Seeking the ‘Truth’ from ‘Enumerating’ Numbers: Leprosy in Census and Public Health Reports of Colonial Bengal: 1890s

Abstract

Figures are required to execute the policies in a way in which the state prepares the statistics of ‘progresses’. This is a form of ‘truth’ that is unquestionable and absolute to the administration. But often, the numbers are constructed, exaggerated and even invented, hiding the grim reality for the sake of upholding the achievements of a welfare state. Census has been one of the ‘scientific tools’ since the nineteenth century, by which the state retains its supervision over the population and preserves the information for future reference. Such process of institutionalising ‘truism’ would be considered as an ultimate solution of the problems that the enumerators encounter with the ‘infirm’. This article seeks to explore how far the enumerations had paved the way for resolving the issues regarding the ‘lepers’ and ‘deformity’ in colonial Bengal since 1891 when the decennial census was taken immediately after the death of Father Damien. The article also intends to problematise the notion on ‘diseased bodies’, that is, ‘lepers’ that the Raj tried to marginalise through census figures to protect the healthy populace from probable degeneration. Thus, it studies the leprosy and ‘lepers’ both by analysing the census and public health reports within the context of Empire and colonial Bengal.

Keywords

Leprosy census infirmity ‘lepers’empire deformity

Of all our infirmities, the most savage is to despise our being. —Michel de Montaigne¹

The subtle idea in the above statement is re-echoed, in centuries after, in Arnold Schoenberg’s ‘A Survivor from Warsaw’, which is a cantata, premiered in 1948 in the United States, described by Gotz Aly and Karl Heinz Roth in their book.² The choir, depicting the Nazi atrocities, is based on a central theme, that is, ‘Counting the heads’. Schoenberg has harped on the way in which people were identified, perceived and dehumanised as mere numbers in the Nazi registrations. After 1933, there were series of registrations conducted in the Nazi regime, for instance, The Labor Book (1935), the Health Pedigree Book (1936), the Duty to Register (1938) and lastly the Personal Identification Number (1944), which concomitantly produced a bureaucratic hierarchy founded on the idea of ‘Survival of the Fittest’. In order to classify the German blood and exterminate the classes causing ‘racial degeneration’, the Nazi administration had divided the population into four categories: superior or high quality, average, acceptable and inferior or low quality. Therefore, these raw data, punch cards, statistical mastery and the registration of population, through which this Nazi surveillance functioned as one of the coercive (nonetheless welfare) states during the 1930s and 1940s to restore the racial purity that were about to be wrecked by the existing ‘undesirable’ traits, had strengthened the regimentation of National Socialism in Germany. Friedrich Zahn, president of the German Statistical Society, was of the opinion that statistics ‘is no longer a mere quantitative population policy, but has developed into a qualitative and psychological one’.³ But this was not a new phenomenon to the European states, though; the intensity of panopticism might vary over a period of time with the changing nature of a nation state, and more precisely, the colonial state and with the structural peculiarities of ruler’s ideology. The questions are: how far was the statistics able to quantify the ‘diseased’ bodies in terms of tables, figures and facts in the colonial censuses, and to what extent did the numbers justify the contentions of ‘white’ people about the racial susceptibility to tropical diseases? Did the figures, especially shown in the censuses, pave the way in which colonisers intended to shape the cultural experience of the subjects encountering with the various epidemic and non-epidemic maladies? These two central issues, thus, constitute the arguments of the present article.

The Western representation of disease and diseased bodies through the census reports somehow manifested the fear of deformity persisting in the colonial mind. As Sander L. Gilman has argued, this sort of portrayal is mostly having dialectical structure; while envisioning the probable collapse of white supremacy, the Western world attempted to place the ailment in ‘others’ who were usually more predisposed to the illness. All sorts of disease representations were subjective in a sense that they had been the illustrations of personal discern about ‘pathogenic threat’; at the same time, they were culturally specific, creating discourses with which the larger community perceived not only themselves but also the others.⁴ The understanding, far from reality and often concocted in nature, had conceptualised the objectives of enumeration in the colonial world.

The difference between ‘naming a disease’ and ‘having a named disease’ was apparent in the figures prepared by the census officials in Raj, though the variability had been frequently misconstrued when the colonial officials had come up with the questionnaire in order to frame the ‘disease’ and its prevalence amongst the communities. Having an indefinable identity, disease, as a sociocultural entity, holds innumerable complex thoughts and relationships ranging from medical vocabularies, emerging out of the physician–patient encounter within an institutional set-up, to possible legitimation for policy making. In other words, disease is non-existent and dysfunctional until the medical/ non-medical groups are keen to believe in its actuality by recognising, designating and experiencing it.⁵ Likewise, census, with its uniqueness, empowered the colonial states to suffice such problems related to diseases which modified the demography, social behaviour and medical perceptions of the colonial society.

The census thus is, nonetheless, one of the essentials to the ‘representational world’ formed out of ‘schemata’ which the individuals or institutions structure throughout their process of development and that create the frame of references to the procedures of perception, imagination and thoughts. With the changing form of schemata, the ‘representational world’ is always influenced by the stimuli ‘arising from within and without the individual’.⁶ The British Raj had tenderly organised the schemata in order to procure the ideal nationhood by employing census as ‘tool of rationality’.

Infirmity and Census: An Enmeshed Journey since the Late Eighteenth Century

During the period of revolutions from 1790 to 1805, the European states such as Britain, France and the United States conducted first censuses, which materialised the perceptions of enumeration. Census taking was, therefore, unswervingly related to enlightenment philosophy of politics, governance and technology. British censuses in the nineteenth century were organised as ‘instruments’ or ‘tools’ of the government to appropriate the idea of governmentality among the British people who exercised this schema to identify themselves as representatives of the supposedly recognised groups and to ‘otherise’ the people who were not entitled to have privileges. By differentiating ‘surplus’ population from the deserving subjects, the census fomented the notion of nationhood founded on aggregation of national population.⁷ The pre-modern states had manifested their power through theatrical displays, coronations, funerals which had been replaced by the classification of spaces, standardisation of languages and registration of deaths and marriages in the eighteenth-century nation states. The achievement and continuance of nation states, as Cohn has pointed out, pivoted on encoding, organising and systematic documenting not merely the past, but also the huge pile of statistical figures on health, demography, education, trade and commerce as they appeared in the reports and enquiries of commissions.⁸

In case of the colonial states, the issues were more likely related to experimentations and applications of modalities, framed exclusively for the colonised territories, than that of understanding the uniqueness of these states’ multifaceted fabric. To the British Empire, collecting the ‘facts’ was only a plausible means of knowing the foreign lands. Therefore, by using the investigative modalities, the colonial government in India had categorised the various forms of ‘knowledge’ to retain the imperialist hegemony over the subjects, even if these subjects were not ‘Public’ in true sense. The colonial censuses, so far as administrative modality was concerned, were the most visible and dynamic puissance structure which intended to put all scholarships, like ethnology, tropical medicine, cartography and so forth, in a single framework. After 1857, the imperial power sought to gather information, regarding the ‘improvement’ it made hitherto in India, through the series of complete decennial enumerations from 1881 onwards. Besides the nominal objective of assembling basic facts about age, religion, caste, literacy and ‘infirmity’, the colonial authority had also set to transfigure the purpose of administration into a more efficient system of analysis; thus, objectification of sociocultural and linguistic variations was one of the primary raison d’êtres of British Empire.⁹ To the Victorian census analysts, the racial questions at home were largely equated with the racial populations across the Empire. The power of colonial states relied not only on a large productive population at home but also on ‘racially healthy colonies’.¹⁰ This article, hence, deals with a particular ‘infirmity’ causing disgrace to the colonial sovereign, that is, leprosy. The census of 1851 in Great Britain was the first enumeration within British dominion where the numbers of the ‘Blind’ and ‘Deaf – Mute’ had been registered as ‘infirmities’.¹¹ It forged the imperial quest to know how many ‘able-bodied’ were available for the service of state considering the ‘infirm’ as ‘unproductive’.

Aparna Nair has pointed out that in spite of having ‘family resemblances’ between medical and disability history, the latter is sporadically traceable in the historiography of colonial medicine. While she is aiming to problematise the concept of impairment in relation to the blindness in colonial India, the emphasis on the contagious diseases is largely seen when the academe explore the colonial archive containing a repository of documents. The archival materials have unwrapped the narratives of Raj concerning the contagion and its containment by means of public health programmes, internment, enhanced sanitation and maternal and child health policies which had been hitherto ignored in the writings on social history of colonial India until the 1980s. But, the idea of impairment, although defined in the official accounts, is seldom providing substantial courses of action against the infectious diseases. Nair has taken up blindness as an ideal example of frequent impairment during British Raj, although it did not receive considerable notice of institutional or medical attention in contrast to small pox and vaccination, which were continuing affair in colonial South Asia. Leprosy,¹² insanity¹³ and recently tuberculosis¹⁴ are a few impairments in colonial India that obtained academic interest, although there is a debate pertaining to the nomenclatures, if not façons de parler, that distinguish ‘impairment’ from ‘disability’. In case of the former, a sort of physical and psychological conditions seem to be linked with, whereas the latter is the way in which restraints are imposed on and manifested to people with disability.¹⁵ If one equates disability with the infirmity, the term ‘infirm’ signifies ‘persons laboring under mental or bodily infirmity disqualifying them from earning a livelihood’.¹⁶ However, leprosy was not an imperial concern until the 1880s. The decennial census of 1881 illustrated that a huge number of leprosy existed in British India. In 1889, the death of Father Damien, who contracted leprosy after serving the lepers for years in Molokai, Hawaii, made the colonial government to think about leprosy and its prevention (or segregation?) in India. Eventually, the National Leprosy Fund (1889) and Leprosy Commission in India were formed within a couple of years.

Empire and Figures: Hard Data of Leprosy in Colonial Bengal c. 1872–1901

For the colonial officials, it was not an easy job to find out the accurate figures of ‘infirm’ which were identified by the Raj. The first initiative to take account of infirm was seen in the all-India census of 1871–1872, wherein a general section named ‘infirmities’ and a subsection ‘lepers’ had been included. Jane Buckingham has rightly pointed out that, in case of Madras Presidency, the situation was as complicated as of other provinces in British India. Surgeon Major W. R. Cornish, sanitary commissioner for Madras, presaged in his report concerning the 1871 Madras census that the statistics about infirmity were ‘probably not very accurate’. He further added that ‘there is reluctance with most people to admit the existence of physical defects and the figures therefore must be accepted with a liberal margin.’¹⁷

Thus, the documentations of leprosy-affected people were highly challenging in the Raj. Besides the problems of identifying ‘lepers’ in different languages and dialects, the very expression which was used to define infirmity bearing numerous meanings in different areas of the same district. Moreover, leprosy in its early phase had a striking similarity with leukoderma, and it was also often mistaken as syphilis or as other forms of skin diseases. The problem was so intense that the Indian Leprosy Commission formed in 1890–1891 came across the fact that almost 9.5 per cent supposedly leprosy sufferers, selected for its examination at various centres, had been suffering from other diseases having similar external manifestation.¹⁸ Though the 1891 census had shown a large diminution in all kind of ‘infirmities’ in comparison with 1881 census, the figure in case of leprosy was still sizeable enough in Bengal.¹⁹ In the 1881 census, the number of leprosy sufferers in Bengal was 56,523, which was reduced to 46,390 in 1891 (Table 1); the disease was, nonetheless, prevalent in the same areas recorded in the previous census; for example, the Western Bengal seemed to be one of the more leprosy prone areas than other parts of Bengal. It is to be noted that the enumerators, according to the view of C. J. O’Donnell, the Superintendent of Census Operations in Bengal, were apparently more ‘meticulous’ in counting leprosy cases. They had excluded the cutaneous disease, known as white leprosy, taking only the tubercular or corrosive leprosy. The method, somehow, was not feasible to some people. Bourdillon was sceptic about the understated leprosy returns of 1881, which were, to him, consisting of ‘confirmed lepers’, especially those ‘in whom the disease was fully developed’. In support of this statement, Bourdillon put forward the view of the Civil Surgeon of Rangpur who surmised that there were 250,000 leprosy sufferers, comprising of those who were not ‘confirmed’ but affected by this disease, in the lower provinces.²⁰

Mainly the ‘lower’ castes were affected most, although, in Western Bengal, all castes were having high prevalence rate of leprosy, that is, from Bhuimalis and Bediyas to the aboriginal tribes of Bauris and Khairas. The enumerators, indeed, were scared of making any generalisation on the basis of received data, because the report illustrated that the disease was not confined to the lower strata only. In Brahman or Sadgop castes, the proportion rate was higher than Dom, Kaora and Chandals. The Kamars in north of the Ganges and the Kurmis in Bhagalpur and Munger were the only castes returning a high proportion.²¹ In Calcutta, the number of leprosy sufferers was reduced to 173, out of which there were 115 males and 58 females, whereas in the prior census the number was 387.²² It was evident from these figures that the enumeration of 1891 was being far from reality; however, H. F. J. T. Maguire, the census officer, strongly accorded with the views of enumerators.²³ This was the time when the Leprosy Commission was formed in order to prepare a report concerning the condition of the disease in colonial India. In 1893, the commission submitted its report in which the commissioners criticised the method by which leprosy figures had been put in order previously²⁴; although the Leprosy Commission did not want to renounce the importance of censuses, it raised a feeling of doubt falsifying at least one of the colonial forms of knowledge, that is, enumeration.

Table 1.

The Number of Leprosy Sufferers in Bengal, Presidency and District-wise

Sub Provinces and Special Tracts	Numbers of Leprosy Sufferers				Distribution Per 10,000 Persons
	Male		Female		Male		Female		Both Sexes
	1881	1891	1881	1891	1881	1891	1881	1891	1881	1891
Northern Bengal Darjeeling Kuch Bihar Eastern Bengal Western Bengal North Bihar South Bihar Bhagalpur and Monghyr Orissa Districts Orissa Tributary States Chota Nagpur Districts Chota Nagpur Tributary The Santal Parganas	5,647 139 956 5,423 13,871 4,188 4,165 1,608 3,485 747 1,419 96 539	3,511 120 621 5,192 11,606 3,645 2,685 1,732 3,248 652 1,038 117 499	1,854 45 326 1,915 5,257 880 817 440 1,176 383 855 41 251	1,125 39 166 1,551 4,168 658 543 513 1,204 335 1,101 43 218	13.4 15.6 30.6 7.2 20.9 7.6 14.6 8.2 18.9 10.5 6.7 2.8 6.8	7.9 9.7 20.5 5.9 17.4 6.3 9.2 8.6 16.3 7.6 4.7 2.5 5.7	4.5 6.7 11.2 2.5 8.9 1.5 2.7 2.3 6.2 5.2 4.0 1.2 3.2	2.6 4.8 6.0 1.8 6.3 1.1 4.7 2.4 5.8 3.9 4.6 0.9 2.4	8.9 11.1 20.9 4.8 14.9 4.5 8.6 5.3 12.5 7.8 5.3 2.0 5.0	5.3 7.2 13.3 3.8 11.8 3.7 5.5 5.5 11.0 5.7 4.6 1.7 4.0
Total	42,283	34,716	14,240	11,674	12.2	9.3	4.7	3.1	8.5	6.2

Source: Census of India (1891), vol. 3, p 246.

The year 1901 was significant for many reasons. It was the first census in twentieth-century colonial India, followed by the implementation of Lepers Act of 1898 in Bengal and the sworn-in ceremony of Edward VII as the Emperor of United Kingdom, British dominions and India after the demise of Empress Queen Victoria on 22 January. The prolonged Victorian era was replaced by the brief Edwardian period during which the technological development and the growing socialist ideas made considerable changes in the society. A few medical men, however, became incredulous towards the racial susceptibility to leprosy which reflected in the 1901 census of the British Empire. In his book Geography of Disease, Dr Clemow was of the opinion that some races appeared to be more susceptible to leprosy than others, but such differences might be attributed to the difference in way of life and of exposure to the disease. ‘All races can become subjects of the malady’—this statement of Clemow had dispensed with the idea of healthy race capable of protecting the body against the possible insurrections of germs. Although he came to believe like his fellow brethren that as far as the White Races and Europeans were concerned, they managed to escape the infliction more than the natives of the colonies.²⁵ In the previous census of 1891, the number of leprosy cases was not as much as registered in the 1881 census. Moreover, a general decline in the leprosy figures was seen in the 1891 census continuing until 1901 (Table 2). Thence, the census of 1901 showed the steady fall in leprosy figures in entire province except Chota Nagpur plateau, where, especially in Manbhum and Sonthal Parganas, the prevalence rate was much higher than that of 1891.²⁶ Along with the contours of the plateau, Orissa and western part of Bengal, mainly Bankura and Birbhum, also received a large number of leprous cases; in case of South Bihar and Saran, leprosy patients often suffered from plague which, to Oldham, the Magistrate of Gaya, proved to be the major cause behind their dwindling numbers in Gaya town.²⁷ Their standard of living, and the sores fomented by the disease, had been liable to infection. There was further decrease in leprosy numbers in Central and Eastern Bengal where no such epidemics occurred frequently. As the improved hygienic habits, environs and growing material prosperity proved to be instrumental for European states getting rid of leprosy, colonial officials started to think that the same factors would probably eradicate the disease from British India²⁸; this was somehow unachievable to the colonial government when it came to the question of economic amelioration, which was, in theory, contrary to the colonial exploitative policy. Paternalism did not necessarily deal with the betterment of subjects; in some cases like public health, the idea of governance was transformed into a system of exclusion by which the colonial state elegantly marginalised the ‘infirm’ and distinguished them from ‘able-bodied’. The census report showed to what extent the colonial government was able to combine this paternalism with the emerging concern regarding ‘imperial hygiene’.

In Calcutta and suburbs, there were 242 leprosy sufferers out of 1,916 infirm registered in the 1901 census. Therefore, in every 10,000 persons in the town, there were three afflicted by leprosy, whereas in suburbs there were two leprosy sufferers. The number of male leprosy sufferers, that is, 180, was quite a few than females (62). Amongst them, 108 were Hindus, which was 44.6 per cent of the 65.1 per cent Hindu population; 94 were Muslims consisting 38.9 per cent of the 29.8 per cent Muslim population; and 40 Christians, which was 16.5 per cent of the 4.25 per cent Christian population. Simultaneously, the largest number of leprosy sufferers was detected within the Eurasian community, that is, 1 person in 689 population, which was considerably higher than Pathan, Mehtar, Sutradhar and Kaora castes.²⁹ In Puri, leprosy sufferers were supposed to be a ‘threat’ to the colonial authority. A civil surgeon, taking a racist stance, felt that leprosy patients should not enter into the hospital. For him, ‘the lower classes [of] Uriyas are dirty race and have no ideas of cleanliness and sanitation.’³⁰ The Commissioner of the Orissa Division, in 1908, requested to the government of Bengal (GoB) to extend the Lepers Act to the Sambalpur district where ‘lepers are a menace to the people amongst whom they live and it is impossible to ensure that they will do nothing to endanger the health of others’.³¹ Moberly, the Deputy Commissioner, reiterated the appeal for extending the Act to Sambalpur. Even quoting the view of the civil surgeon, he explained the necessity of regulations for innumerable leprosy sufferers on the Raipur–Sambalpur Road in order to ensure the health of the general population. But the Lieutenant Governor was not willing to extend the Act to the Sambalpur district. In his reply, he explained that there were, according to the last census report, only sixty-seven lepers in Sambalpur, which was far less than that in other districts of Orissa, for which the number was twenty or thirty times larger. This Act, if it has to be extended, must be applied to those districts first, although the accommodation in the existing asylums was insufficient to enable the government to extend the Act at present.³²

Table 2.

Decline of the Number of Leprosy Sufferers in Bengal, 1881–1901

Leprosy Sufferers (Per 100,000 of the Population)						Districts and Natural Division
Male			Female
1901	1891	1881	1901	1891	1881
72	93	123	23	31	41	Bengal
168	244	287	64	90	107	West Bengal
239	313	444	88	122	159	Burdwan
321	522	485	109	190	182	Birbhum
367	515	540	188	218	214	Bankura
91	122	134	31	36	52	Midnapore
55	115	179	14	25	49	Hooghly
23	47	82	6	14	31	Howrah
46	78	111	14	23	38	Central Bengal
18	50	72	5	18	30	24 Parganas
32	26	63	22	25	37	Calcutta
49	119	150	17	25	42	Nadia
118	129	194	33	38	68	Murshidabad
32	85	65	7	15	16	Jessore
63	88	147	18	29	50	North Bengal
15	30	55	10	17	37	Rajshahi
56	61	104	15	30	42	Dinajpur
110	139	185	38	53	69	Jalpaiguri
43	98	155	27	49	68	Darjeeling
94	107	231	24	27	64	Rangpur
38	81	105	11	25	29	Bogra
46	62	100	11	21	30	Pabna
54	98	110	18	25	37	Malda
125	205	307	37	80	112	Kuch Bihar
55	–	–	25		–	Sikkim
35	59	74	8	19	27	East Bengal
12	18	38	5	8	14	Khulna
39	57	83	12	14	31	Dacca
84	124	129	15	40	39	Mymensingh
17	44	63	4	11	17	Faridpur
9	21	33	4	8	17	Backergunge
22	59	69	5	18	30	Tippera
9	20	34	2	8	18	Noakhali
18	35	61	4	13	28	Chittagong
74	77	–	22	38	–	Chittagong Hill Tracts
37	67		14	33		Hill Tippera
47	65	76	10	12	17	North Bihar
48	85	98	7	10	15	Saran
33	53	62	4	10	10	Champaran
47	52	64	10	5	8	Muzaffarpur
33	41	46	4	7	9	Darbhanga
58	70	75	18	22	26	Bhagalpur
70	94	78	21	28	28	Purnea
77	95	132	12	20	25	South Bihar
77	89	132	8	10	23	Patna
102	127	163	16	27	30	Gaya
57	130	140	9	13	27	Shahabad
73	103	90	13	27	18	Monghyr
170	168	190	49	59	61	Orissa
163	128	171	44	48	57	Cuttack
187	185	214	53	69	64	Balasore
185	229	204	58	82	75	Puri
77	53	72	40	38	39	Chota Nagpur Plateau
15	20	26	9	13	15	Hazaribagh
35}	37		13}			Ranchi
23		40{	18	20	26	Palamau
186	107	160	120	139	87	Manbhum
47	48	52	32	24	44	Singhbhum
122	57	69	50	25	32	Sonthal Parganas
77	73	163	39	38	78	Angul
89	76	100	33	40	53	Tributary States Orissa
40	26	96	25	10	12	Ditto Choto Nagpur

Source: Census of India 1901, Bengal, Vol. 6, Part 1, p. 295.

Finding the ‘Lepers’: Census and Public Health Reports of Colonial Bengal, 1911–1931

The following decade was truly eventful in Indian history. The anti-partition movement had been making strides when the cut-and-dried policy of Curzon to divide Bengal Presidency for ‘administrative purpose’ was in effect. It had an impact on the census report of 1911, which, henceforth, considered Bengal as a separate province from Orissa, Bihar and Sikkim. Moreover, the schism between Moderates and Extremists in the 1907 Surat session of the Indian National Congress (INC), the mounting Swadeshi movement in support of anti-partition solidarity, the revolutionary bustles in colonial Bengal and finally the pronouncement of British government to transfer the capital from Calcutta to Delhi were bringing new dimensions in Indian politics. In such state of affairs, the census of 1911 should have been perceived with a nuanced approach, especially the infirmity section needs to be re-examined. In the preface of the 1911 census, O’Malley put forward the reason for the late appearance of the report which had finally been prepared in March of 1911; but due to the repartition of Bengal on 12 December, the figures both of the 1911 census and each of prior censuses were supposed to be rearranged for the Bengal Presidency and Bihar and Orissa province.³³ The greatest intensity of leprosy, in this new census report, was found in Bankura; almost 23 lepers out of the 10,000 population, which was higher than in districts of Orissa, where the proportion was 10 per 10,000. To the census officials, it was the climatic condition that made lot of difference in the prevalence and incidence rate of diseases. For instance, the lower delta of Central and Eastern Bengal had a humid climate where the leprosy cases were a few, in contrast to the drier and arid climate of western side of the Presidency, mainly the extended Chotonagpur region, where leprosy cases seemed to be endemic. However, they failed to provide a valid rationale for the high incidence rate of leprosy in the seaboard districts of Orissa. In Bengal, most of the leprosy cases were detected in small Sarak, Hajjam communities and Indian Christians. In addition, the other communities in which leprosy was prevalent included Lohar, Kaibartta, Mali and Khaira.³⁴ The report had also given a list of asylums in Bengal managed by either the government or the Mission to Lepers, such as the Albert Victor Leper Asylum at Gobra, which had been declared asylum under the Leper Act in 1901, and wherein the leprosy cases were sent from Fort William, the Suburban and Krishnanagar municipalities. The Purulia Leper Asylum, having accommodation for over 600 lepers, was the largest asylum in two provinces. This institution, which was in the hands of German Evangelical Lutheran Mission, might have received leprosy sufferers from Manbhum. In case of the Raniganj Leper Asylum, leprosy-afflicted persons were sent from Burdwan and Birbhum. Along with that, the asylums at Asansol and Bankura were controlled by the Mission to Lepers in India and East. Thus, all the leper asylums in the two provinces, except that at Gobra, had been retained by the Mission to Lepers or by private endowments. The government, however, frequently contributed to these asylums by giving financial aids.³⁵ In Calcutta, the number of ‘lepers’ further increased to 271, out of which 196 were male and 75 were female.³⁶

To Rev. Frank Oldrieve, Secretary for India of Mission to Lepers, the leprosy figures given in the census was a ‘good deal below the actual number’. The Census Commissioner, according to Oldrieve, believed that leprosy cases registered in the course of enumeration were 40 to 50 per cent fewer than the real numbers.³⁷ Census return was not considered a reliable source of information to the government officials as well. Scurr, one of the members of House of Commons, asked the Undersecretary of State for India on 26 February 1925 about the figure of the leprosy population in British India and whether the numbers showed any precursor of decrease over a period of ten years. While presenting the leprosy figures shown in the 1911 and 1921 censuses, Earl Winterton, the Undersecretary of State for India, replied that the figures were largely erroneous due to the people’s deliberate concealment of the disease, ‘owing partly to ignorance and partly to shame of the sufferers’. Thus, he thought that the number of the diseased might be greater than that of census return.³⁸

As far as the census of Bengal was concerned, 49 males and 18 females out of 100,000 were considered as lepers in 1921. Having a sharp contrast to other districts of Bengal, that is, Bakarganj, Noakhali, Dinajpur, Jessore, Khulna and Hooghly, where leprosy cases were very negligible, the Burdwan division, declared by the enumerators, was one of the most leprosy predisposed areas in India. On the basis of high prevalence rate of the disease, the report estimated that Burdwan, Bankura, Birbhum and Midnapore seemed to be mostly affected areas in Bengal Presidency (Table 3). Although the leper asylums at Bankura, Raniganj and Gobra, Calcutta, had provided accommodations for leprosy patients, constituting only 6.6 per cent of the total leprosy population in 1920.³⁹ This time the colonial authority, however, was more ‘confident’ regarding the accuracy in the return of lepers than before when the diseases like syphilis, leukoderma and other skin diseases were misapprehended as leprosy. Thus, the census of 1921 showed greater reduction ‘in the prevalence’ of leprosy in all parts of Bengal since 1881, but the disease had escalated in Bankura district, after it witnessed a modest improvement in the 1901–1911 interval. Moreover, the report intended to bring the theory of degeneration in order to explain the cause of infection. The Sunris, about 265 cases out of 100,000, and the Lohars, 204 cases of 100,000, were the most leprosy-inflicted castes in the western part of the Presidency, though the rate of infliction was very low in the case of Bhotias, Lepchas, Khambus and Namasudras. It was also rare in the case of Bengali bhadraloks, Europeans and Anglo-Indians.⁴⁰

It seems that the colonial government was ready to concede the fact that the ‘low’ castes were more susceptible to the disease than the higher one, not because of the reason that bhadraloks supposedly lived in preferable hygienic and healthy environment, rather, their ‘high’ position and ‘high’ level of civilisation made them immune to disease.⁴¹ The Census of Calcutta in 1921 had registered 259 lepers in the colonial city, out of which 197 were males and 62 were females. In the Gobra Leper Asylum, there were 139 inmates comprising 109 males and 30 females. But somehow this enumeration was too feasible to make a comprehensive idea about the status of leprosy in the city. It stated that at the time of the census, the leprosy figures were far less than these appeared in the report (i.e., 88 males and 32 females amongst 120 lepers), which did not adhere in any case to the fact shown in the enumeration.⁴² The colonial authority was playing its cards close to its chest and unwilling to declassify the reason why there was so much difference in leprosy numbers of the pre and post census reports. Whatsoever, the number of male leprosy sufferers, according to the census report, was less in the city in comparison with other districts of Bengal except Bakarganj, Noakhali, Rajshahi and Dinajpur, whereas the proportion among females was higher in Calcutta than in Noakhali, Bakarganj, Tippera, Chittagong, Faridpur, Khulna, Jessore, Dacca, Pabna, Bogra, Rajshahi, Dinajpur and Hooghly. The amount of leprosy sufferers was greater in the ages between 25 and 40 than other age groups. To the colonial enumerators, the Sheikhs and Indian Christians altogether shared the larger portion of leprosy cases in contrast to Kayasthas and Hindu bhadraloks.⁴³

Table 3.

The Most Leprosy-affected Districts in Bengal Presidency, 1911–1921

Districts	Total		Males		Females
Districts	1921	1911	1921	1911	1921	1911
Bankura	2,752	2,645	1,817	1.764	935	881
Burdwan	1,613	2,152	1,166	1,537	447	615
Birbhum	1,255	1,528	914	1,114	341	414
Midnapore	1,288	1,541	937	1,132	551	409

Source: Census of India 1921, Vol. 5, Part 1, p. 338.

In the 1931 census, the enumerators had finally conceded that it was in the case of leprosy where the census officers faced ‘greatest difficulties’ in getting hold of accurate figures. Even the executive of the Indian Council of the British Empire Leprosy Relief Association (BELRA) was of the opinion regarding the leprosy returns of the 1921 census that there was ‘good reason to believe that the number (of lepers) is 5 or more likely 10 times’ in reality.⁴⁴ This time the enumerators appeared to be more resolute than ever before. Axing the prior methods of counting heads, A. E. Porter, the Superintendent of Census Operations in Bengal in 1931, addressed the issues with a critical approach. The huge discrepancy between the census figures and the data taken by the independent agencies had smudged the entire process of collecting facts from the very beginning. In the general run of things, the agencies consisting of trained medical professionals were more efficient in finding the true cases of leprosy than general census staff on which the census officers often depended. In the 1931 census, 82 persons had been detected as leprosy afflicted in every 100,000 compared with 66 in 1921. Again West Bengal became the highest leprosy incidence district where it went up to 221 persons in 100,000 compared with 179 in the 1921 census (Table 4).⁴⁵ The incidence was highest in Bankura, Birbhum, Burdwan, Jalpaiguri, Chittagong Hill Tracts, Murshidabad and Rangpur. Dinajpur district was under the microscope of the census officers because the prior census report declared this region as one of the lowest leprosy prone zone, that is, 16 per 100,000 in 1921, whereas it reached to 65 within a decade, which was really unusual. Not only that, the incidence rate of leprosy was much less in Dacca, Faridpur and Tippera, previously shown as the areas having a decent leprosy population.⁴⁶ The census officers were again unable to give satisfactory reason behind such differences between the received facts of two consecutive censuses. One of the probable causes might be, as Porter contemplated, that the treatment was concomitantly given to the sufferers, who concealed their malady previously, when census was in progress. Secondly, in every survey, the number of early cases was greater than the rest, indicating towards its upward growth.⁴⁷ To Ernest Muir, the high prevalence rate of early cases was not the sign of rapid increase of leprosy: ‘There is…an alternative, namely, that it is due to fairly high resistance to leprosy in the majority of cases so that the disease does not increase beyond the early stage except in a comparatively small proportion.’⁴⁸

The two momentous observations were offered by Muir in this census. One was entirely related to cause of contraction. For Muir, erroneous dietary habits, along with the improper balance of foods, vitamins and also poor standard of living, taking decaying meat and fish, could possibly be the chief causes of high incidence of leprosy in India and Bengal. The second hypothesis, dealing with the question of incidence in specific social classes, was more interesting than earlier one. This disease was by no means class specific, as stated jointly by Porter and Muir; instead, it was commonest in those who were ‘in the intermediate state between the aboriginal tribes and the more civilised people’.⁴⁹ Migrated labourers in the tea gardens and the daily wage earners in the industrial concerns were susceptible to this disease. The phrase ‘more civilised’, though, was a problematic one. Muir was unable to explain the locution inclusively.

Table 4.

The incidence of Leprosy in several districts of Bengal proper, 1911–1931

Bengal Province and Districts	Number of Leprosy Sufferers by sexes per 100,000 Persons of the Same sex, 1911–1931
	Male			Female
	1931	1921	1911	1931	1921	1911
Bengal	59	48	56	23	18	19
West Bengal	152	124	137	69	55	57
Burdwan	190	159	200	83	63	80
Birbhum	271	216	241	108	80	88
Bankura	427	357	314	201	183	153
Midnapore	82	70	80	236	265	29
Hooghly	40	21	37	18	8	10
Howrah	30	23	18	11	11	4
Central Bengal	32	30	38	13	11	12
24-Parganas	18	13	15	10	6	5
Calcutta	25	32	32	15	21	26
Nadia	47	43	50	15	13	14
Murshidabad	97	86	90	30	27	24
Jessore	17	21	22	8	5	5
Khulna	15	13	14	7	6	5
North Bengal	60	42	50	22	12	14
Rajshahi	21	12	7	20	7	6
Dinajpur	45	11	42	20	5	13
Jalpaiguri	128	78	89	61	21	29
Darjeeling	63	38	45	33	16	14
Rangpur	96	77	73	24	19	17
Bogra	26	25	30	9	7	6
Pabna	21	20	29	9	8	8
Malda	63	34	55	23	13	15
Coach Bihar State	70	87	98	17	19	25
East Bengal	33	29	31	9	9	7
Dacca	24	33	33	7	10	9
Mymensingh	68	49	67	14	11	13
Faridpur	11	19	16	3	6	4
Bakarganj	13	8	7	5	4	3
Tippera	23	27	26	6	8	8
Noakhali	15	6	5	6	3	1
Chittagong	28	15	12	12	8	3
Chittagong Hill	128	120	76	50	50	28
Tripura State	48	47	52	26	30	14

Source: Census of India (1931), Vol. 5, Part 1, P. 251.

The BELRA had endeavoured to carry out various surveys in the districts of Bengal to find out the real number of leprosy patients. For example, in the district of Mymensingh under the proposed propaganda, treatment and survey (P.T.S) method in 1928, Dr B.N Ghosh, the Leprosy Propaganda Officer of BELRA (Bengal Branch), wrote a letter to C. W Gurner, the District Magistrate of Mymensingh, requesting him to direct the officers in charge of all police stations of the district to make immediate enquiries from the chaukidars and daffadars about the number of ‘lepers’ within their respective areas. Gurner criticised the way in which Ghosh desired to have the information.⁵⁰ On 15 May 1928, he put forward his objections to the Commissioner of Dacca Division. To him, Ghosh’s request to engage the police officers in surveying the leprosy sufferers was not possible, because it did not lie within their extent as defined in the Bengal Police Regulations and would not be probably acceptable to the Inspector General either. Second, the enquiry of chaukidars and daffadars would be likely to abuse on their part and would cause delusion and discontent amongst the sufferers. Third, the reports prepared by the sub-inspectors and ultimately directed to the leprosy propaganda officer were completely contrary to the department’s routine. Therefore, Gurner wanted to refer Ghosh’s proposal for confirmation to Government Political Police Department before taking any action further. It is interesting to note that the Commissioner of Dacca Division instead showed the duties of the police in regard to lepers. As these duties were laid down in Sections 6, 7, 10 and 12 of the Lepers Act, 1898, even the police officers might be asked to supply the information required by any Dr Ghose.⁵¹

Mr Tom Smith raised a question concerning the recent upward growth of leprosy in the House of Commons on the basis of the 1931 census report, but Sir Samuel Hoare, the Secretary of State for India, completely denied the fact by saying that leprosy had not been increasing in India. It was true, as the British government replied that on each occasion, that is, in 1921 and 1931, the real number was significantly in excess of that returned, though that might not be the reason to presume that the incidence of the disease had been escalating. Most of them, who were not taken into consideration previously, were suffering from the malady in a mild form. In the 1931 census, those cases had also been classified as ‘lepers’. According to the colonial account, except the census years, there were no such figures in record for any other years. The local governments in India were entrusted with the responsibility of carrying surveys, treatment, research work and propaganda related to leprosy, which shows that Government of India (GoI) supposed to be the stakeholder of public health issues, as far as the 1919 India Act or Montegu–Chelmsford Act was concerned, without obtaining any accountability.⁵²

Around 21,000 leprosy cases in all the districts and states of Bengal were registered in the 1931 census. But, the leprosy surveys, carried out by the All-India Survey Party and later by the Bengal branch of the BELRA, indicated that the real figure of leprosy was more than ten times the numbers previously recorded.⁵³ The distribution of leprosy in the various districts of Bengal is shown in Table 5.

Table 5.

The Distribution of Leprosy in Bengal Districts as per the Survey of BELRA, Bengal Branch, in the Early 1930s

Division	District	1931 Census Population	1931 Census Figures for Leprosy		Figures based on Survey Findings
Division	District	1931 Census Population	Incidence (%)	Total Cases	Rough Incidence	Probable No. of Cases
Burdwan	Burdwan	1,575,689	0.138	2,178	1.5	20,000
	Birbhum	947,554	0.189	1,792	2.5	20,000
	Bankura	1,111,721	0.314	3,490	3.0	35,000
	Midnapore	2,799,063	0.059	1,659	2.0	40,000
	Hooghly	1,114,255	0.03	331	0.5	5,000
	Howrah	1,098,867	0.021	232	0.5	5,000
Presidency	24-Parganas	2,713,874	0.014	379	0.5	10,000
	Calcutta	1,196,734	0.021	257	0.5	5,000
	Nadia	1,529,632	0.031	480	1.0	15,000
	Murshidabad	1,370,677	0.064	871	1.0	15,000
	^aJessore	1,671,164	0.013	210	0.5	3,000
	^aKhulna	1,626, 148	0.011	184	0.5	3,000
Rajshahi	Rajshahi	1,429, 018	0.02	291	0.5	10,000
	Dinajpur	1,735,432	0.033	580	0.5	10,000
	Jalpaiguri	983,357	0.097	953	1.0	10,000
	Darjeeling	319,636	0.049	157	1.0	3,000
	Rangpur	2,594,785	0.062	1,596	1.0	20,000
	Bogra	1,086,419	0.018	191	0.5	5,000
	^aPabna	1,445,654	0.015	221	0.5^a	3,000
	Malda	1,053,766	0.043	456	1.0	10,000
Dacca	^aDacca	3,432,577	0.016	547	0.5	15,000
	^aMymensingh	5,130,262	0.042	2,170	0.5^a	25,000
	^aFaridpur	2,362,215	0.007	166	0.5^a	2,000
	^aBakarganj	2,939,050	0.009	265	0.5^a	3,000
Chittagong	Tippera	3,109, 735	0.015	461	0.5	10,000
	^aNoakhali	1,706,735	0.011	181	0.5^a	2,000
	^aChittagnong	1,797,038	0.02	352	0.5^a	5,000
	Chittagong	211,922	0.092	195	0.5^a	2,000
	Hill Tracts
^aBengal States		973,336	0.042	409	0.5^a	6,000
		51,000,000		21,254		317,000

Source: WBSA, GOB, Health and Local Self Government Department, Public Health Branch, Pros. B 53-56, File No. PH 2L-10/46, January 1947.

Note: ^a These districts have not been properly surveyed, and the probable number of cases of leprosy in these parts is calculated by multiplying the census figures by 15; the incidence of leprosy in these parts is estimated to be below 0.5 per cent.

Another issue was cropping up during the late 1930s. Whether the section of ‘infirmity’ should be incorporated in the 1941 census or completely left out of the subsequent enumeration had, however, been the crucial apprehension amongst the colonial officers. Colonel Cotter expressed his own beliefs against the inclusion of ‘infirmity’ in the 1941 census in one of his letters to K. C. K. E. Raja, the Assistant Public Health Commissioner with the GoI, New Delhi. Considering the figures as misleading and untrustworthy, Cotter sought to rely only on the public health surveys which were ‘more effective way of bringing to light the true incidence of the disease.’ However, Dr John Lowe and Miller were in favour of enumerating the ‘lepers’ at the next census, as it was the only means of drawing attention to the leper problem. But Raja was not willing to include leprosy at the 1941 census as he found no such relative value of the reports related to leprosy figures. Moreover, Dr Hutton, in a previous census report, stated that England and Wales rebuffed to record physical deformities through census returns prior to 1931 as the census failed to represent the real incidence of diseases. Hutton was keen to follow the similar procedure in the succeeding censuses of the Raj. After the 1931 census, leprosy surveys were carried out in different parts of British India, which helped Dr Lowe to furnish the plausible conclusion concerning the incidence of leprosy in India.⁵⁴ This made Raja to think about the future of a leprosy census:

Under the circumstances, this purpose which the Census Commissioner had been in mind in 1931 appears to have been largely met, and it is doubtful whether leprosy should now be included in the 1941 census.⁵⁵

The ‘infirmity’ section, in due course, was excluded from the 1941 census, although the reports concerning prevention, incidence and prevalence rate of the disease had frequently appeared in the public health reports of GoI and GoB during the 1940s. In 1945, the Bengal Public Health Report registered 1,538 deaths from leprosy, out of which 1,432 deaths occurred in the rural areas and 106 in the urban areas. The mortality rate was, therefore, 0.03 per cent for the whole province, which was unchanged when compared to the previous year. There were 71 deaths due to leprosy in Calcutta, less than the previous year wherein 95 deaths had been recorded. But the GoB was determined not to take further course of action of the provincial scheme for anti-leprosy work till the end of the Second World War and also casting off new proposals for the clinics in Sadar and sub-divisional hospitals.⁵⁶

Though the number of deaths reduced to 923 in 1946, the disease proved to be more severe in Burdwan, especially in mining areas. The BELRA had carried out surveys amongst the workers of Burnpur Works, where out of 14,000 persons, 233 leprosy cases were detected, including 19 of the infectious type. However, the works of the association had been largely inhibited due to the political unrest in Calcutta and the strikes in the mining areas.⁵⁷

Conclusion

The issues of ‘infirmity’ or ‘disability’ continued to remain a key problem of leprosy enumeration, but they were not addressed in the following censuses until 1981 when the number of ‘disabilities’ was divided into three categories and again the questions on ‘deformities’ were dropped in 1991. It appeared once more in the 2001 census wherein five types of ‘disabilities’ were recorded, and it was raised to eight in 2011 census.⁵⁸ Moreover, the total number of the differently able population has increased significantly from less than 1 million in 1881 to around 26.8 million in 2011. The non-inclusion of differently able classes in some of the enumerations since 1941 was not, of course, an inadvertent ‘error’ made by the late colonial and post-colonial governments of India. It was the question of defining a person ‘disable’ or ‘infirm’ that worried the state most. The ‘indirect rule’ of British Empire in the post-mutiny era rationalised the difference between the educated elites, whom Sir Henry Maine thought as ‘natives’, and the settlers supposedly more progressive in nature. The natives were the creation of colonial state, which shifted its epistemological ways, to understand the eccentric cultural milieu of colonised lands, from homogenisation of impulses to administrative concerns. This change, of definition and management of the cultural milieu, was apparent in the transition from direct to indirect rule. Mahmood Mamdani has attempted to explain this as the inevitability of indirect rule of colonialism developing the ‘management of difference’ as the essence of governance.⁵⁹ Census in South Asia was one of the structural manifestations of that management differentiating the able-bodied from the disabled, the tribal from the coloniser and the legislations from habitual observance. Despite viewing census as a bureaucratic form of practice and somewhat repulsive requirement of the modern state counting ‘national population’, the scholars have opined that it also plays a decisive role in constructing the social reality. This process, as James Scott refers, is regarded as the ‘central problem of modern statecraft’ attempting to make a society legible. In other words, the landscape, people and culture of a territory should be appropriated within these methods of observation.⁶⁰ While explaining the appropriation of culture, Cohn has rightly pointed out that ‘census represents a model of the Victorian encyclopaedic quest for total knowledge’,⁶¹ although the discrepancies regarding the data collection had quivered the foundation on which the empire of ‘facts’ was expanded. To the colonial rulers, the British Raj in India was, to be sure, a portrayal of nineteenth-century paternalism associated with the idea of enlightening the ‘orient’. Leprosy was seen more as an Empire’s failure in making of salubrious statehood than as a ‘disease’ which might have possessed subtle vitality. Therefore, in this process of nation building, infirmity, like leprosy, seemed to be a stumbling block to the Raj which forced the sovereign to put a veil over the real ‘figures’. Thus, the aim of colonial authority was to hide the numbers of infirm that might be a cause of ridicule. The issue of nation building, which often troubled the colonial state, was associated with the idea of ‘purity’ and hygiene. In colonial censuses, health and harmony of the social bodies had become the key factors which leaned on the preservation of hygienic populations.⁶² Leprosy population had been seen as a reason of decaying ‘morality’, as opposed to Victorian ideals, for which the colonists intended to control and confine the ‘leprosy’ and leprous bodies in India, instead eradicating the disease until the 1920s, when the colonial policies on leprosy changed into much more sophistication. Even the figures provided by censuses misled the government to frame comprehensive public health policies against this malady. However, the inner dynamics of colonialism had resided with the approach, especially the way in which enumeration was supervised, with regard to the tropical diseases and indigenous populace. Along with that, the popular reactions or responses against the colonial censuses made the entire process problematic. The enumerators eventually were inclined to believe that caste identity was the only basis of social formations in India.⁶³ Therefore, the British Raj, in the course of enumeration, had gradually deviated from what it had imagined as ‘true facts’ about the infirmity to the erroneous numbers they obtained which proved to be irrevocable even in post-colonial fact findings.

Footnotes

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship and/ or publication of this article.

Funding

The author received no financial support for the research, authorship and/or publication of this article.

Appendix

Appendix C.

Leprosy Deaths in West Bengal in 1946

Deaths due to Leprosy in West Bengal in 1946
Sl No.	Town	No. of Deaths	District (Rural)	No. of Deaths
1.	Calcutta	61	Bankura	252
2.	Howrah	12	Midnapore	164
3.	South Suburban	2	Birbhum	136
4.	Titagarh	2	Burdwan	102
5.	Baranagore	2	Hooghly	44
6.	Kamarhati	2	Murshidabad	39
7.	Burdwan	1	Jalpaiguri	26
8.	Katwa	1	Nadia	18
9.	Bankura	1	Howrah	16
10.	Sonamukhi	1	24-Parganas	13
11.	Tamluk	1	Malda	11
12.	Hooghly	1	West Dinajpur	11
13.	Garden Reach	1	Darjeeling	–
14.	Krishnanagore	1
15.	Dhulian	1
16.	Kalimpong	1
	Total	91		832

Source: Bengal Public Health Report for the year 1946, p. 16.

Notes

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