1903: Story of an epidemic in Kashmir

Not to be surprised with the present anxiety over Covid 19 or Coronoavirus disease, Kashmir has been through many phases of epidemics in its history. Fortunately the documentation of that period allows us to get a lesson, plug loopholes and compare the two for the host of factors.

The epidemics first appeared in India in 1896 and later spread to almost all states. In the province of Punjab alone, 3.5 million deaths were recorded up to 1930 which was highest among all the provinces. It spread to Jammu in 1901 and Rawalpindi in 1903.

   

The Jammu outbreak alerted the administration in Kashmir. The British Resident in Srinagar issued a notice stating that all visitors before entering Kashmir had to undergo a medical examination. All the six routes were stationed with examination centres. This was done in order to keep plague away from Kashmir valley, as Rawalpindi and Jammu were at stone throw from valley.

Medical Inspectors were posted at Kohala and Uri, the gateways to erstwhile kingdom and Kashmir valley respectively. They had the job to check health and take temperature of every incoming passenger. The precaution worked fine and prevented one infected person to enter Kashmir. He died of plague at Uri itself.

For three years since 1901 Kashmir was saved, however couple of lapses changed the situation in 1903. A Mitra the then Chief Medical Officer Kashmir writes in The Indian Medical Gazette that in November 1903  the inspectors were blamed for a slip that later cost Kashmir dearly. A tonga carrying a veiled woman from some elite family, and her two servants passed through the check post on November 13, 1903.

They had come from plague stricken Rawalpindi where the woman was living for some time. The inspectors failed to detect the plague in one of the servants namely Ghulam Mohammed, although he had been ill.

It was utter failure on part of passengers in the form of self declaration and criminal negligence from inspectors in detecting the case.

On the evening of 18th November 1903, Ghulam Mohammed was found at the gate of State Hospital in Srinagar with high fever, anxious look, wandering mind, inguinal glands etc and symptoms suggested plague. He was quickly quarantined in a tent away from city.

On investigation the man confirmed that he had been severely ill before coming from Uri. They had been in Srinagar for couple of days and then went to the house of Subhan Bhat, a landlord relative of the woman.

Here Ghulam Mohammed’s health started to deteriorate and ultimately he was brought to the hospital by another servant. He died a day after, thus becoming the first case of Pneumonia Plague in Kashmir.

The body of this first patient was buried in a 10 feet deep grave with 2 feet of carbonate of lime surrounding it. Only two persons helped in the burial. All of his articles were burnt. His three contacts – a hospital assistant, one helper and one sweeper – were quarantined in a camp.

At Kralpura, the house of Subhan But was burnt together with every thing contained in it including the grains kept in the compound of the house by various dealers. 

The woman, her servants and all members of Subhan But’s house, the pony-man who brought the patient to the hospital, and all suspected contacts were quarantined in another camp.

On one side, due to the swift response the governmentwas able to contain the plague but few unseen loose ends spoiled the success.

The tent where the body of patient zero was kept wasguarded by four policemen who were strictly instructed not to go inside.However one policeman soon developed plague and died. The body was again buriedin a deep grave though his relatives demanded body be given back to them.

Later investigation revealed that the constable, probably with the connivance of his brother, who was the hospital attendant on the plague case, went into the tent and touched the body for the purpose of stealing anything which could have been found.

Some say he put his mouth on the finger of the deceased to bring out a ring, biting it with his teeth. “If this story is correct, which I believe it to be, plague commenced in Kashmir from a crime,” writes A. Mitra in the book.

Three days later the hospital attendant, who had beenput under quarantine, escaped the facility prompting health officials to issuered alert. The police was instructed to take the same step as they would taketo find out the whereabouts of a murderer as this man would probably infect andkill others. But the search proved fruitless.

After 10 anxious days news came about death of several persons in two houses in Srinagar. The first house was that of the deceased policeman where two persons died and the second one was the house of another policeman who had visited the first house.

Here five died. Soon different centres of infection spread and all had some contacts with the infected house of the policeman. Mitra gives two possible explanations, either the relatives of deceased policeman had exhumed his body and reburied it at native place or they had found his hospital attendant brother who possibly died at Geru village and subsequently buried by the family in their locality.

Although it seems that situation was going out of hand but the officials took some of the most drastic steps to arrest the rising epidemic. The measures  included evacuation of the infected houses, disinfecting it with chemicals, sealing it and guarding, it so that nobody goes inside.

Quarantine facilities came up near all the infected places to house the inmates of those buildings. Reporting mechanism of any new death was strengthened. A gang of coolies were vaccinated and they were engaged for disposal of dead and disinfection work.

Regarding the attitude of the people, Mitra writes, “in the beginning the people in Srinagar would not believe that it was plague which appeared in the city. Most absurd stories were circulated, and many attempts were made by misrepresentation to discredit the agencies who were fighting at great personal risk for public good.

The superstition of the people was that the police constables and their relations were only suffering for their sins. Many educated people, from whom better things were expected, actually tried to rouse popular opinion against us by making false representations about discomfort in the camps (quarantine facilities) and spreading the rumour that it was only pneumonia and not pneumonic plague.”

Despite opposition the officials held their fort andensured measures were strictly implemented and with the result no new case ofinfection was reported in the vast, congested and insanitary town of Srinagar,except in the isolation camps or in the few infected houses.

However the scattered rural areas with almost no health care facility were not that lucky. The hospital attendant who escaped hospital quarantine caused heavy damage in villages.

He had somehow reached village Geru, where he infected many and ultimately he too died.  The village headman was first to die and then followed his three sons. People from many villages came to his funeral and condolences but unknowingly carried back infection.

From South to North, number of villages were infected and devastated. Mitra writes that he could have mapped the first contact in Geru but till the news reached to him nobody survived in the village to tell the true story.

Hundreds died in villages all due to the escaping of a single patient. It is said that many houses in villages around Wullar lake fell vacant as everyone died.  Though government agencies later strictly followed the segregation policy but it was very late till then.

 “In the carrying out of plague measures (in Srinagar) no help of any kind was received either from the people or their leaders. Everything was done through official agencies.

No heed was paid to the clamour of the people, and measures which were thought right and suitable were carried out with a firm hand. When plague ceased in Srinagar and news of hundreds dying in the rural districts reached the city, a large deputation awaited on us begging to do some thing to prevent its re-introduction into the city and to repeat the measures which were previously taken, should it take place,” writes Mitra in the book.

In the plague which lasted till August 1904, 56 persons died in Srinagar, where effective measures helped lower the death toll. In villages where it took time to control due to lack of resources, a total of 1423 persons died and 20 were cured. Mitra writes that it was entirely due to the fortunate circumstance of them being allowed to deal with the first few cases in Srinagar in a drastic manner, viz., burning the first few infected places/items and segregating the contacts. “In other districts evacuation of houses and segregation of contacts proved the desired result,” he writes.

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