Last week, there were reports that residents of a locality in Madhya Pradesh’s Indore attacked a five-member team of health officials during a visit to screen people for the coronavirus. Attacking frontline health workers who are combatting Covid-19 is not just illegal, but also beyond comprehension.

However, this is not the first time something like this has happened in the country.

During the 1897 plague epidemic, colonial authorities in India faced mass resentment when they started quarantining and isolating people. Violence erupted in Mumbai, Kheda, Delhi and Kolkata and people fled their homes in panic.

David Arnold wrote about placards that came up in Delhi, threatening another 1857-like rebellion. Mumbai’s Arthur Road Hospital was attacked by an angry mob because a sick woman was kept under isolation.

The 1897 reaction against quarantining and isolation was strong enough for the British officials to back off, but they wondered what it was that roiled the natives? Was it, perhaps, the fear of sharing hospital confines with somebody from a different caste? Or was gender a factor? Indians have always been uncomfortable with male doctors examining women, especially in an out-of-house setting.

The Indian aristocracy couldn’t mediate either because their position on quarantine marked them out as collaborators. Upper-class merchants and pen-pushers were uncomfortable too for they were quarantine examined in railway stations, as if they were common people.

All in all, enforcing quarantine in the time of plague was a difficult job – it needed a steady hand and a good aim.

A brief history

Surely, British officials should have anticipated this, but their memories of facing quarantine resistance had faded as these were generations old. Quarantining began at European ports as early as in the 14th century. It was intended to halt the progress of the plague as sailors were suspected of bringing the disease from other lands. Maybe origins of the practice can be traced to Venice. After all, the word comes from the Italian quaranta giorni, meaning “40 days”.

But it wasn’t all that easy to implement it, as sailors would dodge officials and flee to the countryside, spreading the plague and leading to an epidemic. A truly self-fulfilling prophylactic.

This tendency to resist continued for centuries. Captains of merchant vessels docked in the Thames Estuary hid facts from British officials who were determined to implement the Quarantining Act of 1825 and the Public Health Act of 1875. To stave off cholera, the Italian island of Sardinia, in the 1830s, posted armed militia to prevent fields transmission from the docks.

Policemen during the plague in Bombay in the 1890s.

In New York, after the outbreak of yellow fever, quarantining officials walked the streets, power-dressed like soldiers in brass-buttoned uniforms. A piece in The Times Leader dated November 5, 1892, warned against the officials’ excessive zeal as people were likely to “grow nervous under the steady shower of warnings and exhortation”.

Nonetheless, this method of quarantining and isolation persisted and was normalised over decades. Till the early decades of the 19th century, there were riots in several European countries against quarantine to prevent cholera. As time went on, resistance to quarantine lessened but continued in some spaces. By the mid-1860s, even after more than 750 isolation hospitals sprang up all over Britain, the distrust for quarantining persisted.

It was only over 30 years later, at the 1892 Conference of Venice, that European countries acknowledged that the British method of quarantining was the “best practice” to contain an epidemic. To a large extent, Florence Nightingale’s isolation practices in the Scutari battlefield of Turkey also played a significant role.

Social factors

Was the resistance to quarantining because the period was too long? Today, we know better and can track the cycle of transmission for each disease. But traditionally, the number was set at 40 days and no one knew why.

Was it a result of seasoned seafarers’ experiences? Or because Jesus fought the devil in a Judaean desert for 40 days? Or did it have something to do with the Greek philosopher Pythagoras’s preoccupation with the number four?

If Western experience is anything to go by, it is clear that enforcing quarantine is bound to meet with opposition on the ground, whether in Indore or elsewhere. The anger, fear and suspicions may be greater in India, because this practice has not been marinated for centuries here, as it has in Europe. It is not on account of gender or caste that quarantining and isolation is being resisted today and, it is likely, this was not the case in 1897 either.

Senior Indore officials inspect the area in which the medical team was attacked. Credit: PTI

The most compelling reason to oppose isolation – even quarantine – is because the loneliness ensues stigma as well. Illness in India, especially serious ones, are never individual affairs. Families and neighbours are invariably involved and there is no other way around it – to be separated from them when you are most vulnerable is clearly distressful.

Notice, for example, how many relations accompany patients to hospitals in India. This could be because health services are poorly delivered, or because kin and clan provide the social insurance that the state does not.

Can we then overlook the physical attacks on Covid-19 health workers, whether it be in Indore or any other part of the country? Knowing the socio-historical background to the suspicion around quarantine helps us understand it – but it does not excuse it.

Dipankar Gupta is a retired professor of Sociology at Jawaharlal Nehru University.