Understanding the interplay between public health crises, surveillance, control, and ethical governance is paramount in addressing today’s global health challenges. Historical epidemics provide valuable case studies to examine how authorities have navigated these complex dynamics. The 1896 Bombay Plague serves as a compelling example, illustrating how colonial authorities utilised mapping and policing not merely as tools for disease management but as instruments of surveillance and control. By analysing the strategies employed during this epidemic, we can glean insights that are highly relevant for modern public health policy and practice.
The plague and its impact on Colonial India
The Bombay Plague of 1896–97 was a catastrophic epidemic that profoundly affected colonial India. Originating in Bombay through trade networks with the Far East, the plague rapidly spread throughout the Bombay Presidency and neighbouring princely states, eventually permeating across the subcontinent. By September 1899, the epidemic had claimed over 370,000 lives, as documented by the Indian Plague Commission.
The outbreak exposed significant deficiencies in the public health infrastructure of colonial India. In response, the colonial authorities established the Indian Plague Commission in November 1898, under the chairmanship of T.R. Fraser from the University of Edinburgh. The Commission embarked on an extensive investigation, conducting over 70 sittings and examining 260 witnesses, culminating in five volumes of detailed documentation. Despite the wealth of data collected, the Commission struggled to draw definitive conclusions regarding the plague’s origins and transmission. This difficulty reflected the colonial administration’s framing of the plague less as a public health issue requiring community-based solutions and more as a matter of controlling the population and maintaining order.
Emphasis on control over cases
A notable aspect of the Commission’s work was its utilisation of maps. Unlike the iconic spot map employed by John Snow during the 1854 cholera outbreak in London, which pinpointed the locations of affected individuals to identify patterns of disease spread, the maps produced by the Indian Plague Commission diverged significantly in purpose and design. Rather than detailing the residences of plague victims or clusters of cases, the Commission’s maps emphasised railway lines, inspection stations, quarantine zones, and police cordons.
For instance, maps such as the Railway Plague Inspection Stations Map highlighted railway networks and inspection points, focusing on monitoring movement rather than disease incidence. The Chausa Observation Camp Plan detailed the layouts of observation camps with prominent police lines, reflecting a militarised approach to quarantine. Similarly, the Khanpur Station Map showing Disinfecting Lines showcased disinfection zones and the role of police in maintaining these areas. These maps were unusually vibrant in colour for administrative reports of the time, perhaps intended to present control efforts as more effective and to obscure the epidemic’s severity. This cartographic approach shifted the focus from who was affected by the plague to where the disease could infiltrate, mirroring the colonial authorities’ framing of the epidemic as a problem of mobility and security. The emphasis on control points over cases indicated a prioritisation of state mechanisms of surveillance and control rather than epidemiological understanding and community health needs.
Policing and the management of the plague
Policing played a central role in managing the plague, enforcing quarantine measures, monitoring population movements, and collecting plague-related data. This approach aligned with the colonial framing of the plague as an issue of maintaining order and controlling mobility. Observation camps operated by the police were established at railway stations to enforce inspections and quarantines, reflecting a militarised approach to public health.
Additionally, the Bombay Government introduced military ward orderlies in Parel hospital and municipalities, legitimising military control as an effective way of controlling the disease. Police stations served as primary nodes for collecting plague data, with local watchmen (chaukidars) reporting deaths to the police, who then relayed information up the administrative chain. This practice persists in parts of India, where police still contribute to death registration, illustrating a continuity in statecraft.
The reliance on policing and military measures underscored how public health initiatives were intertwined with colonial policing strategies, associating disease control with surveillance and enforcement. The 22nd Law Commission of India, in its comprehensive review of the Epidemic Diseases Act, 1897, observed that the “unbridled and incongruous powers of the State” under colonial rule led to misuse of power instead of effective disease control. Modern times have seen a shift toward medical professionals assuming surveillance roles, reflecting evolving public health strategies and ethical considerations regarding the appropriate functions of police versus medical personnel.
The design and presentation of the plague maps played a significant role in shaping perceptions of the epidemic and the effectiveness of control measures. By emphasising control points such as railway lines and police cordons, the maps directed attention toward state mechanisms of control rather than the disease’s impact on individuals and communities.
The visual presentation of the maps, with their vibrant colours and detailed depictions of surveillance infrastructure, may have served to present control efforts as more organised and effective. This could have potentially downplayed the epidemic’s severity and the harsh measures imposed on the populace. The maps reinforced power dynamics by highlighting surveillance and policing measures, serving as visual representations of the state’s priorities.
By influencing perceptions, the maps may have masked the true scale of the crisis and the suffering of individuals, reinforcing the colonial agenda of maintaining order and control. This approach illustrates how authorities were more interested in where the disease could attack from rather than who was affected, shifting the focus from individual experiences to broader control strategies.
Broader implications for health surveillance and policy today
The historical use of mapping and policing during the Bombay Plague offers valuable insights into the relationship between public health surveillance, policy, and state control, with implications for contemporary practices.
Evolution of surveillance mechanisms: The integration of policing into health surveillance has evolved, with modern practices increasingly favouring medical professionals in these roles. This shift raises questions about how and why responsibilities have transitioned from police to health-care workers, reflecting changes in professionalisation, ethical standards, and public expectations.
Framing of health problems: The historical shift from mapping affected individuals to emphasising control points underscores the impact of problem-framing on policy and action. Recognising this helps us understand the importance of framing health issues in ways that prioritise individual and community well-being.
Ethical considerations: The historical focus on control over care highlights the need for transparency and respect for individual rights in public health policy. Modern strategies must balance effective surveillance with ethical obligations to avoid infringing on personal freedoms. Policymakers must continually ask: Who benefits, and who is harmed?
Power dynamics and representation: Recognising how maps and data can reinforce power structures helps us understand similar dynamics today. There is a need to critically assess how data is collected and used, ensuring it does not perpetuate inequities or serve as a tool for undue control.
Continuities and changes: Examining the continuities and changes from past to present reveals how historical practices influence modern governance and public health strategies. For instance, advanced population registers in some countries now eliminate the need for censuses, reflecting an evolution in state surveillance and data collection methods. Understanding these developments can inform more equitable and effective public health policies.
The examination of the mapping and policing strategies employed during the 1896 Bombay Plague provides a nuanced understanding of how public health crises intersect with surveillance, control, and ethical governance. These historical practices highlight the importance of framing health issues appropriately, prioritising community well-being, and maintaining ethical standards in surveillance and control measures. As we develop more sophisticated surveillance systems in response to contemporary health challenges, it is essential to ensure they promote public health objectives without reinforcing inequitable power dynamics or infringing on personal freedoms. Learning from the past enables us to create public health policies that are both effective and just, fostering trust and collaboration between authorities and the communities they serve.
Philip Jagessar is a researcher based in King’s College London. Sarah Hodges is a researcher based in King’s College London. Vignesh Karthik K.R. is a postdoctoral researcher based in KITLV-Leiden and a Research Affiliate at the King’s India Institute, King’s College London. Rakhal Gaitonde teaches at the Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) Trivandrum, Thiruvananthapuram. S. Anandhi formerly taught at Madras Institute of Development Studies Chennai
Published – December 07, 2024 12:16 am IST
