How B&W Bollywood has preserved a robust, HD picture of India’s public health history
India — just like the world — has changed so much since independence that most of us today have little to no idea about what state we were in in 1947. The permeation of pernicious propaganda from the BJP-Sangh (“nothing happened in India in 60 years of freedom”) has further weakened our already feeble understanding of our own past. It is going to take a while for us as a nation to learn better ways of thinking about history. In the meantime, watching old movies with a sensitive and critical eye can be a fruitful pastime to understand the past, especially the country’s pre-independence baseline. The domain of public health makes for a fascinating example in this cinematic exercise.
[A version of this article was originally published in The Wire in 2019.]
Today, references to cancer, heart disease, and diabetes abound in our films. Big stars have played characters with rare ailments as progeria and Asperger syndrome. However, in 1939, a mainstream blockbuster featured a suave hero (K.L. Saigal) suffering from a malady unthinkable for any Bollywood lead today: tuberculosis (TB). The plot of this film, ’Dushman’, is a love story where TB is the ‘enemy’. The TB-related messaging was inserted in the film as part of a government mandate for movie studios to carry social ‘propaganda’. TB was quite on the radar of the British colonial government’s policymaking, and some screenings of Dushman were attended by the Viceroy of India and the Governor of Bombay.
Apart from TB awareness, Dushman also features perhaps the first screen portrayal in India of what is called ‘germ consciousness’. The idea that many deadly diseases are caused by invisible microbes from whom we must always try to keep a safe distance, is a very obvious one today. A century ago, that was not the case. In India and elsewhere, the concept entered public consciousness only after relentless health education through posters, films, and other forms of mass communication.
In one striking scene in Dushman, we see the protagonist (Mohan) sitting despondent in a restaurant having just learned about his TB diagnosis. He then overhears two men at a neighboring table discussing how they must now eat only in ‘clean restaurants’ to guarantee protection from ‘bimariyon ke keede’ [roughly the bugs of illness]. Mohan starts feeling embarrassed at having gone to such a public place despite his ailment. Then his sight falls on a woman feeding water to a child using a restaurant glass. Ominous background music indicates that he is reaching some grave realization: he gets up, summons the waiter, and asks him where he put away the glass he (Mohan) had used. Mohan is shown that all the used glasses have been dumped on a countertop. In a dramatic gesture, he goes over there, pushes off all the glasses crashing down to the floor in one sweeping gesture of his arm, thrusts some money into the hands of the confounded manager, and leaves the restaurant.
TB was indeed a formidable dushman in early 20th-century India. But the public health dushman no. 1 during this time, with almost a quarter of total annual deaths attributed to it, was malaria. Terrible superlatives were often employed to describe it (India’s ‘most fatal’/‘most devastating’ disease). The colonial government came under immense pressure to reduce malaria incidence and mortality, and like all governments it went for the least upsetting-the-status-quo solution: pharmaceuticals (arguably, measures like reducing economic disparities and halting the environmental damage that continued to create ample breeding ground for mosquitoes would have been far more effective). Quinine, the anti-malaria drug, came to be supplied to the remotest corners of India through a dedicated production and distribution policy.
In the timeless classic Achhut Kanya (1936), the female lead’s father owns a kirana shop where he also distributes the quinine provided by the government. We see many villagers coming to him to fetch the drug for some or the other family member down with fever (for decades in rural India all fevers were assumed to be malaria unless otherwise proven). In the film’s plot, the quinine supply infuriates the local ayurvedic physician who is losing his regular patients to it. As later generations will attest, this antagonism between practitioners of Indian indigenous and ‘Western’ medical systems awaits a lasting resolution even today.
The decades immediately before and after independence were anyway not exactly the best of times to be a vaid or a hakim, as the star of the Indian biomedical doctor was on the rise. Perhaps the most comprehensive film on medicine during this time was the Bengali/Hindi ‘Doctor’. It is an epic story of the trials and tribulations of a father-son duo of physicians. Doctor features a whole gamut of India’s major health problems of the day: cholera, infant and maternal deaths, lack of public hygiene, and a mostly absent public health infrastructure. This is coupled with interesting social insights, like the doctor’s domestic help expressing displeasure at the ritually ‘polluting’ dissection activities in the medical college, presumably stuff that caste-privileged persons should stay away from.
Most importantly, Doctor perhaps set the trend for the portrayal of the Indian biomedical physician as a selfless (male) professional toiling for the nation and its people. This quixotic portrayal later reached its acme during the prime of Nehruvian nation-building when scientific wonders became the new ‘temples’ of India. For almost a decade actor Rajendra Kumar’s quintessentially selfless doctor characters ruled hearts as well as the box office: Chirag Kahaan Roshni Kahaan (1959), Dil ek Mandir (1963), and Aman (1967) among others. The climax of Dil ek Mandir tellingly featured the construction of a huge new hospital — a hospital which uncannily resembled the medical ‘temple’ of the time, the 1956-built AIIMS.
It is not surprising that movies tell us a lot about medicine and society of their period. It is also not surprising that they skip quite a lot, and tell only parts of the story. Most importantly, and for obvious reasons, films fall short of elaborating the social and political origins of ill health. As early as in June 1939, this cinematic shortcoming was succinctly explained by one Dushman reviewer in the Bombay Chronicle. Those words, copied below, are powerfully relevant even today:
A film seriously dealing with tuberculosis would have to go deep into the social injustice of the present economic order — the real “Dushman” of the people. It would have realistic shots of city slums, of working conditIons in factories, it would have close-up (sic) of under-nourished children who are such an easy prey for T. B. germs. No, I don’t think New Theatres [which produced Dushman] — or any of the existing studios in India — will produce such a film. Even if produced, there is every likelihood that the censors will ban it. [emphasis mine]
