The health scene in
Old Potions, New Bottles
Reproductive Health in India
Literature on health scene in India is not exactly abundant. Empirical studies – both at macro and micro levels – have been less than adequate, and are certainly not systemised. Public discourse has been lacking too. The scenario pertaining to pre-Independence India is equally dismal in this regard. Therefore, the following three studies published by the Orient Longman –commissioned by UK’s Wellcome Trust – are welcome additions to the corpus. These books focus on different aspects of the health scenario while taking into account the political, social and medical conditions obtaining in India during the period spanning early-mid-19th century to late-mid twentieth century. The common factor in all the three books is the British Raj that, on the one hand, posed a threat to the indigenous medicine and, on the other, introduced and institutionalised modern medicare systems that helped fight such deadly epidemics as small pox and made childbirth a safe phenomenon even as it spurred on vaids and hakeems to "corporatise" indigenous medicine. The books have been reviewed in a chronological order and should interest experts and laymen alike.
Over the centuries, invaders brought to the subcontinent influences in social, economic, political and cultural fields. The existing institutions were either replaced or hybridised to suit their respective aims and ambitions. Medicine is perhaps the best example. Both the Islamic and the British rulers used medical institutions to promote their politico-cultural designs. While Ayurvedic institutions managed to co-exist with Tibb-E-Yunani, these suffered a bodyblow when western medicine made its presence felt under the British rule. The urban middle class adopted western language, lifestyle and attitude. This enabled the foreign medical system to gain supremacy.
Vaids and hakeems decided to meet the challenge. They had realised that the decline of indigenous medicine was indicative of loss of intellect, enlightenment and, more importantly, authority. They made use of the vernacular press to forge a collective identity in order to counter the threat to their profession, especially with the introduction of the Medical Registration Act.
Kavita Sivaramakrishnan has focused on the efforts made by vaids in Punjab to professionalise their medical practice and recast their learning. She has also highlighted the phenomenon of coalescing of vaids and hakeems into an enduring national movement in support of the indigenous medical systems. This well-researched tome is a valuable addition to the literature on health scene in colonial India. The reading is both informative and absorbing.
Variola is a virus that causes smallpox. Widely prevalent in South Asia at one time, this highly contagious disease caused slow and painful death. The survivors were disfigured for life. It was during the 1930s that Variola was first examined in a scientific manner.
Sanjoy Bhattacharya scrutinises the eradication policies and programmes adopted in the post-Independence India. Even as he debunks the government claims of reforming the vaccination policies developed by the British, he examines the different factors that caused the uneven growth of the vaccination infrastructures, which led to daunting problems for the field-workers. He also examines the strategies adopted to counter the complications that cropped up while implementing the eradication programmes. Then there were hindrances, more from within than without. You realise this while reading Asymmetrical Designs in this book. Other chapters like Troubled and Uneven Expansion, Torturous Advance, etc too underscore the perils and problems that bedeviled the policy and programme to expunge Variola.
What will be of particular interest to the scholars is the methodology adopted for this study. It is based on quite a substantial amount of hitherto difficult-to-access material that was not made use of in any other study. Most of these are unpublished papers kept in the WHO’s Smallpox Eradication Archives. The well-tabulated statistics enhance this tome’s utility to research-scholars.
Before the onset of the British rule, reproduction was considered an essentially biological phenomenon with social connotations. It was not "medicalised", i.e., "`85how the physiological processes of maternity and childbirth" become part of "distinct, professionalised fields of medical expertise and practice." Hodges points out in the introduction to this collection of essays that this medicalisation process comprised two related projects. One was to reform the women’s quarters on sanitary principles and the other was to replace the untrained traditional dai with professionally trained physician and midwife. This was easier said than done as it involved reckoning with entrenched attitudes and practices.
David Arnold shows how the colonial rulers were wary of "direct involvement in the management of reproduction" and, contrary to their personal conviction, medical officers wouldn’t broach the subject of birth-control in public. Barbara Ramusack finds that women physicians’ attitudes towards birth control reflected the contradictions and ambivalence that characterised the promotion of birth control in India. While Sarah Hodges emphasizes the centrality of eugenics to social reform in India, Maneesha Lal establishes the link between purdah and pathology in her study of the adverse effects of purdah system on the health of Indian women. Both point out how the anxieties about health and reproduction framed and rearticulated agendas about women’s health.
Charu Gupta dwells upon the negative effects of communal politics on ushering in birth control related reforms. She also examines the attitudes towards widow remarriage and the complexities of caste and gender politics. Supriya Guha’s essay deals with reforms in birth practices among Calcutta’s urban middle-classes, while Anshu Malhotra maps the evolution of the attitudes of emerging Punjabi middleclass elites towards midwifery and related practices.
Overall, scholars and policy makers will find this thought-provoking volume as invaluable addition to their bookshelves.