Influenza Pandemic of 1918

PERSPECTIVES

in British India alone … Without fear of exag- Infl uenza Pandemic of 1918 geration, it can be stated then that in a few months infl uenza was responsible for six mil- Lessons in Tackling a Public Health lion deaths (including Native States) in India. Catastrophe In the end, few months of infl uenza resulted in more deaths than nearly 20 years of plague in many Indian provinces. The epidemic struck India at a time T V Sekher when the country was least prepared to cope with the calamity. The total failure As India battles hard to combat the hen the world and India are of the monsoon, scarcity of food supply, COVID-19 outbreak, it is important battling hard to combat the inadequate medical facilities and short- COVID to look back and examine how a W -19 outbreak, it is im- ages of health personnel, created a mis- portant to look back and examine how a erable situation in many parts of India. major pandemic that occured major pandemic that occurred nearly a White (1919: 5) pointed out: nearly 100 years ago—the century ago, the infl uenza pandemic of Infl uenza within the space of four or fi ve infl uenza pandemic of 1918 or 1918, or Spanish fl u, was tackled. This months was responsible for the death of 2% pandemic killed around 12 million people of the total population of British India, the “Spanish fl u”—was tackled by the in India alone, more than in any other percentage of persons falling victims vary- then colonial administration. country. The challenges encountered by ing between 5.7 in the Central Provinces and 0.4 in Bengal. As regards the incidence of The challenges encountered are the then administration in colonial India the disease in Native States but little infor- examined, drawing specifi cally are examined, drawing specifi cally from mation is, at present, available, with the sin- the experience of the state of Mysore, gle exception of Mysore. The total number from the experiences of the state of which was considered one of the better- of deaths ascribed to infl uenza in Mysore, in Mysore, considered as one of the administered “progressive” prin cely states 1918, was 1,27,651, which is equivalent to a death rate of 22.37 per thousand. well-administered, “progressive” in British India. Census data and archival princely states in British India. records, available both in India and Eng- Exact data on the prevalence of infl u- land, are used to make a historical anal- enza among the general population was ysis of the administrative challenges in not available for most provinces and handling the pandemic. only the mortality data were compiled. However, the statistics on incidence and Infl uenza Mortality in India mortality of jail inmates of some provinces The infl uenza pandemic of 1918 claimed were available (Table 2, p 33). Those up to 70 million lives around the world, provinces reported high infl uenza mor- until it unexpectedly disappeared in 1919. tality among the general population but The author is grateful to Wellcome Trust, United No other outbreak has appeared Table 1: Influenza Deaths in British India, 1918 Kingdom for funding the research. The facilities with such intensity and devasta- Province Population Total Estimated Influenza and cooperation extended by the archives of tion in large parts of the world (Census 1911) Influenza Death Rate per Deaths Thousand the British Library and Wellcome Trust Library within such a short time as the at London; Karnataka State Archives, Bengaluru; Central Provinces Divisional Archives, Mysuru; National Archives, infl uenza outbreak in 1918. In and Berar 1,39,16,308 7,90,820 56.8 New Delhi; and other libraries are acknowledged. India, the infl uenza pandemic Delhi 4,16,656 23,175 55.6 The author also thanks the anonymous cost at least 12 million lives, Bombay 1,95,87,383 9,00,000 45.9 reviewers for their helpful comments on an though the estimates vary con- Punjab 1,93,37,146 8,16,317 42.2 earlier version of this article. siderably.1 The sanitary com- North-West Frontier Province 20,41,077 82,000 40.0 This paper is an updated version of an earlier missioner of the Government of United Province 4,68,20,506 10,72,671 22.9 paper, “Public Health Administration in India, F Norman White (1919: 1), Princely Mysore: Tackling the Infl uenza Coorg 1,74,976 3,382 19.0 Pandemic of 1918,” Sekher, T V, published in noted in his preliminary report Madras 4,00,05,735 5,09,667 12.7 India’s Princely States: People, Princes and on the pandemic: Assam 60,51,507 69,113 11.4 Colonialism (2007, W Ernst and B Pati [eds], From the incomplete information, at Bihar and Orissa 3,44,89,846 3,59,482 10.3 London and New York: Routledge, pp 194–211). present available, it would appear Burma 98,55,853 60,000 6.0 that no country suffered as severely T V Sekher ([email protected]) is with the Bengal 4,53,29,247 2,13,098 4.7 as did India, during the last quarter International Institute for Population Sciences, British India 23,80,26,240 48,99,725 20.6 of 1918. Altogether infl uenza was Mumbai and co-author of the book Health and Source: “A Preliminary Report on the Influenza of 1918 in India by the responsible for a death-toll of ap- Medicine in the Indian Princely States: 1850–1950. Sanitary Commissioner with the Government of India,” Simla: Government proximately fi ve millions [Table 1], Monotype Press,1919 (London: Wellcome Library).

32 may 22, 2021 vol lVi no 21 EPW Economic & Political Weekly PERSPECTIVES also showed high mortality among jail the state. According to government re- of Mysore, Sri Krishnaraja Wodeyer (1921). inmates, though the jail population can- cords, the total number of incidents was On 22 October 1918, at the prize distri- not be a representative of overall popu- 8,83,491 and the death toll amounted to bution function of the dasara industrial lation for various reasons, including the 1,66,391 (Table 3; GoM 1919a: 3). The and agricultural exhibition, he said: huge differences in sex and age structure 1921 Census for Mysore revealed that the Ladies and Gentlemen, once our Annual Dasara and higher chances of infection in a crow- number of deaths per 1,000 in 1918 was Exhibition has turned its course and it is my ded environment. According to available about 30 (though the Mysore Gazetteers pleasant duty to distribute the principal prizes to successful Exhibitors. I wish that we could evidence, the prevalence of infl uenza later provide much higher fi gure as shown have met under happier circumstances and was fairly constant across the provinces, in Table 4), whereas in the previous year that the complete success which this Exhibi- but the mortality varied considerably. it had been 10 and for the year 1919 it tion deserves had not been somewhat marred was only eight, a good indication of the by the adverse season and the sickness which Situation in Mysore State severity of the epidemic.3 is prevailing everywhere and which has nat- urally kept away many visitors, besides de- The fact that Mysore was the only Table 4: Death Rates in Mysore State, 1913–1925 priving the Committee of the services of their princely state that could provide timely Year Death Rate per Year Death Rate per Secretary and a number of their working staff. Mille of Population Mille of information on infl uenza mortality is an Population indication of its administrative effi ciency, 1913 18.07 1919 16.44 Administrative Measures even during crisis situations. This may 1914 18.66 1920 14.99 In fact, the chief secretary to government, have been partly due to 50 years of 1915 15.53 1921 14.22 C S Balasundaram Iyer, issued an order direct British rule from 1831 to 1881, 1916 16.63 1922 14.52 directing the temporary structure for when the administrative machinery in 1917 19.54 1923 16.09 the exhibition to be placed at the dispos- 1918 60.28 (Year of Influenza) 1924 21.18 the state was modernised, thereby con- al of the president of the Mysore city mu- 1925 17.44 tributing to Mysore’s subsequent reputa- Source: C Hayavadana Rao (1927–30): Mysore Gazetteers, nicipal council, for opening a provisional tion as a “progressive princely state.”2 compiled for Government, Bangalore,1927–30. dispensary for the treatment of infl uenza Infl uenza made its fi rst appearance in Apart from increased mortality, infl u- patients.4 The chief secretary issued strict a mild form in Bangalore city in July 1918, enza also affected the spirit of celebra- instructions to the deputy commissioners but disappeared soon without causing tions at the most important annual of the districts and the presidents of any signifi cant loss of life. It reappeared events of Mysore, that is, the dasara fes- the two municipalities, Bangalore and in the middle of September 1918 and tival celebrations and exhibition. This is Mysore, regarding the monitoring and co- spread with lightning speed throughout evident from the speech of the maharaja ordination of relief work.5 The district Table 2: Influenza Mortality Rates, Incidence Rates and Case Mortality Rates: Selected Provinces medical offi cer, the sanitary offi cer, the and Jail Populations, British India, 1918 (rate per 1,000) amildars (revenue offi cers), and the Sl Province Province Influenza Jail Influenza Jail Influenza Jail Influenza No Mortality Rate Mortality Rate Incidence Rate Case Mortality deputy amildars were to tour the taluks 1 Central provinces 67.6 34.8 457.5 76.1 and ensure that the government instruc- 2 Bombay presidency 54.3 36.0 348.0 103.4 tions were implemented effi ciently. 3 United provinces 47.2 20.9 296.7 70.4 They also were to liaise with a variety of 4 Punjab 46.0 38.9 334.7 116.2 medically trained people, such as vaid- 5 North West frontier 44.4 28.6 311.1 91.8 yas, sanitary inspectors and hakims, to 6 Assam 26.1 5.9 351.1 16.7 facilitate the distribution of medicines. 7 Lower Burma 16.2 6.4 278.6 22.9 8 Madras presidency 15.8 10.9 318.7 34.3 Action Plan Sources: Proceedings of the department of education, Sanitary-Part A,1918; and annual report of the Sanitary Commissioner with Government of India, 1918 (as cited in Mills 1986: 12). Daily messages and weekly reports Table 3: Mortality from Influenza in Mysore State, 1918 were sought to take stock of the situa- Sl District/City Population (Census of 1911) Attacks Deaths Percentage of Deaths to tion and chalk out action plans. Even in No Total Population places where the epidemic was under 1 Bangalore city 88,651 40,000 2,074 2.3 control, the fi ling of reports was to be 2 Mysore city 71,306 36,550 1,296 1.8 discontinued only after consultation with 3 Bangalore district 7,59,522 1,52,323 16,600 2.2 government. The offi cial memorandum 4 Kolar 7,89,153 77,800 19,631 2.5 5 Tumkur 7,35,346 1,56,316 35,260 4.7 6 Mysore 12,70,765 1,15,997 23,841 1.8 7 Hassan 5,80,200 1,49,340 20,766 3.6 8 Shimoga 5,16,716 77,716 22,741 4.4 available at 9 Kadur 3,38,457 24,355 5,867 1.7 U Nagesh 10 Chitaldurg 5,64,243 53,094 18,815 3.3 Times Agencies Total 57,05,359 8,83,491 1,66,391 2.9 14-11-876, Nayabasti, Begum Bazaar The total figures (population and deaths) are reproduced here as provided in the government order. However, they do not tally. Source: “Report on the Epidemic of Influenza: Proceedings of the Government,” 4 March, GO No G, 19409–21-MED. Hyderabad 500 012, Telangana. 56–18–96, General and Revenue Departments, Government of Mysore, Karnataka State Archives, Bangalore, p 3.

Economic & Political Weekly EPW may 22, 2021 vol lVi no 21 33 PERSPECTIVES from the chief secretary instructed as brief weekly report, not exceeding one fi nal report of the deputy commissioner follows: page, of the work done by the medical of Chitradurga district: Daily Messages and Weekly Reports or department, should be submitted by him As the outbreak of the epidemic was sudden Returns may be submitted as explained to government every monday. and took the people as it were by surprise, hereunder: (ii) The sanitary commissioner will be and as almost all the patels [village head- (i) The Presidents of the Municipalities of expected to maintain correct up-to-date men] and shanbogs [village accountants], Bangalore and Mysore should intimate to the information regarding the state of the who are the proper agency for the collec- government, early every morning, the fi g- disease in various parts of the state, tion and report of correct statistics in such ures of total mortality and mortality from matters, together with a number of Sheik- infl uenza on the previous day. This should review the same from day to day, bring dars [sub-taluk revenue offi cers], were also be followed by a brief report, (which unless to the notice of government any defi - taken ill and several of them died, there was necessary need not exceed a dozen sentenc- ciencies in existing arrangements and practically no means by which the necessary es) on the state of the epidemic each day, the special facilities required and arrange information could be gathered, and the sta- manner in which the organization for deal- tistics must therefore be necessarily said to ing with epidemic is working and any fur- for bacteriological and other investiga- ther facilities or help required from govern- tions. He should submit a report to be defective. In fact several villages that got ment. Copies of the daily messages and the government every Monday.7 infected could not, owing to these causes, 11 report should be simultaneously forwarded M Srinivasa Rao, sanitary commis- come into the accounts at all. to the senior surgeon and sanitary commissioner, issued a special statement regar- The administrative report for Mysore sioner. 8 (ii) The deputy commissioner in each dis- ding the cure and prevention of infl uenza. for the year 1918–19 confi rmed the under- trict should similarly intimate by wire in a The printed version of this, both in reporting of infl uenza mortality further few sentences, the fi gures as far as avail- English and in the local Kannada lan- and provided an adjusted fi gure, refer- able of total mortality in each taluk and the guage, was distributed throughout the ring to “the unparalleled death-roll of district, areas newly affected and any special state to better inform the public. In his 1,95,437, representing a ratio of 34.3 per facilities or help needed from government. GoM Copies of these should be forwarded simul- note, Rao highlighted in particular what 1,000 population” ( 1919b). However, taneously to the senior surgeon and sanitary measures and precautions should be tak- mortality across districts varied consid- commissioner. en by people affl icted with infl uenza and erably, with the highest fi gure of 44 per (iii) The presidents of the two municipali- those still in a healthy state. 1,000 in Shimoga district to 17 per 1,000 ties and the deputy commissioners of Dis- In many places, entire families were in Kadur district and the cities of Mysore tricts should submit a brief det ailed report (which need not exceed one page) once a affected and there was no one to attend and Bangalore reporting about 18 and week, every Saturday, regarding the state to the wants of the patients, prepare 23, respectively (GoM 1919a: 1). of epidemic, extent of cooperation received food or collect medicines. Many offi cials In many places, individuals came from offi cials and the non-offi cial public, also fell sick and died. At one point, even forward to help and provide relief for supply of medicines and medical men, relief the chief secretary himself, C S Balasun- the needy. Incidents of humanitarian to the poor and the adequacy or otherwise of the existing arrangements, copies of the daram Iyer, and most of his offi ce staff gestures were frequently cited in the 9 report being furnished simultaneously to the suffered from infl uenza. In most areas, reports of the presidents of the two Senior Surgeon and the Sanitary Commis- including taluk headquarters and large municipalities and deputy commissioners. sioner.6 towns, people accepted Western medicines Special committees comprising of leading readily. However, in some places they citizens and local offi cers were consti- Tasks of the Offi cials were most unwilling to take them. tuted and provisions were made for water This memorandum also specifi ed the re- Interestingly, in one instance, the supply and fuel in the cremation grounds. sponsibilities of the senior surgeon and amildar of Holalkere taluk reported to be In the districts of Kolar, Tumkur, Kadur the sanitary commissioner respectively ill and repeatedly applied for leave. This and Shimoga, sheds were erected near in handling the pandemic. resulted in local people becoming suspi- the dispensaries to house the affected (i) The senior surgeon will be responsible cious and sending a telegram to the diwan people (GoM 1919a: 2). By the end of for all the medical arrangements neces- to request him to enquire into the matter. October, the disease had spread through- sary in connection with the disease such The deputy commissioner was asked to out the state and it became impossible as maintaining an adequate staff of pay a surprise visit, along with the district for regular medical staff to cope with medical men in each affected locality, medical offi cer, to examine the amildar, the increasing demand. Consequently, the supply of medicines, entertainment who had confi ned himself indoors. They the services of local pandits and hakims of additional medical staff, the opening found no trace of fever on him and heard were utilised, and the senior surgeon of new dispensaries, etc. He should be that the amildar never got himself treat- regularly in correspondence with the ed by the local sub-assistant surgeon. It presidents of the two municipalities and emerged that he was fi ne and wanted to available at the deputy commissioners and utilise in avoid exposure to the epidemic.10 consultation with them, every available In many districts, the actual mortality Forum Book House 170/1, Rastreeya Vidyalaya Road agency for adopting curative and other was much higher than originally reported. Visveshwarapuram, Bengaluru 560 001 measures for combating the disease. A This is evidenced, for example, by the

34 may 22, 2021 vol lVi no 21 EPW Economic & Political Weekly PERSPECTIVES instructed the students at the medical that the president of the municipality 4 pm to 8 pm to facilitate patients’ access school to work in conjunction with the saw it necessary to refrain from attend- to treatment (GoM 1919a: 1). As the dis- medical subordinates in the cities of ing the dasara durbar at Mysore. ease spread, accommodation was found Bangalore and Mysore (GoM 1919a: 1). Subba Rao prepared a detailed to be insuffi cient. Considering the mag- scheme whereby an organised attempt nitude of the problem, the government Civic Response and Relief was to be made to supply food and medi- decided to open a new temporary infl u- Operations cines free to the sick at their own enza hospital in Bangalore. The hospital At the meeting of the city municipal homes.14 The city was divided into sev- under canvas came into instant existence council on 5 October 1918, it was noted eral blocks and small parties were ap- on 30 October at the municipal garden. that the so-called “mysterious fever” of pointed for each block. A house-to-house Altogether, 1,062 outpatients and 198 in- Bombay had been imported into Banga- survey, which commenced on 11 Octo- patients were treated here; 28% of them lore and had widely spread in the city.12 ber 1918, was carried out to locate sick died (GoM 1919a: 1). The chief offi cer, R Subba Rao, informed people. The free distribution of medi- St Martha’s Hospital, the Convent of the council that this disease was the cines and conji (rice porridge) com- Mary at Chamarajpet and several Unani infl uenza pandemic in some of its graver menced on 12 October 1918. The in- dispensaries and Ayurvedic vaidyasalas manifestations (BCMC 1918a). It was structions were very particular regard- attended to the treatment of the sick reported that the attendance of the ing the duties of relief parties, prepara- in Bangalore city. The relief work in patients at the municipal dispensaries tion and quantity of food, and distribu- Bangalore had started with a few people, had doubled and that there were long tion of medicine. mainly municipal councilors, missionaries lines of waiting patients at private dis- Conji will be prepared in the govern- and members of the Gokhale League, pensaries and chemist shops. The wards ment anna chattram (free meal distribu- but it gradually saw increased participa- for the in-patients in hospitals were tion centre), by a special staff under the tion by a number of volunteers. Fifty-fi ve overfl owing with patients and many supervision of Hari Rao and Vasudeva Rao relief parties numbering 218 volunteers people were sent away due to lack of ac- alternatively. Sooji will be fried and were working in Bangalore city during commodation (BCMC 1918a). boiled in water; an equal quantity of milk the infl uenza season, apart from munici- The municipal council passed a reso- will be added; sugar to taste and appro- pal offi cials. The organisations actively lution urging the government to provide priate quantities of powdered carda- engaged in the relief operations were the suitable treatment and accommodation moms and saffron will be put in. Conji Amateur Dramatic Association, Wesleyan as quickly as possible for about 100 will be ready for issue to the relief parties and London Missions at Bangalore, Young in-pa tients, make available more staff by 9 am. The relief parties will start dis- Men’s Christian Association, National High and increase the stock of medicines in tributing Conji in their blocks at not later School, Central College, Government the dispensaries. It also instructed the than 9.30 am. The quantity to be issued Collegiate High School and Civic and health offi cer to publish and circulate will, for the present, be fi xed at 1 pint or Social Progress Association.16 A large leafl ets explaining the nature of the 20 ounces per adult and half the quantity body of students—including those from illness and measures to be adopted. It for children. An endeavour will be made the Vokkaligara Sangha, the Veerasaiva decided to secure voluntary assistance for the issue of milk to very young chil- Students’ Hostel and the City Boy Scout from retired medical men and others. dren. Notebooks will be issued to the organisation—participated in the relief Two municipal councillors, Fr P N Briand relief parties wherein the name of each work. The students from Bangalore and Rev D A Rees, promised the co- patient, age and quantity of nourishment Medical School played a key role in assist- operation of people in their parish and and medicine issued day by day should ing the compounding work at the in- mission respectively. Considering the be entered.15 struction of the senior surgeon, even gravity of the situation, K P Puttanna The government anna chattram, near risking their own lives. Chetty, president of the municipal council, the municipal garden, was fi xed as the Supply of medicines was a major chal- immediately instituted enquiries and central issuing station for the relief lenge. A team of volunteers spared no personally visited all parts of the city parties to obtain their supplies and to efforts, day and night, in arranging and extensions. In his letter to the chief proceed to their divisions. The internal medicines for distribution. A total quan- secretary of the government of Mysore, administration of the drug Thymol was tity of about 6.25 lakh of doses of on 7 October 1918, he pleaded for imme- undertaken both as a routine treatment Thymol, 3,898 packets of epsom salt, diate assistance for the senior surgeon and as a prophylactic. The Public Health 8,334 packets of cough powders for and sanitary commissioner, so that they Institute at Bangalore provided the internal administration, and 1,500 ounces were able to control the epidemic effec- nece ssary medical advice on the types of of eucalyptus oil for external application tively (BCMC 1918b). A census conducted treatment. A special ward was opened in were distributed through volunteer in Bangalore on 6 and 7 October indi- the Epidemic Disease Hospital in Banga- agencies. A total quantity of nearly 40,000 cated that there were about 10,000 per- lore to prevent overcrowding and dis- seers (sihrs) of conji was issued from the sons suffering from infl uenza on those pensaries were ordered to be kept open government anna chattram and distrib- days.13 In fact, the situation was so critical from 7 am to 12 noon and again from uted by the volunteers throughout the

Economic & Political Weekly EPW may 22, 2021 vol lVi no 21 35 PERSPECTIVES divisions, using bullock carts, jutkas the relief operations in a more systematic The diwan paid generous tribute to (horse-driven carts) and bicycles.17 At manner and the involvement of various the government servants and volunteers the height of the pandemic, a minimum organisations and volunteers made it involved in relief operations: of 6,000 persons were undergoing daily possible. The leadership provided by Our meed of praise is due to the presidents Thymol treatment and at least 3,000 K P Puttanna Chetty, president of the of the two municipalities and deputy com- persons received conji doles daily in municipality, who had handled the ear- missioners to the many offi cers and subor- the city.18 lier plague epidemic effi ciently by liais- dinates of the revenue and medical depart- Relief parties worked on the information ing with various organisations in the ments, and particularly to the numerous public men who came forward to assist Gov- furnished by the municipal councilors, city, is notable. ernment and the municipal authorities and sanitary inspectors, medical practition- gave freely to their money, time, and energy. ers and residents of the locality. They Appreciating Public Participation Nor should I omit to mention the enthusiasm patrol led the areas and distributed After inspecting the work of the relief of the younger generation—students and medicines and food free to all deserving parties on 25 October, the diwan Sir other volunteers—who showed such a fi ne spirit of unselfi sh service in carrying food cases. The chief secretary issued a state- M Visvesvaraya expressed his satisfac- and medicines to every door of the poor and ment on 13 October 1918, in which he tion with the efforts that had been un- the needy, without any regard to the risks specifi ed the responsibilities of every dertaken, stating that he had the highest they were running.20 offi cer with regard to the measures to hopes for the future generation. He was be adopted in the cities of Bangalore impressed by the harmonious working Infl uenza in Assembly Sessions and Mysore (Table 5). together of the old with the young, the The dasara session of the Mysore Repre- In addition to the above, Bangalore offi cials with the non-offi cials, and the sentative Assembly held on 17 October municipality issued further guidelines rich with the poor. He referred to the 1918, confi ned its deliberations mainly to for the supply of essential items (Box 1). spirit of civic responsiveness in the two crucial issues: necessary measures Compared to Mysore, the Bangalore face of great suffering and considerable to combat the epidemic and the deterio- municipality seems to have organised fi nancial loss.19 rating food situation. Out of 263 members, only 88 members attended the Table 5: Responsibilities of Officers in Combating Influenza in the Cities of Bangalore and Mysore meeting. Others remained in their areas Measures to Be Taken Officers Responsible for Taking Measures Time Given to organise relief measures (MRA 1918). 1 Opening up of temporary Senior Surgeon and Presidents of City 1 week dispensaries Municipal Councils of Bangalore and Mysore In his address to the dasara session of the 2 Appointment of the Senior Surgeon and Presidents of 1 week assembly, the diwan, M Visvesvaraya, medical and other staff city Municipal Councils of Bangalore and Mysore echoed the concerns of the administration: 3 Supply of medicines Senior Surgeon 1 week We are passing through anxious times. The 4 Provision for tents or sheds Presidents of City Municipal Councils, 1 week war, the drought, the high prices of neces- Bangalore and Mysore saries of life, the plague and the epidemic 5 Providing conveyance, etc, of infl uenza, which has recently spread into to voluntary workers -Do--Do this part of the country, mark distressing 6 Reporting action taken Senior Surgeon and Presidents of combination of calamities which are press- City Municipal Councils of Bangalore and Mysore 10 days and thereafter ing heavily on the population and especially every week ending on the poorer classes. —Saturday until—the subsidence of the epidemic The defi ciency of food supplies is a common experience all the world over at the present 7 Educating the public with Sanitary Commissioner time. The position in Mysore is intensifi ed regard to the preventive and remedial measures by the almost entire failure of the southwest by issuing pamphlets, etc monsoon. At one time the outlook seemed Source: “Anti-Influenza Operations” (1918): Med. File 56/1918.sl. no: 1301–132. Circular from Chief Secretary to Government, very gloomy, but a few heavy showers dur- 15 October 1918 (Karnataka State Archives). ing the last and the current months have partially relieved the situation. The diffi culties have arisen chiefl y from panic, due to Box 1: Guidelines for the Supply of Food and Medicines, Bangalore City the withholding of stocks by the cultivators (1) Sub-dividing the several divisions of the city into blocks, the size of each block depending on the and attempts at profi teering on the part of MRA number of volunteers forthcoming to take up the work. the merchants. ( 1918: 1) (2) Organisation of relief parities to take charge of one or more blocks. The diwan also issued a stern warn- (3) The minimum number of persons necessary to form a relief party. ing to traders and businessmen in the (4) How relief parties were to obtain information of illness in their blocks. same session: (5) The duties of relief parties. The strong hand of government must always (6) Nourishments, how and where to be prepared and issued to relief parties. be in evidence and continue to interfere when- (7) How relief parties were to obtain supplies from the central issuing station. ever any section of the community tries to (8) Quantity of nourishment to be issued per head. take advantage of the diffi culties of the public. (9) The issue of medicine. (10) The compilation of statistics. To deal with the shortage of food supplies, the government attempted to control

36 may 22, 2021 vol lVi no 21 EPW Economic & Political Weekly PERSPECTIVES the movement of principal foodgrains. It is no doubt true that the taluk ofﬁ cers did support was granted by the princely gov- Price limits were enforced for the sale not make as generous a use of the ample funds ernment to the two municipalities and the placed at their disposal as the government of ragi and rice in certain districts. De- intended, but there is no reason to suppose districts. The entire administrative ma- pots were opened in the cities of Banga- that assistance was denied in deserving cases.22 chinery was geared through coordinat- lore and Mysore for the sale of grains at In fact, the expenditure statement on the ed efforts to face this public health chal- low cost. The diwan pointed out the relief measures shows that the government lenge. Daily messages and weekly reports crucial role of traders in normalising allotted generous funding for inﬂ uenza re- were sought from the lower rungs of the the food situation: lief operations. Out of the total allotment administration to monitor the ground situ-

What is required is that the existing food of `1,13,866, the expenditure incurred ation. Many offi cers were able to evoke supplies should be properly conserved and was only `81,386, of which `32,186 was trust and civic responsiveness from the distributed, and the producers, traders and for the supply of medicines (Table 6). public, while keeping in view the cultural consumers should realize the peculiar diffi - Table 6: Expenditure Incurred for Influenza Relief Measures in Mysore State, 1918 culties of the situation and work in a spirit of Sl District/City Allotment Expenditure Remarks harmonious co-operation. (MRA 1918) No (`) (`) 1 Bangalore city 19,430 19,113 To what extent this appeal had the 2 Mysore city 8,750 9,369 (Excess expenditure) desi red effect is diffi cult to establish. It is 3 Bangalore district 5,500 1,091 clear though that there was food scarcity 4 Kolar 5,550 2,480 (Mulbagal Taluk accounts still due) in rural areas in particular. Public senti- 5 Tumkur 7,000 3,875 ments can be gauged from newspaper 6 Mysore 8,000 2,002 (does not include expenditure of Hunsur taluk) reports, such as those from Sira and 7 Hassan 6,000 4,263 Biroor. These expressed the agony and 8 Shimoga 8,000 2,963 anger of the rural people about the non- 9 Kadur 5,500 2,044 10 Chitaldurg 8,000 2,000 availability of foodgrains. They com- 11 Sanitary commissioner 3,490 3,490 Cost of Thymol plained that the government was not 12 Senior surgeon 28,696 28,696 Cost of medicines supplied enough to provide essential supplies to Total 1,13,866 81,386 21 people in the countryside. Source: “Report on the Epidemic of Influenza: Proceedings of the Government,” 4 March, GO No G, 19409–21–MED. 56–18–96, General and Revenue Departments, Government of Mysore, Karnataka State Archives, Bangalore, p 3. Disparities in Relief Operations Only in Mysore city more money was sensibilities and beliefs of the masses. The In the assembly session on 28 April 1919, spent on relief efforts than what the gov- stern measures enforced by the Mysore a member, citing newspaper reports, ernment had allocated. For the tempo- administration to regulate the price of argued that the cities received all possi- rary infl uenza hospital in Bangalore, the foodgrains and the free supply of essen- ble help, with medicine and conji being government sanctioned `10,000, but at tial goods and medicines helped to over- carried to the doorsteps of the suffering the same time instructed the municipa- come a famine-like situation (Sekher poor, but that the rural areas received lity to meet one-third of the total ex- 2018). However, in many rural areas, the very little attention. In response, the pense. The city council however refused relief measures were not very successful. offi ciating diwan, A R Banerji, pointed to meet its share of the costs, citing other Nevertheless, these concerns were freely out that the government had spent about fi nancial commitments.23 expressed in assembly discussions and `81,000 for relief work during the infl u- newspaper reports, and the princely gov- enza season and that some of it had been Conclusions ernment was receptive to these complaints. spent in rural areas. He was rather evasive The 1918 infl uenza pandemic in India ac- The century-old experience of princely about exactly how much had gone to the counted for around one-fi fth of total Mysore in combating the infl uenza pan- latter. Some assembly members therefore deaths in the world causing widespread demic provides very useful lessons. They demanded that the expenditure incurred havoc and disrupting lives and the involve a combination of strong admin- in urban and rural areas be specifi ed economy, but it has received very little istrative measures, including strict mon- (MRA 1919). Though both towns and vil- attention of researchers (Arnold 2019). itoring of public health and sanitation lages were affl icted by the epidemic, due However, the impact of this pandemic, services, timely gathering of data and to acute food shortages, mortality and inclu ding mortality, varied considerably information, well-organised relief oper- the level of distress were higher in the across the provinces in India. In Mysore ations, regulating the price of foodgrains, rural districts, as is evident in the admin- state, the well-organised administrative the administration’s sensitivity towards istrative report of 1918–19 (GoM 1919b). machinery and the existing health and public grievances and cultural sentiments, In many cases, it was not the shortage sanitation infrastructure made it possible and the involvement of civilian and of funds, but the diffi culties in reaching to minimise the calamity. Instructions community organisations. out to the affected areas that resulted in from the chief secretary and the guidelines Notes lack of relief measures. The deputy com- from the senior surgeon and sanitary com- 1 Studies cite between 11 million and 18 million missioner of Shimoga district in his fi nal missioner provided the general framework excess deaths due to infl uenza in India (Mills 1986; report on infl uenza pandemic admitted: for the relief measures. Required fi nancial Davis 1951; Chandra et al 2012; Arnold 2019).

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According to Hill (2009), the mortality effects 9 “Letter from Mysore camp to Mirza Ismail, BCMC (1918a): “Proceedings of the Ordinary Gen- of the 1918 Infl uenza pandemic were higher in Huzur Secretary to Maharaja, Dasara,” Files of eral Meeting of the City Municipal Council, India than anywhere else in the world. In the Maharaja’s Private Secretariat, 1918, Divisional Bangalore, held on 5 October 1918 in the Coun- worst-affected Bombay Presidency alone, Archives, Mysore. cil Chamber, Bangalore City Municipal Offi ce,” 675,222 infl uenza deaths were reported in Oc- 10 “Final report on infl uenza from the deputy No G 28-31-Medical, Camp Mysore, Karnataka tober 1918 in the “Annual Report of the Sani- commissioner of Chitaldrug district to the State Archives (KSA), p 5. tary Commissioner for the Government of chief secretary,” p 8, KSA. — (1918b): “Letter no: 98 from the President Bombay, 1918 (Bombay [1919], p 23), and 11 Final report on infl uenza from the deputy com- of the Bangalore City Municipal Council to the Ramanna (2003). missioner of Chitaldrug district to the chief Chief Secretary of the Government of Mysore,” 2 The “progressive” image of a few Indian princely secretary,” p 7, KSA. 7 October, No G 28–32–Medical, Annexure, states, including Mysore, is generally ascribed 12 This belief/feeling was common even in Camp Mysore, 9 October 1918, p 4, KSA. to the administrative modernisation, state sup- the districts, as can be seen from the report of — (1918c): “Letter No 107, from the President, Mu- port for social services—mainly for education the deputy commissioner of Kadur: “the infec- and health—and the introduction of represen- nicipal Council, Bangalore City,” 13 October, tion was fi rst imported to Kallenahalli, a vil- Med-File 56-18, sl No: 130–32, KSA. tative institutions (see Ramusack 2004). lage in Sivane Hobli. The Pattegar merchants 3 According to the census, the reported numbers of the place were in the habit of visiting Chandra, Siddharth, Goran Kuljanin and Jennifer of deaths from fevers (including infl uenza) Bombay once or twice a year to buy silk and Wray (2012): “Mortality from the Infl uenza were 1,00,511 in 1918 and 32,954 for 1919. It cotton yarns necessary for their trade. Three Pandemic of 1918–19: The Case of India,” De- also reported 7,552 deaths from plague, 4,584 Mahomadan merchants who went to Bombay mography, Vol 49, pp 857–65. from smallpox and 3,166 from cholera in in the middle of September when that town Davis, Kingsley (1951): The Population of India and Mysore state in 1918 (Thyagarajaiyar 1922). was infected, returned to their village suffer- Pakistan, Princeton NJ: Princeton University 4 “President of the Mysore Municipality is ing from fever and cough and died three or Press. requested to take necessary action to open the four days afterwards … It is possible that per- GoM (1919a): “Report on the Epidemic of Infl uen- hospital in consultation with the Senior sons coming into the district in the Railway za: Proceedings of the Government,” 4 March, Surgeon and report the action taken to gov- from Bombay and other infected localities also GO No G, 19409-21-MED 56-18-96, General ernment at once. A sum of `3,000 will be sanc- might have introduced the epidemic into the and Revenue Departments, Government of tioned for equipment and other charges of the district.” “Final report from the Deputy Com- Mysore, Karnataka State Archives, Bangalore, hospital.” Proceedings of the Government of missioner of Kadur district on infl uenza to the p 3. Chief Secretary,” File 56/1918, Sl No 94, p 6, KSA. Mysore, Treatment of Infl uenza Patients, General — (1919b): “Report of the Administration of My- and Revenue Departments, No: G 7856–60– 13 “Report from the Sanitary Commissioner on sore for the Year 1918–19,” Bangalore: Govern- MED, 56–18–22, 29 October 1918, p 10, Karna- the Outbreak and Prevalence of Infl uenza in ment Press, British Library, London, p 68. taka State Archives. Mysore State during 1918 to the Chief Secre- Hill, Kenneth (2009): “Infl uenza in India 1918: Epi- 5 Mysore was the second largest princely state in tary of the Government” (1918): 28 December, center of an Epidemic,” 26th IUSSP Insterna- India with a population of about 6 million File 56/1918, KSA. in 1911. For administrative purpose, Mysore 14 Proceedings of the meeting of leading Munici- tional Population Conference, Marrakech, state had been divided into eight districts, each pal Councillors and citizens at City Municipal iussp2009.princeton.edu/papers/93252. presided over by a deputy commissioner. Every Offi ce held on 10 October 1918, Enclosure Manor, James (1977): “Political Change in an Indian district consisted of several taluks under the su- of the letter no: 107 from the President of State: Mysore 1917–1955,” Australian National pervision of an amildar. The amildar was re- the Municipal Council, Bangalore City, File University Monograph on South Asia, No 2, Delhi: sponsible for revenue administration, and also no 56/1918, SL Nos 130–32, p 3, KSA. Manohar Publications. for judicial and police work. The taluk had been 15 Proceedings of the meeting of leading Munici- Mills, I D (1986.): “The 1918–19 Infl uenza Pandemic: subdivided into as many hoblis, which were un- pal Councillors and citizens at City Municipal The Indian Experience,” Indian Economic and der the supervision of sheikdars or revenue of- Offi ce held on 10 October 1918, Enclosure of Social History Review, Vol 23, No 1, pp 1–40. fi cers (see Manor 1977). the letter no: 107 from the President of the Mu- MRA (1918): “Proceedings of the Mysore Repre- 6 “Offi cial Memorandum from the Chief Secre- nicipal Council, Bangalore City, File no: sentative Assembly,” Dasara Session, October, tary to Government, General and Revenue 56/1918, SL Nos 130–32, p 4, KSA. part A Karnataka State Archives. Secretariat” (1918): Mysore, 15 October, p 1, 16 “A brief report on the relief work organised — (1919): “Proceedings of the Second Session of Karnataka State Archives (KSA). during Infl uenza epidemic of October and the Mysore Representative Assembly for the November 1918 in Bangalore city,” File No 56/1918 7 Offi cial Memorandum from the Chief Secre- year 1918–19,” 28 April, Karnataka State sl no 85, p 2, KSA. tary to Government, General and Revenue Sec- Archives, p 140. retariat” (1918): Mysore, 15 October, p 1, Karna- 17 A brief report on the relief work organised dur- Ramanna, Mridula (2003): “Coping with the Infl u- taka State Archives (KSA). ing Infl uenza epidemic of October and Novem- enza Pandemic: The Bombay Experience,” The 8 Mysore state had a well-established sanitation ber 1918 in Bangalore city,” File No 56/1918 sl Spanish Infl uenza Epidemic of 1918–19: New department. In 1897, the Epidemic Diseases no 85, p 4–5, KSA. Perspectives, Howard Phillips and David Kill- Regulation was passed in Mysore empowering 18 A brief report on the relief work organised dur- the government to take appropriate measures ing Infl uenza epidemic of October and Novem- ingray (eds), Routledge: London and New York, and to prescribe temporary regulations necessary ber 1918 in Bangalore city,” File No 56/1918 pp 86–98. to deal with epidemics. The Mysore Village Sani- sl no 85, p 5–6, KSA. Ramusack, Barbara (2004): The Indian Princes and tary Regulation Act, was passed in 1898. The 19 A brief report on the relief work organised dur- Their States, The New Cambridge History of Vaccination Regulation Act of 1906 provided ing Infl uenza epidemic of October and Novem- India, III 6, Cambridge: Cambridge University for compulsory vaccination throughout “noti- ber 1918 in Bangalore city,” File No 56/1918 Press. fi ed areas.” Since 1902, the sanitary commis- sl no 85, p 7, KSA. Rao, C Hayavadana (1927–30): Mysore Gazetteers, sioner was responsible for public health servic- 20 A brief report on the relief work organised dur- various volumes, compiled for Government, es. In 1907, the Mysore government sanctioned ing Infl uenza epidemic of October and Novem- Bangalore. a scheme for a separate sanitary service that led ber 1918 in Bangalore city,” File No 56/1918 Sekher, T V (2018): “Addressing Public Health and to a uniform policy of sanitary administration sl no 85, p 6, KSA. Sanitation In Mysore, 1881–1921: ‘Model’ State throughout the state. The establishment of the 21 Mysore Star (Kannada newspaper), 3 November and ‘Native’ Administrators,” Health and Medi- Public Health Institute at Bangalore in 1911 1918. Microfi lms, Karnataka State Archives. cine in the Indian Princely States: 1850–1950, strengthened the governmental efforts in im- 22 “Final report from the Deputy Commissioner of W Ernst, B Pati and T V Sekher (eds), London proving public health and for laboratory test- Shimoga district on infl uenza to the Chief Sec- and New York: Routledge, pp 26–41. ing of sample cases. To strengthen the sanitary retary” (1918): File No 56/1918, Sl No 92, Thyagarajaiyar, V R (1922): “Census of India 1921, reform, a full-time sanitary commissioner was 24 December, KSA. appointed in 1917 as head of the department. Mysore,” Bangalore: Government Press. 23 “Adjustment of Expenditure incurred in connec- Along with the development of sanitary servic- White, Norman F (1919): “A Preliminary Report on tion with the Infl uenza Epidemic in the cities of the Infl uenza of 1918 in India by the Sanitary es, the government undertook the expansion of Bangalore and Mysore,” 11 November 1918, KSA. health services. In 1881, there were only 24 hos- Commissioner with the Government of India,” pitals and dispensaries in the state, including Simla: Government Monotype Press, London: two asylums, one for lunatics and the other for References Wellcome Library. lepers. By 1918, the number of medical institu- Arnold, David (2019): “Death and the Modern Wodeyer, Bahadur Krishnaraja (1921): “Speeches tions increased up to 178 (see Rao 1927–30). Empire: The 1918–19 Infl uenza Epidemic in by His Highness, Sri Krishnaraja Wodeyer For a discussion on the evolution of public health India,” Transactions of the Royal Historical Bahadur, Maharaja of Mysore, 1902–20,” Ban- services in Mysore state, refer to Sekher (2018). Society, Vol 29, pp 181–200. galore: Government Press, p 236.

38 may 22, 2021 vol lVi no 21 EPW Economic & Political Weekly