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1918 Bombay Fever: How voluntary groups sprang up in the face of state ‘neglect’ –

The influenza pandemic broke out in Bombay city in June 1918, when seven police sepoys were admitted to hospital with non- malarial fever. Between June 15 and June 20, workers of W&A Graham & Co, HSBC, Bombay Port Trust, the Dockyard, Telegraph and Mint & Rachel Sassoon Mills were all affected.

The state threw up its hands, in despair, neither knowing how to treat it nor having enough personnel to deploy as many doctors being away on war duty. There were differences of opinion among the colonial officials about the source of the infection, which came to be known as the Bombay Fever or Bombay Influenza. John Andrew Turner, Health Officer, Bombay city, contended that the crew of a ship that had docked in the port, at the end of May, had brought the fever while the colonial government of India ascribed it to the characteristic unsanitary conditions of the city. The Sanitary Commissioner, Bombay, Lt Col Hutchinson believed that influenza was endemic to India and little could be done to check its spread.

Turner pointed out that he had anticipated disease since Bombay was the port of arrival and dispatch for troops. Charges were traded between Turner and the Health Officer of the Bombay Port about the latter’s failure to report cases. The vigilant local press commented on this in the February 3, 1919 edition of the Bombay Chronicle, contending that the city and the whole of India had paid “dearly” for this neglect. Concern was expressed in the Municipal Corporation about the suppression of information about the disease among the personnel on military vessels.

‘Came like a thief’

The June outbreak lasted four weeks and took 1,600 lives. The Times of India, in its June 25, 1918 edition, wrote, “Nearly every house in Bombay has some of its inmates down with fever and every office is bewailing the absence of clerks.” Unlike cholera, smallpox and plague, where the causative agents were known, influenza, in the words of Turner, “came like a thief at night, its onset rapid and insidious.” Bombay in June “was like a huge incubator with suitable media already prepared for the insemination of germs of disease.”

It was an overcrowded city with a large working-class population living in conditions “which lend themselves to the rapid spread of the disease.” From 92 deaths on June 21, mortality rose to 230 deaths on July 3.

The epidemic soon spread to other parts of the Presidency, and in July and August to Northern India. The second, more virulent wave came in September 1918 and spread even further. The failure of the Southwest monsoon and the subsequent crop failure led to a large influx of migrants into Bombay city. It was difficult to compile statistics because influenza was not among the heads under which mortality was recorded. Often the reporting agency was ignorant. More women fatalities and stillbirths were recorded.

During the second wave, mortality in the city rose to 768 deaths on October 6 from 219 deaths on September 16. NH Choksy, Medical Superintendent, Arthur Road Hospital, wrote that “in its rapidity of spread, the enormous number of its victims and its total fatality…influenza reached a virulence before which even plague with all its horrors fades into insignificance.”

The Government’s recommendations were isolation of the infected, opening up ill-ventilated buildings, encouraging people to sleep in the open and disinfection of the clothing of the infected. The Surgeon General, RWS Lyons recommended gargling with diluted potassium permanganate, aspirin, warned against the use of quinine as a curative or prophylactic, immediate medical attention when fever appeared, and finally, hospitalisation.

In Bombay city, accommodation for serious patients of influenza was made available in the Government-run Jamsetjee Jejeebhoy, established in 1845; Goculdas Tejpal, established in 1874; Arthur Road hospitals, established in 1892 and today known as Kasturba Hospital; and at a military camp in the suburb of Dadar. Suitable, well-ventilated school rooms were also used.

British official John Andrew Turner had anticipated disease since Bombay was the port of arrival and dispatch for troops. Credit: Wikipedia

The Bombay Municipal Corporation formed a medical sub-committee under the chairmanship of Rahimtulla Currimbhoy, with Dr Kavasji Dadachanji, President of the Bombay Medical Union, Sir Cowasji Jehangir, and Dr MC Javle as members. They visited dispensaries and brought to the attention of the Controller of Prices, the need to reduce the high prices of medicines. Letters were sent to the “large employers of labour” suggesting the steps to be taken, while mill managers were summoned to discuss preventive measures to be adopted in mills. Posters were put up in English, Marathi and Gujarati, advising the people to call in medical help or go to hospitals. Arrangements were made for the distribution of milk and pneumonia “jackets”, two pieces of cloth with an inch thick layer of cotton between, sown like a quilt, and fastened on the sides with tags.

By way of affording additional facilities for the poor in the disposal of their dead, burning and burial fees were suspended at the municipal cemetery. The military authorities provided orderlies and ambulances for the removal of patients to hospital. While the Surgeon General claimed that they had done everything in their power to combat the epidemic, the press did not think so.

The Bombay Chronicle said officials remained in the hills during emergencies. Young India commented, “Government which at other times claims to be maa baap now chose to throw them on the hands of Providence.” Gujarathi asked where were the highly-paid Government experts? Purushotamdas Thankurdas and SA Upasani raised questions in the Bombay Legislative Council, only to be told that Government had limited funds. Only in October did the Government stop the export of wheat. The inadequacy of governmental resources to cope with the epidemic was soon apparent, and the Sanitary Commissioner admitted as much.

Quick public response

Turner appealed to the public for assistance in coping with the crisis, observing, at the same time, that the ignorance and superstition of the people, their different social surroundings, and modes of life had made it difficult for the authorities to check the spread of disease. The response to his appeal was immediate.

The Hindu Medical Association took the lead, under the guidance of a committee of doctors, and volunteers made house visits and directed those who had no one to nurse them, to hospitals. The patients were mainly poor mill workers “who were ill fed and lived in badly ventilated dark rooms with smoky atmosphere full of coal and dust”. Initially, the people seemed to have been uncommunicative and had to be persuaded to avail of treatment. As many as 4,195 out-patients were treated at various centres, maintained by the Association. The figures collated showed that the very young and those in their prime were the most affected.

The other body that responded to Turner’s appeal was the Social Service League. Founded in 1911, by social reformers, NM Joshi, NG Chandavarkar, Bhatwadekar, BN Motivala and GK Parekh, it had the provision of medical relief and the promotion of sanitation and hygiene among its aims. It had conducted anti-tuberculosis campaigns and provided training in first aid. Now, the League set up the Influenza Relief Committee comprising of industrialists, judges and doctors, and collected a fund of Rs 52,148. This included contributions from NM Wadia Charities, Tata Sons, Richardson & Cruddas, the Cotton Brokers Association, the Cotton Merchants and Mukadams Association. Individual contributions ranged from small sum by anonymous donors to Rs 500 donated by Parbhuram Popatram, a well known vaid.

Around 20 centres were opened in different parts of the city to distribute the stock mixture, milk and clothing, reaching out to 17,684 persons. While arrangements were made for the temporary boarding and lodging of patients discharged from hospitals, a special corps arranged for the cremation of the dead. The work of the Social Service League was particularly lauded by the Times of India in its October 8, 1918 edition.

Social reformers NM Joshi and NG Chandavarkar. Credit: Wikipedia

Community hospitals

Temporary hospitals for castes and communities were started, as had been done during the plague epidemic of 1896-’97. The Jains were the first to open a hospital at Girgaum, the Lohanas opened a facility at Mazgaon, the Marwaris at Kalbadevi, the Bohras at Null Bazar and the Pathare Prabhus at Chowpatty. For Parsis, beds at Parsi Fever hospitals and the Bomanji Petit Hospital, Cumballa Hill, were provided.

To overcome objections from communities, nurse volunteers from the St John Ambulance Brigade Overseas represented Hindus, Parsis and Jews. A group of Parsi volunteers formed the Parsi Emergency Corps which included a batakiwalla or town crier, who made announcements about dispensaries and arranged for an ambulance. At least 200 volunteers were provided by 25 organisations. These included community and caste associations of the Dawoodi Bohras and Ismaili Khojas, who had done exemplary work during the plague epidemic of 1896, the Kutchi Lohanas and Bhatias, the Pathare Prabhu Social Samaj, Kitte Bhandari Aikyawardhak Mandali, Kshatriya Bhandari Dnyati Samaj and the Gaud Saraswat Brahmin Mitra Mandal.

Other bodies who were involved in the effort were professional associations like the Kamgar Hitwardhak Sabha, St George’s Nursing Association, youth organisations like Radiant Club, Students’ Brotherhood, Students’ Social Union, Young Men’s Hindu Association, Young Men’s Mohamedan Association, Young Men’s Khoja Association, Presidency Students’ Federation, professors and students of Wilson College; political groups like the Home Rule League; and miscellaneous bodies like the Temperance Association, the Bombay Humanitarian League, Matunga Residents’ Association, and Swajan Hitachintaka Samaj, Telugu Free Library, and the Church Mission Society.

Providing medical treatment were 12 doctors, two of whom were women and senior students of the Grant Medical College. Letters to the editor of the Indian Medical Gazette suggested belladonna, creosote, laudanum, camphor and a mixture of iodine with chloroform. Advertisement for T Walker’s Elixir promised not only to cure influenza but also prevent it. Ayurvedic preparations were also promoted, as effective cures. Thus, the Bombay Chronicle carried advertisements for “shastric medicines” developed by the “world-renowned inventor” of Amrtidhara, Kavi Vaidyabhushan Pandit Thakur Datta Sharma. Laxmi Vilas Ras was meant to cure the debilitating after effects of influenza. Kalpataru Ayurvedic Works sold anti-influenza tablets.

The Western India Turf Club lent their premises as an office, while the Japanese and Shanghai Piece Goods Association operated two relief stations. Blankets were provided by mills and cologne waters and tubes of menthol were given by Messrs Gobhai & Company. The Hindusthan, in its October 9,1918 edition, rightly observed that the principal burden had fallen on the philanthropic sections of the public. Turner, on his part, paid credit to all these organisations and also acknowledged the support of officials like the Vaccination Superintendent, the Deputy Health Officers, the sanitary and conservancy staff, who had been relieved of their regular duties.

In Bombay city, serious patients were accommodated in state-run hospitals, like Goculdas Tejpal Hospital. Credit: Wikipedia

This public involvement in dealing with the influenza, which was a worldwide pandemic, doubtless reduced casualties in Bombay. After the vigorous opposition to the interventionist measures adopted during the plague of 1896, the colonial health policy was ad hoc. In the efforts of individual officials like Turner, there was an attempt to promote co-operation with the public, and to search for solutions at the ground level, by successfully liaising with Indian doctors, philanthropists, civic leaders and established local bodies like the Social Service League. This collaboration had resulted in the establishment of the Bombay Sanitary Association in 1904 and the Bombay Anti- Tuberculosis League in 1912. The public’s readiness to contribute generously to relief efforts, in the cities, was in keeping with the practice started in the previous century, when several medical institutions in the city were founded and funded by Indian philanthropy.

The caste and community organisations and professional associations involved in this effort represented the cosmopolitan social composition of the urbs prima in Indis. It is significant that a number of the voluntary organisations, referred to above, had healthcare and dissemination of knowledge about sanitation and promotion of smallpox vaccination and the plague prophylactic among their aims. They made suggestions for post- influenza: the establishment of more hospitals and dispensaries and the training of more nurses. Private medical practitioners suggested “drastic sanitary measures to purify the air” and better water supply. This is indicative of growing civic consciousness and of the understanding that health was as much a public responsibility as that of the state.

Nevertheless, the impact of the influenza epidemic on India was devastating. Upwards of 12 million people, and possibly as many as 18 million, died from influenza or from pneumonia and respiratory complications. The Social Service Quarterly pointed out that no part of the country escaped, whether it was the hill tops of Simla, cities like Bombay or Calcutta, or isolated villages. There was a correlation between poverty, hunger and debility and influenza and pneumonia. The other strong Indian sentiment was in keeping with the political temper of the time.

Young India asked in the aftermath of Jallianwala Bagh, whether the Government realised the psychological effects of the epidemic. The feeling on the streets of Bombay was that to a Government that allowed 60 lakh people to die on the city streets like rats without succour what were a few deaths by shooting?

An earlier version of this article appeared in The Spanish Influenza Pandemic of 1918-1919: New Perspectives (Routledge, London, 2003).