropologists and historians. Perhaps, the most powerful portrayal of this image was the biblical metaphor employed by the legendary Dr. Albert Schweitzer when talking about his “call” to serve in colonial Africa. When Schweitzer saw in Colmar the statue of an African, he was challenged and felt that “out there in the colonies…sits wretched Lazarus.”5 This imagery “appealed” to medical missionaries like Sir Clement Chesterman who, while working on the construction of Yakusu Hospital in the former Belgian Congo in the 1920s, sent Dr. Schweitzer “a card-index of the case of Lazarus:” Name: Age: Residence: Occupation: Disposal:

Lazarus Unknown Doorstep Beggar Abraham’s Bosom.6

Diagnosis: Treatment: Diet: Result:

Full of sores Dog licks Crumbs Died

It can be argued that both Dr. Schweitzer and Sir Clement were imbued with the idea that they were “the true successors of Christ the Healer.”7 This is, indeed, Chesterman’s position when he points out that the task of 4

See T. O. Ranger, “The Mobilization of Labour and the Production of Knowledge: The Antiquarian Tradition in Rhodesia,” Journal of African History 20 (1979): 507–24. 5 Albert Schweitzer, On the Edge of the Primeval Forest and More from the Primeval Forest: Experiences and Observations of a Doctor in Equatorial Africa (New York: Macmillan, 1948), 1. 6 Clement Chesterman, “The Medical Missionary,” Transactions of the Royal Society of Tropical Medicine and Hygiene 73, no. 4, (1979): 360. For a general overview on medical missionaries in Africa see transactions of the Ordinary Meeting Symposium of the Royal Society of Tropical Medicine and Hygiene on “The Contribution of Medical Missionaries to Tropical Medicine,” Transactions of the Royal Society of Tropical Medicine and Hygiene 73, no. 4 (1979): 357–66. See also Osaak A. Olumwullah, Dis-Ease in the Colonial State: Medicine, Society and Social Change among the AbaNyole of Western Kenya (Westport, CT and London: Greenwood Press, 2002), chap. 1. 7 Terence Ranger, “Godly Medicine: The Ambiguities of Medical Mission in Southeastern Tanzania, 1900–1945,” in The Social Basis of Health and Healing in Africa, ed. Steven Feierman and John Janzen (Berkeley, Los Angeles and London: Univ. of California Press, 1992), 257.

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medical missionaries to Africa was not only “to convert the heathen or to save the perishing” but also to “show care and compassion” in the true “sense of Christian duty.”8 As the historian, Sheldon Watts has observed, this iconography of heathen and/or perishing Africans belonged to mid- to late nineteenth-century Social Darwinist racialized constructions of humankind into higher (meaning white) and lower (black and colored) beings. When combined with the idea that medical missionaries were carrying out their Christian duty, the marriage between Jesus Christ and Herbert Spencer was complete;9 so much so that once in Africa, missionaries but also men of science were doing battle not only with nature itself but also with the very essence of Africa.10 The urgency with which this marriage was consummated and its implication for Africa, are well captured in a 1902 article in a journal of the Universities Mission to Central Africa. In this article, “The Black Man as Patient,” the author points out that taking a broad biological view of the different races of man and regarding their relationship with the animal world, it is impossible not to remark that, starting from the more highly organized races and going down the scale, the acuteness of pain experienced seems to grow less and less…the blunted feeling of pain…give us some clue to the vitality as a race exhibited by the [sick] negro...[who] has many amusing ways....Dying he creeps out into the sun, or hides away in the long grass, like some animal.11

Triumphantly endorsing this accomplishment, Lewis Gann and Peter Duignan, two renowned historians of the British Empire, would declare in the mid-1970s that “whatever political disadvantages colonialism might possess, from the biological standpoint its record is one of the great success stories of modern history.”12 Yet, ten years later, the two scholars would admit that the effect of Western medicine on Africa as a whole [was] hard to assess since improvements in communications, labor migration and wars of conquest had introduced a variety of new afflictions

8

Chesterman, “The Medical Missionary,” 360. Sheldon Watts, Epidemics and History: Disease, Power and Imperialism (New Haven, CT and London: Yale UP, 1997), 75. 10 Terence Keel, The Religious Pursuit of Race: Christianity, Modern Science and the Perception of Human Difference (PhD diss., Harvard University, 2012). 11 W.P., “The Black Man as Patient,” Central Africa 20, no. 231 (March 1902), 45–47, quoted in Watts, Epidemics and History, 75. 12 Lewis Gann and Peter Duignan, Burden of Empire: An Appraisal of Western Colonialism in Africa South of the Sahara (New York: Praeger, 1967), 292. 9

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and were convinced that since the end of the nineteenth- century, Africa, especially Anglophone Africa, had gone through a medical revolution. Credit for this is given to colonialism which, they argue, led to “one of the most successful attacks on tropical diseases in the history of Africa” between 1890 and 1914, when “Westernization had clearly changed African conditions for the better.” This assessment is pegged on the contention that, initially, the colonial rulers faced formidable problems in trying to develop the continent. Men and animals were sickly and suffered from scores of debilitating and killing diseases. Little was known before 1900 about the parasites and insects that attacked men, plants, animals and soils. Resources in manpower and money were lacking to do much scientific research. But there were some important beginnings; departments and institutes were started and research teams were organized to study ways to make Africa a more productive and healthier place.13

What was important for these individuals was the belief that improvements in African health in the twentieth century and the conditions for their possibility, are to be attributed entirely to colonialism as well as to Western medical science. This was a triumph that vindicated the vision of quintessential imperialists who had come to see the colonizer as the precursor and architect of a “higher civilization” in Africa and Western medicine as the crucible in which this civilization would be forged. This point is well brought out by Sir Charles Eliot, architect of white settlement in Kenya. Commenting on the colonizer as the precursor of a “higher civilization” in Africa, Eliot observed that as in Europe, Asia and North America, where nature had “submitted” to the influence and discipline of the white man, in the early twentieth century, in Africa, nature must also be reclaimed, disciplined and trained. Here, too, marshes had to be “drained, forests skillfully thinned, rivers be taught to run in ordered courses…a way must be made across deserts and jungles, war must be waged against fevers and other diseases.” To Charles Eliot, not very unlike medical missionaries such as Schweitzer and Chesterman, “nature” meant not just the physical characteristics of Africa but also the inhabitants of the continent who, for him, were not only “primitive” but also “natural” since they were not “cultured.”14 It can be said, using Eliot’s own sense of mission, that if Africa was a mosaic whose peculiarity revealed only 13

Lewis Gann and Peter Duignan, The Rulers of British Africa, 1870–1914 (Stanford: Stanford UP, 1978), 291, 297, 308–9. 14 Charles Eliot, The East Africa Protectorate (London: Edward Arnold, 1905), 4, 143.

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primitive proclivities, disease and naked death, its “reclamation” had to have the “taming” of nature in both its physical and human attributes as an important item on the imperialist agenda. In other words, if the domestication of nature was what differentiated the cultured, civilized and assiduous West from Africa, the process of reclaiming, disciplining and training nature in Africa was also meant to bring the “savage” and “primitive” societies of the continent into the realm of the visible.15 To this notion of a constant accretion of ideas on Africa as patient and as nature, were added other things. As the historian Gwyn Prins has observed, until the dying days of the nineteenth century, Europeans in Africa “trembled ignorant and defenseless for the most part before the ghastly, invisible legions of African diseases which struck them down with even greater ferocity than they did the native population.” The question that disturbed the West was: “Why should such primitives survive illness that so swiftly felled civilized whites?”16 The search for an answer to this question, coupled with the image of the continent as nature and as patient, contributed powerfully to the strongly drawn racial stereotyping that characterizes the European–African encounter: Africans as diseaseresistant demons or, all at once, “children of nature” who were always “merry, full of life and extraordinarily musical…somewhat like black Irish”17 but sadly, destitute and vulnerable.18 The position that these writers and observers and others take, has a long historical pedigree with its roots in late modern European empiricism and in the enthusiasm generated by the late nineteenth-century discoveries of Pasteur and Koch and the rise of “the new specialism of tropical medicine.” 19 Thus, writing in the true tradition of the Whig interpretation of history, the story that these historians tell is one of “the triumphs of tropical medicine” that becomes almost “the last justification for imperialism.”20 Indeed, from the time of conquest to the constitution of 15

Osaak A. Olumwullah, “Nature of Empire or Empire of Nature? Imperialist Nostalgia and the Constitution of the ‘Other’ in British East Africa” (Staff Seminar Paper, Moi University, 1992). 16 Gwyn Prins, “Review Article: But What Was the Disease? The Present State of Health and Healing in African Studies,” Past and Present 124 (1989): 159–60. 17 Ronald Ross, Memoirs (London: John Murray, 1923), 382. 18 Prins, “Review Article,” 160. See also Philip D. Curtin, The Image of Africa: British Ideas and Action, 1780–1850 vols. 1 and 2 (Madison: Univ. of Wisconsin Press), 1964. 19 Vaughan, Curing Their Ills, 34. See also John Farley, Bilharzia: A History of Imperial Medicine (Cambridge: Cambridge UP, 1991), 1–2. 20 Farley, Bilharzia, 1–2.

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colonial states in Africa, Europeans always craved for the sensitivity of being different. This was partly because of their position as “protectors” of the sick child that Africa was supposed to be and partly because they knew that they had the “expert knowledge” needed to extirpate disease and death on the continent. The definition and execution, therefore, of this difference came to depend on the language and symbols of biomedicine. Here, languaging, defined as “shaping, storing, retrieving and communicating knowledge into one open-ended process,”21 would be produced, affecting the representation of diseases and their site of occurrence to the world. The languaging in the “repertoire of prior texts, acquired over a lifetime,” was shaped, “reshaped and used in making sense”22 of the continent. This was a process that took place largely outside Africa, making knowledgeproduction on disease an exclusionary practice that either downplayed or completely silenced other discourses in the explanation and representation of Africa to the world.23 This chapter argues that the ideas, thus produced, were worked into a powerful ideology for the reproduction of the structures of racism and social domination.24 If imperialism was indeed more than “a political and economic event,” as the geographer Jane Jacobs has convincingly argued, there is reason to agree with her that “through a range of cultural processes” it went beyond “a singular political economy of ‘the world’” to embrace, quite fundamentally, the use of social constructs to invigorate domination.25 The main components of these constructs included the categorization, or naming, of “new” disease entities—African syphilis, 21

A.L. Becker, Beyond Translation: Essays Toward a Modern Philology (Ann Arbor: Univ. of Michigan Press, 1995), 9. See also Osaak A. Olumwullah, “BioScientific Research on East African Highlands Malaria Since the End of WWII: An Outline of a Research Idea,” Mimeo, 2015. 22 Ibid., 15. 23 On changing language and medical thought-styles in Europe, see, for example, Irma Taavitsainen, “Medical Case Reports and Scientific Thought-styles,” Revista de Lenguas para Fines Específicos 17 (2011): 75–98; “Historical Discourse Analysis: Scientific Language and Changing Thought-Styles,” in Sounds, Words, Texts and Change, ed. Teresa Fanego, Belén Méndez-Naya and Elena Seoane (Amsterdam/Philadelphia: John Benjamins Publishing Company, 2002), 201–26. 24 On the case of South Africa, see, for example, Karen Jochelson, The Colour of Disease: Syphilis and Racism in South Africa, 1880–1950 (New York: Houndmills, Basingstoke, Hampshire, 2001). The creation of racialized colonial medical encounters through the developing veterinary science has been dealt with at length in this volume by Estella Musiiwa (Chapter Seven) in her discussion on the control of East Coast Fever in Swaziland. 25 Jacobs, Edge of Empire, 2, 14.

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African relapsing fever, African trypanosomiasis, African hernia and so on—not according to these diseases’ biological, epidemiological, or pathological manifestations but rather according to their geographical and/or racial incidence. As both biological and epidemiological paradigms,26 these categorizations resonated well with the idea of Africa as nature and as patient since they spoke to the location of new meanings of health and disease at a “particular site defined by the exteriority of its vicinity.”27 It can, thus, be argued that if these champions of colonialism saw Western medicine as an important tool in the destruction of pestilence in Africa, they also came to link this science to imperialism, since it was through the latter that “civilization” was brought to the African Other. The conquest of disease was central to this process. From this perspective, it would not be far-fetched to argue with Adam Ashford that Africa was, from the very beginning, constituted into a “problem” whose “solution” demanded the application of the values and techniques of mastery, the mastery of “man” over “nature.”28 The image of Africa as a Lazarus was, thus, a very important discursive strategy not only in the logistics of conquest but also in the creation of colonial states on the continent. Like the all-embracing “native problem”29 in latter-day official discourses on the African, this image came to constitute the “intellectual domain in which the knowledge, strategies, policies and justifications necessary to the maintenance of domination were fashioned.”30 The idea of Africa as both patient and nature meant other things too. To the West, the continent was not only wild, isolated and sick; throughout the colonial period the image of hopeless suffering due to tropical diseases and cultural backwardness was in this discourse enhanced in provenance and magnitude by what was seen as brutal climatic conditions and poor soils.31 Trembling “ignorant and defenseless for the 26

Gill Seidel, “The Competing Discourses of HIV/AIDS in Sub-Saharan Africa: Discourses of Rights and Empowerment vs. Discourses of Control and Exclusion,” Social Science and Medicine 6, no. 3 (1993): 177. 27 Michel Foucault, The Archaeology of Knowledge (New York: Random House, 1972), 17. 28 Adam Ashford, The Politics of Official Discourse in Twentieth-Century South Africa (Oxford: Clarendon Press, 1990), 4. 29 Raymond L. Buell, The Native Problem in Africa, 2 vols. (New York: Macmillan, 1928; London: F. Cass, 1965). 30 Ashford, Politics of Official Discourse, 1. 31 Prins, “Review Article,” 159; W. O. Henderson, “German East Africa: 1884– 1918,” in History of East Africa, vol. 2, ed. V. Harlow and E.M. Chilver (Oxford: Clarendon Press, 1965), 123. See also M. Gelfand, Tropical Victory: An Account of the Influence of Medicine on the History of Southern Rhodesia, 1890–1923

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most part before the ghastly, invisible legions of African diseases which struck them down with even greater ferocity than they did the native population” as the historian Gwyn Prins has observed, Europeans were disturbed until the dying days of the nineteenth century by this question: “Why should such primitives survive illness that so swiftly felled civilized whites?”32 The search for an answer to this question, coupled with the image of the continent as nature and as patient, contributed powerfully to the strongly drawn racial stereotyping that characterizes the European– African encounter: the African as half devil and half child. The combination of these two indeterminate stereotypes completed the image formation of Africa as a medical problem in that while the one represented Africans as disease-resistant demons, the other constructed them as destitute, vulnerable and childlike.33 This state of concavity importuned European protection and care. In this sense, Charles Eliot’s vision of British East Africa had been vindicated; that of Albert Schweitzer and Clement Chesterman, too. But what does this triumphalism, beyond its sanctimonious posture, reveal about Gann and Duignan’s “medical revolution”? What lies behind this discourse and its truth-claims? What kind of medical knowledge was produced in the process of framing the colonial period around this seemingly ethical triumph? The urgency with which these questions are posed is pegged on the problematic of framing the colonial period in two moments of extreme pessimism. On the one hand, there is an epidemiological landscape whose marker is the sheer sense of desolate hopelessness. At the other end of the spectrum is a healthy and boisterous world devoid of disease and death, thanks to the wonders of biomedical scientific conquest. The only concern in the latter case is with the decidedly Malthusian fear of population explosion and its threat to resources that are not infinite. In an attempt to answer these questions, the following section of the chapter argues that to understand this triumphalism, we must go back to a twentieth-century medical drama whose philosophical foundations lie deeply rooted in late nineteenth- and early twentieth-century medical thought-styles in tropical medicine and epidemiology. These thought-styles have continuously vied for narrative

(Cape Town: Juto, 1953); P. Russell, Man’s Mastery of Malaria (London: Oxford UP, 1955); G.S. Nelson, “Medical Aspects—Commented Discussion,” Symposium of the British Society of Parasitology 16 (1978): 15–23. 32 Prins, “Review Article,” 159–60. 33 Ibid., 160.

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control in the conceptualization and production of medical knowledge on Africa. 34

Tropicality and the Rise of Tropical Medicine The story of the rise and development of tropical medicine as a specialism with its own institutions—Liverpool (1899), London (1899), Harvard (1900), Hamburg (1901), Paris (1901), New Orleans (1902), Berlin (1905), Brussels (1906) and Amsterdam (1912)—journals, research programs and education courses and qualifications35 cannot be divorced from a multiplicity of practices through which Europe constructed and represented what, since the fifteenth century, had come to be known as the tropical world. As Felix Driver and Brenda Yeoh have argued, this world was in simultaneity both a “geographical imaginary” and an “interpretative frame.” As Europeans moved to and settled in it, it was “constructed, enacted and disciplined,”36 making it as much physical as it was historical and conceptual.37 Perceived variously as the “torrid zone,” as “an earthly paradise, a veritable Garden of Eden,” and as “landscapes of desire,” the 34

Osaak A. Olumwullah, “Bio-Scientific Research on East African Highlands Malaria Since the End of WWII: An Outline of a Research Idea,” Mimeo, 2015; Cindy Patton, Globalizing AIDS (Minneapolis: Univ. of Minnesota Press), 2002. 35 Michael Worboys, “Colonial Medicine,” in Medicine in the Twentieth Century, ed. Roger Cooter and John Pickstone (Netherlands: Harwood Academic Publishers, 2000), 70; David Arnold, ed., Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500–1900, vol. 35 (Amsterdam: Editions Rodopi, 1996); P. J. Miller, “Malaria Liverpool”: An Illustrated History of the Liverpool School of Tropical Medicine 1898–1998 (Liverpool: Liverpool School of Tropical Medicine), 1998; H.J. Power, Tropical Medicine in the Twentieth Century: A History of the Liverpool School of Tropical Medicine, 1898–1990 (London and New York: Kegan Paul International, 1999); H.E. Annett, “The Work of the Liverpool School of Tropical Medicine,” Journal of the African Society (October 1, 1901): 208–13; Philip Gibbs, “The London School of Tropical Medicine,” Journal of the African Society (April 7, 1903): 316–24; Alfred C. Reed, “Tropical Medicine,” The Scientific Monthly 29, no. 5 (November 1929): 458–64; Ellis Herndon, “Tropical Medicine: Its Scope and Present Status,” The Scientific Monthly 58, no. 1 (January 1944): 42–48; Anonymous, “The Liverpool School of Tropical Medicine,” African Affairs 47, no. 189 (October 1948): 222–27. 36 Felix Driver and Brenda S. A. Yeoh, “Constructing the Tropics: Introduction,” Singapore Journal of Tropical Geography 21, no. 1 (2000): 4. 37 David Arnold, “‘Illusory Riches’: Representations of the Tropical World, 1840– 1950,” Singapore Journal of Tropical Geography 21, no. 1 (2000): 7. See also David Arnold, The Problem of Nature: Environment, Culture and European Expansion (Oxford: Blackwell Publishers, 1996), esp. chap. 8.

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tropical world and the “discourse of tropicality” it generated in many ways came to represent “an enduring alterity.”38 Although the cultural and political construction of this world did not conform to a single stereotype since its symbolism was “deeply ambivalent”—a world at once teeming with “natural abundance and great fertility” and “a landscape of poverty and disease”—in broad terms, its representation came to capture the way in which “the power of nature dominated human existence and to no small degree determined its characteristics and quality.”39 As David Arnold has convincingly argued, this representation “evolved symbolically with the natural and human sciences” as well as with the “perceived dominance of nature and the role that naturalists, physicians and geographers played in constructing ideas” that would eventually shape colonial practice. In this sense, “the emergence of tropicality was intimately associated not just with the visual arts and literature in Europe and North America but also with its scientific disciplines and technical specialties.”40 Naturalists like Charles Darwin, Joseph Dalton Hooker, Alfred Russel Wallace and, before them, Alexander von Humboldt, were thus pioneers who “helped invent the tropics both as a field for systematic scientific enquiry and a realm of aesthetic appreciation.”41 Nevertheless, it was the “duality that made the tropics appear as much pestilential as paradisiacal,” with the Western gaze increasingly coming to be trained on what its “primitive, violent, destructive and…detrimental” side could do to “the moral and physical well-being of human inhabitants,”42 that must help us in framing our answer to the question raised at the end of part one of this chapter. This is because at core of these representations was the increasing location of the perils of this world “in such diseases as yellow fever, dysentery and malaria and in ideas of race as well as place.”43 Situated in the middle latitudes of the globe, between the tropics of Capricorn and Cancer, the tropics “became, over the centuries, a Western way of defining something culturally alien as well as environmentally distinctive from Europe…and other parts of the temperate zone. The tropics existed only in mental juxtaposition to something else—the perceived normality of the temperate lands.” In this case, tropicality was “the experience of northern whites moving into an alien world—alien in climate, vegetation, people and

38

Arnold, “Illusory Riches,” 7. Ibid. 40 Ibid. 41 Ibid., 8. 42 Ibid. 43 Ibid., 9. 39

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disease.”44 Although first articulated with reference to the Caribbean, ideas about “the climate and diseases of the tropics” came as early as the nineteenth century to encompass other parts of the “tropical world,” which, its diversity notwithstanding, was endowed with “a large measure of environmental homogeneity, viewed from an external temperate zone.”45 Onto the idea of tropicality was, in Africa in this period, mapped the metaphor of the Dark Continent 46 which, in all its potential lethality, moved Euro–American debates from mere concerns with the vicissitudes of climate to debates about the correlation between “the presumed antiquity of the physical geography of the continent and the moral condition of its inhabitants.”47 This correlation but more so the duality of pestilential and paradisiacal Africa was, in the mid-nineteenth century, captured in the image of the continent as a long-suffering woman by Winwood Reade, who wrote: There is a woman whose features, in expression, are sad and noble but which have been degraded, distorted and rendered repulsive by disease; whose breath is perfumed by rich spices and by fragrant gums, yet through all steals the stench of the black mud of the mangroves and the miasma of the swamps; whose lap is filled with gold but beneath lies a black snake, watchful and concealed; from whose breasts stream milk and honey, mingled with poison and with blood; whose head lies dead and cold and yet is alive; in her horrible womb heave strange and monstrous embryos. Swarming around her are thousands of her children, whose hideousness inspires disgust, their misery compassion. She kisses them upon the lips and with her own breath she strikes them corpses by her side. She feeds 44

Arnold, The Problem of Nature, 142–43. Ibid. 46 See, for example, Patrick Brantlinger, “Victorians and Africans: The Genealogy of the Myth of the Dark Continent,” in Critical Inquiry 12 (1985): 166–203; C.L. Miller, Blank Darkness: Africanist Discourse in French (Chicago: Univ. of Chicago Press), 1985; Patrick Brantlinger, Rule of Darkness: British Literature and Imperialism, 1830–1914 (Ithaca and London: Cornell UP), 1988; Lucy Jarosz, “Constructing the Dark Continent: Metaphor as Geographic Representation of Africa,” in Geografiska Annaler: Series B, Human Geography 74, no. 2 (1992), 105–15; Clive Barnett, “Impure and Worldly Geography: The Africanist Discourse of the Royal Geographical Society, 1831–73,” in Transactions of the Institute of British Geographers, New Series, 23, no. 2 (1998): 239–51; Johannes Fabian, Out of Our Minds: Reason and Madness in the Exploration of Central Africa (Berkeley, Los Angeles, London: Univ. of California Press, 2000). 47 Clive Barnett, “Impure and Worldly Geography,” 246. See also Dorothy Hammond and Alta Jablow, The Africa that Never Was: Four Centuries of British Writing about Africa (Prospect Heights, IL: Waveland Press, 1992), esp. chap. 5. 45

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Chapter Eleven them at her breasts and from her own breasts they are poisoned and they die. She offers them the treasures of her lap and as each hand is put forth the black snake bites it with his fatal fangs.48

Reade ends this reflection rather rhetorically, “Look at the map of Africa. Does it not resemble a woman with a huge burden on the back?”49 Thus, created as much as invented, this is the world—regressive, primitive, barbaric and forgotten by time and shunned by civilization50 — Adalja and company were talking about. And this is the world that would, so it was thought, succumb to discipline, reclamation and domestication. The mighty hand of Western science, having proven itself in conquering nature in the West and elsewhere, would see to that. This self-assurance notwithstanding, the problem—indeed the paradox—persisted, of how to go about a Euro–American conquest of and settlement in, a world that was both appallingly contagious and resplendently rich. To what extent and at what sacrifice, could this world be coaxed into permitting permanent white settlement? As David Arnold has succinctly argued, the search for answers to this question and the debates elicited in the process, drew not just on the fate of ancient civilizations or the collapse of Caribbean ventures but also on what was seen by Anglo-Saxon writers as the failure of Iberian attempts at colonization and the spread of civilization. Indeed, much of the British and North American discourse on tropicality in the late nineteenth and early twentieth centuries reads as a critique of Spanish and Portuguese “miscegenation” and tropical degeneration and hence as an argument for maintaining, by contrast, the vigour and purity of the AngloSaxon race.51 Be that as it may, “it was hard for naturalists and geographers to envisage the lasting transformation of the tropics without white settlers.” Otherwise, “how could tropical agriculture ever be improved? How could the tropical world be made more productive and efficient without the stimulus and example of white labour? Were the tropics inherently unsuitable for Europeans, or could they be ‘made safe’ by modern medical and sanitary science?”52 According to Arnold, the rise in the

1890s and 1900s of the disciplines of tropical medicine and tropical agriculture “exemplified the intensified search for practical solutions to the 48

Winwood Reade, Savage Africa, 2 vols. (New York, 1864), 383, quoted in Hammond and Jablow, The Africa that Never Was, 71–72. 49 Ibid. 50 Arnold, “Illusory Riches,” 10. 51 Ibid., 14. 52 Ibid.

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paradox of the rich-but-poor tropics.” These were “new specialties,” and they brought about “not only a new technical specificity to the investigation of the tropics but also reinforced many negative representations.”53 In the case of tropical medicine, this development can be attributed to, on the one hand, the turn-of-the-century new imperialism that was “associated with the annexation of new colonies in Africa and the consolidation of possessions elsewhere” and, on the other, “the medical developments associated with the identification of specific bacterial pathogens as the causes of epidemic and infectious diseases.”54 Perhaps, the most important element in the latter aspect of this development was “the identification of the role of the mosquito in spreading the malaria parasite and the hopes this raised that such knowledge could be applied to reduce European mortality and morbidity” in the tropical world, thus encouraging settlement, trade, investment and the spread of civilization.55 Whichever way one looks at this enterprise—whether with regard to its rise and development, to the debates that went on concerning who discovered what and to its complicity in Western re-imaginings of the tropical world —two things seem clear in its early history. First and foremost, as Western discourses on tropicality moved center stage in the constitution of tropical medicine, the contours that defined the differences between the temperate and tropical worlds became even sharper, as the movement of ideas on diseases and their treatment was assumed to be unidirectional, that is, from the former to the latter world. The argument behind this was that indigenous medical systems, if there were any, were “superstitious, backward and ineffective, with nothing to teach European medicine.”56 Second, though the constitution of tropical medicine into a specialism occurred in a space of barely fifteen years, its roots were just as deep as the path of its development was inconsistent. While, for example, France and Germany seemed to favor “the direct transfer of the programs of laboratory medicine to the colonies, essentially exporting the schools of Louis Pasteur and Robert Koch,” in Britain and America “tropical medicine and hygiene developed distinct interests and approaches, focusing on a small group of vector-borne parasitic diseases said to be unique to tropical-colonial conditions.” For this developing specialism, malaria increasingly became “the most significant disease both practically and symbolically, with conditions such as sleeping sickness, schistosomiasis, leishmaniasis and leprosy reinforcing the notion that the tropical disease 53

Ibid., 15. Michael Worboys, “Colonial Medicine,” 70. 55 Ibid. 56 Ibid., 71. 54

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environment was one of parasites and vectors and quite different to temperate climes.”57 As Patrick Manson observed with reference to the health of whites in West Africa in the second half of the nineteenth century, malaria, a “tropical disease,” was “the chief of the endemic diseases…(and) the principal cause of sickness and death there and of social stagnation.”58 From this perspective, it can be argued that the discourse on tropicality was about, on the one hand, “the problems Europeans and Americans encountered in their distant occupations, reflecting both the reality and the fantasy of the colony,” and, on the other, the rise of a new way of perceiving and thinking that was “crucial to the development of certain modern concepts of disease.”59 Thus, whether it was the “transfer of programs of laboratory medicine to the colonies” as was the case with the French and Germans, or the “focus on a small group of vector-borne parasitic diseases said to be unique to tropical-colonial conditions” as was the case with the British and the Americans, “the displacement of the scientific laboratory from the academy to the field was crucial to the discovery of etiologic agents.” This was in part because “it enabled researchers to study diseases across a wide range of cases—a population— and in action.”60 This development had a number of implications, the most important being, first, the move toward “the association of once only hypothetical disease agents with actual illness, finally establishing germ theory and the technology of vaccination.” Second, the displacement of the laboratory to the field meant that the late nineteenth-century “version of germ theory made sense because it was consistent with the political logic of invasion and occupation”61 of the tropics by Europe and America. Third, this political logic had to violently deride, refute and reduce Tropical Worlders’ therapeutic knowledge about disease and disease causation to superstition. As opposed to African therapeutic know-how, Western medicine was seen as being empirically grounded and thus possessing “the authority of truth.” The necessity for using violently 57

Ibid. Patrick Manson, “A School of Tropical Medicine,” Proceedings (London: Royal Colonial Institute 31, 1900), 180. On the mortality of British expatriates in colonial West Africa, see L. J. Bruce-Chwatt and Joan M. Bruce-Chwatt, “Malaria and Yellow Fever: The Mortality of British Expatriates in Colonial West Africa,” in Health in Tropical Africa during the Colonial Period, ed. E. E. Sabben-Clare, D. J. Bradley and K. Kirkwood (Oxford: Clarendon Press, 1980), 43–62. 59 Cindy Patton, Globalizing AIDS, 34. 60 Ibid., 34–35. 61 Ibid., 35. 58

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derisive, confrontational and reductive language in the constitution of the “African tropical world” as superstitious spoke not only to Western cultural positioning but also to an “ethnocentric moment… aimed explicitly towards an intellectual reduction that would complement the rules of orthodoxy and conformity.”62 In explaining this, Cindy Patton argued that like much nineteenth- and early twentieth-century social thought, colonialism operated through homology: the scientific lab was not an organ of the state; rather, it sat in homologous relation, as the state, to the domain of disease, over which it held paternal control. Similarly, the colony of germs was homologously represented in a body or on an agar plate. Tropical medicine tried to predict where disease might be by analyzing the chain of homologous spaces—from the state to the agar plate—that were characterized by the telescoping structure of power relations.63

Since tropical medicine was only “feasible because colonial administrators believed that local diseases did not affect indigenous people in the same way they affected” European and American settlers, a tropical disease was understood to be proper to a place, to a there but only to operate as disease when it affected people from here. Pathogens in a locale were recorded in medical history mainly when they appeared as disease in a colonist’s body. Tropical disease was contained by virtue of already being there, in the “tropics.” Critically, the very idea of tropical medicine rested on the ability to reliably separate an indigenous population, thought to be physically hearty but biologically inferior, from a colonizing population, believed to be biologically superior even though subject to the tropical illnesses.64

Operating on the basis of “a presupposed map and hierarchy of bodies,” tropical medicine thus “grew out of and supported the idea that a First World body is the proper gauge of health; the Third World is the location of disease, even though its occupants are not properly the subjects of tropical medicine….Only Europeans are subjects in tropical accounts and not in relation to disease but in relation to a prior presumption about ‘being from here.’”65 62

V. Y. Mudimbe, The Invention of Africa: Gnosis, Philosophy and the Order of Knowledge (Bloomington and Indianapolis: Indiana UP, 1988), 47, 52. 63 Cindy Patton, Globalizing AIDS, 35. 64 Ibid.; emphasis in original. 65 Ibid., 35–36. On the Third World body in imperial medical discourses, see, for example, Warwick Anderson, “The Third World Body,” in Medicine in the

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Thus, Euro–American presence in the Other World, the Tropical World, was replete with “anxieties about being—and compulsions to be— in proximity to the primitive.” This not only led to “an interest in natural immunity” that would provide the Euro–American with the capacity to safely colonize and “live in proximity to germs that appeared to characterize the colonized;” at the level of languaging, it also led to the way in which both diseases and the ailments that afflicted the colonizer in this Other World came to be “described in melodramatic terms” as the monsters “inside the domestic space, the evil endemic to the colony.” Seen from this perspective, the “quest for immunity” by Euro–Americans once in the tropics both “sustained the hierarchical difference between the colonized, immune body and the colonizing, immunizable body” and reversed “the culturally legible fear of being penetrated by alien germs” into “a tale of fearlessness,” creating, as it were, the very conditions of possibility for the “vaccinated colonizing body” to “safely live in close proximity to, by colonizing the very immunity of, the colonized body” that was “conceived as being ‘naturally’ close to disease.”66 This was a “melodramatic narrative” in which, among other things, the “ailing body” of the colonizer was portrayed not as “the victim of dislocation” but rather as “the most intimate site of domesticating the tropics,”67 as a heroic marker of both the intimate knowability of ailing and the conditions of possibility for convalescence. However, unlike tropical thinking, epidemiology, defined as the scientific and medical study of the causes and transmission of disease within a population, spoke to, or “told the story of pathogens, not of bodies in places.”68 Operating through statistical technologies as its main form of reasoning, epidemiology was inclined toward the separation of the germ’s story from the body, allowing it, as it were, “to declare ‘disease’ from some but not all conjunctures of body and pathogen.”69 From the foregoing discussion, it can be argued that the production of medical knowledge on Africa and Africans in the nineteenth and early twentieth centuries was heavily infused with Western “assumptions about racial superiority.”70 Deemed as (an) other place, as we have seen in the Twentieth Century, ed. Roger Cooter and John Pickstone (Netherlands: Harwood Academic Publishers, 2000), 235–45. 66 Patton, Globalizing AIDS, 36–37. 67 Ibid., 37–38. 68 Ibid., 39. 69 Cindy Patton, Globalizing AIDS (Minneapolis: Univ. of Minnesota Press), 2002. 70 Bill Freund, The Making of Contemporary Africa: The Development of African Society since 1800, 2d ed. (Boulder, CO: Lynne Rienner, 1998), 2. A good

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above sections, the continent was bracketed and dissociated from the allknowing West, increasingly turning it into a laboratory for languaging—not only the shaping and storing of a repertoire of texts on Africa acquired over a lifetime but also their retrieval at the right moment “for communicating knowledge into one open-ended process.”71 This process took place and continues to take place, largely outside Africa, making knowledgeproduction on Africa as patient and as nature an exclusionary practice that either downplays or completely silences other discourses in the explanation and representation of disease to the world. In this sense, the image of Africa as “raw nature” and as “patient” came to constitute the “intellectual domain in which the knowledge, strategies, policies and justifications” necessary to the logic of conquest and the maintenance of domination were fashioned.72 How does malaria, “both practically and symbolically” the most significant of all tropical diseases,73 help us in contextualizing these issues?

Malaria and Africa David Arnold has argued that even before the advent of DDT, the “conquest” of malaria seemed synonymous with the “conquest” of the tropics.74 Indeed, by the turn of the twentieth century, malaria had “become the quintessential tropical disease and the revelation of its etiology the chief triumph of the new discipline of tropical medicine.”75 It is, despite having been eradicated in the industrialized North, perhaps the most prevalent and important disease worldwide today.76 Every year, there introduction to the activities of colonial administrators and medical/health experts in this field is E. E. Sabben-Clare, D. J. Bradley and K. Kirkwood, eds., Health in Tropical Africa during the Colonial Period (Oxford: Clarendon Press, 1980). On the production of colonial knowledge, generally, on Anglophone Africa, see Douglas Rimmer and Anthony Kirk-Greene, eds., The British Intellectual Engagement with Africa in the Twentieth Century (New York: St. Martin’s Press, 2000). 71 A. L. Becker, Beyond Translation: Essays Toward a Modern Philology (Ann Arbor: Univ. of Michigan Press, 1995), 9, 15. 72 Ashford, The Politics of Official Discourse, 1. 73 Worboys, “Colonial Medicine,” 71. 74 Arnold, “Illusory Riches,” 15. 75 Lyn Schumaker, “Malaria,” in Medicine in the Twentieth Century, ed. Roger Cooter and John Pickstone (Netherlands: Harwood Academic Publishers, 2000), 704. 76 L. Schuyler Fonaroff, “Rethinking Malaria Geography: Problems and Potentials for the Profession,” in Environment and Health: Themes in Medical Geography, ed. Rais Akhtar (New Delhi: Ashish Publishing House, 1991), 73.

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are an estimated 300 to 500 million cases of malaria in more than ninety countries worldwide. Ninety percent of these cases occur in Africa. This represents an estimated 2.3 percent of global disease and 9 percent of disease in Africa. Malaria remains the first cause of death for children under five years on the continent.77 In Kenya, a country with a population of about 42 million people, an estimated 8.2 million cases of malaria are reported every year. The scourge is responsible for the greatest number of consultations (30 percent of new cases in medical centers within the public health service) and is the most common reason for hospital admission (22,000 cases per year in public hospitals).78 The late 1980s through the 1990s, witnessed an escalation in the prevalence of the disease on the continent. Between 1994 and 1996 alone, malaria epidemics in fourteen sub-Saharan countries not only caused “an unacceptably high number of deaths, many in areas previously free of the disease”79 but also revealed what economists came to see as the effect of the disease on economic growth on the continent.80 This resurgence was attributed to, among other things, difficulties and/or failure in mosquito eradication programs; the development of vector and parasite resistance to insecticides and antimalarial drugs; and to alterations in the earth’s climate regime due to

77

Oluwatosin Omole, Babafemi Adenuga and Joshua Adeoye, “The End of Malaria?” accessed September 2, 2017, https://www.project-syndicate.org/comm entary/mosquirix-malaria-vaccine-by-oluwatosin-omole-et-al-2015-09. 78 Press Dossier, “Changing National Malaria Treatment Protocols in Africa: What is the Cost and Who will Pay?” Based on summary of a paper by Jean-Marie Kindermans, February 13, 2002, Nairobi, Kenya, p. 1–2, 9; Thomas C. Nchinda, “Malaria: A Reemerging Disease in Africa,” Emerging Infectious Diseases [serial online], July–September, 1998 [December 9, 2002], vol. 4, no. 3. Available at http://www.cdc.gov/ncidod/eid/vol4no3/, World Health Organization. Investing in Health Research for Development. Report of the Ad Hoc Committee on Health Research Relating to Future Intervention Options, Geneva: The Organization, 1996, Report No. TDR/Gen/96.1; Harvard Malaria Initiative, “The Ancient Scourge of Malaria,” accessed September 2, 2017, http://www.hsph.harvard.edu/Malaria; World Health Organization (WHO) and United Nations Children’s Fund (UNICEF), “State of the World’s Vaccines and Immunization” (Geneva: WHO, 2002). 79 Thomas C. Nchinda, “Harare Declaration on Malaria Prevention and Control in the Context of African Economic Recovery and Development,” in Proceedings of the 33rd Ordinary Session of the Assembly of Heads of State and Government, Organization of African Unity, June 2–4, 1997, Harare, Zimbabwe. 80 For a good summery and analysis of the latter point, see F. Desmond McCarthy, Holger Wolf and Yi Wu, “The Growth Costs of Malaria,” December 1999, www.Malaria.org/.

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human activity.81 Other factors mentioned in the literature include the frequent armed conflicts and civil unrest in many countries that forced “large populations to settle under difficult conditions, sometimes in areas of high malaria transmission”; migration of “nonimmune populations from non-malarious and usually high to low parts of the same country where transmission is high;” changing rainfall patterns as well as “water development projects such as dams and irrigation schemes” that created new mosquito breeding sites; adverse socioeconomic conditions leading to “a much reduced health budget and gross inadequacy of funds for drugs;” high birth rates, leading to “a rapid increase in the susceptible population under 5 years of age”; and “changes in the behavior of vectors, particularly in biting habits, from indoor to outdoor biters.”82 Though the literature suggests that malaria in Africa is, as a matter of fact, a disease of failed development, emphasis has, nonetheless, continued to be placed on resistance of malaria parasites to drugs, alterations in climatic conditions, human migrations and changes in vector behavior as the main foci in the analysis of the disease on the continent. Research questions posed throughout the 1990s and whose answers led to the above conclusions have, needless to say, been important with regard to the understanding of and genuine need for the eventual control of malaria. It, however, seems that by all accounts, models for the eradication of malaria in Africa initiated in the 1950s through the early 1960s had all but failed by the end of the 1980s. Since the early 1990s, it has been clear that models for both the study of the relationship between the incidence of malaria and its control and the impact of environmental change on the ecology of the anopheles mosquito required fundamental rethinking. What went wrong at this point? Where exactly should the failure in control and eradication be located: in the control methods that had since the 1950s been the first line of approach in the attack against the disease, or in “biomedical history and

81

B.M. Khaemba, A. Mutani and M.K. Bett, “Studies of Anopheline Mosquitoes Transmitting Malaria in a Newly Developing Highland Urban Area: A Case Study of Moi University and its Environs,” East African Medical Journal 17, no. 3 (March 1994): 159–64; The Harvard Working Group on New and Resurgent Diseases, “New and Resurgent Diseases: The Failure of Attempted Eradication.” The Ecologist 25, no. 1 (January/February 1995): 21–26; Paul R. Epstein et al., “Biological and Physical Signs of Climate Change: Focus on Mosquito-borne Diseases,” Bulletin of the American Meteorological Society 79, no. 3 (1998): 409–17. 82 Nchinda, “Malaria.”

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the management structures” these methods were driven by?83 Where do we locate tropical and epidemiological thought-styles in this history and these management structures? The malaria epidemics of the 1980s and 1990s was by no means the first in twentieth-century Africa. Neither, for that matter, did the disease achieve its first and sustained presence on the continent in the twentieth century. Before the time of colonial conquest, Africans knew about malaria—its incidence and bodily manifestations, its seasonality and spatial distribution, its control and/or treatment—and they had, as in many other cultures and as in the case of other diseases, names for the malady and ways of dealing with it. However, unlike in the twentieth century, when the disease began to appear with more frequency—at times in epidemic proportions in areas where it had been non-existent—in the precolonial period, it was more often than not long drawn out and subtle rather than dramatic in its occurrence and effects. In this case and as Marcos Cueto pointed has out in the case of the Peruvian Andes, malaria was in the precolonial period “accepted as a natural inconvenience of life.”84 Things do not seem to have been the same come the twentieth century: the records are replete with cases of serious malaria epidemics such as those that took place in South Africa in the late 1920s and early 1930s85 and in Ethiopia in 1958.86 In Kenya, for example, written and verbal sources are full of examples of similar epidemics that are extensively discussed and/or commented upon by men of science, by administrators and by victims of the disease.87 In newspapers, in public 83

John Porter, Jessica Ogden and Paul Pornyk, “Infectious Disease Policy: Towards the Production of Health,” Health Policy and Planning 14, no. 4 (1999): 322–28. 84 Marcos Cueto, “The Meanings of Control and Eradication of Malaria in the Andes,” Parassitologia 40, no. 1–2 (1998): 177. 85 D. Le Sueur, B.C. Sharp and C.C. Appleton, “Historical Perspectives of the Malaria Problem in Natal with Emphasis on the Period 1928–1932,” South Africa Journal of Science 89 (1993): 232–39. 86 R.E. Fontaine, A.E. Najjar and J. S. Prince, “The 1958 Malaria Epidemic in Ethiopia,” American Journal of Tropical Medicine and Hygiene 10 (1961): 795–803. 87 See, for example, J.H.H. Chataway, “Report on the Malaria Epidemic in the Lambwe Reserve (August, 1928),” Kenya and East African Medical Journal 20 (1929): 303–9; J. M.Campbell, “Malaria in Uasin Gishu and Trans Nzoia,” Kenya and East African Medical Journal 6 (1929): 32–43; Anderson T. Farnworth, “Report on an Investigation of Health Conditions on Farms in the Trans Nzoia with Special Reference to Malaria,” East African Medical Journal 6 (1929–1930): 274–308; A.T. Matson, “The History of Malaria in Nandi,” East African Medical Journal 34 (1957): 431–41; J.M.D. Roberts, “The Control of Epidemic Malaria in

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forums and especially in the (Kenya and) East African Medical Journal, issues and ideas ranging from arguments about the enervating conditions of the African climate, descriptions of cultural differences and accounts of the customs, manners and spatial practices of African societies and their role in disease causation, to representations of geographical landscapes and their role in the incidence of malaria, have been discussed extensively. Thus, at a time before sexually transmitted diseases became an issue in the interwar period and with plague appearing only intermittently up to the end of the 1920s and the incidence of trypanosomiasis increasingly coming to be associated with African shenzi cattle that threatened the development of white dairy farming, malaria remained the disease that would continue to engage, in almost equal measure, the administrator and the man of science throughout the colonial period and beyond. Around it—from its naming and mapping to strategies about its conquest—would unfold ideas about the tropical world and the dangers it posed to the reclaiming, disciplining and training of this torrid zone for white settlement, about prophylaxis, about race and about control and eradication. Even after WHO’s initial successes at eradicating malaria in the 1950s, it would remain through the 1990s an infectious disease that was both intriguing, in terms of approaches to its control and eradication and confounding, in terms of the practices that were brought to bear on these processes. The scenario—environmental, etymological/biological, political, economic, social—that has emerged since the recognition of the disease and its status as a major medical problem in Africa, raises questions as to whether scientists, in their search for a lasting solution, should incorporate in their “reading” of the disease “historically deep and geographically broad” questions that encompass more than concepts of change.88 These are questions about complexity, including social and philosophical complexity, important not only because they constitute the Highlands of Western Kenya. Part I. Before the Campaign,” Journal of Tropical Medicine and Hygiene 67 (1964): 161–68; J.M.D. Roberts, “The Control of Epidemic Malaria in the Highlands of Western Kenya. Part II. The Campaign,” Journal of Tropical Medicine and Hygiene 67 (1964): 191–99; J.M.D. Roberts, “The Control of Epidemic Malaria in the Highlands of Western Kenya. Part III. After the Campaign,” Journal of Tropical Medicine and Hygiene 67 (1964): 230– 37; R.B. Heisch and J.O. Harper, “An Epidemic of malaria in the Kenya Highlands transmitted by Anopheles funestus,” Journal of Tropical Medicine and Hygiene 30 (1949): 187–90; C.B. Symes, “Present State of Malaria in Nairobi,” East African Medical Journal 17 (1940): 339–55. 88 JoAnn McGregor and T.O. Ranger, “Displacement and Disease: Epidemics and Ideas about Malaria in Matabeleland, Zimbabwe, 1945–1996,” Past and Present 167 (May 2000): 266.

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“perhaps the central general scientific problem of our time”89 but also because they bring to bear “the unequal positioning of groups within larger populations,”90 the unequal relations between the global North and the global South and the competition over narrative control in the generation of knowledge about malaria in the framework of these relations. Most recent literature on the introduction of a Western therapeutic tradition in Africa91 focusses on three things with regard to colonial medical performance, though the emphasis here has been on how colonial governments in the early years of colonialism were generally plagued with insufficient resources and lack of manpower. First, it has been argued that medical work in this period was mostly urban-oriented and its clientele consisted of the European population in particular and government employees in general. Second, medical emphasis was on curative, not preventive, medicine. Third, the colonial states’ endeavor to deal with medical problems in rural areas was late in coming and, when it came, the approach employed was haltingly haphazard. As argued elsewhere,92 it seems that it was largely because of these factors that much of the work in the provision of these services fell on the shoulders of medical missionaries. It has further been argued that the shift in colonial medical policies in the years immediately after World War I was mainly due to the realization on the part of many governments that the innumerable diseases, many of them of epidemic proportions, that had been devastating rural areas were a threat not only to the African rural folk but also to European populations. That this realization came out of some “new understanding” that these diseases, after all, knew no racial or class boundaries can hardly, at least from the way this argument has been articulated, be gainsaid. On this basis, some scholars have concluded that the government move to improve health standards in rural areas in the interwar period was motivated not by a concern for the health of the colonized per se; rather it was predicated as much on the need to protect the health of the colonizer as on the fear that these epidemics were a threat to the African labor needed for settler economic enterprises, particularly in Kenya, South 89

R. Levins, “Preparing for Uncertainty,” Ecosystem Health 1 (1995): 47–57. Paul Farmer, “Social Inequalities and Emerging Infectious Diseases,” Emerging Infectious Diseases 2, no. 4 (October–December 1996): 266. See also Farmer’s Pathologies of Power: Health, Human Rights and the New War on the Poor (Berkeley, Los Angeles, London: Univ. of California Press), 2003. 91 For a summary of this literature, see Steven Feierman, “Struggles for Control: The Social Roots of Health and Healing in Modern Africa,” African Studies Review 28, no. 2–3 (1985): 73–145; Prins, “Review Article,” 159–79. 92 Osaak A. Olumwullah, Dis-Ease in the Colonial State, in particular Chapter 5. 90

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Rhodesia and South Africa. A very good example of this argument comes from Megan Vaughan, who writes, Early colonial administrators…frequently faced a major epidemic of one sort or another. Most often the fear was that European populations would be affected. Africans were regarded as a “reservoir” of disease and…this often provided a medical rationale for racial segregation (in urban areas). Settler economies were…much more prone to this particular formulation than were peasant-based economies…where the consequences of depletion of the African producing population were a focus of another kind of concern. In either case, there were only scant resources at the disposal of the colonial state to deal with epidemic diseases. This was not, at this stage, because of the triumph of the “individual pathology” model of disease and a resulting bias towards curative medicine. Rather it was because the early colonial state was generally impoverished and, in any case, did not conceive of its role as providing health (or education) services on any scale, except to white minorities. The problem of epidemic disease threw this issue into sharp relief for, though epidemics affected the poor severely, they also showed an alarming tendency to cross race and class barriers. If one was going to protect the health of the European population, then the health status of Africans would have to be addressed, at least in a minimal way.93

In line with Megan Vaughan’s arguments, several early liberal critics of the colonial system in Africa and colonial medical experts themselves commented extensively on these issues. For instance, W. M. Macmillan commented in 1938 that rural Africa was “after all the crux of the health problem" and that a health policy geared toward urban areas was bound to be counterproductive, as Africans kept on flocking into these towns, thus constantly re-infecting them.94 With regard to threats to African labor, especially in Kenya, the colonial medical department expressed serious concern in 1926 over the population shortfall that had resulted from various famines and epidemic diseases in the rural areas, citing an urgent need for active measures to reverse this trend;95 this, however, does not indicate complete lack of government support during the outbreak of epidemics, as during the plague epidemics in the first decade of the twentieth century. For example, in 1905, during a devastating outbreak of the epidemic in Kisumu, Kenya, the colonial government not only admitted 93

Megan Vaughan, Curing Their Ills: Colonial Power and African Illness (Cambridge: Polity Press, 1991), 39; emphasis added. 94 Macmillan, Emergent Africa, 230. 95 Colony and Protectorate of Kenya, Annual Medical Report for 1926, 15.

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that this was the result of economic changes that had been taking place in the region but also promptly dispatched a bacteriologist, Dr. P. H. Ross, to inspect the situation and put in place a program for combating it.96 Government action in handling the epidemic can also be gauged from Ross’s communication to Major Will, the principal medical officer, in January 1905. According to Ross, Kisumu was not just some isolated and “unhappy termination of the Uganda Railway;” what was happening in the town called for “all precautions” because “while outbreaks at isolated stations may be regarded without fear the presence of many centres of a more or less insanitary character along the line makes an outbreak of plague the cause of greatest apprehension.”97 Ross’ concern—and indeed the concern of both the colonial medical establishment and the nascent colonial state—was born out of the fear that, left unchecked, the disease was bound to affect the health of the European population in the town. Thus, it can be argued, the measures adopted for dealing with the disease—the imposition of quarantine and isolation of the sick, the inspection of the Indian bazaar, the burning down of the hut-tax collector’s quarters and the zoning of Kisumu into Indian, African and European areas—were not devoid of racist ideas, for they indicated the need to keep “the native and European areas apart” since “the disease appear[ed] to be endemic about the Victoria Nyanza.”98 However, if the Uganda Railway was to pay for itself, as the British Foreign Office envisaged and if the region had become, economically, central to this vision, as we have argued elsewhere,99 then the outbreak—indeed, the disease itself—was quickly translated into a social metaphor whose meaning spoke not only to the issue of the protection of European health but also to the social control of Africans in the town as well as to the self-evident need of establishing and maintaining a robust colonial economy in the region. Thus Kisumu, being not just some isolated and “unhappy termination of the Uganda Railway,” became one of the first areas the Kenyan colonial state focused on in its 96

Plague Report, Enclosure in S. Bagge, Provincial Commissioner Nyanza, to D. Stewart, Commissioner EAP, March 13, 1905, CO: 533/1; Dr. P. H. Ross to Major Will, Principal Medical Officer, January 25, 1905, CO: 533/1. See also J. A. Haran, “Plague in the British East Africa Protectorate, Report No. 1,” Journal of Tropical Medicine and Hygiene 8 (1905): 177–78. 97 Ross to Will, January 25, 1905. CO: 533/1. 98 The Secretary of State, Lyttelton, to Commissioner Stewart, April 24, 1905, CO: 533/6; see also Report on Kisumu Township, on the General State of the Township and the Improvements Contemplated, April 1907, Nyanza Province Annual Report, 1907–1908. 99 Osaak A. Olumwullah, Dis-Ease in the Colonial State, esp. chap. 5.

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reform program. And this would remain the case until medical policy was rethought in the run-up to Kenya’s independence in the early 1960s.100 Embedded within the discourse of disease as social metaphor were other fears and anxieties about and over the tropics. As Kavita Philip has observed in her work on colonial India, the story of colonial science was not just about the fear of whites living in proximity to the colonized native; it encompassed “multiple, tangled narratives of race, class, gender, nation and scientific progress,” as seen in, for example, the construction of nature more often than not intersecting with the construction of other narratives like that of “primitives.”101 This would increasingly be the case in sub-Saharan Africa where, as recent scholarship has shown, programs and policies meant to fight sexually transmitted diseases like syphilis were based on “prejudicial models that assumed Africans and other social categories on the margins of the privileged white colonial community such as poor whites to be sexual deviants:”102 where a “close relationship between European residence…and nervous illness”103 was firmly established; and where, in colonies such as Kenya, race and the eugenics movement became intertwined during the interwar period.104 The first line of attack against tropical diseases such as malaria in the years of colonialism reflected the thinking in Britain, where, at the end of 100

See N.R.E. Fendall, “Planning Health Services in Developing Countries: Kenya's Experience,” Public Health Reports (1896–1970), 78, 11 (November 1963), 977–88. 101 Kavita Philip, “English Mud: Towards A Critical Cultural Studies of Colonial Science,” Cultural Studies 12, no. 3 (1998): 300. 102 Terence M. Mashingaidze, “Power, Disease and Prejudice: A Historiographical Overview of the Syphilis Contagion in Colonial Sub-Saharan Africa, 1890s– 1950s,” Special Issue: History of Medicine in the Global South. Global South eMagazine 6, no. 3 (July 2010): 42; Karen Jochelson, The Colour of Disease: Syphilis and Racism in South Africa, 1880–1950 (Palgrave, 2001). 103 Anna Crozier, “What Was Tropical about Tropical Neurasthenia? The Utility of the Diagnosis in the Management of British East Africa,” Journal of the History of Medicine and Allied Sciences 64, no. 4 (2009): 520. See also Islands of White: Settler Society in Kenya and Southern Rhodesia, 1890–1939 (Durham: Duke UP, 1987); Dane Kennedy, “Diagnosing the Colonial Dilemma: Tropical Neurasthenia and the Alienated Briton,” in Decentring Empire: Britain, India and the Transcolonial World, ed. Durba Ghosh and Dane Kennedy (London: Sangam, 2006), 157–81; Dane Kennedy, “The Perils of the Midday Sun: Climatic Anxieties in the Colonial Tropics,” in Imperialism and the Natural World, ed. John M. MacKenzie (Manchester, UK: Manchester UP, 1990). 104 See, for example, Chloe Campbell, Race and Empire: Eugenics in Colonial Kenya (Manchester: Manchester UP, 2007).

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the nineteenth century, Ronald Ross’s discovery that the anopheles mosquito was the vector for malaria had led to “the mosquito doctrine”105 and its application in the tropical world. A number of conclusions were reached on the basis of this doctrine. First, as we have seen in the preceding section, conventional wisdom at this time had it that malaria was wholly a tropical disease and it went without saying that people native to this part of the world were already infected with it. Second, colonial officials from Britain were not; they only got infected once they arrived in the tropics and set up camp next to the infected natives. The latter point was forcefully brought home after a series of malaria expeditions to West Africa in the late nineteenth and early twentieth centuries concluded, among other things, that residential segregation as a primary method of prophylaxis against malaria was in the best interest of Europeans living in the tropics.106 Along with European residential segregation “at a distance of at least half a mile from native dwellings,” other preventive methods insisted upon in West Africa ranged from the annihilation of “mosquitoes and their breeding places” through drainage of surfaces in the neighborhood of European quarters and the “removal of the very numerous pots and pans, bottles and calabashes, tins, mugs and numerous other articles which fill the surrounding premises of all native huts and dwellings, to the reconstruction of streets and road and the filling up of swampy districts and the leveling of the beds of streams.”107 The argument behind this approach—an argument that was later articulated into a colonial medical policy by Colonial Secretary Joseph Chamberlain via confidential letters to the governors of all British colonies in 1901108—was that the “close proximity of many native huts containing numerous children whose blood [was] laden with malarial parasites and the presence of many anopheles105

Anonymous, “The Fight against Malaria: An Industrial Necessity for our African Colonies,” trans. Sir William MacGregor, Journal of the African Society 5 (October 1902): 150, 154. 106 For a detailed analysis of the Sierra Leone case, see Stephen Frenkel and John Western, “Pretext or Prophylaxis? Segregation and Malarial Mosquitos in a British Tropical Colony: Sierra Leone,” Annals of the Association of American Geographers 78, no. 2 (1988): 211–28. 107 Annett, “Liverpool School,” 209–10. For a typical manual used in the fight against the disease in West Africa, see “Sanitary Instructions: Issued by the Committee of the Liverpool School of Tropical Medicine for the Use and Observance of Agents of Firms, Companies, or Business Houses in Malarial Places,” Journal of the African Society 8 (July 1903): 213–15. 108 Stephen Frenkel and John Western, “Pretext or Prophylaxis?” 216. See also Anonymous, “The Fight against Malaria: An Industrial Necessity for our African Colonies,” 149–60.

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breeding collections of water,”109 were always a lethal combination when it came to white settlement in the tropics. Native bodies, especially native children’s bodies, not only harbored “animal parasites of all kinds from the parasite of Malarial Fever in the blood with its complicated life history to the simple round worm of the intestine whose life history is well known,” but also, because of “the uncleanly habits of uneducated natives,” afforded “the most effective way by which infection with these parasites [was] rendered easy (Malarial Fever can certainly be regarded as a disease produced directly by lack of sanitary conditions).”110 Urban-oriented prevention against malaria in Kenya in the first two decades of the twentieth century thus came to revolve around programs that had been articulated in places like West Africa and given a stamp of approval by a thought-style that saw the disease not only as a tropical and African, disease but also as the “arch enemy of the white man in the colonies;” many of the latter had been “converted from men of blooming health to debilitated, bloodless victims of the climate, from whom Africa has sucked the marrow of their bones and energy from their souls.”111

Conclusion Of all the diseases afflicting the global South, malaria, as historian Lyn Schumaker has observed, had by the turn of the twentieth century “become the quintessential tropical disease and the revelation of its etiology the chief triumph of the new discipline of tropical medicine.”112 It is, despite having been eradicated in the industrialized North, perhaps, “the most prevalent and important worldwide disease today.”113 Research questions posed throughout the twentieth century and more so in the 1990s, have, needless to say, been important in understanding the disease and seeking ways to meet the genuine need for its eventual control. However, as discussed above, by all accounts the models for the eradication of the disease in Africa that were initiated in the period from the 1950s through the early 1960s, had all but failed by the end of the 1980s. To understand 109

Annett, Liverpool School, 209. Ibid., 212. 111 Anonymous, “The Fight against Malaria,” 150–51. 112 Lyn Schumaker, “Malaria,” Medicine in the Twentieth Century, ed., Roger Cooter and John Pickstone (Netherlands: Harwood Academic Publishers, 2000), 704. 113 L. Schuyler Fonaroff, “Rethinking Malaria Geography: Problems and Potentials for the Profession,” in Environment and Health: Themes in Medical Geography, ed., Rais Akhtar (New Delhi: Ashish Publishing House, 1991), 73. 110

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the apparent failure of the control and eradication program, it is imperative to consider the tropical and epidemiological thought-styles that informed the “biomedical history and the management structures” that drove the control methods employed in this program.114 These methods have, on the one hand, been largely about the problematics of framing policy around malaria as a “specific infectious disease” that is “understood to be acquired by individuals (thus the focus of treatment and cure) but…[is] communicable to others in a population (thus a parallel emphasis on prevention).” On the other hand, the management structures behind these methods draw our attention to how the emphasis on treatment, cure and/or prevention reflect both the embeddedness of this approach within the “structures of Western biomedicine” and a vertical, top-down approach whose focus was on “short-term outcomes.”115 Furthermore, because the framing of infectious disease policies has always tended to “relate to specific infectious diseases,” decisions on how to deal with these diseases have more often than not tended to concentrate on “micro” policy; this, in turn, is related “to the development of control methods using the biomedical model and the resulting vertical program structure.”116 Because epidemiologists “look at the interaction between the infectious disease agent, the host and the environment,” an approach that logically leads to the “development of control structures which address the source of infection,…interrupt transmission,…and protect the susceptible population,” the tendency for those “working in infectious disease research [is] to see ‘the control program’ as the policy: they concentrate on developing guidelines for managing a specific disease in a specific population…with an emphasis on treatment and cure.” This means that the “exclusively biomedical orientation of program structures [is] generally assumed to be appropriate and the development of policy focuses on the need to improve diagnosis and treatment.”117 Is this bioscientific approach the be-all and end-all in the production of knowledge about malaria in Africa? Paul Farmer, the Harvard-based physician and medical anthropologist, reminds us that the way we choose to view infectious diseases like malaria and the popular and scientific commentary on them, “poses a series of corollary questions which…demand research that is the exclusive province of neither social scientists nor bench scientists, 114

John Porter, Jessica Ogden and Paul Pornyk, “Infectious Disease Policy: Towards the Production of Health,” Health Policy and Planning 14, no. 4 (1999): 322–28. 115 Ibid., 322–23; emphasis in original. 116 Ibid., 323. 117 Ibid.

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clinicians, or epidemiologists.”118 According to Farmer, models as well as assumptions on infectious diseases that have explanatory power, must elicit questions that address the changing clinical, or even molecular, phenomena but also link these phenomena to the overall local and transnational social forces that would eventually shape the patterns of disease emergence. These questions, he remarked, must, therefore, be framed as: How much attention do bio-scientists pay to the underlying socio-historical influences on people’s behavioral choices and patterns and population health? How, for example, do the analytical frameworks used by these scientists “limit our ability to discern trends that can be linked to the emergence of diseases”?119 However, more fundamentally, what does an examination of the history of malaria epidemics in Africa reveal? How have the images of malaria control and “the actual reality of control” underwritten Africans’ experiences of the disease?120 How can both these experiences and the changes involved in malaria’s visibility be socially contextualized? Malaria, like any other infectious disease, demands “contextualization through social science approaches” that include but are not limited to, “the grounding of case histories and local epidemics in the larger biosocial systems in which they take shape.”121 It is easy to argue that increase in highland malaria in East Africa in the 1990s was due to “the failure of drugs used to cure” the disease because the “period during which epidemic malaria was absent from the highlands corresponds to the time when pyrimethemine and chloroquine were still effective malaria treatments.”122 This explanation, needless to say, is as technical as they come and fails to link this therapeutic failure to “the more complex socioeconomic transformations” altering the region’s illness and death patterns. As Farmer has argued, “Standard epidemiology, narrowly focused on individual risk and short on critical theory, will not reveal these deep socioeconomic transformations, nor will it connect them to disease

118

Farmer, “Social Inequalities,” 265. Ibid., 261–62. 120 Randall Packard, “‘Malaria Blocks Development’ Revisited: The Role of Disease in the History of Agricultural Development in the Eastern and Northern Transvaal Lowveld, 1890-1960,” Journal of Southern African Studies 27, no. 3 (September 2001): 596. 121 Farmer, “Social Inequalities,” 264. 122 M.A. MalaKooti, K. Biomndo and G.D. Shanks, “Reemergence of Epidemic Malaria in the Highlands of Western Kenya,” Emerging Infectious Diseases 4, no. 4 (October–December 1998): 675. 119

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emergence.”123 In addition, this literature raises questions that have long been outside the purview of medical research. Perhaps among the most important is the question, what “effects might the interface between two very different types of health care systems have on the rate of advance” of infectious diseases like malaria?124 The answer should not only address the issue of medical pluralism but also interrogate WHO’s approach of the 1950s and 1960s with an emphasis on “wonder drugs and perfect vaccines and atomic insecticides,” tended to privilege “biomedical technology over environment and over local perceptions of disease.”125 As in Southern Rhodesia, in East Africa this period of “confidence in the potential of biomedical technologies” dovetailed not only with settler perceptions of the environment but also with African “nationalist visions of modernity.”126 Biomedical technology as the first line of action was, “at best a diversion and at worst a catastrophe” with regard to malaria eradication in some parts of sub-Saharan Africa.127 This was true also because the epidemics of the 1990s raised doubts over “the efficacy of biomedical interventions and the role and capacity of the state,” leading, as it were, to “a renewed interest in custom and tradition, local attitudes and practices.” 128 As WHO itself began to come to terms with this issue in the early 1980s, promulgating its program of “Health for All by the Year 2000,”129 attention to the understanding and eradication of malaria shifted to focus more on “indigenous understanding of and response to disease, with an emphasis on social, cultural and economic as well as narrowly medical 123

Farmer, “Social Inequalities,” 265. See also A. McMichael, “The Health of Persons, Populations and Planets: Epidemiology Comes Full Circle,” Epidemiology 6 (1995): 633–36. 124 Farmer, “Social Inequalities,” 266. 125 McGregor and Ranger, “Displacement and Disease,” 205, 208. See also Randall M. Packard, “Post-Colonial Medicine,” in Medicine in the Twentieth Century, ed., Roger Cooter and John Pickstone (Netherlands: Harwood Academic Publishers, 2000): 97–112. 126 McGregor and Ranger, “Displacement and Disease,” 208. For a South African study on this point, see Aran S. MacKinnon, “Of Oxford Bags and Twirling Canes: The State, Popular Responses and Zulu Antimalaria Assistants in the EarlyTwentieth-Century Zululand Malaria Campaigns,” Radical History Review 80 (Spring 2001): 76–100. 127 McGregor and Ranger, “Displacement and Disease,” 208. 128 Ibid., 206–7. 129 Gerald Bodecker, Chairman of the Global Initiative for Traditional Systems (GIFT), “Tropical Medicine and Traditional Methodologies: Maximizing Options for Safe and Effective Health Care Coverage,” quoted in McGregor and Ranger, “Displacement and Disease,” 205.

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factors.”130 In this case, bioscientific research on “highlands malaria” seems to limp after reality in the processes of knowledge-production on the disease. Ranger and McGregor are, in fact, advocating “a participatory model” that engages with not only local peoples’ ideas about malaria but also the history of these peoples’ own encounters and experiences with the disease, in order to push our knowledge of malaria to new frontiers. Unlike most histories of malaria that still focus primarily on the researchers’ and doctors’ side of the story, the plea is for an analysis that combines local ideas with the experiences of sufferers, since both, in their combination, may offer “insight into the emergence of those metaphors and practices that scientists and the public use to frame disease and that ultimately come to constitute both popular and medical/scientific knowledge.”131 Taking cognizance of the fact that our understanding of malaria, like any other disease, should include a close examination of how “multiple levels of experience” and “multiple forms of knowledge interrelate and change over time,” the chapter has, thus, called for an interrogation of not only “the discursive and practical interrelation of science and people” but also the time and place where the disease was epidemiologically framed, giving it its own “researchable symptoms” attached to “a scientifically derived name.”132 In revealing the impossibility of postulating clear dichotomies between “scientific” and “indigenous,” between official and private, between “tradition” and modernity,” the chapter has, through its interrogation of the concept of tropicality, called for a rethinking of biomedical thought-styles that have through time and space continued to shape the production of medical knowledge on Africa. Central to this rethinking is our understanding of how languaging in these thought-styles falls back onto a “repertoire of prior texts, acquired over a lifetime,” 133 in shaping and reshaping the representation of diseases and their sites of occurrence to the world. This approach will, it is hoped, complement, if not completely dislodge, “scientific discourses from the privileged position in the history of malaria and provide alternative and ideally useful, understanding of the disease.”134

130

McGregor and Ranger, “Displacement and Disease,” 205. Ibid., 206–7. 132 Cindy Patton, Globalizing AIDS, xxiii, xxiv. 133 Becker, Beyond Translation, 15. 134 Lyn Schumaker, “The Experience of Malaria,” in Medicine in the Twentieth Century, ed., Roger Cooter and John Pickstone, quoted in McGregor and Ranger, 206. 131

CONTRIBUTORS

Poonam Bala is currently a Visiting Scholar in Sociology at Cleveland State University and a Fellow in the Department of History at UNISA, South Africa, with a recently-held Visiting Professorship at the University of Crete. She has also held Visiting Professorships in South Africa and India. She has authored and edited several books on social history of medicine in India. Her select publications include Imperialism and Medicine in Bengal: A Socio-Historical Perspective; Medicine and Medical Policies in India: Social and Historical Perspectives; and Culture, Diaspora and Identity: Asian Indians in America, with edited works including Biomedicine as a Contested Site: Some Revelations in Imperial Contexts; Contesting Colonial Authority: Medicine and Indigenous responses in 19th- and 20th-century India; Medicine and Colonialism: Historical Perspectives in India and South Africa; and Contesting Colonial Authority: Medicine and Indigenous Responses in 19th- and 20th- century India (South Asian edition). Sutanuka Banerjee is Assistant Professor in Women’s Studies and Research at Banasthali University, Rajasthan. Her research focusses on culture and gender studies. Her publications focus on a range of areas, including gender, health, sexualities, reproduction, human rights and politicisation of masculinity. Amongst her several research publications, the most recent is “Probing the Problematics of Gender and Sexuality: An Intercultural Approach to Critical Discourses on Body in the Colonial Bengali Magazine, Nara-Naree” in Global Media Journal (online Indian edition). Rachel Berger is Associate Professor of History and Fellow of the Simone de Beauvoir Institute at Concordia University, Canada. She is a historian of health and the body in South Asia, and has published extensively on the historical aspects of Ayurveda and its location in the political history of colonial India. Her recently published monograph, Ayurveda Made Modern: Political Histories of Indigenous Medicine in North India, 1900-1955, addresses the reinvention of Ayurveda in late colonial India, and evaluates its transition from a composite of ancient medical knowledge into a modern medical system. Her current research

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focuses on the history of food and nutrition in interwar and early postcolonial India, refracted through the lenses of health, consumption, gender and governance. Narin Hassan is Associate Professor in the School of Literature, Media, and Communication at the Georgia Institute of Technology, USA. Her research and teaching focus on the areas of Victorian literature and culture, the history of medicine, and gender and postcolonial studies. She is the author of Diagnosing Empire: Women, Medical Knowledge, and Colonial Mobility. She has also co-edited a book collection (with Tamara Silvia Wagner), Consuming Culture in the Long Nineteenth Century: Narratives of Consumption. Her essays have appeared in a number of book collections, as well as journals including Nineteenth Century Gender Studies and Women’s Studies Quarterly. She is currently working on gender, travel and botany in the nineteenth century. Ushehwedu Kufakurinani is Senior Lecturer in Economic History at the University of Zimbabwe. His research interests are in historiography, gender and empire, colonial settler societies, land conflicts, migration and industrialisation. He has published widely on various aspects of women and domesticity in colonial Zimbabwe, gender and family, and migration and its impact on gender. Estella Musiiwa is Senior Lecturer in History at the University of Swaziland. She teaches History of Southern Africa and History of Latin America. Her research and publications focus on history of medicine, and include “Diseased Bodies, Diseased Migration: The ‘Making of Cholera’ in Budiriro (Harare) and Beitbridge, 2008- 2009” in International Journal of Humanities. Nakanyike Musisi is Associate Professor in History at the University of Toronto. She also heads the Makerere Institute of Social Research at Makerere University in Uganda. Her research focuses on women and development and women and education. She has edited (with J. Allman and S. Geiger) Women in African Colonial Histories, (with N. Muwanga) Makerere University in Transition: 1935-2000, and (with D. Asiimwe) Decentralisation and Transformation of Governance in Uganda. Seggane Musisi is Professor and Senior Researcher at the former Department of Psychiatry at Makerere University College of Health Sciences in Uganda, and former Director of the Psychiatric Crisis Intervention and Liaison Services at York Central Hospital in Toronto. He

234

Contributors

is editor-in-chief of the bi-annual African Journal of Traumatic Stress, and his research focuses on psychosomatics and intensive care psychiatry (such as eating disorders, sleep disorders, Tourette’s Syndrome, psychorheumatology and psychiatric intensive care). He has published extensively on mental health problems of mass trauma, HIV/AIDS, orphans, African traditional medicine in mental health and the psychiatry of old age, brain degenerations and dementia in Africa. Sam Nesamony teaches modern education at SRM Institute of Science and Technology, Delhi-NCR. He was a Consultant at the National University of Educational Planning & Administration (NUEPA) in New Delhi. He has published articles on missionary education and missionary medicine, and their role in knowledge creation, transfer and transformation of the lower sections, and nation building in colonial India, focusing on South India, particularly Travancore. His most recent publication is “Reverberating Higher Education: Christian Missionaries, Knowledge Society and Nation Building in South India” in Christians in the Public Square (edited by Varughese John and Nigel Kumar). Osaak Amukambwa Olumwullah, is Associate Professor of History with affiliate status in the Black World Studies Program at, Miami University, Oxford, Ohio. His research focuses on twentieth-century Sub-Saharan Africa, with special emphasis on colonialism, biomedicine, and processes of social change, global disparities, environmental change, and health in Africa, and violence, history and the present past in Africa. He has authored Dis-Ease in the Colonial State: Medicine, Society, and Social Change among the AbaNyole of Western Kenya, with a forthcoming book manuscript titled, The Contested River: Tana’s Futures in Tana’s Pasts? Nature, Culture, and Development in the Lower Tana River Basin, Kenya. Srirupa Prasad is Associate Professor in Women's and Gender Studies and Sociology at the University of Missouri-Columbia. Her primary research interests are in culture and politics of contagion, hygiene, body, and infectious diseases. She is also interested in issues of critical feminist pedagogy and teaching. She is the author of Cultural Politics of Hygiene in India, 1890-1940: Contagions of Feelings, and is currently working on a new project on the history and contemporary politics of tuberculosis and care work in India.

INDEX African Trypanosomiasis 207 African- Indian encounters 3 Agris 14 American Board Commission on Foreign Missions 181 Arya Samaj 30, 41, 43 Arya Vaidya Samajam 19 Asiatic Registration Bill 105 Australian Presbyterian Mission 185 Ayurvedic Mahasammelan 25 Baby Farms, 73 Bandis 176, 190-191 Bhadralok 13 Bhandaris 14 Boards of Indian Medicine 28 Bombay Medical Service 14 Bombay Native School and Book Society 14 Board of Education 14 Calaval Cunnum Chettiars Free Dispensary 24 Calcutta Medical College 15 Cape Boers 110 Church Missionary Society 14 Church of England Zenana Missionary Society 182 Dais 35 See also Dhais, Dhye Dampati Arogyata Jeevanshastra 34-35 Dhais 66, 179, 197 See also Dhye Dhye 69, 73, 80-87 and European families 70 See also Dhais Dip Tanks 107, 122-124 Dorokha Niti 58 Dr.Bhimrao Ambedkar 39 Dufferin Fund 194

Dyarchy 20 Edinburgh Medical Missionary Society 181, 183 Epidemiological paradigms 207 Federation of Women’s Institutes of Southern Rhodesia 155-158, 160-161, 163-164, 166-167, 169-170 Grant Medical College 16 Grhalakshmi 31 Hindu Boys’ School 14 Hindu Malthusian League 39 Hindu shastra 45 Indian Contagious Act 18 Indian Councils Act 19 Indian Opinion 87-89, 96, 98-99, 110, 102, 104 Indian Systems of Medicine 23 Indianization 21 Jeevan Shastra 42 Kabaka 131 Khoikhoi 4 Kolis 14 Kraals 118-120, 125 Lahore Medical College 17 Languaging 212-213 and disease 212 London Missionary Society 177, 182-184, 186-187, 190-191,195197 Lukiiko 150 Maasai 108 Madras Medical Registration Act 24 Makerere Medical School 145 Malaria 165, 171, 181, 191, 210, 213-214, 217-222, 225-231 Margaret Sanger 40 Marie Stopes 40, 52 Mary Scharlieb 70, 74 Medical Board Committee 168

236 Medical Research Council 20, 22 Mengo Hospital 133,135 Mengo Nursing and Midwifery School 135, 142 Montagu Chelmsford Reforms 21 Morley Minto Reforms 19, 21 Mountstuart Elphinstone 14 Muktifauj 184 Mulago Hospital 139,142 National Association for Supplying Medical Aid 193 National Council of Women of Southern Rhodesia 158-162, 165,169 Native Medical Institutions 14-15 Native Medical School 15-16 Native Medical Society 21 Native Opinion 17 P.S.Varier 20 Palsikar Brahmans 13 Panchkalshis 14 Parsis 14 Pathare Brahmins 14 Prabhuram Ayurvedic College 24 Prafulla Chandra Ray 19 Premchand 38, 40-41 Print culture 6, 8 and national identities 6 Rand Plague Committee 101 Rinderpest 111, 121 See also Y.pestis

Index Royal Colleges of Physicians and Surgeons 22 Satyagraha 88, 100, 103, 105 Scottish Missionary Society 14 Shenzi 221 Social Hygiene Council 159 Stri Darpan 31 Subhas Chandra Bose 39 Suyogi 37-38, 41, 43 See also Swaraj Swaraj 37-39, 93 See also Suyogi The Wesleyan Methodist Missionary Society 185 Transvaal Department of Agriculture 113 Tropical medicine 16, 205, 208, 213, 215 and tropicality 210-214, 217, 227 rise of 209 Valobasar Bighno 53 Vatsyayana 31 Veterinary science 9, 106, 108 Y.pestis 98 See also Rinderpest Yakusu Hospital 202 Yashoda Devi 2, 21, 27-38, 41-45 and population control 41-42 and Vedic shastras, 42 See also Suyogi and Swaraj Zenanas 193, 195