Experiences of Mysore state

"The strong hand of government must always be in evidence and continue to interfere whenever any section of the community tries to take advantage of the difficulties of the public". This was the stern warning issued to traders and businessmen by Diwan M Visvesvaraya while addressing the Dasara session of the Representative Assembly on October 17, 1918, during the early days of the Influenza pandemic (also known as "Spanish flu") in the princely state of Mysore.

The influenza pandemic of 1918 claimed up to 70 million lives around the world until it unexpectedly disappeared in 1919. In India, it cost at least 12 million lives though some estimates by scholars put the death toll around 20 million. A few months of influenza resulted in more deaths than nearly 20 years of plague in many Indian provinces.

The epidemic struck the country at a time when it was least prepared to cope with the calamity. The total failure of the monsoon, scarcity of food supply, inadequate medical facilities and shortages of health personnel, together created a miserable situation in many parts of India.

It is important to look back and see the challenges encountered by the administration in colonial India, drawing specifically from the experiences of the state of Mysore, considered as one of the better administered 'progressive' princely states in British India. The research on archival records available both in India and England and Census data provides us with interesting historical perspectives on the administrative challenges of tackling the pandemic a century ago in an Indian state.

Influenza made its first appearance in a mild form in Bangalore city in July 1918 but disappeared soon without causing any significant loss of life. It reappeared in the middle of September and spread with lightning speed throughout the state. According to government records, the total number of incidents was 8,83,491 and the death toll amounted to 1,66,391. The 1921 census for Mysore revealed that the number of deaths per 1,000 in 1918 was about 30 whereas in the previous year it had been 10 and for 1919 it was only eight— a good indication of the severity of the pandemic in this part of south India.

Apart from increased mortality, influenza also affected the spirit of celebrations at the most important annual events of Mysore—the Dasara festival celebrations and exhibition. In fact, chief secretary to government C S Balasundaram Iyer issued an order directing the temporary structure for the exhibition to be placed at the disposal of the president of the Mysore city municipal council, for opening a provisional dispensary for the treatment of influenza patients.

In many places, entire families were affected and there was no one to attend to the wants of the patients, prepare food or collect medicines. Many officials fell sick and died. At one point, even the chief secretary himself and most of his office staff were suffering from influenza. In most areas, people accepted western medicines readily. However, in some places, they were most unwilling to take the medicines prescribed by the government.

At the meeting of the Bangalore city municipal council on October 5, 1918, it was observed that the so-called ‘mysterious fever’ of Bombay had been imported into Bangalore and had widely spread in the city. It was reported that the attendance of the patients at the municipal dispensaries had doubled and that there were long lines of waiting for patients at private dispensaries and chemist shops.

The government Anna Chathra was fixed as the central issuing station for the relief parties to obtain their supplies and to proceed to their divisions. The internal administration of the drug Thymol was undertaken both as a routine treatment and as a prophylactic. The Public Health Institute in Bangalore provided the necessary medical advice on the types of treatment.

Special ward

A special ward was opened in the Epidemic Disease Hospital in Bangalore to prevent overcrowding. As the disease spread, accommodation was found to be insufficient. Considering the magnitude of the problem, the government decided to open a new temporary influenza hospital. The hospital under canvas came into instant existence on October 30 at the municipal garden.

The 1918 Influenza pandemic in India accounted around a fifth of total deaths in the world, causing widespread havoc disrupting the lives and the economy. However, the impact of this pandemic, including mortality, varied considerably across the provinces. In Mysore state, the well-organised administrative machinery and the existing health and sanitation infrastructure made it possible to minimise the calamity.

Instructions from the chief secretary and the guidelines from the senior surgeon and sanitary commissioner provided the general framework for the relief measures. Required financial support was granted by the princely government to the two municipalities and the districts. The entire administrative machinery was geared through coordinated efforts to face this public health challenge, which was remarkable.

Daily messages and weekly reports were sought from the lower rungs of the administration to monitor the ground situation. Many officers were able to evoke trust and civic responsiveness from the public while keeping in view the cultural sensibilities and beliefs of the masses. The stern measures enforced by the Mysore administration to regulate the price of essential food grains and the free supply of essential goods and medicines helped to overcome a famine-like situation.

However, in many rural areas, relief measures were not successful. Nevertheless, these concerns were freely expressed in Assembly discussions and newspaper reports, and the princely government was receptive to these complaints.

The century-old experience of princely Mysore in combating the influenza pandemic provides very useful lessons - a combination of strong administrative measures, strict monitoring of public health and sanitation services, well-organised relief operations, and the involvement of civilians and community organisations.

(The writer is Professor at International Institute for Population Sciences, Mumbai)