I’ve lived in Bombay most of my life and though I have seen more than my fair share of Labrador sized rodents, the mention of bubonic plague ignites thoughts of the Dark Ages in Europe and modern-day Madagascar rather than Mandvi, near the Mumbai Port Trust.
Mandvi was however where the first case of Bubonic plague was detected in In September 1896. I recently met an Aunt of mine who told me about the plague that ravaged Bombay from the 1890s to the 1920s and about Dr Viegas, who besides tussling with the pestilence also happens to have represented Catholics in the drafting of the constitution of India. While reading about him, I stumbled upon ‘Room 000 – Narratives of the Bombay Plague’ a gripping book on the Plague Epidemic in erstwhile Bombay. Sadly, much like myself, few know about this epidemic and even fewer know of contributions of Dr Viegas’ and Nusserwanji Choksy.
In the late 1800s, the rapid growth of Bombay’s commerce led to a massive influx of workers. The 1891 census the population of Bombay was counted to be 820,000. Even back then, the city services were not geared toward the well-being of large parts of the population. The death toll due to plague was estimated at 1,900 people per week through the rest of the year. Many people fled from Bombay at this time, and in the census of 1901, the population had actually fallen to 780,000.
Dr Acacio Gabriel Viegas, a former President of the Bombay Municipal Corporation, diagnosed the first plague victim despite having never seen the disease in his practice and began cranking the administrative cogs to start putting measures in place to control an outbreak besides launching a vociferous campaign to clean up the slums and exterminate rats. The resistance from the British led to costly delays and loss of innumerable lives, but he plodded on steadfastly until he achieved his purpose.
With a case fatality rate of over 90%, various preventive measures were taken: from scouring, disinfecting and lime-washing houses in affected districts to clearing the sewers. Civil unrest was rife, fuelled by the increasing hospital admissions and setting up of plague camps to isolate people from the unsanitary conditions that were thought to be causal. For most Indians, hospitals were places of utter pollution, with blood and faeces, and loci of the unacceptable mingling of castes and religions. For most Indians, both hospitalisation and segregation led to the loss of their job or their income. To avoid these measures, victims were smuggled out to search-free areas or well hidden within their own houses. The bubonic plague proved an implacable adversary. As time passed, the government had to fight both the epidemic and the people as an endless stream of rumours flourished, skillfully aided by the press. These rumours reveal a deep suspicion of Western medicine: doctors and hospital staff intended to poison Indians; in the hospital, you would be killed so that the doctors could cut you up and, at the same time, extract a mysterious oil from your body, known as momiai. The ‘Sarkar’ dealt with civil insurrections brutally with soldiers, horses, lathi sticks, and big guns as a reserve measure. The Indian people did what seemed most sensible– they left affected areas as quickly as they could–and grabbed moribund relatives from the hospitals and camps to take with them.
Most Mumbaikars are vaguely aware of the Haffkine Institute for infectious disease research, even if few now know that it was established as the Bombay Plague Laboratory, and was eventually named after the Russian microbiologist who came to Bombay to look for a vaccine for the disease. Incidentally, the aforementioned book is named after Room 000 at Grant Medical College where Waldemar Mordecai Haffkine celebrated his creation “of the very first successful vaccine against bubonic plague”. This room is now part of the blood bank at Grant Medical College!
The other hero is in this plot was Nusserwanji Choksy, who was handed the unenviable responsibility of studying the multiple inoculations available, of which Haffkine’s was one, and decide on which one would be implemented. He was described as an indefatigable clinician, having documented over 4000 cases of plague, and an acclaimed infectious disease specialist. His dilemma in choosing the right inoculating agent went on to be known as Choksys dilemma. It was said that the British study methodologies seemed almost hypocritical given that nought but 40 years later they’d be pioneering the Nuremberg Code.
Once chosen, British and American Philanthropists set up vaccination centres in railway stations and missionaries inoculated with a few annas and a little rice. However, rumours abounded that these inoculations would cause instantaneous death, impotence, and sterility, and besides, the needle was ‘a yard long’. The Government of India initially reacted sceptically: the serum was thought to be still in the experimental stage and evacuation, and thus other sanitary interventions, would be more effective. When time proved these assumptions wrong, the government tried to persuade people to accept inoculation, but it proved a difficult task.
Various theories have been put forth as to how the epidemic started in Bombay: some postulated that the disease came from Garhwal along with sadhus on their way to Kumbh Mela, others said that it must have made its way from Hong Kong through sick rats stowed away in ships and still others blamed the railways that connected all parts of the country.
Whatever the source may have been, plague continued to ravage Bombay until 1923. By the end of the 1920s, the disease was in gradual decline until it disappeared in 1935. According to David Arnold, this decline was, “probably due less to medical and sanitary intervention, than to the natural limits set on its spread by a variety of zoological and ecological factors, such as the geographical distribution of certain species of rat fleas and the growing immunity of rats to the plague bacillus.”
Plague continued to come and go in Bombay with further epidemics in 1908, 1949, 1952 and 1994. Were it not for the epidemic, the Bombay City Improvement Trust, responsible for the reconstruction of south Bombay, would never have come into being, but what became of our ‘mythical’ heroes?
Well if you do go to Arthur Road Hospital, Nusserwanji Choksy has a ward named after him, but rumour has it that no one there knows of his contributions to public health in Bombay. The next time you go to Metro Theatre look carefully, and you will find Dr Viegas’ statue, laden with pigeon poop, it’s a small consolation that (pardon my language) at least someone still ‘gives a shit’!
- Room 000 – Narratives of the Bombay Plague – Kalpish Ratna
- Choksy’ Dilemma – A Commentary
- When Plague came to Bombay – Scroll
- Shah Ebrahim International Journal of Epidemiology