A few months after her arrival in Bareilly in 1870, the American medical missionary Clara Swain prepared for a crucial meeting with the Nawab of Rampur. The nawab, Sir Kalb Ali Khan, owned numerous properties, including a plot of land close to the Methodist mission in Bareilly. It was felt the land would be ideal for a much-needed dispensary and hospital for women, especially those who, by custom, lived in seclusion in the zenana.

What Swain and the collector of Bareilly, Robert Drummond, had not anticipated was the lavish welcome that awaited them in Rampur. The nawab spared nothing in order to create a good impression. They were taken in palanquins in a procession that included horses, camels and even elephants. For entertainment, Swain and Drummond were provided hand-cranked and wind-up music boxes. This was followed by an athletic performance. The welcome ceremony went on longer than they expected, but the meeting with the nawab lasted mere minutes.

Barely had the initial formalities been completed and the request for land made than the nawab broke in. “Take it, take it. I give it with pleasure for such a purpose,” he said, according to a letter from Swain to her sister in New York.

For Swain, this was the true beginning of her work in India. The hospital that came up on the nawab’s land in 1873 was the first hospital for women and children in Asia.

Credit: ‘A Glimpse of India’, Archive.org

‘Doctor Miss Sahiba’

Swain had arrived in Bombay in January 1870 and was the first “woman medical missionary” to travel from America under the auspices of the Women’s Foreign Missionary Movement and the Methodist Episcopal Church. For the next 25 years, she stayed on in India, dividing her time between Bareilly and the princely state of Khetri, returning home only thrice for short visits.

Spreading the gospel was an essential part of her work, but what has really endured is her contribution towards the betterment of women. During her time in India, she helped set up institutions like the hospital that bears her name today, educated women to deliver medical assistance to women and children, spoke up in favour of raising the age of sexual consent for all girls, and argued for ending female infanticide.

A collection of Swain’s letters to her sister and friends, titled A Glimpse of India (1909), documents the challenges she faced as “Doctor Miss Sahiba” – the title by which she was often addressed – and her concerns about women’s health. But there is much more in the letters. Readers can find in them glimpses of domestic life in 19th-century India, the state of civic infrastructure, hazards of long-distance travel, and unexpected calamities like floods. What gives her account special significance is her acute awareness of everyday inequalities, although overlaying all this is the consciousness of her duties, her desire to help those who needed it.

Journey to India

Clara Swain was born on July 18, 1836, in Elmira, New York, the youngest of ten children. Her two biographers describe her as ever-helpful and given quite spontaneously to acts of charity. She spent a few years in Castile, New York, assisting at the sanatorium of American physician Cordelia Greene, who was a mentor of sorts for Swain. In 1866, like Greene, she travelled to study at the Women’s Medical College in Pennsylvania.

Around this time, a missionary named DW Thomas, who ran an orphanage in Bareilly, communicated to the Methodist Mission the need for a woman doctor in India. Swain heard of the plea, saw it as “God’s Will” and readily volunteered.

This was a period when advances in spheres like women’s education coincided with religious revivalism and reform. The Methodist Church was setting up hospitals and orphanages in different parts of the world, and aiding the sick was its “social gospel”.

Swain departed for India from New York on November 18, 1869, reaching the Suez within days of the canal’s completion. She described a short boat journey down the canal – it hadn’t been opened to ships yet – and debating the chances of its success with fellow passengers. Although she was merely passing through the region, its inequalities did not escape her. Farming thrived in the Nile region, she wrote, and yet the cultivators remained poor owing to high taxes.

She reached Bareilly on January 20, 1870, two months after she had set off from the US. Her journey up from Bombay was covered by train, including a daak ghari (postal carriage), and in a dooli (palanquin) carried by bearers over a pontoon bridge on River Ganga.

On her first day in Bareilly, as word got around of her arrival, she attended to 14 patients. By the end of the first year, she had “...visited seventy different families in the city and adjacent villages, with two hundred and fifty visits in the homes of my patients, besides prescribing for twelve hundred and twenty-five patients at the mission house,” she wrote.

Healthcare access

In that first year, Swain began teaching 17 young women so that they in turn could provide medical assistance, widening the net of healthcare access. The students were taught anatomy, physiology, and the science of medicine – all through an interpreter. Three years later, these women were allowed to practice on their own after an examination conducted by the civil surgeon.

Credit: ‘A Glimpse of India’, Archive.org

Once the dispensary was functional, and the hospital up and running, it became popular among women patients. The facility was built like a sarai since the ailing women visiting it were inevitably accompanied by entourages who slept and cooked their meals outside. As Swain wrote:

“A motley collection of conveyances may be seen in front of the dispensary almost any morning. Bullock carts in which a whole family has come; ekkas or pony carts, carefully covered with a cotton covering; a more pretentious rath with beautiful white oxen, from some one of the better homes of the city; a palanquin or two, and the little doolies which are simple string cots so small that it is a puzzle to imagine how a woman can sit in it, though, truth to tell, I have seen not only a woman emerge from one but two or three children besides. There are other women who come on foot, sometimes leading a very old or perhaps a blind person.”  

Over time, Swain got accustomed to some things: dampened grass mats hung across doors to offset the summer heat, bountiful mangoes during the rains, and rice as a staple of meals. One thing that struck her, though, was the custom of offering paan as a gesture of welcome.

Beautiful country

In 1885, at the request of Raja Ajit Singh, she made the 510-kilometre journey from Bareilly to Khetri to attend to his ailing wife Champavatiji Sahiba. Her successful treatment of the queen impressed Singh so much that he requested Swain to stay on in Khetri as a doctor to run a dispensary and to train the queen and other women as nurses. Swain agreed to the offer, but on the condition that he also set up a girls’ school and let her associate PE Pannell manage it.

Apart from starting the school, Singh – who later became a patron of Vivekanand and a sponsor of his 1893 visit to America – offered incentives to encourage attendance. To begin with, the girls were given new skirts and head coverings. Every morning, each of them would get a pound of wheat flour (equal to what they earned in daily wages). And every Saturday, an extra pound of flour was provided to those who did not miss school all week.

Swain remained at Khetri for nearly a decade and, during this time, became fond of the royal princesses. It was therefore a disappointment to her when the older princess was married off at age 12. In her letters home, she recalled some of the more distinctive events in Khetri: when she went on a tiger hunt, met a visiting team of American balloonists, and when ice came all the way from Delhi during a particularly hot summer.

She left Khetri in 1896 to return to the United States for good, although a decade later, she did visit Bareilly briefly to mark the jubilee celebrations of the hospital she helped set up. During World War II, the hospital rendered vital assistance when Allied soldiers were airlifted from the Burma war front to Bareilly. The Clara Swain Mission hospital still operates today.

Swain never regretted her time in India. She found the country beautiful, though it was the rainy season she found especially delightful.

“The rains have begun and everything looks fresh and green and beautiful. No place is more lovely than India in the rainy season; that is my opinion, others may not think so. The mangoes are just in their glory, so ripe and delicious. I bought a hundred this morning for fifty cents. I wish you could help me eat them.”  

This article is part of a series on notable Americans who visited India before mid-20th century. Read the rest of the series here.