NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
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(6) If a coolie once becomes. involved in the vicious cycles that
besot him,. he is likely to find great difficulty in getting
out of them.
It may be said that the average coolie in the Duars is well off,
and that the considerations that we have just discussed do not apply
to more than a certain number. We are well aware that among the
older coolies many have attained a condition of comparative comfort ;
but this does.not alter the fact that every new coolie entering the
Duars has to encounter conditions such as we have described, a total-
ly new environment to which he must accustom himself before he can
hope to thrive. In other words, the new coolie must become acclima-
tised to these conditions as well as to the effects of malaria-to which they
strongly predispose him; and we believe that one of the main reasons
why the aboriginal races from Chota. Nagpur have been found as a
matter of experience to " stand the climate " of the Duars better
than any other class of labour is not because they possess racial
immunity to malaria, a disease which seems not particularly pre-
valent in their country, but because for many generations they have -
been habituated to hardship and privation.
In this connection we wish to make it quite clear that it is not the •
question of the pay the coolie draws on paper that concerns us, nor
even the food he buys. Our interest is entirely centered upon the food
which he actually eats, for this undoubtedly bears a definite relation
to the question of his bodily fitness and ability to withstand malaria.
To reduce the effects of malaria in a community it is not so essential
that it should be paid highly as that it should be well-fed ; and the
two conditions are not necessarily coincident. How far from,
absurd such a view is will be clear from an abstract describing the
methods used in bringing about the great sanitary triumph in the
Panama Canal zone :—
" Two towns that were practically cities of mud and malaria.
had to be drained, cleaned and supplied with water for
all purposes. A working population unaccustomed to
habits of cleanliness had to be disciplined and properly
housed. A commissary department had to be establish—
57
ed, and curiously enough the workmen employed had
to be compelled to eat. The workmen thus far engaged
are in the main the easy-going negroes of the West Indies-
Moved to the less healthful climate of the canal zone and
compelled to labour instead of idling their time away,
they would rapidly lose strength and health unless pro-
perly fed. In one of the reports issued by Colonel Gorgas
there is made the curious statement that it proved easier
to supply uncooked food for these workmen at ten cents.
a day than to persuade them to eat it ; so it was determined
to charge them thirty cents a day for cooked food, and
to deduct the price from their wages. Since the labourer
is compelled to pay whether he eats or not, it has been
found that he will eat. As long as he had the option of
not paying or eating, he would endeavour to live as he
did in Jamaica or Santo Domingo on a banana or two a
day and save his money against his return home. Too
often his insufficient food sent him to his long home."
"This is one of the many lesser problems which Colonel
Gorgas has had to solve, and which, sounding trivial,-
have been in fact most serious ones."
This abstract is quoted not because it is suggested that the
methods adopted by Colonel Gorgas in the circumstances mentioned
are suitable for India, where caste prejudice would render their appli-
cation often impossible, but because we wish to make it absolutely
clear that the question of alimentation cannot be neglected if malaria.
is to be dealt with. As matters stand there is no adequate considera-
tion given to such fundamental questions and they are customarily-
put aside by the everywhere present notion that the coolie, being a
free agent, can and must make his own arrangements, and that the
less he is interfered with the better. The limitations of such art-
outlook are apparent.
HOUSING.
As in the case of other matters, so in regard to the provision
of housing, we have in the Duars no "protection" of the coolie ; and
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the fact that no one is responsible for the provision of suitable dwel-
lings falls most heavily on the new coolies. An ordinary coolie line
to casual observation usually appears to be a more or less straggling
collection of thatched huts with walls composed of thin layers of thatch
grass interlaced with bamboo. More careful examination shows,
however, that houses may be differentiated ; and it soon becomes
possible to pick out the houses of the more permanent residents from
those of the newer coolies. The house of the settled coolie, while
mainly composed of material similar to that of the other houses, is
generally provided with a raised mud plinth extending below the-
eaves which are widened in front to form a small verandah. The
house too generally contains two compartments and is plastered with-
in and frequently on the outside also. The thatch also is generally
of a thickness sufficient to afford ample protection from heavy rain,
It will be seen that the old settled coolie can take care of himself very
well as regards housing. But in the case of the new arrivals and a
largo proportion of the less settled coolies things are far different; and
as a part of the general principle of leaving the coolie to make his own
arrangements, it frequently happens that such people are exposed
to very great hardship. The custom universal throughout the greater
part of the Duars is for coolies to be given on their arrival a certain
amount of material, usually bamboos and thatch grass, and to be
allowed several days to build their own houses, either where they
like or in parts of a line allotted to them. In other cases where
labour is short the houses are built by contract; and in some instances
steps have been taken to prevent the houses being built too close to-
gether. In the main, however, with few exceptions the houses provid-
ed throughout the Duars conform to one type. This type, except
to superficial view and as regards the primary materials used, is very
different from the houses of the settled coolies even in the same line-
It is built with a bamboo framework on the ordinary level of the
ground, with a minimum of thatch on the roof and a thin screen of
the same materials to the four sides to form the walls. It may be
built of single compartments ten or twelve feet square, or a house twenty
by ten may be divided into two compartments, in each of which
from two to four single coolies are accommodated. The door-ways
are usually closed with movable thatch or laced bamboo screens.
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The idea generally held and frequently expressed is that this
type of house is the one built by the coolies themselves, and there-
fore must be according to their liking and in every way the most
suitable for them. Bat this is not a full statement of the facts.
It is true the coolie who is a new-comer builds the primitive type
of hut described; but if asked whether he is accustomed in his own
home to such temporary dwellings he explains that ho is not, but
that the lack of material or more frequently the limited time allow-
ed him does not enable him to construct a better house. If his at-
tention is called to the superior residence of the permanently settled
coolies, he usually replies that, as he is never certain how long he may
remain, it is useless to spend his own time and labour on what may
bo only the most temporary home. As such, a large proportion of
the garden coolie population is either new or semi-permanent, it thus
happens that the majority are housed in a manner at once primitive
and temporary. It is not our intention to put forward any type
of house as necessary or desirable, the point that seems to us import-
ant is that at the present time there is no recognised obligation upon
the employer in regard to house accommodation for coolies, the typo
of house provided very often being the very minimum that can bo
offered, and far below in point of comfort, cleanliness, or as a shelter
from the weather, the kind of house which the favourably situated
coolie in the Duars cares to occupy of which one may see examples
here and there on every garden and almost everywhere in the neigh-
bouring villages.
Clearly it is the now coolies who are most likely to suffer from
this condition of things, and as a matter of fact we have seen such
Coolies obviously enduring considerable hardship on account of in-
adequate or unsuitable accommodation. We have seen 14 people-
men, women and children—huddled together in a hut of the kind
described, measuring only 16 by 10 feet. We have seen families
of new coolies—up about a month from their country, in huts of the
same kind built level with the ground and subject to flooding with
every heavy fall of rain. In one case where the houses were visited
late at night in company of the manager, cases of cholera having
been reported, the occupants of such houses—men, women and chil-
H 2
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dren,—all new coolies, were found sleeping on a little straw on the
bare ground, which was still covered with green grass.
Fires are a frequent occurrence, the custom of building the
houses—both roof and walls—entirely of such inflammable mate-
rials as thatch and bamboos increasing very greatly the danger of
fire to which coolie lines are always liable ; and owing to the very
common neglect of proper spacing such fires sometimes destroy many
houses in a line and render a large number of people homeless. One
result of this is the exposure of such people to special hardship. An
example of this was seen by us. As a result of a fire two families
were forced to find new quarters. One family consisting of a man
and his wife obtained shelter in a house already containing a family;
the other consisting of a man and his wife and child were less fortunate,
being reduced to occupying half a little cowshed. At a subsequent
visit it was found that the man had died (from cholera?) and the
woman had gone with her child to another garden. We have seen a
fire in which no less than thirty houses were destroyed just before
the onset of the rains, and as far as could be ascertained the people
who were thus deprived of shelter had to seek accommodation in
other houses already occupied with their full complement, or to
leave the garden with a view to finding homes elsewhere. In one
base after an extensive fire we saw many families camping out
through the rainy season under pieces of tarpaulin, etc. We have
mentioned these instances merely to illustrate the point that we
consider of importance, that owing to the lack of any obligation
to supply more than the minimum of housing accommodation
necessary to retain labour the standard being fixed only by what
is customary throughout the district, coolies, especially those who
are new-comers or otherwise unable to look after their own in-
terests, are often subjected to exposure and hardship to which they are
not accustomed and in a climate which is very different from that of
their own country. As a result the weaker among them especially
suffer and large numbers even among the more robust are under these
conditions rendered more liable to become the victims of malarial in-
fection.
GENERAL SOCIAL CONDITION AND STANDARD OF COMFORT.
It is generally taken for granted that the free coolie under cir-
cumstances such as we have described, is existing under conditions
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to which he is accustomed. Yet consideration will show that
this is far from being the case. The following are some examples
of changes which may appear trivial to some, "but are really matters
of importance and affect the coolie to a far greater extent than might
at first sight be imagined.
(1) The coolie is either drawn from the ranks of (a) independent
cultivators or (6) landless labourers. In the one case he is accustom-
ed to depend upon a store of food stuff of his own growing, in the other
case he almost invariably receives his daily food ration as part of his
pay.
Under his new conditions he has to calculate and arrange to
purchase a weekly supply of food from the local market.
(2) In their own country the vast majority of the people from
whom the tea garden coolies are drawn are used to deal in kind, not
in coin. Dhan or rice is practically their standard of value and
many of their purchases are by barter.
In the Duars they are all forced to deal in currency and calculate
an expenditure upon an average wage which as we have seen allows
of no margin.
(3) The average coolie has in his own country been living in a
comparatively healthy climate, very dry for the greater part of the
year, and the house to which he is accustomed is usually both comfort-
able and substantial.
In the Duars ho finds himself exposed to the discomforts of a
climate at one time excessively wet, at another dry and often cold
His house is usually as primitive and comfortless as it can well be,
and in addition in his new conditions he becomes subject to malaria,
if not to actual cachexia or anæmia.
Settled coolies are generally fairly comfortable, but our impres-
sion is that for the first few years of their stay in the Duars the ordi-
nary coolie frequently lives in poor condition with a low standard of
comfort. They frequently have inadequate clothing and very often
their remaining worldly possessions are only a couple of cooking pots.
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It is said that the coolie if he wishes it can leave the garden, but Unless
he leaves the country he will not improve his condition by doing so,
and under the sardari system he is tied by his advance so that there
does not seem much likelihood of the average coolie being able to
adopt the latter course. His only chance is an advance from his
sardar to cover the cost of his journey, and unless a coolie so indebted
can be trusted to return, or to provide a substitute, he is not likely
to obtain this. The coolie already heavily in debt will certainly find
it difficult to getaway. Many coolies do leave the Duars temporarily
or permanently, but these for the most part are the ones who have
prospered, and those who are going to recruit, or others who have
come to the Duars with the intention of remaining only a few
months.
Perhaps one of the most striking object-lessons in the Duars is
the condition of the "bustees" or villages where the old coolies have
settled down to cultivation. A distinction must be drawn between
true villages and " bustees," which are in reality only garden lines situ-
ated on or or garden land. In the case of the latter, things are much
the same as those already mentioned, but when we come to the true
village communities we generally find conditions very different to
those general on the gardens. The houses conform to the type al-
ready described as the ones with which the permanent garden resident
usually provides himself, well built with plinth and verandah and
plastered within and without. The children are generally found to
be fat and healthy, the people usually cheerful and showing evidence
of existing in fair comfort. Yet these people almost always are to bo
seen living in places that would be picked out as the most swampy
and presumably most unhealthy situations in the district, such places
being, of course, the most suitable for rice cultivation.
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VII.—SICKNESS AND ARRANGEMENTS FOR THE MEDI-
CAL TREATMENT OF THE SICK.
SICKNESS.
The amount of sickness is very great. Among 100 persons ex-
amined in one line 16, not counting young children, were definitely
ill with fever, anæmia, etc. In a portion of another line containing
a total population of 146 persons, 70 adults were away, 32 at home.
Among these latter 6 were found to be seriously ill. During the
healthiest season of the year in a line containing about 3,000 total
population 14 cases of serious sickness were found, 12 were malaria,
one phthisis and malaria, and one dysentry and malaria. In a line
containing about 279 people, 26 were either themselves sick or were
prevented from going to work on account of children seriously ill.
In a lino visited in September every house occupied had one or more
persons sick; and in another line, in a different part of the district
during the same month, we found a nearly similar condition of things,
many families showing more members sick than healthy. In three
houses in a group, in a line containing new coolies, we found in the
first house 12 people from Orissa, of whom six were ill with fever.
In the second were two Santals; the wife was ill with fever and spleen,
the husband at work. In the third house were two Ooryas, the hus-
band was ill with fever and a large ulcer, and the wife was at work.
In the case of a family of four now coolies from Lohardugga we found
only one old man able to work, two of the coolies having fever and one
a large ulcer. In a house with six persons, three young adults and
three children, two adults and a child had fever. In a house with two
coolies, a man and a boy of ten, who had been up a month from Dhum-
ka, both were laid up with fever. In a small garden with about
300 or 350 working coolies, 31 were seen who had been incapacitated
from work for a considerable time owing to serious illness; 21 of these
were suffering from intense anæmia.
In a house were a married couple, their son's wife, a daughter
and a child of 8. The child's father (their son) had died, the old man
and woman had to be helped to walk to the sardar's house, the daughter
was intensely anæmic and apathetic, the mother was seen sitting in
the verandah with fever, miserable and apathetic; the child had a
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suppurating scalp. At another place a family of new coolies was found
consisting of two old people, their son, his wife, and four children, the
eldest old enough to work. The two old people were in a condi-
tion of great debility, the eldest girl was ill and the youngest child, an
infant at the breast was also so ill as to prevent the mother working_
A youth of about 18 was seen dying from intense anæmia, dropsy and
dysentery in a little lean-to shed adjoining another house. He had
no relations, and there was no one looking after him. His sardar was
supposed to be supplying him with food, but there was no sign of food,
no fire, although it was cold weather, and the boy had no blanket.
A Paharia woman was seen in one of the houses together with a child
of five, the woman was suffering severely from phthisis and could
not stand, the child had chronic dysentery and was a mere skeleton,
the husband was at work.
A woman and her daughter, nine months from Nepal, were both
found to be seriously ill. The woman was intensely anæmic; the
girl was emaciated and scarcely able to. stand, appearing very apa-
thetic with intense anæmia and very large spleen. A man and
his daughter belonging to the same batch were both ill. The man was
extremely anæmic and intensely apathetic, the girl greatly emaciated
and too feeble to remain standing. On one of the medium-sized gar-
dens in June, no less than 63 severe cases of ulcers were seen, in each
case incapacitating the subject from work; many of these cases were
of more than a month's standing. In another garden in a Paharia line
with about 15 houses, there were about a dozen severe cases of oph-
thalmia, six cases of fever and anaemia and five cases of dysentery.
One old woman, who was very seriously ill, had no relations and no
means of getting even water which was at a considerable distance.
In another case a woman was found suffering from intense anæmia and
dropsy, she had been ill for six months, her husband had died and
her only support was a small boy of about ten. Instances of this
kind could be multiplied indefinitely, especially wherever large
drafts of new coolies are concerned.
PREVALENT DISEASES.
The great majority of cases ordinarily met with are malaria and its
sequelæ. In addition there exists to an extraordinary extent, notably
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among now coolies, a condition of impaired vitality and anæmia. On
one occasion an inspection of adult leaf pickers, who were seen bringing
in loaf on one garden, showed among 81 males 40 with marked pallor
of the conjunctiva and other signs of severe anæmia, while among a
total of 75 women 34 were similarly intensely anæmia.
Apart from malaria the following diseases assume from time to time
considerable importance in the Duars :—
Cholera.—No serious outbreak has come under our own observa-
tion, but we have been informed that cholera is by no means infre-
quent, and that there have been a number of instances where it has
broken out with disastrous results among garden coolies. The most
serious outbreak of which we have heard on a garden occurred in 1906
when over 200 coolies are said to have died in one week.
In the same year to our knowledge, three other considerable out-
breaks took place OIL gardens in one instance with 70 deaths. We
heard of another outbreak in 1907 where 45 coolies died within a
month.
During the course of our enquiry occasional cases have been en-
countered by us and in one case 5 deaths from cholera took place during
the few days we were upon the garden, while we heard of ether deaths
on several adjoining estates. The conditions referred to in the chapter
on Sanitation arc mainly responsible for these occurrences.
Phthisis.—Phthisis is especially prevalent among the Paharia
coolies from Nopal and the Darjeeling hills. It is impossible to give
the actual incidence, though we have seen a large number
of cases and it appears to be an important cause of sickness and mor-
tality among certain classes of the population. We have not visited a
single garden in which we have not seen one case, and where hill coolies
are present in large numbers we have generally come across from three
to five cases, but the absence of any reliable record prevents our obtain-
ing any precise information regarding the prevalence of the disease.
Ulcers.—An extremely important condition involving a great
amount of inefficiency is a form of phagedenic ulcer especially common
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about the time of the early rains and prevailing in epidemic form
These ulcers usually attack the lower third of the leg ; and while no
particularly intractable to early and "thorough treatment they become
when neglected or left to the careless methods and inadequate atten-
tion of the ordinary Duars' " doctor babu," the source of much suffer'
ing and disability among the coolies, many ulcers remaining unhealed
for months. The ulcers appear to have a specific origin and a large
bacillus occurring in the granulation tissue is possibly the casual ·
agent.
Diseases of the eye.—Diseases of the eye, notably infective conjunc-
tivits, are very frequent, and in the absence of effective medical
arrangements, exert very serious effect upon large numbers of the po -
pulation. The actual cases of conjunctivits that occurred in the Duars'
during 1908 must have run into many -thousands. At the time that
the disease was prevalent from March onwards, numerous cases were
seen on every garden visited ; over a hundred cases were seen during
a brief stay on a garden with a total population of about 900 people.
The disease attacks both children and adults, and whole families
may be seen suffering at the same time. We have been told that it
recurs more or less severely every year, but no steps appear to be taken
to check or limit the epidemic. In the case of one garden where very
large numbers of the coolies were seen to be suffering from the disease,
the " doctor babu " was away on several months' leave and there was
no substitute to attend to his duties.
Kala-Azar.—In the absence of hospitals and under the existing
lack of medical system splenic puncture is rarely possible, and the
amount of Kala-Azar infection cannot be gauged; but clinical evidence
does not show the disease to be prevalent in the Duars, and though
occasional sporadic cases may be met with, Kala-Azar does not figure
largely in the pathological picture of the district.
Small-pox.—This disease occurs from time to time in the form of
more or less isolated outbreaks. We have heard of some three or four
such outbreaks during the present year on widely separated gardens.
We are informed that vaccination on the gardens is carried out by
Government vaccinators who, it is statedd," are paid by the coolies for