How a Bengali woman became a physician to King Prithvi Bir Bikram Shah and the Nepal royal family

Jamini Sen’s mornings and daytime hours were spent between her chamber at the palace and at the Prithvi–Bir Hospital. The hospital was in its nascent stages, and had other medical personnel, but the young Jamini poured her energy and her ideas into making it a place where recoveries outdid deaths, and where new mothers received the care they needed.

As word of this new centre of healthcare spread, patients started coming in from other regions as well. They had heard of a new doctor, a woman from Bengal who was often there. They said she was as fierce as a kukri41 but clever like the memsahibs. And that she didn’t turn anyone away. And so, the poor, the forgotten and the wild-born, all slowly came to Dr Sen.

Not only did they come to her, but she, using the medical machinery that was put at her disposal, reached out to places that needed care but had been neglected.

Jamini’s main concern was sanitation and clean water – for they alone could go a long way in reducing the burden of disease. To that end, she met with various officials and sought measures to execute her ideas. Fired with new zeal, and now with a very able Dr Sen to lead the charge, Prithvi tried to get the Rana prime minister and his people to do the work. This was not about their rivalries; this was for the people they all wanted to serve, and for the land they all loved. They must see that.

The 19th century saw what has been called “the great sanitary awakening”. Disease was no more just punishment from the gods, a sign of moral failing or a diktat of fate. Instead, filth was seen as a cause of disease, as well as a carrier of disease. Illness was now blamed on unhygienic habits and poor living conditions, not only on spiritual failings. Public health involved a social responsibility to ensure good sanitation. Epidemics were seen as something preventable, and not just treatable. Methods like patient isolation were broadened to include cleanliness and good sanitation. Piety, faith, cleanliness and hygiene were all invoked together to maintain good health. This was, thus, the century that truly saw the coming together of cleanliness with godliness.

Water purification was also identified as a means of not only controlling the spread of disease, but of being a preventive method altogether. Methods of controlling contagion now included various interventions, from sanitation to clean water and immunisation. It became more and more established that a clean environment, good hygiene, clean water and immunisation could stop the spread and maybe even the very occurrence of disease.

British India’s work in sanitation had begun not very long ago, starting with the reports of the Royal Commission of 1859. The mortality rate amongst British troops was extremely high and a cause for great worry for them. Following an investigation, the commission in 1863 recommended the setting up of a Commission of Public Health in each presidency and highlighted that in order to improve the health of the British Army, sanitation must improve among civilians, since that would help prevent contagion and epidemics. So, under the Military Cantonments Act of 1864, a sanitary police force was formed under the charge of military medical officers who would look after the improvement of military hygiene. For the betterment of civil sanitary conditions, sanitary boards were formed in each province. Sanitary inspector generals, also known as sanitary commissioners, replaced these boards and took over the charge of sanitation. To entrench it more firmly within the system, in 1870, the sanitary department was merged with the vaccination department to form a central sanitary department.

Jamini had seen in Bengal how diseases like plague and cholera ran rampant, killing hundreds and thousands. The poor, the destitute and the malnourished were the first to fall prey. Children, especially, were easy victims of deadly diseases.

In the early part of the 19th century, cholera was a more Bengal-centric disease, but it didn’t remain confined to this geographical limitation and spread instead to other parts of British India. It was a cause of great concern for the British, being a threat to its company officials and the army. After the cholera epidemic of 1868, a committee was set up, and their recommendation was improvement in sanitation, better hygiene and better organisation of gatherings like fairs and festivals, where travellers and pilgrims were likely to carry the disease and infect others.

Plague, which had been a curse for many parts of the country, was especially rampant in port cities like Calcutta and Bombay and the first official records of the bubonic plague date back to 1896. Jamini, in the course of her early work in Calcutta, had seen some cases where the patient’s body was mottled dark and painful boils emerged from the skin. The disease had already been there in Bengal much before the official records. It devastated India and spread like wildfire, seeming impossible to control or treat. The Plague Commission was formed in 1896, under the leadership of Professor T.R. Frasor, and in the years to come, their report recommended disinfection, improved sanitation and control over mass movement of people.

In Nepal, Jamini saw the same signs that cause sudden surges of epidemic and sickness and she urged Prithvi to work faster and pave the way for better hygiene, sanitation and clean water.

The Nepali people were fierce in their devotion to their gods and their native beliefs and had always turned to traditional medicine, their shamans and their deities at times of sickness. Jamini knew from her experience with the village people in Bengal that if they were told to adopt new practices and drop the old, they would rebel. So, she suggested an all-inclusive method. They would keep their beliefs and their faith but add new habits of cleanliness and hygiene. Piety would blend with modern methods and it didn’t matter who got the “credit” as long as the patient was healed.

In the meantime, Jamini got more and more engrossed in her work as physician to the royal household. Over the months, her afternoon meetings with the queen mother had become much talked about, especially since it became known that the otherwise aloof woman placed a lot of trust and reliance on the young doctor. The palace watched for the saree-clad figure who would briskly march into the queen’s boudoir and proceed to do a daily check-up. Tea followed, but it was short, since Jamini often had other members of the family to attend to as well.

There was Prithvi’s first wife, the jetha bada maharani (senior queen), who had a daughter hardly five years old. The daughter was fine-boned and strong but it was the mother who Jamini worried about more. She was a sensitive girl, a princess from Kangra, now in Himachal Pradesh, and often grew melancholic in this foreign kingdom. And there was the new baby in the household, Princess Rama Rajya Laxmi, who Jamini kept a close eye on. The usually taciturn doctor loved watching the tiny face break into a little smile when held and rocked, and often visited her last so that she could spend more time with the baby.

And there was, of course, Prithvi himself, who insisted that Dr Sen visit him once every day. For a few days, he had taken to sending a servant to find Jamini and summon her. The first time Jamini had quickly delegated the patients she was seeing to another doctor and rushed to the palace’s inner sanctum, fearing she would find the king suddenly and gravely ill. Instead, she had found Prithvi pacing the floor, his normally pale complexion florid because the Rana prime minister would not let him go horse riding outside. The young king fumed and fretted and tried to explain to a now visibly annoyed Jamini how unfair it all was. A servant, the king’s valet, stood by, wringing his hands and watching his master anxiously. Another servant was collecting a pile of fruit from the carpet. The king had apparently tossed a plate of apples over in his rage. Jamini looked at Prithvi, recommended a cold bath and marched out.

The second time the same palace servant appeared in the hospital in the early hours of the morning, Jamini, who had just finished a round of the wards, went with him quickly. The king would surely not do the same thing twice. As she made her way to the palace, she was making a list of possible ailments that could have so suddenly befallen the young ruler. Overindulgence on sweetmeats was a high possibility, she wryly admitted to herself.

Upon arrival at the palace, Jamini found a dishevelled Prithvi robed in a huge flowing silk dressing gown, sitting in an armchair in a corner of the library room. His face was pallid and he wore a haunted look. All the windows were shuttered closed and the electric lights were blazing.

On seeing her, Prithvi accused her of lateness. Didn’t she care that the king of Nepal was on his deathbed? Dereliction of duty! That’s what this was. He would report her.

When Jamini calmly asked, “To whom?” Prithvi got to his feet, and with his hands clasped behind his back, paced the floor, bemoaning his fate and raging at all doctors.

It emerged that Prithvi had had bad dreams. Nightmares. He had been thrashing around in the bed, all entangled in his sheets when the valet had woken him up. He was convinced that it was a bad omen. He was going to die. That very day.

Jamini asked him to be seated and, in her cool, precise voice asked the valet to have the windows opened and have some black tea brought in. As Prithvi subsided in his chair, the servant hurried to do her bidding. She took a notepad out of her medical bag and sitting opposite the young king asked him for a list of what he had eaten the night before.

He looked askance at her – how dare she question the food of the king? Jamini persisted. Prithvi finally named lamb curry and brain curry but by this time the valet had arrived with the tea, and as he served them, trying to be helpful and unaware of his boss’s discomfiture, he gave Dr Sen a full list. It finally stood at more than 18 items, not including desserts. Jamini wrote them all down and then placed the list before Prithvi. His nightmares were omens, but they weren’t about his death. They were about his diet. If his highness would reduce this list by half, she could assure him of restful sleep at night.

Excerpted with permission from Daktarin Jamini Sen: The Life of One of British India’s First Women Doctors, Deepta Roy Chakraverti, Penguin India.