An Indian Doctor in Imperial Service: Dr Kaiwar Raghvendra Rao and Indian Agency in Times of Crisis III

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

1918-19 were bad years for most of the Globe. The War in Europe that stretched from 1914 to 1918 saw slaughter on an industrial scale. The battlefiels of Verdun, Somme, Flanders are seared into the collective memory of Europeans and India too was not unaffected as soldiers from India participated in the war and nealry a million lives were lost. It is sad that the commonwealth War Memorial Commission does not regard Indian war graves worth of memoralizing. 1918 saw the gradual return of peace and with it came the deadly Pandemic, known as the Spanish Influenza.

Pandemics have been part of history and the historical record is rich in detail about the impact they have had. The Black Death or the bubonic Plague that raced through Europe in the Fourteenth Century taking nearly a quarter of its population has left iys macabre signature in the child's nursery rhyme: Ringa Ringa Roses, Pocket Full of Poises, Hush Busha WE ALL FALL DOWN. The rash on the skin and the fatal bout of sneeze are sharply brought out. 1918-19 saw the spread of the Influenza Epidemic in India and one of the worst affected places was Madras. The year was also ne that was amrked by large scale social and political disturbances as grain price sharply incresed and surpus grain was shipped off to Europe to feed the every hungry Arimes of the Imperial Powers. It is against this background that we have to evaluate the work of Dr Kaiwar Raghavendra Rao who as the Halth Officer of the Madras Corporation had to oversee the Influenza Campaign as well.

Lady Willingdon, the wife of the Governor of Madras Presidency took keen interest in the affairs of the Corporation and we find Dr Raghavendra Rao thanking her for her assistance to the cause of Public Health. One initiative of the Lady that needs to be highlighted is her interventions in matters relating to Maternal and Child health. Lady Willington took personal interest in the Lying=in Hospitals which was the then contemporary usage for Maternity Hospitals. And at this point a remarkable woman enters the picture: Dr L N Virasinghe-Chinappa, a colleague of Dr Rao who is made the Superindendent of the Maternity Hospitals in Madras now Chennai. Unfortunately, in some of the earlier volumes of the Reports her name is inexplicably given as L Vira Singh. But in 1919 her signature appears alongside that of Dr Raghavendra Rao.

The stress of the Epidemic and the need for a qell equipped diagnostic lab neccisitated the construction of a Laboratory complete with the Clayton's Apparatus which was used apparently for nebulizing sera. Dr Raghvendra Rao writes that 1919 began with " omnious possibilities of sickness and death".By the end of December 1918 itself Plague had started claiming lives in Triplicane and Cholera had spread to the northern part of the city. The disease was notified as an epidemic in January 1919 and it subsided only to be replaced by the Influenza Pandemic by March 1919. The frightful pace at which the Influenza spread, resulted in the formation of a Committee with Dr Lt Col C Donovon IMS as the Chairman and Dr Raghvendra Rao, then Health Officer as the Convener.

The Committee met on the 21st of July 1919 and recommended a series of Public Health Measure to te Government of the Prsidency:

1) Temporary Structures be set up as isolation units Quarintine those affected by the Influenza
2) Requst people to go to the Influenza Homes so that the spread of the disease could be curtailed
3) Requisitioned drugs

For meeting the expenses the Corporation of Madras sanctioned a sum of Rs. 15,000. Public awareness was sought to be increased by printing Influenza Posters both in English and vernacular lnguages which adviced those suffering from the defined symptoms to report to the nearest Infuenza Homes. In just 10 days after the Meeting, the Government notofied Influenza as a "dangerous disease" under the Madras Municipal Act and a GO # 1208 dated 13 August 1919 was passed. Roypuram was chosen as the quarintine zone and we know that it was kept at full capacity as the emigrants bound to South Africa were kept here. Dr Rao took on the challenge of vaccination and spent his energy ensuring that children below the age of 1 year were vaccinated for small pox. Thus, he reduced the morbidity of the disease in Madras which had acquired a dubious fame as the centre of the diseas.

Given the fact that Madras Presidency was the most seriously affected by the Influeza Epidemic second only to Bombay, the eager exwertions of Dr Raghavendra Rao contributed in no small measure in reducing the human toll'

I thank Mrs Sudha Vyas for giving me a photograph f Dr Kaiwar Raghavendra Rao.

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.

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

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

A few days back I read a small piece in Madras Musings about Dr K Raghavendra Rao and since primary sources are unavaiblabe due to Lockdown I have written this Blog on the basis of evidence culled from the 10 volumes of "Health Department Reports" presented to the Corporation of Madras whose Health Officer was Dr Raghavendra Rao. This is only the first part of my work and will return to the theme as and when interest material and inclination permit.

PartI 

The late Nineteenth century and the early Twentieth centuries were Hard Times for India and Indians. Charles Dickes was able to see Hard Times for his people in England but an astute observer would see te same in India, as well. The Railways, the Suez Canal, the introduction of Telegraphs and the gradual introduction of electricity were all factors that changed the urban landscape. And in this times of change stradling the lte nineteenth and early twentieth century we encounter Dr Kaiwar Raghavendra Rao, a trained Physcian and a Public Health specialist with higher qualification from the University of Cambridge. As his name suggests, the Doctor was probably hailed from the Kaiwar region of present day Karnataka, and was born in 1884. He took his BA degree from Bangalore Central College, the nucleus of the Bangalore University and came to Madras now Chennai to join the Madras Medical College,

Medical Education in Madras Presidency was undergoing a major change at around the time Raghavendra Rao entered th Medical Clooge. Until just a few years earleir Indians who wanted to qualify for the Medical Profession and practice in the Presidency were restricted to the LMP certification which was essentailly a Licentiate in the field of Medicine. Theferfore Dr Raghavendra Rao was one of the first qualified mediacal professionals in India. The introduction of the MB&CM degree from 1904 meant that Indians did not have to make the costly trip to England to take their qualifying examinations for the Royal College of Suregeons/Physicians at London or Edinburgh, Scotland. Dr Rao lived though the time when Medical traditions and practices were slowly but surely undergoing irreversible changes.

Indians traditionally depended on their vaids, acharyas, siddhas for medical needs and were quite content to leave their fate to the enthusiastic though largely unqualified people. The East India Company opened a small dispensary for its Englih soldiers in Fort Saint George and the practice of Western Medicine. Right from the start there was an undercurrent of competition, indeed hostility, between the two traditions: the Native and the European. Traditional Indian medical practices were neither codified nor were there any prescribed cerification for its practioners.

Indians traditionally depended on their vaids, acharyas, siddhas for medical needs and were quite content to leave their fate to the enthusiastic though largely unqualified people. The East India Company opened a small dispensary for its Englih soldiers in Fort Saint George and the practice of Western Medicine. Right from the start there was an undercurrent of competition, indeed hostility, between the two traditions: the Native and the European. Traditional Indian medical practices were neither codified nor were there any prescribed cerification for its practioners. Introduction of Western Education, particularly the establishment of the University of Madras in 1857 was to change native perceptions. The immense prestige of Western Education began to outpace the validity and legitimacy of Indian medical practices. Efforts were made from time to time to drive Indian practices under ground by creating the smokescreen of Quakery. It is against this background that young men like Dr Raghavendra Rao, fresh from College, were attracted to the brave new world of scientific medicine. At the time when Dr Rao was a student the Medical Degree course consisted of 4 years with six months of internship. I have not been able to locate a copy of the Syllabus of the Madras Medical College. However, it may not have been that much different from other medical colleges. Chemistry, Physiology, Anatomy, Medical Statistics and Hygine together with exposture to reallife on the ground training in an establsihed Hospital must have formed part of his training. Dr Rao retained th lesson learnt well because as Medical Officer of the Madras Corporation during the Influenza Pandemic of 1918-19 he drew upon all these methods in order to study the Influenza Pndemic in the Madras Preseidency. We are running ahead of the story.

Dr Kaiwar Raghvendra Rao lived in Madras and died in the city in 1944 just as World War II was drawing to a close. He lived through two major Wars and died a few yeras shy of the transfer of power in 1947 folloing the Partition of India. I have been able to  piece together a part of his professional life from the Reports of the Health Department of the Cororation of Madras. He seems to ve joined as an Assistant Health Officer soon after he graduated and spent the rest of his life serving Madras Presidency. The introduction of the minto-Morley Reforms in 1919 saw Public Health as a transfered subject and a Department of Public Health established with Dr Raghvendra Rao as its first Director of Public Health.

To be continued in Part II

COVID 19 India's Response and World Issues

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

The COVID 19 pandemic has not left India unaffected. We are under lockdown and days seem to stretch into inflinity. We cannot leave the House and so have not been blogging. Today my daughter helped me configure her old lap top and am back blogging after quite a while. I am a Historian, a Professor of History a Researcher and an Animal Rights'Activist. We need a curfew pass to move out and being a senior citizen I am given some relaxation in the number of curfew passes I am issued. I drive from the Campus to the town and get the stuff we need and return in the blazing sun,as the shops close by 1100.At least I have tonnes of books to read and have an interesting project to work on. Living through COVIID 19 has given me time to relect and this blog is on my two cents worth.

When the Pandemic began. i was more or less convinced that the virus was the result of an AmericanGerm Warfare experiment gone horribly wrong. Now I have changed my mind and believe that the Communist Regime in China have a lot of explanation to give to the International Community. Wuhan Wet Market which they blamed for the outbreak is not the primary source of the virus. It was probably the Wuhan Institute of Virology that was reponsible. It is too early to say if this was a deliberate attempt at disrupting the world economy or an accident in the lab. Whatever be the circumstances, China owes an expalnation and has to make a clean confession and International sanctions may be invoked to make the State comply. And the behaviour of China, in trying to make profit off the suffering of human beings all over the world is despicable even by Communist standards. India and Germany have changed the norms of Foreign Direct Investment to prevent hostile Chinese takeovers and China is threatening to take matters to the WTO. A bad move as China virtually dands isolated in the World today.

USA is devastated. Seeing the rising number of casulities which is reaching the 50,000 mark I cannot help feeling a tinge of sorrow at the stoicism of the American people. They are going through hell and they are bearing their immense suffering with great dignity. I dont want my words to be seen as patronizing or taken as a wise crack. I mean it. Did Trump err in calling it the Chinese virs. I dare to say NO. I am now convinced that the virus originated in China and the WHO has worked overtime to hide the involvement of China in this tragic Greek Opera that is unfolding before our very eyes. And the attention of the Trump Administration was distracted by the Impeachment Proceeding launched by the Democrtas precisely at the time when the US Administration was rlizing the gravity of th situaton and had imposed the travel ban.

India does not see a huge spike in COVID cases. The Government of India acted at the right time. A Nationwide Lockdown was imposed on March 25th even as the country saw less that hundred cases on that day. Under Lockdown which was imposed nder the  Infectious Disease and Epidemics Act, which was legislated in the nineteenth century, the Government can arrest people for breaking the curfew. Barring one particular identity group, all behaved the citizens behaved well. This brings to to the Tablighi Jamaat or Single ource Event as we refer euphemisticlly.

THe Tablighis, a group of orthodox Sunni muslims were found to have gathered in large numbers in Nizamuddin Area in New Delhi and violating the Social Distancing norms they hind in moques all over India thereby infecting and contaminating places which were free of the virus. The states of Maharashtra, Telengana and Tamil Nadu are the worst affected. I think the situation in West Bengal is also grim.

Unlike USA, India's strategy was different. It imposed Lockdown and undertook tracing and tracking of those exposed to the virus and strict quarantine measure are in place. An APP Arogya Sethu was rolled out which alerts smart phone usere of the possible Covid hot spots. It tracks using the GPS and blue tooth, This app has been effevtive and more than 70 million people have downloaded it. Though travel restrictions are in place, the country has not been seeing fatalities as what was witnessed in USA, Italy, Spin and  UK. The Nation must thank the Prime MInster for his pro active steps,

Every night as I watch Andrew Coumo, the Governor of New York speak on CNN I hear the words"flatten the curve". The basic mistake that USA dis was to address the problem from the wrong end. The models as indeed all models in such cases were wrong and predicted a situation that was both impossible and hellish. Had the US not depended on statistical models which are Bayseian in their basic architecture and relied more on prctical measures as were put in place after the 1918-19 Pandemic, the US would have fared better.