"To take vaccination is a dirty act. I consider taking it equivalent to eating beef". Three children had died at the Sabarmati Ashram in just three days; yet, the Mahatma was unrelenting. Early vaccines had involved scarification of a cow; they were therefore tainted. "If I change my principle and announce that there is no harm in taking vaccination", Mohandas Gandhi argued, "what value remains in my truth? What is the meaning of my faith in God? Even if the whole Ashram is wiped out and so long as there is no evidence of substantive mistake, it is my religion to adhere to it".
"I cannot welcome death like this", Gandhi's close aide, Mahadevbhai Desai, wrote in response to the Mahatma's argument against vaccinations. For him, lives were more important than an ideology. "I bow my head to the parents of the three children".
Last week's mocking polemic by Ramkrishan Yadav against science-based medicine and doctors""allopathy is a stupid science", the godman, known as Baba Ramdev to his followers, proclaimed"has provoked an angry response from India's medical community, on the frontline of the country's battle against a pandemic that has claimed hundreds of thousands of lives.
Even though health minister Harsh Vardhan sought to contain the damage with a letter demanding Yadav retract his statements, the yoga and Ayurveda entrepreneur's opinions aren't an outlier. Members of Parliament and several ministers have also promoted the efficacy of cow urine, dung and ritual practices in battling the pandemic. Vardhan himself appeared to promote and endorse a herbal remedy, earning sharp reprimand from experts.
The problem, though, is more complex than Hindu nationalism or political opportunism"though both play a role. As Gandhi's words show us, anti-science and anti-rationalism have deep roots in India's political culture, and cut across the political spectrum. The words of Desai teach us Indians also know there is a better way. This summer of death, however, the time for equivocation has ended.
From early in its course, nativist tendencies within the independence movement viewed modern medical science with suspicion. Enveloped inside Ã©lite enclaves, and enmeshed with Imperial power, modern medicine had little to do with the lives and well-being of India's peoples. Efforts to battle colonial-era epidemics"and thus protect its economic interests in India"often led the Empire into brutal confrontation with the habits and customs of the country's inhabitants, historian Sasha Tandon has shown.
For many nationalists, modern medicine"and science itself"was part of the project of subjugation: other systems, modern,authentically Indian, were what a free country needed.
As scholar Shamshad Khan has shown, these questions were intensely debated as Indians acquired greater political power. In 1938, a private member of the Legislative assembly, Qazi Muhammad Adil Abbasi, called for compulsory vaccination against smallpox. His proposals were vigorously opposed, among others, by Indra Deo Tripathy, who argued that vaccination was"anti-Swaraj"; a deception of the Indians who had been "promised that we want to establish Ram Raj".
Lal Bahadur Shastri, later Prime Minister, noted that, smallpox cases"sometimes fatal"had broken out even among those vaccinated. Another legislator, Ram Swarup Gupta, argued that many of the diseases were occurring because of the modern system of treatment as it weakened the natural vitality of the body.
For Gandhi, medical science itself was a kind of "black magic", seducing "people to put an undue importance on the body and practically ignore the spirit within". He wanted treatment, instead, to begin with Ramnama, taking god's words into the heart.
The modernists, among them Prime Minister Jawaharlal Nehru and Health Minister Vijaya Lakshmi Pandit, responded by arguing they were seeking to raise traditional systems, like Ayurveda and Unani, to modern scientific standards. The argument elided over the real questions of science: the physical properties of chemicals do not change, after all, whether administered by traditional practitioners or doctors; nor is information made more or less true because of its cultural genesis.
Even though the nativists lost the debates of the 1930s, not everyone within the Congress was ready to give up the battle. In the summer of 1950, Prime Minister Nehru wrote to rebuke state governments on their messaging around medical systems, recording he felt unhappy "when what is called modern medicine was condemned and other systems were praised".
From Independence on, though, it became increasingly apparent that indigenous knowledge alone could not ensure the health of Indians. Ever since 1901, regular epidemics had claimed hugenumbers of lives; 105,781 in 1950-1951 and 68,998 in 1957-1958. Ever since the nineteenth century, there had been fitful efforts to vaccinate against the disease. The country was the global epicentre of the lethal disease; in 1963, three out of every four deaths from smallpox took place in India alone.
Then, from 1968, the State threw its weight behind mass vaccination"sometimes in the face of violent opposition. DA Henderson, a World Health Organisation expert, who played a key role in the drive, recorded the use of military-style "Dawn Raids", which he claimed were "particularly effective" in the campaign: Backed by police, large teams of vaccinators descended on remote villages at 4.30 AM and proceeded to vaccinate entire populations under duress.
Extremely committed public health officials"just like in the ongoing pandemic"provided the backbone for the campaign. Henderson tells the story of "an Indian District Health Officer and his team, who were captured by tribal villagers and saved at the last minute from execution by burning, but who returned to control the outbreak".
This high noon of India's medical effort, though, also saw the revival of anti-science as a potent force in public life. Already, in 1978, the scholar Robert Jeffries was pointing to the diminishing power and influence of the medical establishment over decision-making and policy.
He wrote: "There is a general feeling that politicians permit and encourage this only because indigenous practitioners are very influential; when it comes to their own care, the politicians prefer to use the latest, Western-style facilities. Though this is not true for all politicians, it does point to a significant weakness in the political position of the doctors: because of their very poor penetration of rural areas, and their social distance from the mass of the rural population, they cannot mobilise mass support".
Following Independence, the doctors who stepped into positions of authority were those who were enmeshed with Imperial power. Few concerned themselves with expanding access to healthcare for the public; life-expectancy in peasant societies remained low; enormous numbers of lives were lost to easily-preventable diseases. For the vast mass of Indians, the quack and the traditional practitioner were more reliably-present arbiters of health than science.
In the 1980s, as Meera Nanda has argued, the Hindu-nationalist Right and the post-Marxist Left joined in assailing science and reason, seeking to knock what they saw as "Western" paradigms off their privileged perch. The Right sought to heal the wounds of a colonised culture with comforting salves like Vedic Mathematics or the greatness of ancient Indian medicine; the Left attacked scientific knowledge itself as a Western, hegemonic project, an imperialism of the mind.
Indians have, through the pandemic, suffered the choices that these twin attacks led to"choices few fully understood, let alone had a meaningful role in making.
In the absence of genuine mass knowledge of science and scientific method, fear and desperation guided the actions of millions of Indians. Where Indians have had a choice, they have exercised it in favour of science; more often than not, though, that choice has simply not existed. Cow-urine might treat no disease, but it's proved itself considerably more likely to be available than a doctor or a hospital bed. Faith offers comfort, even if it cures nothing.
The pandemic has also made clear, though, that India has no prospect of emerging as a credible, middle-income power without a health system that can guarantee civilised standards of care for its peoples. Long after we have forgotten the images of patients gasping for their last breath in filthy rural hospitals, or corpses floating in the Ganga, the economic and social costs of the pandemic will continue to be visited on the Republic.
Little choice exists but for India to embrace science"and the world-view it engenders, which we call modernity. The alternative is more decades of unimaginable misery and civilisational irrelevance. To make that choice, however, requires a painful engagement with our past, and the dead-ends it has led us to.