Blood, Empire, And Quinine: How Malaria Spread With Colonial Development In India

Every year on April 25, World Malaria Day reminds us of a disease that, while now largely preventable and treatable, once claimed millions of lives, particularly in India. Between 1800 and 1921 alone, an estimated 20 million people died of malaria in colonial India, making it the second biggest killer after cholera.

While malaria was endemic to India long before the British arrived, the 19th century saw a dramatic rise in its spread. Ironically, it was aided by colonial infrastructure. Railways, irrigation systems, and deforestation transformed the landscape, often without regard for local ecology or health implications. Stagnant water bodies, created inadvertently by canals and embankments, became breeding grounds for the Anopheles mosquito, the vector of the malarial parasite.

Colonial Concerns and Contradictions

Malaria was a silent epidemic. Unlike cholera or plague, it didn't cause panic or upheaval, but it steadily drained the strength of the population, both economically and physically. Despite being the principal cause of sickness and death among Indians, malaria remained a low priority for British administrators. The disease did not threaten public order, and its economic impact, though significant, was mostly indirect.

Yet, malaria held symbolic value in the colonial imagination. It was viewed as a marker of India's "backwardness", a justification for the so-called 'civilising mission'. Controlling malaria became entangled with imperial rhetoric, even as actual policies often failed to reflect meaningful concern for the affected Indian population. Criticism of the British government's inadequate malaria control came not only from nationalists but also from some imperialists, frustrated by the gap between lofty promises and grim reality.

Early Efforts and Breakthroughs

Efforts to combat malaria during the British Raj were sporadic and inconsistent at first. But by the late 19th century, things began to change, thanks to scientific breakthroughs.

A turning point came in 1897, when Sir Ronald Ross, a surgeon in the Indian Medical Services, discovered that malaria was transmitted by the Anopheles mosquito. His groundbreaking research in Secunderabad earned him the Nobel Prize in Medicine in 1902 — the first Briton to win it. Ross's work marked a paradigm shift, redirecting malaria control strategies toward mosquito eradication.

This discovery spurred the British administration to organise malaria conferences and studies across the subcontinent. Institutions like the Central Malaria Bureau in Kasauli (1909) and the Punjab Malaria Bureau undertook detailed research, surveillance, and public health interventions, albeit often in urban or militarily significant regions.

Malaria And The Making Of Public Health

The Indian Medical Services (IMS), largely staffed by military surgeons, laid the groundwork for institutional public health in India. Yet, it wasn't until the decentralisation reforms of 1919 and the rise of provincial autonomy that malaria control began to be seen as a broader public responsibility. Drainage improvements, quinine distribution, and mosquito control initiatives were introduced. However, this was again more of an urban and military affair that suited the British administration and accessibility for the rural poor remained limited.

Quinine — the key antimalarial of the era — was distributed at post offices and jails at subsidised rates, often in the form of 5-7 grain packets sold for just a quarter anna. Still, these measures were insufficient in tackling the scale of the problem, particularly in hyper-endemic areas like Punjab and Bengal.

Gender And Medicine: The Lady Dufferin Fund

Interestingly, malaria control intersected with gender politics, too. The Dufferin Fund, established in the late 19th century to improve healthcare access for Indian women, trained female physicians and midwives. While it aimed to "uplift" Indian women, it also reflected colonial stereotypes — blaming Indian men for women's poor health and resisting indigenous medical practices. Instead of empowering local female health workers, the fund often relied on British women doctors, reinforcing imperial hierarchies even within social welfare projects.

Lessons From The Past

Today, India has made great strides in malaria control, with a 55% decline in cases between 2015 and 2021, according to the WHO. The country aims to eliminate malaria by 2030 — a goal once unimaginable. But the historical trajectory of malaria offers crucial lessons: that infrastructure development must go hand in hand with environmental and health planning, and that public health must be prioritised with equity over convenience.

Colonial India's battle with malaria was shaped as much by politics as it was by pathogens. Understanding this legacy helps us recognise the complex interplay of science, governance, and inequality — issues that remain relevant even today.

On this World Malaria Day, let's remember not just the lives lost but also the struggles for medical justice that continue to shape India's public health landscape.

 

Kirti Pandey is a senior independent journalist. 

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