Sunday, April 26, 2020

An Indian Doctor in Imperial Service: Dr Kaiwar Raghavendra Rao and Indian Agency in times of Crisis

A look at the world of politics, statecraft, diplomacy and books

Part II
Dr K Raghavendra Rao BA, Mb&CM, DPH
(Cantab)

In Part I we traced the intellectual and historical context in which the career of Dr Kaiwar Raghavendra Rao is best studied. He was amongst the earliest Indians to qualify himself as a Doctor and devoted his entire life to public service in that he chose to work within the limits of governmental institutions eschewing the more lcrative pastures of private pratice. He lived through hard but interesting times and at the high noon of Empire carved out a niche for himself in the public realm. The fact that Lord Curzon was the Viceroy of India may have contributed to the steady but relentless entry of Indians into the portals of the Indian public service. Beginning his life as a Malaria Officer, Dr Raghavendra Rao steadily rose in prominence, becoming the Health Officer of the Madras Corporation under Chartes Molony in 1915 and retired as the first Director of Public Health in 1940. Dr Kaiwar Raghavendra Rao medical exertions intersected two very grave challenges: first, the Malaria with its seasonal recrudesence and secondly, the 1918-19 Influenza Pndemic which claimed at least 12 million lives in India and upward of 50 million lives world wide. Today as we live through another Pandemic, the Chinese virus or the COVID 19 virus, we can reflect on the past and learn the impact the Pandemic had on India in the year following the end of World War I.

The English Administration had always identified Malaria as the great disease of India, a killer that struck with alarming regularity contributing to the very high mortality rates both among Indians and the European population. One immediate consequence of the feared morbidity of the disease can be seen in urban town planning: the European part of the cities and towns were sequestered from the main City. Paradoxically, the very measures taken by the British to make Empire pay for itself were  responsible for spreading the dreaded disease, The expansion of irrigation and canal building activites meant that large pools of stagnant water were available for the vector to breed. In 1897 the Venice Conference on Helath and Sanitation threatened embargo (in today's less politile language we would say Sanctions)  on Indian goods if Hygenine and Sanitation were not significantly improved. This measure ould have certainly hurt British interests as it would have curtailed the export of manufactured products from Britain. Immediate action was needed and we find Ronald Ross discovering the Anopholene vector as the cause for the spread of Malaria winning him the Nobel Prize for Medicine in 1900.

Dr Kaiwar Ragavendra Rao was appointed as the first Malaria Officer of the Coroporation and later became its Health Officer. As the Malaria Officer we find Dr Rao presenting extremely lucid and detailed Reports on the anti Malaria work undertaken by him. From 1914 when Retrenchment had reduced his staff to the barest minimum we find his identifying the breeding brund of malaria infested vectors by catching mosqutoes and identifying them, He identified a number of areas of Madras now Chennai as disease ridden: Washermanpet, Puruswakkam, Triplicane, Buckingham Canal, Saidapet and Egmore. The preence of stagnant water provided ample scope for the larvae to breed and so in consultation with the Authorities Dr Rao enthusiastically introduced a number of measure, In large ponds he introduced Ducks and as he ruefully notes in his Report the experiment with American ducks turned out to be a failure while the native breed was more effective. And he used to power entrusted  to him by the Corporation to have particular ponds or well filled. In Edward Elliot;s Roar and Mobrray's Road were large ponds which were filled at the expense of the owners. Introduction of fish was another measure. I puddles left behind by the monsoon rains he "petrolized" meaning thereby disinfected the puddles using a mixture of crude petroleum and other chemicals. Un doubtedly Dr Kaiwar Raghavendra Rao was a successful and diligent Malaria Officer and his hard work was rewarded whn he was made Health Officer of the Corporation of Madras and when the Influeza Pandemic struck Madras in 1918-19 we see him hard at work in his Ripon Building Office as the Health Officer.

The portofolio of the Health Officer combined Anti Malarial tasks as well as adminstering and overseeing a number of public dispensaries located all over Chennai. Dr Raghavendra Rao points out in his Reports quite frequently that there is season vriation in mortality rates and levles throughout the year. He now has to deal with Cholera and Malaria and they struck at different times and the demographics of the disease were different. The construction of the Madras harbour was a factor that caused considerable damage to the environment and the coast stretching from the Harbour to Ennore was chock a block with health hazzards, Cholera being the most deadly. He now began advocating Housing --well ventilated-- housing as the answer to some of the health issues faced by Madras. Tuberculosis was a a major factor leading to essentially a lowering of the average or mean mortality of the male to a mere 20 years. A significant drop in mortality level. As Health Officer we find him putting the weight of his experience and office behind the Madras Tramway Corporation as he felt that decongestion of morbid areas like Georgetown, Puruswakkam and Triplicane will lead ti improvement in health.

1918 marked the end of World War I. But even before the war ended a strange new disease had entered Madras. Like the present Pandemc caused by the Chinese Virus or COVID 19, the Influenza Epidemic was also cause by a "corona" virus as has been esablished a century later through tests carried out on the tissue samples preserved from that era. Dr Rao is not just a medical professional. He is a statistician as well. He gives detailed breakdown of the age and gender of the victims of the disease and suggests that Quarintie measures be taken to contain the disease. I am not sure from the records available to me if he used the Indian Infectious and Epidemic Disease Act of 1897 but he did recomend strict quaritine as a measure to contai the spread of the disease. Throughout 1919 the toll taken by the Influennza Pandemic was relentless and by 1920 disappeared.

After his success with the Influenza Epidemic, Dr Kaiwar Raghavendra Rao was sent to Cambrigde for the course on Public Health. He seems to have spent at least 18 months in England, and I am unable to determine the exact duration or dtes of his stay there. On his return he was made the Director of Public Health,and occupied the position until he retired.


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Balakrishna Raju said...
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