Fractures States: Smallpox, Public Health and Vaccination Policy in British India 1800–1947

Abstract

Fractured States , part of an exciting series from Orient Longman entitled New Perspectives in South Asian History , provides a nuanced narrative of state vaccination policy and its implementation in different regions of India from the nineteenth century through to independence. The book succeeds in challenging the dominant historiography of state medicine in colonial India which has assumed on the one hand that the colonial state was monolithic and thus that its health policies were hegemonic, and on the other that the technology of vaccination was both uniform and efficacious. Fractured States is a political history of vaccination that argues for the contingent nature of the colonial state and its dependence upon an aggregate of local authorities with considerable influence and differing opinions. It de-emphasises the significance of religious and caste issues to the history of the successes and failures of state vaccination, focusing instead on administrative, technological and economic, rather than cultural, explanations for the development of particular vaccination policies and the ways in which they were put into practice. By studying the implementation of vaccination policies in a variety of regions at different historical moments, Fractured States suggests that colonial public health policies were inconsistently administered, constantly contested from both within and without the state medical services, and locally adaptable. This account allows for considerable agency on the part of both Indian public health officials and the civilian population in relation to how, when and if vaccination was performed. It also presents a much more complicated narrative of the operation of the colonial state which consistently changed its health care delivery strategies to adapt to regional differences and political exigencies.