Florence Nightingale on Social Change in India: Collected Works of Florence Nightingale, Volume 10

Implementing Sanitary Reform

Implementing Sanitary Reform F rom the time of the initial institution of the presidency sanitary commissions in 1864, reported in Health in India, it was the role of the sanitary commissioners to co-ordinate sanitary work in their capacity as advisors and administrators. Nightingale’s correspondence in this section helps to relate the development of the work of sanitary officers from 1864 on and highlights the work of two eminent sanitary commissioners in India: J. Pattison Walker1 in Bengal and T. Gillham Hewlett2 in Bombay. The two were appointed as soon as the Indian sanitary commissions were established, and did exemplary work for several decades. They were, in Nightingale’s mind, real ‘‘health missioners.’’ Their correspondence with Nightingale shows how crucial their work in the field was and how vital was the information they regularly sent to Nightingale. Hewlett, in particular , was a proponent of the active participation of Indian nationals in sanitary work. When Nightingale’s closest collaborator, John Sutherland, was about to retire, his replacement on the commission became a key issue as he had been its only paid member. Nightingale favoured Hewlett as his successor, but unhappily he died before this could happen . The work of the Army Sanitary Commission is a major subject in Health in India, while the evolution of the commission, including threats of its complete abolition are more at issue in this volume. The monitoring in London of sanitary work done in India was made possible by the publication of annual sanitary reports, memoranda and minutes, which Nightingale insisted should be written regularly even at the time the royal commission was reporting. Those 1 James Pattison Walker (1823-1906), secretary to the Bengal Sanitary Commission . See the biographical sketch in Health in India (9:990). 2 Thomas Gillham Hewlett (1832-89), sanitary commissioner for Bombay. See the biographical sketch in Health in India (9:991-92). / 23 Blue Books were based on information received from India, first drafted by C.C. Plowden during his term as clerk at the India Office (1864-75), and supplemented by Nightingale’s private sources. They reported on progress in the sanitary infrastructure of Indian towns and villages, focusing mainly on water supply, drainage, sewers, canals and irrigation. Most reports and memoranda contained a section written by Nightingale herself and those sections are reproduced below. The aim of those reports was not only to provide information on what was done in India but to ‘‘give a practical direction to Indian work’’ (see p 130 below). Other implementation issues are brought in as they appear chronologically . There is a small section on the establishment of a Native Army Hospital Corps and a more elaborate section on changes in the Army Sanitary Commission, the crucial organization for overseeing the ongoing work of implementation. Nightingale rejoiced at the appointment of J. Pattison Walker as secretary of the Bengal Sanitary Commission, ‘‘the first board of health India has ever had.’’ She considered ‘‘the sanitary ‘mission’ in India’’ as ‘‘perhaps the greatest ‘mission’ in the world’’, and frankly stated, ‘‘I envy you.’’ She offered all practical support in sending materials.3 In Society and Politics a letter to Walker, sent around the same time as his appointment, called for the ‘‘establishment of a chair of hygiene,’’ important for the ‘‘future progress of the cause,’’ also for Bombay and Madras, and that ‘‘the question of public health’’ should be brought before institutes and native societies for discussion (5:318). In the letter to him below, about the proceedings of the sanitary commission, Nightingale raises issues of caste, asking ‘‘if you take the heads of castes into your counsels, disarm their prejudices, how much might be done?’’ She also specifically addresses the issue of disposal of the dead. Nightingale noted that the work would have great opposition , ‘‘but great works do not prosper without opposition.’’4 3 Letter of 10 March 1864, in Health in India (9:487). 4 Letter of 3 June 1864, in Society and Politics (5:318). 24 / Florence Nightingale on Social Change in India Source: From a letter to J. Pattison Walker, Boston University 2/2/3 10 March 1864 Private. Before I heard of your appointment I sent to Messrs Smith and Elder the Report on the Mediterranean Stations, the first copy I could get from the printers. This shows the general method of procedure . But I need not tell you that the barrack plans...