The ‘Migrant-Leper’ as the Undeserving Outsider: Historicising Leprosy Policy in Delhi, 1920–60

Abstract

Discussions on migration and leprosy in India, largely absent from historical enquiries, feature dominantly in epidemiological studies that frame the migrant with leprosy as a bacterium-carrying outsider, crossing interstate boundaries to spread infection and increase prevalence rates in urban spaces. The paper seeks to reframe the debate by analysing the migrant with leprosy not as a risk factor, but as a social identity that has historically animated public policy. By analysing leprosy policy in Delhi from 1920 to 1960, the paper explores how leprosy-affected beggars in Delhi were seen as an indolent class of outsiders burdening state finances, unworthy of adequate support.

Keywords:

• Archives
• Delhi
• Delhi Improvement Trust
• Delhi Municipal Committee
• health
• leprosy
• migration
• planning

Acknowledgments

I extend my deepest appreciation to the anonymous readers for their time and effort in reviewing the manuscript and providing their valuable comments that strengthened the paper. In addition, I express my sincerest gratitude to Dr. Rinju Rasaily for her invaluable guidance and vital feedback on a preliminary draft of this paper. Lastly, I am indebted to Sanjay Kumar Garg, deputy director, Delhi Archives, and his wonderful staff for helping me navigate through and utilise the vast array of archival documents.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. India has had a troubling institutional history of discriminating against people with leprosy—from the colonial Lepers Act of 1898 enforcing mandatory segregation of affected people, to at least five personal laws (in force until 2019) providing for leprosy as grounds for seeking divorce from one’s spouse. Despite significant progress made since the implementation of the National Leprosy Eradication Programme in 1984, multidrug therapy and various awareness campaigns, India still accounts for over half of the world’s new cases: see Maitri Porecha, ‘India Accounts for 52% of World’s New Leprosy Patients, Says Health Minister’, The Hindu, February 16, 2023, accessed February 16, 2023, https://www.thehindu.com/news/national/india-accounts-for-52-of-worlds-new-leprosy-patients-says-health-minister/article66513013.ece.

2. Gwen Robbins et al., ‘Ancient Skeletal Evidence for Leprosy in India (2000 BC)’, PLoS One 4, no. 5 (2009): 1–8, https://doi.org/10.1371/journal.pone.0005669.

3. M. Solomon Raju, P.S. Sundar Rao and K. Govindasamy, ‘Socio-Medical Perspectives on Leprosy in Indian Religions’, Leprosy Review 91, no. 2 (2020): 190–99.

4. Vicki Luker and Jane Buckingham, ‘Histories of Leprosy: Subjectivities, Community and Pacific Worlds’, The Journal of Pacific History 52, no. 3 (2017): 265–86; 276, https://doi.org/10.1080/00223344.2017.1379124.

5. Sanjiv Kakar, ‘Medical Developments and Patient Unrest in the Leprosy Asylum, 1860 to 1940’, Social Scientist 24 (1996): 62–81; 68, https://doi.org/10.2307/3517791.

6. Jane Buckingham, Leprosy in Colonial South India: Medicine and Confinement (New York: Palgrave, 2002): 47.

7. Biswamoy Pati and Chandi Nanda, ‘The Leprosy Patient and Society: Colonial Orissa, 1870s–1940s’, in The Social History of Health and Medicine in Colonial India, ed. Biswamoy Pati and Mark Harrison (Oxford: Routledge, 2009): 113–28; 115.

8. Manmohan Krishna, ‘From Criminalization to Confinement: The Leprosy Sufferers of Colonial Bihar and Chotanagpur 1870s–1940s’, Proceedings of the Indian History Congress 73 (2012): 982–96.

9. The data is taken from the 256th report of the Law Commission of India, which itself cites it from the Leprosy Mission Trust India, one of the largest non-governmental organisations in India working on leprosy. Till date, the government has maintained no data on the number and state of such leprosy colonies across India—an issue calling for urgent redressal: see Law Commission of India, Report no. 256, Eliminating Discrimination against Persons Affected by Leprosy (Delhi: Ministry of Law and Justice, 2015): 10.

10. V.N. Sehgal, A. Ghorpade and K. Saha, ‘Urban Leprosy—An Appraisal from Northern India’, Leprosy Review 55, no. 2 (1984): 159–66; 159, https://doi.org/10.5935/0305-7518.19840019.

11. Ibid., 165.

12. D.D. Ganguli et al., ‘Year of Leprosy Control: A Short Analytical Study in a Colony Hospital at West Delhi’, Indian Journal of Dermatology, Venereology and Leprology 67, no. 2 (2001): 78–81.

13. Namrata Chhabra et al., ‘Leprosy Scenario at a Tertiary Level Hospital in Delhi: A 5-year Retrospective Study’, Indian Journal of Dermatology 60, no. 1 (2015): 55–59; 57, https://doi.org/10.4103/0019-5154.147793.

14. V. Relhan et al., ‘Trends in Profile of Leprosy Cases Reporting to a Tertiary Care Centre in Delhi during 2006–2015’, Indian Journal of Leprosy 88 (2016): 217–25; 224.

15. See Bindu Shajan Perappadan, ‘Tahirpur Was His Heaven and Hell’, The Hindu, February 17, 2013, accessed June 15, 2022, https://www.thehindu.com/news/cities/Delhi/tahirpur-was-his-heaven-and-hell/article4424863.ece; also see Rebecca Hobson, ‘Vaccine Brings New Hope to India’s Largest Leprosy Colony’, BBC, September 12, 2016, accessed June 15, 2022, https://www.bbc.com/news/world-asia-india-37316907.

16. The Bela region is the marshy scrub jungle along the banks of the Yamuna river in north Delhi. As of 1924, the area was governed by the newly established Fort Notified Area Committee, one of the eight urban local bodies that were at the time overlooking land use in Delhi: see Subhash Anand, Solid Waste Management (New Delhi: Mittal Publications, 2010): 60.

17. Nazul lands were once the property of the Mughal state and seized by the colonial state post-1858. The word ‘Nazul’ in Arabic means land annexed by the royal head which was not acquired through any form of payment.

18. Viceroy of India to the Delhi Chief Commissioner, letter, June 19, 1924, Delhi Archives, Chief Commissioner Series, 6/2. The Council consisted of the viceroy as the president, representatives from local governments and administrations along with members of the princely states as vice-presidents, and a medical advisory committee.

19. Chief Commissioner Office to Delhi Medical Officer, letter, July 29, 1924, Delhi Archives, Chief Commissioner Series, 6/2.

20. Delhi Chief Medical Officer, ‘BELRA Questionnaire’, undated, Delhi Archives, Chief Commissioner Series, 6/2.

21. Delhi Chief Commissioner to Director General of the Indian Medical Service, letter, August 28, 1924, Delhi Archives, Chief Commissioner Series, 6/2.

22. Delhi Director of Public Health to Chief Commissioner, letter, July 16, 1924, Delhi Archives, Chief Commissioner Series, 6/2.

23. Government of India, Report of the Health Survey and Development Committee, Vol. II: Recommendations (New Delhi: Manager of Publications, Delhi, 1946): 186.

24. Government of India, Report, 118.

25. Hari Ram to Delhi Nazul Officer, letter, July 20, 1928, Delhi Archives, Deputy Commissioner Series: 12.

26. Letter from Secretary of the Fort Committee to Delhi Nazul Officer, August 20, 1928, Delhi Archives, Deputy Commissioner Series, 12.

27. Note by Delhi Nazul Officer, February 17, 1929, Delhi Archives, Deputy Commissioner Series: 12.

28. Findings of the Mission to Lepers Conference of Leper Asylum Superintendents, February 7, 1920, Delhi Archives, Deputy Commissioner Series, 12.

29. Ibid.

30. Health Officer, FNAC, to the Delhi Nazul Officer, letter, October 30, 1928, Delhi Archives, Deputy Commissioner Series, 12.

31. Secretary, DMC, to the Deputy Commissioner, December 3, 1935, Delhi Archives, Deputy Commissioner Series, 6/39.

32. Deputy Commissioner to the Chief Medical Officer, letter, February 26, 1936, Delhi Archives, Deputy Commissioner Series, 119.

33. Chief Commissioner to the Delhi Women’s League, letter, March 16, 1939, Delhi Archives, Deputy Commissioner Series, 59.

34. Ibid.

35. W.H. Crichton to E.M. Jenkins, letter, March 13, 1939, Delhi Archives, Chief Commissioner Series, 59.

36. Assistant Director of Public Health to the Delhi Chief Commissioner, letter, 1939, Delhi Archives, Chief Commissioner Series, 6/85.

37. Jyoti Hosagrahar, Indigenous Modernities: Negotiating Architecture and Urbanism (Oxford: Routledge, 2005): 135–39.

38. Ritu Priya, ‘Town Planning, Public Health and Urban Poor: Some Explorations from Delhi’, Economic & Political Weekly 28, no. 17 (1993): 824–34.

39. Ibid., 825.

40. Delhi Improvement Trust, Three Years’ Programme: 1941–1944 (New Delhi: Delhi Improvement Trust, 1940): 2.

41. Diya Mehra, ‘Planning Delhi ca. 1936–1959’, South Asia: Journal of South Asian Studies 36, no. 3 (2013): 354–74; 358, https://doi.org/10.1080/00856401.2013.829793.

42. Ibid., 358.

43. Government of India, Indian Information: January–June (New Delhi: Bureau of Public Information, 1941): 294.

44. After the Delhi Durbar of King George V in 1911, the Delhi Town Planning Committee decided against expanding the northern part of the city around Civil Lines to build the new capital. The committee argued that the administration would incur massive expenditure improving the Bela region (where the leprosy colony existed) to ensure sanitation, prevent the spread of malaria and provide an ‘aesthetic effect’: see Delhi Town Planning Committee, First Report of the Delhi Town Planning Committee on the Choice of a Site for the New Imperial Capital (London: His Majesty’s Stationery Office, 1913): 3.

45. Delhi Improvement Trust, Three Years’ Programme, 34.

46. Ibid., 35.

47. Stephen Legg, ‘Ambivalent Improvements: Biography, Biopolitics, and Colonial Delhi’, Environment and Planning A 40 (2007): 37–56; 51.

48. K.B. Mian Abdul Aziz, Report of the Delhi Municipal Organisation Enquiry Committee (New Delhi: Government of India, 1948): 37.

49. Delhi Improvement Trust, Three Years’ Programme, 55.

50. Delhi Improvement Trust, Administration Report for 1950–51 (New Delhi: Delhi Printing Works, Improvement Trust, 1952): 8.

51. Mark Harrison, Public Health in British India: Anglo-Indian Preventive Medicine 1859–1914 (Cambridge: Cambridge University Press, 1994): 6.

52. Leprosy patients residing at Naya Basti, Bela Road, to the Minister for Public Health, letter, March 20, 1955, Delhi Archives, Chief Commissioner Series, 27/14.

53. Unnamed correspondent, ‘Leper Menace in Karachi’, The Times of India, July 25, 1933, accessed June 15, 2022, https://www.proquest.com/docview/346223104/F8AB69561058468DPQ/1?accountid=143508.

54. M.K. Spencer, ‘The Leper Problem in India: What Karachi Is Doing’, The Times of India, September 16, 1933, accessed June 15, 2022, https://www.proquest.com/docview/740134258/4ABB9FA19929467APQ/1?accountid=143508.

55. M.K. Spencer, ‘The Lepers Act’, The Times of India, February 20, 1941, accessed June 15, 2022, https://www.proquest.com/docview/616066197/3CCA2CBB44634121PQ/1?accountid=143508.

56. There is a dearth of work on internal migration of people with leprosy in India. An exception to this is Vyas et al.’s work on a leprosy ashram in Jodhpur, Rajasthan. Most people living in this ashram belonged to southern India and argued that migration to faraway places helped them protect their families from leprosy stigma. In the study, at least 70 percent of the people in the leprosy ashram cited the fear of losing family prestige to be the reason for migration to a place as far away from home as possible. The high presence of people with leprosy from Madras staying in Karachi can be explained in similar terms. Such migrations ensure anonymity in the face of severe social stigma in the places of origin: see G.K. Vyas et al., ‘A Sociological Study of Leprosy Cases in the Gandhi Kusth Ashram, Jodhpur (Rajasthan)’, Leprosy in India 54, no. 2 (1982): 324–31.

57. Letter from the leprosy patients, Delhi Archives, Chief Commissioner Series.

58. Ibid.

59. The Times of India News Service, ‘Jamuna River Overflows’, The Times of India, October 8, 1955, accessed June 15, 2022, https://www.proquest.com/docview/517294056/E786CD02724D4EE8PQ/3?accountid=143508.

60. Secretary of the University Grants Commission to Deputy Commissioner, letter, October 18, 1955, Delhi Archives, Chief Commissioner Series, 27/14.

61. YWCA to the Secretary for Rehabilitation, letter, October 28, 1955, and December 29, 1955, Delhi Archives, Chief Commissioner Series, 27/14.

62. Note by Superintendent for Health Operations, November 2, 1955, Delhi Archives, Chief Commissioner Series, 27/14.

63. Leprosy patients residing at Naya Basti, Bela Road, to the Chief Commissioner, May 25, 1957, Delhi Archives, Chief Commissioner Series, 1/190.

64. Gandhi Memorial Leprosy Foundation, Wardha, to the Leprosy Advisory Committee, letter, January 7, 1956, Delhi Archives, Chief Commissioner Series, 27/2.

65. Minutes of a meeting of Advisory Committee, Leprosy Home, January 22, 1956, Delhi Archives, Chief Commissioner Series, 27/2.

66. Resolution no. 187 passed by the DIT, June 19, 1956, Delhi Archives, Chief Commissioner Series, 1/190.

67. Directorate of Health Services to Ministry of Health, Government of India, letter, November 6, 1957, Delhi Archives, Chief Commissioner Series, 39/51.

68. Directorate of Health Services to the Medical and Public Health Department, letter, March 12, 1958, Delhi Archives, Chief Commissioner Series, 27/14.

69. Note by Finance Department, September 5, 1956, Delhi Archives, Chief Commissioner Series, 27/14.

70. Directorate of Health Services to the Medical and Public Health Department, letter, March 12, 1958, Delhi Archives, Chief Commissioner Series, 27/14.

71. The scale uses chhataank, a traditional unit of measuring weight in the Indian subcontinent. One chhataank roughly equals 58 grams.

72. These calculations exclude meat and vegetables since the diet scale doesn’t specify the exact type of these items.

73. Labour Bureau, Report on the Working of the Minimum Wages Act, 1948, for the Year 2009 (Chandigarh/Shimla: Government of India, 2011): 5.

74. Marie J. LeClair, Labor in India: Issue 188 (Washington, DC: United States Department of Labor, 1961): 19.

75. Yudhvir Singh to the Directorate of Health Services, letter, September 27, 1957, Delhi Archives, Delhi Administration Series, 27/13.

76. Medical and Public Health Department to the Directorate of Health Services, letter, October 28, 1957, Delhi Archives, Delhi Administration Series, 27/13.

77. Medical and Public Health Department to the Finance Department, letter, November 5, 1957, Delhi Archives, Delhi Administration Series, 27/13.

78. Note by Finance Department, April 1958, Delhi Archives, Delhi Administration Series, 39/51.

79. Medical and Public Health Department to the Finance Department, letter, May 22, 1958, Delhi Archives, Delhi Administration Series, 39/51.

80. Note by the Finance Department, October 6, 1956, Delhi Archives, Chief Commissioner Series, 27/12.

81. Ibid.

82. Ibid.

83. Note by the Finance Secretary, July 11, 1957, Delhi Archives, Chief Commissioner Series, 27/12.

84. Note by the Secretary, MT&CE, July 16, 1957, Delhi Archives, Chief Commissioner Series, 27/12.

85. Unsigned note, July 18, 1957, Delhi Archives, Chief Commissioner Series, 27/12.

86. Medical and Public Health Department to the Directorate of Health Services, letter, March 24, 1958, Delhi Archives, Chief Commissioner Series, 27/12.

87. Rod Edmond, Leprosy and Empire: A Medical and Cultural History (New York: Cambridge University Press, 2006): 110–43.

88. See Zachary Gussow and George S. Tracy, ‘Stigma and the Leprosy Phenomenon: The Social History of a Disease in the Nineteenth and Twentieth Centuries’, The Bulletin of the History of Medicine 44, no. 5 (1970): 425–49; for specific examples of such racial aetiologies, see Edmond, Leprosy and Empire.