NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
17
AID AFFORDED BY THE MILITARY.
Owing to the terrifying effect the heavy mortality from plague
produced on the lower, classes of natives in Bombay, it was almost impos-
sible to procure servants of any description to serve in plague hospitals ;
and when procured, tempted by the high rates of wages' offered, their
stay was most uncertain. It constantly happened that men joining the
hospital for duty only remained for a few hours. The constant change
in menial staff thus caused gave much extra trouble to the Medical
Officers concerned, and was most detrimental to the well-being of the
patients. With the sanction of His Excellency Lieut.-Genl. Sir Charles
Nairne, K.C.B., Commanding the Forces, Bombay, the services of troops
in the Bombay District, both British and Native, were placed at the dis-
posal of the Bombay Government, and, in response to the call for volun-
teers, officers and men sent in their names en masse. Henceforward
wherever and whenever in the Presidency assistance was required to
assist in house visitation, to work as required in the hospitals as clerks,
storekeepers, ward masters, dressers, cooks, orderlies, or to draw the
spring ambulances, parties of sepoys were detailed for these purposes
and placed on permanent duty in the district in which their work lay.
They were clothed in a working dress of blue drill with putties,
wore no side arms, and, except in the case of large detachments detached
to distant points in No. 10 District, they left their rifles in regimental
charge. Both the European soldiers and sepoys employed on plague
duty were segregated, tents or huts being provided for them close to
their work. A cot was given to each man to keep him off the ground,
and the following scale of pay was passed, as remuneration for the
extra work done :—
Rates of Plague Pay and other Allowances—
British Non-Commissioned Officers ... ... ...
Extra ration money ... ... ... ... ...
British rank and file ... ... ... ... ...
Extra ration money (unless food is provided)
Native Ranks—
Subadars
...
...
...
...
...
...
Jamadars
...
...
...
...
...
...
Non-Commissioned Officers ... ... ... ...
Sepoys
...
...
...
...
...
...
...
Rs.
1
0
0
0
1
1
0
0
a.
0
6
12
6
8
0
12
8
p.
0 per day.
0 "
0 "
0 "
0 "
0 "
0 "
o
„
The ration money to be espended in food daily, and not given to the men.
2 suits of cheap khaki or blue drill.
A puggry (Native Infantry).
Runee one Per month for wear of boots.
1 mattress, straw filled
1 blanket.
1 sheet.
1 pillow case.
for British
Troops.
Can be regimental and thoroughly
disinfected with perchloride of
mercury before returning to
barracks.
1 cot per man for British and Native troops.
On the decline of the plague In June 1897, this scale was modified
and a reduction effected in the pay of each grade.
The work was hard and exceedingly trying at times, and the
remuneration offered was much appreciated. Owing to the precautions
18
taken as to segregation and disinfection, but few casualties from plague
occurred amongst the troops, though 11 deaths from this disease were
recorded amongst the sepoys employed.
It is gratifying to note the extreme cordiality that existed
throughout the whole period during which the troops were employed,
between the Military on duty and the Civil population. Every kindness,
consideration, and civility were shown to the people by the men ; this
was thoroughly appreciated, and the result was the entire absence of
complaint; no difficulty was experienced by European slodiers or sepoys
employed in searching or on disinfection duty.
It is also due to the Officers and Native Officers in charge of
detachments to say that great care was taken by them to enquire into
any minor dispute or misunderstanding brought to light; and liberality
was displayed by them on all occasions.
The total number of troops employed was—
British.
Native.
B. 0. N. 0. 0. Men.
B. 0. N. 0. N. C. 0. Men.
3
6
20
4
11
29
537
It will be observed that but comparatively few European soldiers were
employed, and these, with the exception of fourteen men in the Colaba
ward, were engaged in overseer and inspecting work. The reason of
this was, first, that the European garrison of Bombay is small and is very
fully occupied with guard and other duties, and, secondly, that in work
which takes the British soldier into Native houses there is always a
risk, owing to his absolute ignorance, in most cases, of the language and
habits of natives, of a misunderstanding arising which may lead to
serious offence being given where none is intended,
It is obviously impossible for British Officers to be responsible for
a large number of small detachments of three or four men scattered
over a town in house visitation or disinfection, and Justices of the Peace
work more freely and happily with men of their own race than with
European soldiers.
In all there were 3 attacks amongst British troops in Bombay
with no deaths; but the Native troops lost 11 men out of 14 cases
reported.
It must be observed that every reasonable precaution was taken to
ensure against infection ; the strictest sanitary regime was enforced
amongst all soldiers, British and Native, in the garrison, whether
employed on plague duty or not; the Native town was placed out of
bounds ; the whole of the Native portion of the force, whose lines are in
close proximity to the city, was put under canvas ; all regimental
followers were placed in chajppar huts at Colaba ; and a strict daily
medical supervision was kept over troops and barracks during the
epidemic ; the families belonging to the Native Infantry Regiments
were sent to their homes and no case of plague was reported amongst
them.
19
Chapter II.
HOSPITALS.
An important basis of the operations for the eradication of plague
in the City of Bombay was the establishment of temporary hospitals
to which plague cases could be sent ; and concurrently with the many
details of the organisation, and the division of the City into districts and
sub-divisions, sites for such hospitals were selected to meet the needs of
each of the ten districts.
o
The aims of the. Committee were directed to procure such
situations for the hospitals that the removal of patients to them from
any part of a district should not involve too great a distance, to
add the fatigue of transport to the dangers of the disease ; that the
patients should be placed under every possible advantage of modern
skill and knowledge, and that the position of the hospitals should
ensure air, healthy surroundings, convenience of water-supply, and
other important hospital and sanitary details, while giving every
consideration to the health and sentiments of the people in the neigh-
bourhood.
The Committee, in determining on this line of action,
took into consideration the existing hospitals which were especially
devoted to plague purposes—the Arthur Road (Municipal) Hospital,
the Government Eouse Parel Hospital, and the Grant Road (Municipal)
Hospital. The three latter were set apart for special purposes in the
districts in which they were situated and will be referred to in
detail. In some of the larger districts it was found necessary to erect
a hospital in each sub-division to meet requirements ; for instance, in
No. 9 District three temporary hospitals were put up, and in No. 10 there
were also three temporary hospitals, besides the Parel Government House
Hospital. The selection of sites commenced from the Colaba end of the
Island, Colaba being named No. 1 District. In the Sub-division of Upper°
Upper Colaba
being the southern
portion of Colaba.
Colaba * a temporary Plague Hospital at Pilot Bunder was already being
worked by the Military Authorities ; this was taken over by the Com-
mittee and several improvements effected in its equipment. In Lower
Colaba another site was selected and finally obtained from the Port Trust-
ees on the Jamsetjee Bunder, and here Government Hospital No. 2 was
erected. It was surmised that these two hospitals would be equal to
the hospital requirements of No. 1 District, and the result justified this
forecast,
20
In No. 2 District, which included sub-divisions of Fort South,
Fort North, and Esplanade, a site was selected at Mody Khana, also on
Port Trust ground, and the erection of Government Hospital No. 3 on it
was ordered for the reception of all patients from No. 2 District and
also for cases occurring amongst the shipping and country craft.
In this district were also situated the Sahebs' Servants' Hospital
(instituted by Professor Miiller and Brigade-Surgeon-Lieutenant-Colonel
Barker) and the St. George's Temporary Plague Hospital, both of
which had already rendered excellent service to the public during the
epidemic.
No. 3 District included Mandvi, Dongri, Chakla, and Oomer-
khadi ; a difficulty was found in obtaining a site for a hospital here,
and the Port Trustees being unable to place a godown at the disposal
of the Committee for the purpose, Government 'Hospital No. 5 was
not established; patients from No. 3 District were eventually sent to
Government Hospitals Nos. 3 and 8.
No. 4 District. No convenient site could be found in the crowded
area of No. 4 District, containing Market, Bhuleshwar, Khara Talao, and
Kumbharwada, and it was decided that, owing to want of space and pos-
sible popular prejudice against a plague hospital, this district should
work to No. 4 Government Hospital, which was enlarged to meet the
requirements of both districts.
No. 5 District comprised Chaupatti, Girgaum, Fanaswadi, and
Dhobi Talao. A site for Government Hospital No. 4 was selected
in the Charni Road Gardens on the Kennedy Sea Face ; permission being
granted by Government, by whose orders the gardens were closed to
the public.
No. 6 District, consisting of Kamatipura and 1st and 2nd
Nagpada, was already supplied with a hospital, viz., Grant Road
(Municipal) Hospital No. 6. Its equipment was completed with the
utmost despatch, and quarters for the staff were built in the Northbrook
Gardens, which were placed at the disposal of the Committee by the
Municipal Commissioner and closed by him to the public. This hos-
pital proved of the greatest service in receiving all cases from No. 6
District and surplus cases from the surrounding districts, as it was cen-
trally situated for District Nos. 3, 4, 5, 7, 8, and 9.
No. 7 District, comprised Walkeshwar and Mahalakshmi ; a
convenient site could not be found here, although several were selected.
It was finally arranged that this district should work to Government
Hospitals No. 4 (Charni Road), No. 6 (Grant Road), and No. 14 (Arthur
Road).
No. 8 District included Khetwadi, Tardeo, and Byculla, in
which was situated the permanent Municipal Hospital, ic., Arthur Road,
21
and to which cases tip to date had been sent from all parts of the
City. To diminish overcrowding the. Committee ordered that only
Byculla and part of Mahalakshmi snb-divisions should work to the
Arthur Road Hospital, Tardeo and Khetwadi working to the Grant
Road Hospital No. 6.
At the urgent request of the Commissioner of Police, the Committee
erected a Special Plague Hospital for the Police force capable of accom-
modating sixty beds. The site selected was on an enclosed space
belonging to the Municipality used for the storage of road metal near the
Foras Road Market in the Tardeo Sub-division of No. 8 District.
No. 9 District was composed of Tarwadi and Mazgaon sub-division
districts which had suffered most severely. Three temporary hospitals
were allotted, i.e., one on the Reay Road, near Frere Bunder, a
second at Narielwadi, and for a third the Port Trust Chairman was
asked to allow the Plague Committee the use of the Port Trust Hospital
at Wari Bunder, extension being made for the needs of the outside
public. As, however, this hospital had been designed to meet the
requirements of the Port Trust employes only, the proposal was not
accepted, but permission was given to the Committee to erect a hospital
of their own on the vacant space adjoining the Port Trust Hospital; and
here the Wari Bunder Government Hospital No. 8 was built. Three
private hospitals—the Parsee (No. 19), the Hindu (No. 23), and the
Khoja (No. 24) hospitals—were already in good working order in
this district.
No. 10 District was an extensive one and included Parel,
Sewri, Worli, Sion, and Mahim. The Government House Parel Govern-
ment Hospital No. 15 was already in working order, and it had
been decided that it should be utilised for the purposes of a
hospital for the Parel, Sewree, and southern portion of the Sion Sub-
division, for convalescents from all other hospitals in the urban area,
and as a training school for Nurses and Ward Orderlies—British
and Native. To this hospital also were attached for instruction
all Medical Officers and Subordinate Medical Officers joining for
duty under the Plague Committee. A site for Government Hospital
No. 16 was fixed on at Sion Koliwada on ground belonging to
Mr. Harkisandas Narotamdas, who readily gave permission for its
use. Plague cases and suspects from the Sion Causeway, G. LP.
Railway, and Sion District were treated in this hospital. In this sub-
division a private hospital was sanctioned for the people of Dharavi
village who are principally tanners, amongst whom plague was
severe ; the cost of erection and maintenance of the hospital was
borne by the owners of the Tanneries.
The site for Government Hospital No. 17 was chosen on the
foreshore near the Mahim Causeway, and the Police Superintendent's
house close by, having been vacated, was given as quarters for the
22
Nurses by the Commissioner of Police. Cases coming to this hospital
were principally from Mahim Causeway Road Inspection, B. B. & C. I.
Railway, and the Mahim District.
The site for Government Hospital No. 18 was selected at Worli
on Cleveland Bunder, which was placed at the disposal of the
Committee by the Trustees of that property. This hospital met the
wauts of the Koli fishermen and of the Worli District, where the epi-
demic had been very severe.
At Bandora a special hospital was erected for the people employed
at the slaughter-houses, where there had been a serious outbreak of the
disease. The arrangements for the building of this hospital, main-
taining it, and overcoming the dislike of the butchers to hospital regime
were placed in the hands of Veterinary-Major Mills, J.P., Principal of the
Veterinary College, Parel, who was granted the special powers of 1st
Class Magistrate by Government for this purpose.
DETAILED CONSTRUCTION OF HOSPITALS.
A scheme of hospital organization was prepared and a standard
plan of hospitals was designed, a special equipment of staff, stores,
furniture, and appliances being drawn up on a ready basis, suitable to
any pressing demands.
In designing the hospital, a section was taken as the unit ; this
held 20 beds in an area of 120'X24', giving each bed a superficial area
of 144 square feet, a somewhat liberal provision ; but bearing in mind
the necessity for attendance of one or two relatives with the patient, and
looking to the fact that a large cubic space of fresh air favorably
influences the progress of recovery and lessens the possibility of
contagion, it was determined by the Committee to adhere to the above
measurements. Subsequently it was found convenient to build half-
section hospitals (10 beds) and quarter section hospitals (5 beds) in
districts where few cases were anticipated.
The standard adhered to, however, was that of a one-section
hospital, and to it was apportioned its standard equipment, so that on
an order being issued by the Committee for the institution of a hospital
of any proportion, the District Medical Officer had merely to follow the
orders laid down on the subject for a hospital of the size indicated.
This saved much delay in ordering staff, stores, &c., for any hospital,
more especially at outlying stations. Copies of the plan and equipment
of a one-section hospital were accordingly issued to the various execu-
tive departments of the Committee, and to all contractors, with directions
to regulate the construction of buildings and the supply of stores,
medicines, and furniture accordingly.
23
As will be noticed by referring to Plan No. 4 attached to the
Appendices of this Report, the hospital was enclosed in a ring fence con-
structed of bamboo matting fixed on bamboo uprights.
The Plan No. 4 shows a one-section hospital and is designed to
fit into the smallest area possible, viz., 140'X160', but wherever more
room was available, advantage was taken to spread the buildings over
more ground.
The two wards for males and females were placed at the end of the
site further from the enclosure gate, and the accommodation for families
of patients was built near the door, as far from the actual hospital as
possible ; the arrangement shown was adhered to, as far as feasible, in
all Government Hospitals.
All hospital buildings were constructed of the lightest and cheapest
materials compatible with safety. The posts and framing were of
bamboo or benteak set well into the ground on a 12" plinth ; the sides
were of single bamboo matting; the roofs of two thicknesses of jowli or
cadjan (plaited palm leaf in general use in tropical countries), the
latter in some instances lined inside with cloth. The whole hospital,
inside and out, except, the roof, was lime washed at intervals.
The cook-houses were constructed of corrugated iron, both roof
and sides, on wooden framing.
Drinking water was drawn from two or more taps to meet the
wants of the various castes.
As regards sanitary arrangements, the privies were on the dry
system, the nightsoil being removed by hand after being disinfected
with perchloride of mercury or carbolic acid; a washing-place, with
one or more taps, with a paved space around it, was always provided in
a convenient position, and from that and the bath-rooms in connection
with the Nurses and Hospital Assistants' quarters and the various cook-
houses, was led a small open drain constructed of 4" stoneware pipes cut
in half and laid on concrete, connected either with cesspools or the
nearest available drain.
It has generally been found convenient to supplement the buildings
shewn on the plan by a general cook-house for the wards, and an extra
bath-room for Nurses' quarters ; in some hospitals which were continually
fall, a dispensary and office were also given, otherwise a corner of one
of the wards was made use of for this purpose. It was also found
desirable to place a width of rabbit-wire netting round the lower walling
of the mortuary, or to supply a wire bier cover to prevent dogs
interfering with corpses lying therein ; the mortuary was, wherever
practicable, placed well away from the hospitals and quarters.
24
The cost of the buildings above described averaged annas 6 per
square foot of area covered ; the arrangement and style were found to be
eminently successful, and the generality of Government Hospitals were
much cooler than those of private hospitals located in permanent buildings.
The staff of a one-section hospital was fixed as follows :—
2 Nurses.
1 Ayah.
1 Hospital Assistant.
4 Ward Orderlies.
1 Bheesty.
2 Sweepers.
2 Nurses' Servants.
1 Hospital Cook.
If there were many severe cases, it was found necessary to supple-
ment the staff with an extra nurse, to increase the number of ward
orderlies, and when the caste and other conditions of the patients required
it, the number of cooks also. The equipment of furniture, clothing,
medicines, and instruments of a one-section hospital are all given in the
Appendix No. 8.
PRIVATE HOSPITALS.
The promulgation of the order by the Committee that all cases of
plague must invariably, and without exception, be removed to the Hos-
pital at once, raised many intricate questions relating to caste, race,
habits, food, religious scruples, and such like difficulties, which required
very careful treatment.
It was suggested to the leaders of the various communities
that each caste and sect should establish either a separate Hospital,
supported and managed entirely by their own medical board, officers
and staff, or that they should maintain a separate ward, or separate beds,
for their own people in one of the Government Hospitals.
The suggestion was at once adopted by a number of wealthy and in-
fluential citizens of all creeds ; applications for what were termed "private
hospitals" rapidly came in. The moral as well as the practical support
that the Committee received on this account was invaluable, as it at once
quelled the misgivings and fears of the majority of the people, who were
apprehensive on these matters and passively resisted ideas so contrary
to their ordinary modes of life.
It was, however, distinctly explained that a private hospital,
open to all members of any particular caste or sect, could alone be
sanctioned ; some applications for hospitals for private individuals, or for
a group of private individuals, were refused accordingly. The Com-
mittee declined to admit any difference in treatment between the rich and
the poor ; the closest attention was paid to the wants of all ; and the
hospitals were utilized for every class of people in the same caste or sect.
25
The Committee had, however, not only to consult the wishes of a
large and easily excitable populace, but they had to face a serious amount
of obstruction against the course they had adopted. In the published
records of opinions by eminent Scientists and Medical authorities, there
was a great diversity of opinion on the private hospital system, and it
was held by many persons that the multiplication of Plague Hospitals
in the City and their- location in thickly-populated quarters would cause
virulent centres of infection, which would be. a source of greater
danger than the alternative of treating the sick persons in their own
houses.
This important question was keenly discussed and considered,
but the Committee adhered to its decision that the private hospital
system would meet the requirements of many who by reason of caste or
custom would not have gone to hospital under any circumstances with-
out forcible removal.
Accordingly applications for private hospitals were sanctioned on
the distinct understanding that all arrangements in connection therewith
would be carried'out by a hospital "board, and that the medical attendants
and staff should be under the supervision and control of the Medical
Officer of the District in which the private hospital was located ; and
this officer was made responsible for compliance with the orders of the
Committee.
The results of the system have fully realised the convictions of the
Committee, and the opinion, generally expressed in many quarters, that
the private hospitals would be a further source of danger to the City
proved erroneous ; the careful supervision maintained by those in charge
of these institutions secured the result that in no single instance was the
disease spread by the proximity of a plague hospital to other dwelling
houses, and notably there was an example in the Khoja Hospital
in Tantanpura Street, which had a number of patients and was next
door to an Orphan School in which none of the children suffered from
plague.
The Committee are most grateful to the munificent founders of
these hospitals, to the gentlemen who formed the hospital boards, and
to the medical men in charge, who so cordially and efficiently worked
in concert with the Committee and its officers for the public benefit.
From the list of private plague hospitals shewn on Plan No. 1, it will
be seen that all castes, sects, creeds, and. races joined in thé movement.
The small Chinese community in Bombay also offered to start
and equip a hospital, but the offer was held in abeyance owing to the
¡decline of the Plague.