# Modern Hyderabad (Deccan)/Chapter 11

CHAPTER XI.
Medical.
The total population of Hyderabad State being 13,374,676 persons, it is somewhat surprising to find that during the years 1320-1321 Fasli (October 1910-1912 A.D.) the yearly average of patients treated in the government hospitals and dispensaries was only 767,222 men, women and children, and that the in-patients averaged during the same period only 5,850 persons. The administration report says of the period under consideration : — "While there has been some increase in the number of in-patients, there has been a considerable and continuous decrease in the number of out-patients."
Yet the Census for 191 1 shows an extra-ordinary increase in the total for infirmities in the State since 1901, and says "a 20 per cent, increase of population (from 1901 to 1911) cannot be held to account sufficiently for an one thousand per cent, increase in the number of persons suffering from the infirmities included in the Census." ​ Possibty plague had something to do with this. The year 1321 Fasli (1912 A.D.) was the most disastrous since plague first entered the Dominions, and in that year the City was for the first time attacked by the epidemic. The total number of plague cases in 1912 was no less than 30,632 and the deaths numbered 27,367. The masterly manner in which the epidemic was handled and finally stamped out reflects on His Highness's government and on Lieutenant-Colonel H. E. Drake-Brockman, I.M.S., Director of the Medical Department, vast credit; but the evil effects of the scourge may possibly have had something to do with the great increase in the number of persons suffering from the four infirmities mentioned in the Census, and more especially with the fact that no less than 16,263 persons are returned in it as blind, while in the Census of 1901 only 1,344 persons were returned as suffering from that infliction. The Census for 1911 says that blindness claims sixty per cent, of the total afflicted in the State, and the number of women sufferers equals, and in some places exceeds, that of the men, and it suggests that smoky wood fuel in ill- ventilated kitchens has much to do with the loss of eyesight among the women. ​ The same authority states that the Mahomedans are better off than the Hindus in respect of all infirmities except insanity; and that the Animists, who live a simple life, free from the worries of rains and crops, so wears and sircars, are better off as regards infirmities than either Hindus or Mahomedans.
The Census for 191 1 gives the following figures for the four principal infirmities of the State — insane 2,560, deaf-mute 4,421, leper 3,785, blind 16,263, and it says that the worst period as regards these afflictions is for the men from 40 to 45 and for the women from 60 to 65. The largest proportion of lepers occurs at the age period 40-45. Far fewer females than males become lepers, but the Census thinks that women can more easily hide this infirmity than is the case with men.
There are in the State 91 government hospitals and dispensaries, and the Afzalganj and Victoria hospitals in Hyderabad city are the only government hospitals of any size or importance. The former has an average of 62.120 in and out-patients per annum; and the latter, which is strictly purdah, treated during 1912 10,808 out-patients and 1,516 in-patients — chiefly maternity cases. ​ I will now briefly describe my visit to the Afzalganj hospital in October 1913, because by doing so I can give the best idea of what this hospital needs at the present time.
I had received an introduction to a minor official, and on my arrival, at about 11 a.m., he called a peon and sent me to the room of the head surgeon. This place was empty, but an open door led into an operating chamber, and I was told that I could go in there, if I liked. The screams proceeding from the operating theatre were so agonising that I left the surgeon's room in a hurry and returned to the person to whom I had an introduction, and after considerable hesitation and much explanation he promised to show me the hospital after the doctors had gone away. So I waited until the doctor Sahibs had finished their business, watching the windows of the operating theatre, outside which stood crowds of men with heads thrust forward and eyes fixed, no doubt, on the patient, and thinking of the time when, in England, lunatics, prisoners and sick persons had been sights that the public delighted to visit. That was not so very long ago, and but for Florence Nightingale might still be ​the same, perhaps. Now, in England, kings and queens visit hospitals and send gifts of game, fruit, and other things to the patients, rich people endow beds in and leave large sums of money to hospitals, and well-educated and refined women nurse the sick and attend to the ying. And in British India, the wives of viceroys and governors all try to follow the royal example as regards hospitals and nurses.
Government charity must always be a cold and barren business; yet in a purdah country how can any woman become a Florence Nightingale and make hospital nursing fashionable? The care of the sick and suffering is, no doubt, woman's special province, and what women can do in Hyderabad in this direction is proved by the Victoria Zenana Hospital, which was visited in September 191 3 by the late Lady Hardinge. and pronounced by her to be up-to-date and excellent. But in a hospital where men are nursed, as well as women and children, no purdah lady can set foot, and probably that is the real reason why government mixed hospitals and dispensaries are so unpopular all over His Highness the Nizam's Dominions. ​ It was 12 a.m. before I could go over the Afzalganj Hospital, and then the drains seemed to overflow with disinfectants. Dressings were being carried away, and a foul smell met me at every turn in the over-crowded wards, and the whole place depressed me past words, although the minor official assured me that in his time great improvements had been made and that he remembered the day when men and women wore the same uniform and messed together on the open verandahs. The under-paid and over-worked nurses, the dirty blankets, the herding of children with grown-up people — well it all cried loudly for Florence Nightingale, the woman of whom Queen Victoria wrote, "She has such a clear brain. I wish we had her at the War Office."
The total expenditure by government on the Medical Department in 1321, Fasli (1912 A.D.), was 6,35,520 O. S. rupees; and it may be noticed that expenditure on this department has of late years become less and less and that during 1320-1321 Fasli (1910-1912 A.D.), not one rupee was spent on buildings.
In the districts I visited many hospitals and dispensaries, and I found them clean, but ​badly equipped and wanting in medicines and instruments. Many reasons were assigned for this state of affairs, and a missionary doctor, who has an up-to-date hospital and a good private practice, assured me that the government would supply the necessary medicines and other things if the people in charge of the hospitals and dispensaries did not take them home and sell them! I was "minded" to ask the Director of the Medical Department about these matters ; and one day, when I happened to be at a small railway station in the Medak district, I very nearly did so, for one of the carriages of an in-coming train was labelled "Reserved for Lieutenant-Colonel Drake-Brockman." But it was only about 9 a.m., and I was told that the doctor Sahib was asleep, and I felt sure that if I woke him up, he would not give me the information I needed, for officials belonging to H. H. the Nizam's service will seldom answer any question that is put to them. Polite they are, but very discreet, and the enquirer is sent from office to office until he learns to "read, mark, learn, and inwardly digest" official documents.
A government medical school in the capital trains both sexes to become doctors ​and surgeons, and during 1320-1312 Fasli (1910-1912 A.D.), fourteen students passed out of it, five as Assistant Surgeons, and nine as Sub- Assistant Surgeons.
The Yunani (native treatment) branch of the Medical Department has its own medical school, and it is said that the training given there includes Misri (Egyptian) treatment. The Yunani dispensaries in the districts have increased of late, but no statistics as to the number of people treated in these places are available. Such dispensaries are in the districts largely supported by local funds, and receive a little help from the government.
The Lunatic Asylum is in the Hyderabad Central Jail, and during 1320-1321 Fasli (1910-1912 A.D.), 284 lunatics were there; and it is said that about 383 per cent, of the cases of insanity in the State are caused by an excessive use of narcotics.
Of the sanitary department, organised since 1912, no report has as yet been published by His Highness's government.