“Indian Cholera”- the Tumultuous History of Religion and Epidemics in India
And how it has played out during Covid-19
In August 2020, an Indian court made some observations that certainly will be considered momentous by future historians of medicine and public health. These observations pertain to the discriminatory actions of the Indian state against the Tablighi Jamat, an international community of Islamic missionaries, many members of which caught Covid-19 during a congregation in Delhi in March. The Hindu supremacist state, with the assistance of the government-friendly mainstream media — often ridiculed as “modia”— created a narrative which blamed this event, and by dog-whistle corollary the entire Muslim populace of India, as the main cause of India’s rising Covid-19 cases during those early months of the pandemic. This attitude of the Indian government was chastised by the court:
“A political government tries to find a scapegoat when there is pandemic or calamity and the circumstances show that there is probability that these [Muslims] were chosen to make them scapegoats… This indirectly gave warning to Indian Muslims that action in any form and for anything can be taken against them… It appears that the State Government acted under political compulsion and police also did not dare to exercise powers given to them under provisions of procedural law like Cr.P.C. and substantive laws.”
Even as recently as last month (December 2020), some more members of the Tablighi Jamat were finally released by another court from unnecessary, politically-motivated imprisonments. In its mixing of religious polemic with public health policy, the Indian government abandoned some of the basic principles of the Indian republic as enshrined in its Constitution. The state’s highhandedness also reminded many commentators of the British colonial period, when large epidemics elicited similar scapegoating and disproportionately severe action against the marginalized.
Epidemics and religious congregations
There are many terrains where public health and religion cross paths, but epidemics certainly are the bumpiest. In colonial India, religion featured prominently in official and unofficial conversations on epidemic control and influenced government policies for the two great epidemic diseases of the 19th century: cholera and plague. In a racial phrasing similar to the “Chinese virus,” cholera in the 1800s was called, in Europe and America, either “Asiatic cholera” or “Indian cholera.” The early officially noticed epidemics started in eastern India, and along with that also began the convenient scapegoating of Indians for any cholera trouble in the West. While the Gangetic towns in Bengal were blamed for the origins of the disease, religious gatherings in other parts of India (Haridwar, Puri, Pandharpur) and in western Asia (Mecca) were blamed for its eventual spread into the West.
Here is an American medical professional writing in 1892 about “Oriental” links to cholera:
“It is beyond human possibility to put India in good sanitary condition in any reasonable time, and to make the pilgrims observe the commonest rules of hygiene and cleanliness would require two soldiers for each pilgrim. The most riotous imagination could scarcely exaggerate the filth of India and Egypt and of the Hindoo and Mohammedan pilgrims… So long as the pilgrimages continue, Europe and this country will be endangered.”
The obsession here to blame Indians as a danger to the white nations of the West matches the obsession of the current Indian government and television news presenters who intentionally (and incorrectly) blamed the Tablighi Jamat congregation as the main driver of Covid-19 in the whole country.
Mistrust and Rumors
Though the British administration was not new for Indians in the 1890s, many British medical ideas were still considered alien and even irreligious. The majority of Indians looked at biomedicine (then known commonly as “Western medicine”) and government-introduced public health measures with suspicion and mistrust, a state of affairs which was often worsened by the offensive actions of government officials.
When the bubonic plague struck India in the late 1890s, the colonial government came up with severe, top-down (and ultimately ineffective) measures to stem its spread. The measures included such actions as soldiers entering people’s houses at will to look for plague patients and then defiling sacred kitchens and temple areas with their boots, physical examination of women for signs of the plague, and autopsies on bodies of plague victims without the consent of relatives. Angered at the colonial government’s anti-plague response that often clashed with their religious and cultural beliefs, many Indians hid plague patients at home and refused to cooperate with authorities.
In a fascinating book on British Indian public health policies, historian David Arnold describes how during stressful times like epidemics, mistrust would metamorphose into extraordinary rumours. Among these were rumours was one about the covert dissection of Indian bodies (dissection was anathema to the religious beliefs of Hindus and Muslims alike). In October 1896, an infectious diseases hospital in Bombay was mobbed by hundreds of mill workers when a local woman was forcibly taken there. The workers believed that [quoting from Arnold here] “there was ‘something diabolical’ about a hospital ‘which claimed so many victims.’ Patients, it was said, were ‘bled to death through the soles of their feet’.” Even during the contemporary Covid-19 pandemic, an attack on healthcare workers in Indore displayed a similar pattern of general mistrust in the political establishment, circulation of rumours, and high-handed official actions.
From highhandedness to negotiation
Such fierce opposition from Indians forced British officials to ameliorate their attitudes and reach out to local Indian community leaders for help in anti-plague measures and messaging — although, in the colonial setup, this was more a strategy to avoid further popular discontent and less out of genuine respect for public participation.
Historians Biswamoy Pati and Ujaan Ghosh have written about how for a short while, the British toyed with the idea of banning an important Hindu pilgrimage (Puri Jagannath) altogether as it was considered one of the biggest sources of cholera in India (and hence of its spread into the West). But the idea was soon abandoned. Officer W.W. Hunter described these developments in an 1872 volume thus:
“In 1867 a last effort was made to enlist the educated classes against [the pilgrimage]… The Viceroy, while disclaiming any wish to interfere with the religious feelings of the people, urged them to consider the ‘exposure, disease, and death,’ which pilgrimage to Jagannath entails. But the answers which came in from every part of Bengal admitted of no hope. [Eventually] All that remained was to institute a system of sanitary surveillance and quarantine, which should reduce the inevitable loss of life to a minimum.”
Social sciences research shows that it is impossible to mount an efficient public health response when the public does not trust the responders and the authorities in charge. What works better is making communities and their leaders — including religious leaders — a major part of public health discussions and decisions right since the beginning. At the same time, stigmatization and scapegoating need actively to be avoided.
During the recent Ebola epidemic in western Africa, for example, health workers faced similar challenges. Local communities felt their religious and cultural practices were under threat when it was found that some of their rituals augmented the chances of viral infection. Rumours too were common, like ones that claimed that Ebola treatment centres were used for the extraction and trafficking of human organs. In a 2015 speech, the then World Health Organization (W.H.O.) chief Margaret Chan discussed some lessons that could be learnt from the Ebola experience. One of the biggest lessons, she said, was that “the outbreak will never be brought to an end in the absence of full community engagement and cooperation.”
While that lesson came from the W.H.O.’s experience with Ebola, it resonates equally well with humanity’s experiences with epidemic control throughout history.
[A version of this essay was first published in The Wire in April 2020.]
