Cholera, sometimes called the Blue Death because a person’s skin may turn bluish-gray from extreme loss of fluids, has been responsible for nearly a lakh deaths every year. Over the past 250 years, millions have died in 6 global pandemics. Today, Cholera pandemics are associated with disasters, such as war or natural calamities.
Cholera is caused by the bacteria Vibrio Cholerae, which usually spread through fecal matter. While many people can carry the disease without showing any symptoms, some people can develop extreme cases of diarrhea, which can lead to dehydration. If untreated, a person can die within hours due to a lack of water.
The disease existed in the Gangetic plain for centuries, but the rapid urbanization and trade that followed British colonization created conditions for a pandemic. Overcrowding and industrialization led to poor sanitation conditions.
While Cholera outbreaks may have happened many times in history, Trade and war by the colonial government caused it to spread across the world. From the first major outbreak in the 1810s, British troops carried the disease to different countries. Outbreaks of Cholera would occur nearly every twenty years, and the reach spread, to across Southern Asia, from Indonesia to China in the 1810s. Then to Europe and America in the 1830s. In the 1850s, it spread across America. In the 1860s, it spread through Africa and the Middle East.
In response to the pandemic Cholera caused, the British developed the first systems of public health and sanitation. Cities began to be designed so that they would move water in and out of buildings quickly, through piped water. Early systems of sanitation were about moving waste out of the view of the city. This was done in the name of the people, but it did not help all people equally. Some suffered. When pipe water moved the wastewater far away, manual scavengers continued to be employed, but now they had to work in concentrated filth. Their work became more dangerous and illnesses became even worse.
Surveillance and social distancing norms also came into force but were less successful. Pilgrimage sites, which were also used by some for political mobilization, came under scrutiny. Laws to regulate travel by pilgrims were not so effective, as for many people in the country, pilgrimages were a natural response to a sudden illness in the community. The British government was able to surveil the pilgrim sites, and a crackdown on any political mobilizations that occurred, but this did little to prevent the spread of Cholera. The British were also able to use the massive pilgrimages, Kumbla Mela in particular, to justify their draconian policies.
The history of Cholera is linked to the history of public health in India. While trade and rapid industrialization were the cause of the Cholera outbreaks and spread, the state responded focusing on developing systems of public healthcare and sanitation. It also tried to take advantage of the situation by pushing systems of surveillance. The measures adopted by the state did not protect everyone equally, and across the world, the poor and the working class were not protected. In India, with the caste inequalities, some communities were pushed into greater risk.
Recently, with a public lockdown that aims to protect people from another pandemic, we can ask again. Who is being protected? Who is being placed at risk?