Contagion and Enclaves: Tropical medicine in colonial India by Nandini Bhattacharya (review)

The Postcolonialism across the Disciplines Series seeks to span “the traditional range of disciplines… in postcolonial studies but also those less acknowledged” (front matter). Nandini Bhattacharya’s Contagion and Enclaves does this admirably by considering how state actors, medical practitioners (British and Indian) and planters governed colonial enclaves and tea plantations in the Darjeeling hills of northern Bengal, through the intersection of political economy and “tropical” medical “therapeutics.” Bhattacharya asserts, “Despite the richness of recent historiography on public health and Tropical Medicine in colonial India, historians have not analysed the discourse and praxis of medicine within colonial enclaves and the communities they engendered.” She thus provides a “social history of disease within two such enclaves,” which “argues that disease and its control was linked to the essential modes of colonial functioning, in practices of settlement, governance and in economic productivity.” In Bhattacharya’s terms, the “book studies disease control as a mode of colonial power, governance and intervention in… special zones of economic interest and social habitation” (8–9).

Bhattacharya’s first primary focus is “colonial governance through the control of disease” among, and medical research on, the mostly immigrant Nepalese labourers in tea plantations producing for export. This governance of plantations as “sites of private enterprise” involved constant negotiation between colonial government and planters (9–10, 16–17). Plantation medicine was enacted through a racialized and class hierarchy between a small number of British physicians who treated Whites and supervised labourer “care” during epidemics, overworked mostly high caste Bengali “doctor babus” responsible for labourer health, and Indigenous ojha (healers) who likely enacted most “daily medical care” (71, 74–81, 192).

The book’s second primary focus is “practices of settlement and medicine,” and “medicalized leisure,” predominantly for the British, in “the sanatorium enclave” of “the hill-station of Darjeeling” (10, 20). Here the Indian elite and many “servants and minor clerks necessitated” by colonialism “subverted the idyll” of this exclusive enclave. As “a sanatorium town” for members of the White colonial elite and British troops, but also as “the summer capital of Bengal,” Darjeeling, like the plantations, linked the colonial order “to the globalized imperial economy” (11–12, 14).

Contagion and Enclaves provides fascinating analysis of the intersections between medical ideas and practices, and the struggles of colonial political economy. I provide just one nugget from Bhattacharya’s examination of each “enclave.” She illustrates that British efforts for racialized exclusivity were co-produced with (and arguably more important than) medical concerns in the development of hill stations such as Darjeeling. This involved a double segregation: 1) between the masses and elites (in the hill station versus plains, and among practitioners of, versus labourers for, medicalized leisure); and 2) between the White European versus Indian elites who patronized respectively Darjeeling’s Eden Sanitarium and Lowis Jubilee Sanatorium (35–39). A “proportion of friends and relatives residing” in Eden equal to that of patients—suffering from “medically vague conditions”—revealed how the social function of these institutions was at least as important as their medical practices (44–47).

Relatedly, Bhattacharya’s analysis of the dual dynamics of racialization and liberal capitalism in the governing of plantations reveals that “disease control as a mode of colonial power” involved a project of limited medical effectiveness. She highlights how “colonial discourse constructed… racial typologies with reference to labourers’ bodies.” This racialization was reflected in a physical segregation of plantations that facilitated “control over the labourers.” Yet the legal definition of plantation labour as “free” also justified colonial state reluctance to intervene in plantations with regard to anything from vital statistics gathering to “preventive health and sanitations, clean water supply or vaccinations.” Labourers were racially managed but medically neglected. This colonial medical regime was rationalized in two primary ways: as best enacted through the “paternalistic benevolence” of planter oversight, and as limited by the “cultural dispositions among the labourers” (33, 64– 68, 81–82, 110–11, 114–18, 153).

I encourage the editors and authors in this series, which seeks to produce cross...