This is an interesting new book on public health in India which examines the response of the Indian state to outbreaks of plague, cholera, malaria and yellow fever. Epidemic outbreaks, and public health policies that were devised to contain them, have already been the subject of several monographs in recent times. Indeed, it would be fair to say that much of the existing research on the history of medicine in India has been limited to this theme, though there have also been several attempts to break new ground. The book under review does not provide a strikingly new perspective on this overworked theme, but it differs from existing literature in two substantive ways: it attempts to situate epidemic outbreaks in India within the international perspective; and it uses the concept of ‘risk’ to examine the responses of the Indian state. What makes the task easier for the author is her choice of themes: cholera, plague and yellow fever, as we know, received a great deal of international attention, and the Indian subcontinent occupied a central place within these discussions.
Despite some overlaps with existing research, the book contains several interesting observations, especially in the context of malaria and yellow fever. The author, for example, makes a detailed survey of quinine production in the subcontinent and also outlines the overall attitude of both the central and provincial governments towards the control of malaria. Colonial policies regarding yellow fever are also discussed in detail, especially the strikingly different position that was adopted on the subject of quarantines against yellow fever.
In making these observations, though, Polu also makes some controversial remarks. For example, while discussing malaria research in India, she notes that ‘over the course of four decades (between 1890 and 1930), the government of India had gradually achieved its goal of establishing India’s pre-eminence in the world of medical research’ (p. 67). In a similar vein, she also notes that the government of India made ‘continued efforts to make research in India rank among the best in the world’ (p. 66). Such statements depict the colonial government as single-mindedly pursuing the goal of research excellence and effectiveness. Contrary to this, it could be argued that the colonial government in India was in fact distinguished by its strikingly small investment into medical research, despite huge mortalities and regular outbreaks of ‘tropical diseases’.
Polu also uses the concept of ‘risk’ in an interesting way. At several points in the book, she refers to the Indian government’s perception and management of risk in the context of epidemic outbreaks. These concepts have borrowed from the financial sector and used in the historical context without adequate reformulation. Indeed, several other recent ideas and notions have also been applied somewhat unreflexively to the nineteenth century. For instance, in one place Polu makes the observation that epidemics led to a loss of working days, loss of efficiency and so on (p. 14). Such quantitative cost–benefit analysis in terms of loss of working hours is a rather recent development, and is perhaps not equally relevant in the context of the nineteenth century. At another point, the author betrays her proclivity for free-market policies by noting that the Indian government’s policies against yellow fever amounted to ‘reactionary public health protectionism’ (p. 136). What is forgotten is that such ‘reactionary protectionism’ was in fact proposed and adopted in the first instance by many European governments, who are today the chief advocates of free markets and non-interference.
These minor quibbles apart, the book is an important contribution to the historiography of public health in India and would be useful reading for specialists working in the field. It also places Indian epidemic outbreaks squarely within the international context, which yields some valuable insights.
