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Western Medical Education and Women’s Healthcare in Colonial Bengal

Manas Dutta ( teaches history at Kazi Nazrul University, West Bengal.

Gender, Medicine, and Society in Colonial India: Women’s Health Care in Nineteenth and Early Twentieth Century Bengal by Sujata Mukherjee, New Delhi: Oxford University Press, 2017; pp XXXV + 223, 895.

Social histories of health and medicine in colonial India have emerged as major themes of interdisciplinary research in South Asian history since the late 1990s. These studies aimed at transcending conventional boundaries. Several important works have appeared in recent times on diverse aspects of women’s healthcare in colonial India within the framework of gender, medicine, and society. Among them is Sujata Mukherjee’s authoritative account, Gender, Medicine, and Society in Colonial India: Women’s Health Care in Nineteenth and Early 20th Century Bengal.

The monograph under review takes a broad view of the subject, but focuses, geographically, on Bengal. Mukherjee begins with an impressive introduction which delineates the historiography of the role of medical missionaries in women’s healthcare in India; medicalisation of childbirth; politics of reproductive health; growth of women’s medical education and profession; careers of female practitioners of indigenous medicine; curative facilities for female patients in hospitals and asylums; and philanthropic involvement of British women in designing healthcare for Indian women. This sets the stage for a more nuanced understanding of colonial health policy during the 19th and early 20th centuries in India. Mukherjee says:

Crucial developments in the discursive as well as empirical fields of medicine and healthcare touched the lives of women in significant ways, and that gender and politics of medicine contributed in multiple ways in formulating perceptions and identities at the intersection of colonialism, class, caste, communities and nation. (p xii)

The study has drawn upon a number of Bengali women’s magazines, popular health magazines and professional medical journals in English and Bengali that represent both nationalist and official viewpoints on the medicalisation of childbirth and maternal and infant health. It has also used annual reports of the medical institutions to chart the history of institutionalisation of midwifery and has drawn upon archival sources—the medical and educational proceedings in particular—in the West Bengal State Archives and the National Archives of India (pp 186–90).

The study begins from the early 19th century when the earliest scientific essays on women’s healthcare, including childbirth and pregnancy, began to appear in Bengali women’s magazines such as Bamabodhini Patrika, Bharati, Antahpur, and Mahila. The author focuses not only on the women’s healthcare but throws light on issues concerning different curative institutions, reforming midwifery, notions of sexuality, marriage reforms, birth control, discourses on delivery and healthcare, evolution of public health administration, politics of control, and emergence of women’s associations in the late colonial period. One must point out that the reforming of midwifery constituted one of the ways of modernising the middle-class women as mothers. In the 20th century, the argument for medicalisation was further driven by nationalist recognition of family and health as important elements of the nation-building process. This study provides a historical analysis of how institutionalisation of midwifery was shaped by the debates on “the women’s question,” nationalism and colonial public health policies, all intersecting with each other in Bengal.

Impact of Colonialism on Bengal

Bengal being the earliest seat of British power in India was also the first to experience contact with Western civilisation, culture and thought. It also had the most elaborate medical establishment along Western medical lines since the foundation of the Calcutta Medical College (CMC) in 1835. The aim of the CMC was to implement systematic education of Western medicine, to train the native youth irrespective of caste and creed in techniques of surgery, curative medicine, midwifery, etc (p 35). In the early 19th century, Bengal’s institutions of Western medicine were ahead of both Madras and Bombay presidencies.

Bengal’s sluggish response to reforming women’s healthcare was perceived as a consequence of the long-standing Bengali perception of childbirth and women’s health as an exclusively feminine domain, defended by practices of seclusion (purdah) and, therefore, impassable to Western medicine. Unlike the West, where professionalised obstetrics was characterised as an essentially male domain, the evolving professional sphere of obstetrics in Bengal was largely dominated by female doctors. The study demonstrates that since the 1880s, the domain of medical knowledge in Bengal was shared by both female and male medical practitioners. Together, they contributed to the evolution of a new medical discourse on childbirth and health policies in colonial Bengal. The study shows how the late 19th century initiatives to reform practices of childbirth were essentially a modernist response of the Western-educated colonised middle class to the colonial critique of Indian sociocultural codes.

Women and Medical Knowledge

The chief objective of the book is to analyse how women’s healthcare emerged in relation to social reform movements of the 19th century as well as nationalist politics and colonial public health policies of the 20th century. At the same time, it seeks to explore the role played by Christian missionaries as agents for modernising practices of childbirth, especially in the early years of colonial rule, and locate issues of women’s healthcare within a wider and more complex range of social drivers. The monograph argues that in the 20th century the profession of obstetrics came to constitute an ever-expanding space mediated by a wide range of actors such as the medical professionals, middle-class women activists, and the local self-governing bodies who were influenced as much by nationalism and colonial public health policies as by global discourses on health. In analysing the shifting strands of women’s healthcare in Bengal over a century, the study seeks to discern the process through which Bengali women’s bodies—which were once perceived as the repository of modesty and cultural purity, and hence, shielded from public sight by patriarchal norms of eclusion—became, by the end of the colonial period, a subject of intense medical, public, and nationalist scrutiny. It also demonstrates how Western medical knowledge mingled with local medical traditions; this entailed a dynamic interpretation of two distinct systems of thoughts that caused both of them to lose some of their steadfastness and undergo a process of reformation and rearticulation in a bid to complement or replace each other. The unravelling of a range of vernacular “medical” literature also demonstrates a vibrant coexistence of Western and local medical knowledges available for women. Favourable situations were being created so that native women could receive education in Western healthcare.

Native Women Medics

The earliest institutions devoted to women’s health were lock hospitals in different presidencies from around 1805, which were essentially established for the confinement and treatment of prostitutes suspected of suffering from venereal diseases. Gradually, overcoming racial and gender discrimination, social taboos, and active opposition from authorities and their families, several women were capable enough to receive Western medical education and thereby become doctors and practising physicians. Brahmo Samaj, Bamabodhini Sabha and several women’s organisations and agencies helped women fulfil their dreams. Both hospital medicine and preventive medical care popularised Western forms of medical care in the 19th and the early 20th centuries in Bengal. This created a space where women could receive Western medical care in contrast to the native forms of medical care and they were able to receive it outside the purdah or zenana for the first time.

The sociocultural reform movements during the colonial period played a pivotal role in bringing about changes in attitudes towards women, who had, till then, been confined to the domestic sphere. Government support, efforts of the Christian missionaries, and the zeal of elite Indians led to significant reforms affecting women’s lives; this laid the foundations of women’s medical education.

Mukherjee says that enthusiastic Brahmo reformers like Durga Mohan Das and Dwarkanath Ganguly were the earliest supporters of medical education for women. She quotes from Brahmo Public Opinion:

We know of several instances in orthodox Hindu families, where the female members suffer from the most complicated diseases, but yet would not allow male doctors to visit and treat them. The consequence is, they are treated second-hand through the assistance of uneducated quake native midwives, and in ninety-nine out of a hundred, they are never radically cured. (p 44)

Therefore, the admission of women into medical education, the reformers thought, would help solve these problems as women themselves would become doctors and address issues like surgery, pregnancy, childbirth, and women-related diseases. It was not Bengal, but Madras, which provided leadership in the field of women’s medical education (p 45). The entry of women medics into the medical profession was not smooth in the colonial period. Indian women faced racial discrimination, sexism, and even hostility, which made it extremely difficult for them to carry on their professional duties in the hospitals. Sometimes, male colleagues made derogatory comments. They were denied full salaries and permanent appointments, unlike their European, Eurasian, or even Indian native male counterparts.

However, there were several women medics, such as Kadambini Ganguly, Jamini Sen, Virginia Mary Mitter, and Haimabati Sen, who excelled in their careers and created new opportunities for aspiring women who wanted to join the medical profession. Mukherjee argues that the contributions of less prominent lady doctors also need to be acknowledged, as they often took up practice in the mofussils and faced hostility from the local male populace (pp 57–60). She points out, however, that Western healthcare and treatments were available only to a handful of fortunate women mostly residing in urban and semi-urban areas; the majority were often denied such medical assistance due to several reasons (p 60).

Reproductive Health, Sexuality and Domesticity

Apart from institutionalisation of midwifery (in Bengal they were called dhai) training, various means were adopted for reproductive healthcare for women. The knowledge of prenatal and postnatal care through guidebooks and essays were circulated among pregnant mothers. Here the author mentions names such as Jadunath Mukhopadhyay and Sundari Mohan Das who wrote tracts in simple Bengali language on maternity and childbirth so that a large number of women could easily understand them. Even, the Bamabodhini Patrika published detailed and informative articles on midwifery, discussing pregnancy, its symptoms, appropriate care, and the process of delivery. Madhusudan Gupta asked for official intervention on these issues (p 71). The gradual reform of midwifery started in Bengal since 1870 that enabled not only literate but also illiterate women —who often belonged to lower classes and castes and were associated with the task of midwifery—to learn the art of childbirth and care for infant.

A new colonial discourse of domesticity, Indian family life, and values were propounded in such a manner that the idea of giving birth to a strong and healthy child became very important. These ideas were disseminated through contemporary vernacular texts, domestic and official medical manuals, guidebooks, pedagogical writings, and vernacular periodicals. Concern for a healthy nation in general and Bengali community in particular became a major preoccupation of middle-class Hindu Bengalis. According to the author, this new discourse played a significant role in formulating the indigenous idea of modernity, which could be strengthened with the introduction of Western science and medicine and by restructuring the Indian nation.

Discourses on sexual and conjugal lives and ideas of domesticity focused on remodelling women’s roles as health-conscious good wives and mothers. Mukherjee shows how contemporary Bengali periodicals as well as medical and quasi-medical literature explained that social customs like child marriage, masturbation, and excessive sexual intercourse even with one’s own husband could harm women’s health, leading to maternal mortality or birth of sick and weak babies (p xxv). This literature also emphasised that women should learn proper home management, scientific nurturing of children, regulation of dietary habits, and maintenance of hygiene. She was expected to know a bit of all forms of medical care, including folk medicine, allopathy, homeopathy, kaviraji (Ayurvedic medicine) and hakimi (Unani medicine).

Discussions around sexuality and domesticity give us an idea of the private domain of the nation. These coincided with debates and demands for marriage reforms. Colonial modernity is arguably coterminous with the changing notions of health and hygiene, giving rise to a new idea of colonial domesticity. Mukherjee shows that the second half of the 19th century saw social reforms which articulated its demands in terms of physiological and medical concerns, as becomes evident from debates around the age of consent and marriage. Women’s organisations also participated in these debates. The colonial government could not ignore such demands as these were voiced as medical concerns.

The first half of the 20th century saw sociopolitical developments in India that prioritised public health. Alongside government initiatives, there were other organisations such as Lady Reading Fund, Lady Chelmsford Fund, Women’s Indian Association (WIA), Mahila Samiti and Saroj Nalini Dutt Memorial Association for Women (SNDMA), which tried to train native women in domestic science and hygiene both in rural and urban areas. Mukherjee points out that there were 250 autonomous agencies in 1925, which increased to 305 by 1930, for promoting sanitation and public health. The issue of birth control gained attention around this time both from colonial officials and a section of native women medics who argued that birth control is necessary for reasons of health, social-economic considerations, and national well-being (pp 133–36).

Women, Public Health and Famine

One of the strongest chapters is on issues related to the growth of public healthcare administration and its impact on women’s health, which ends with an account of the devastating famine of 1943–44. During the famine, women died in large numbers not only due to famine-induced epidemics, but also because they suffered abandonment and destitution, leading to the adoption of survival strategies that affected their health. The famine exposed how poor health, inefficiency of public health administration, dietary deficiency particularly among women and children, etc, made them vulnerable to starvation-induced deaths, lowering the health status of women even further.

Recent researches illustrate the relationship between famine, epidemics, and mortality in colonial India. The Bengal famine of 1943 led to a breakdown of the social fabric and produced a series of immediate problems that further affected the mortality and sickness patterns of the population. Poverty, insufficient availability (or non-availability) of food, the onset of diseases, and poor public health administration (especially the health conditions of women and children) continued to get complicated due to the famine. Therefore, Mukherjee (2012) argues:

The famine of Bengal and the resultant epidemics exposed the vulnerability of the poor rural population, as well as the inefficiencies of the public health organisation in Bengal. While like earlier famines of the colonial period it magnified the forces of death already present in the region, its uniqueness lay in the fact that it exposed the defects of the public health organisation of colonial Bengal as well as the limitations of imperial medical policy. The quinine policy, for example, left such strong loopholes that artificial, man-made scarcity could be created to add to the woes of the famine-stricken population, which led to a tremendous rise in mortality. (p 162)

Mukherjee observes that women suffered more than men in the famine of 1943. Women seemed to get inadequate relief because of abandonment and destitution. Following Paul Greenough’s study (1983), the author says that patriarchal norms did not allow women to be proactive in getting food for the family. In rural Bengal, we know that women customarily had low socio-economic status in the family, and the famine as well as the wartime situation further exacerbated their limited access to food and other life-saving essential requirements (p 167).

Following Mukherjee, one can explain how the shortage of cloth curtailed women’s mobility. They could not have moved about like men to get food or to seek temporary work in the nearby towns or in far-flung cities. Citing the statement of F O Bell, a civil servant during the time of famine of 1943–44, Mukherjee says that women were “badly off for clothing as the people who used to help them [were] badly off” (p 168).

This chapter also highlights how women, especially those who were younger, got entrapped in prostitution because of poverty, hunger, destitution, abandonment by male members of the family, and for the sake of other family members. They considered it as an alternative means of survival. This was rampant in Chittagong, Comilla, and Noakhali. This was mostly visible in cantonment areas. Following P C Joshi’s estimate, Mukherjee argues that 30,000 out of 1,25,000 destitute women were in brothels and one in four of them was a young girl. She goes on to say that distress and famine forced poor women to join the Military Labour Corps where they were infected by venereal diseases. The army health report in India from 1938 to 1944 witnessed a sharp increase in venereal diseases. The government report pointed out that this was because of the presence of large numbers of women in cantonment areas. Later on, the government’s continued negligence had been criticised by the All Bengal Women’s Self Defence Committee, the All India Women’s Conference (AIWC), and the Nari Sewa Samiti for not taking any step in solving the problems of sexually transmitted diseases and venereal diseases (p 169).

The sharp decline of childbirth, according to the author, had been evident due to the adverse effects of the famine of 1943–44 in Bengal. This could perhaps be explained by several complex factors, like decrease in marital intercourse because of separation, deliberate birth control or self-restraint, stillbirths, abortions, and even psychological changes because of starvation, all of which are known to render women infertile. One can further argue that the famine made the situation worse for women who were about to give birth. The Health Survey and Development Committee, also known as the Bhore Committee, after considering all these issues declared in its report in 1946 that “any plan for improving the health of the community must pay special attention to the development of measures for adequate health protection to mothers and children” (p 169). The committee also criticised existing public health services and sought better healthcare for women (p 181). The fact that dietary deficiency among Indians, especially women and children, was responsible for poor health had been highlighted in the final report of the Famine Enquiry Commission.

Concluding Remarks

Overall, this book is a welcome step towards the understanding of ideas/ideologies, and their corresponding contradictions, which shaped colonial public health policy and issues related to women’s healthcare in colonial Bengal from the 19th century to the early 20th century. Using Bengal as a case study, the book goes beyond conventional narratives and traces the beginnings of women’s healthcare and health policies of the colonial government. The role of rhetoric, nationalist politics, and institutions (such as CMC, Calcutta Municipal Corporation,WIA, AIWC) assumes centrality in this analysis. This book combines two approaches: the “women in medicine” approach, which examines the role played by women in medical practices and policies; and the “gender and medicine” framework which explores how new forms of medical knowledge and growth of institutions produced certain stereotypes about gender (p xxviii). It will hopefully encourage further research on the subject. Building upon existing research by Biswamoy Pati, Mark Harrison, Deepak Kumar, Raj Sekhar Basu, Ambalika Guha and others, Mukherjee has successfully produced an authoritative account on gender and medicine in colonial India.


Deepak, Kumar and Raj Sekhar Basu (eds) (2013): Medical Encounters in British India, New Delhi: Oxford University Press.

Greenough, Paul R (1983): Prosperity and Misery in Modern Bengal: The Famine of 1943–44, New Delhi: Oxford University Press.

Guha, Ambalika (2018): Colonial Modernities: Midwifery in Bengal, c 1860–1947, London; New York: Routledge.

Pati, Biswamoy and Mark Harrison (eds) (2009): The Social History of Health and Medicine in Colonial India, New York; London: Routledge.


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