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Fatalism is with an Oriental a formidable obstacle to the recognition of the
utility of any plague measures, but it can be and is overcome. What he does
resent, and bitterly, is to be obliged to submit to measures, the use of which he
does not understand, and of which he is naturally suspicious. It is most essential
to prepare the people before an outbreak by telling them as far as possible what
measures they will be required to submit to.
In the opinion of the Government of India much may be done by a strong,
sympathetic and respected District Officer to remove doubts and suspicions and to
secure the co-operation of the leaders of the people.
If the popular leaders are hostile or indifferent, the task of convincing the
ignorant and suspicious masses will be hopeless. Experience has made it clear that
the first principle of all plague measures is to eschew compulsion, except in extra-
ordinary circumstances, and the efforts of Government officials should be directed to
convincing the people of the utility of particular methods, and to inducing them to
carry them out not by force but by exercise of their own free will, and as a conse-
quence of their appreciating and understanding the benefits to be anticipated
therefrom.
Methods of Discovering Cases of Plague during Life.
Paragraphs 7 to 15.
Government agree with the Commission that the compulsory notification of
sickness can only be relied on in the very exceptional cases where the medical
establishments employed are sufficient to take advantage of it, and where the
obligation to report can be efficiently enforced.
Regarding the system of house visitation and house search which has now
fallen into general disuse, the strong hostility to it leads the Commission to conclude
that with a very strong establishment and with a very limited amount of infection
to deal with such a system may result in the detection of nearly every case of
plague, and that when such conditions exist the advantages of house searches may
possibly more than counterbalance the objections to them. But these conditions
will be rarely found, and in other conditions house-to-house searches will be un-
productive of good as well as irritating to the people. The Government of India
do not absolutely 'prohibit the adoption of this method of endeavouring to discover
cases of plague, but consider that it should be employed only when it is clear that
it will be effectual in saving the people from disaster, and only when plague exists
in small and well defined areas such as an isolated quarter of a town, or a single
village in a neighbourhood otherwise completely free from infection.
Surveillance over persons arriving from infected areas is essential at places in
their neighbourhood or in constant communication with them, but depends for its
success upon the active and intelligent co-operation of the people themselves. It is
difficult, especially in towns, to maintain an efficient surveillance, but it is one of
the most useful means of preventing a healthy place from becoming infected.
Government agree with the opinion of the Commission and consider that in towns
supplied with special sanitary and medical establishments the duty of supervising
the arrangements for surveillance can be entrusted to such establishments, but the
actual work of surveillance can best be performed by the people themselves, and
the inhabitants of towns and villages threatened with plague should be encouraged
and assisted to keep an organized surveillance over persons arriving from infected
areas.