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Introduction to Volume 10 S ocial Change in India is the second of the two volumes on India, which are volumes 9 and 10 in the Collected Works of Florence Nightingale. They follow the introductory Life and Family, three volumes on religion (Spiritual Journey, Theology and Mysticism and Eastern Religions), two on social reform work (Society and Politics and Public Health Care), a highly personal, pre-Crimea, European Travels, and Women (including women in medicine, midwifery and prostitution). Health in India provides much historical background information on the British occupation of India, health concerns there and the state of Western and Indian medicine of the time. It also presents a vast amount of information on the creation of and work done for the Royal Commission on the Sanitary State of the Army in India. It relates the first work implementing that royal commission’s recommendations , a theme continued here. Following these volumes are the philosophical Suggestions for Thought, two volumes each on nursing and war, and Hospital Reform. Health in India is focused on top-down, expert-led reforms, from a royal commission which consulted the best experts (Nightingale saw to that) and collected extensive data from the field (organized and analyzed by the same). Collaboration with leading officials predominates , notably Sir John Lawrence, governor general of India 1864-68. Unexpected famines occurred in this period, and continued to, so that famine prevention, especially through irrigation and canals, became a major theme. This volume also contains considerable material on disease prevention, notably of epidemic disease, through better provisions for drainage and sewerage. Nightingale’s frustrated attempt to bring trained nursing into India, also related in volume 9, was another top-down measure, a recommendation of the royal commission for which the governor general himself sought Nightingale’s advice on implementation. However, the modest proposal she designed was augmented beyond recognition by officials / 1 in India, and then rejected as too expensive. Later on she was to help again, although not to the same degree, with nursing initiatives in India. This smaller amount of material is reported in Social Change in India. British politics, and Nightingale’s own strong and never-wavering Liberalism, are part of the context in which all of her India work must be understood. She worked with politicians Liberal or Conservative, of course, and often bemoaned the fact that her fellow Liberals were no better than the Conservatives. On some matters, however, there were clear partisan differences. The Conservatives, for example, were fiercer imperialists. Queen Victoria was named empress of India in 1876 by the Conservative prime minister, Benjamin Disraeli. Nightingale , who never referred to the title, disapproved. That same Conservative government under Disraeli was, Nightingale thought, reckless in its military expansionism. The former Liberal prime minister, W.E. Gladstone, made foreign policy reform (moderation and scaling back) the central thrust of his election campaign in 1880, and won on it. Thus shifts in British imperial policy and government are reflected in Nightingale’s work, which at times offers a contrapuntal accompaniment to official views. Nightingale’s political liberalism was accompanied with a strong belief in free markets, free trade and running of the economy by the private sector. She was a left-leaning Liberal, a supporter of co-operative measures and a significantly improved welfare state, but no socialist. Her economic liberalism was pragmatic, however, holding for example that the state should create jobs in times of economic distress (long before Keynesian counter-cyclical public spending). She abhorred the classical laissez-faire liberalism of the political economy school, or Manchester School, which justified so much misery in her own country and actual starvation in India. The very term ‘‘political economy’’ appears here only as a negative, for its use as an excuse for governmental non-interference in the economy, even in times of famine. Laissez-faire liberalism was widely accepted in both the major political parties of the time. It was well entrenched in British officialdom, both at home and in India. Indian officials were taught it at Haileybury , the college established by the East India Company, by no less than Thomas Malthus (1766-1834), who continued to oppose government intervention in times of scarcity, for reasons set out in his classic Essay on the Principles of Population, 1798. Health in India made the argument that Nightingale increasingly saw the need for action by Indian nationals themselves, a view that 2 / Florence Nightingale on Social Change in India...

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