CHAPTER IX.
PUBLIC HEALTH.
General Health — Malaria - Cholera — Small-pox — Vital statistics. Medical Institutions — Civil hospital at Vizagapatam — Institutions at Bimlipatam — Pálkonda — Vizagapatam — Vizianagram — And Bobbili — Tho Waltair Lunatic Asylum.
Except for the malaria of the Agency, the district is healthy enough and is not known for the special prevalence of any particular diseases. Elephantiasis used to be common in Bimlipatam and Vizagapatam, but has been checked since more care has been taken regarding the water-supply. Beri-beri prevails along the coast. Leprosy is brought into prominence by the leper asylums the Schleswig-Holstein Mission has established at Jeypore and Sálúr, but is not really more common than in the average district.
Malaria prevails throughout the whole of the Agency. The worst localities are perhaps the Bissamkatak side, the Malkanagiri taluk and the Golgonda hills. The worst season of the year for the disease is undoubtedly in the rains, which is contrary to the usual rule in such matters. The least unhealthy period is from November up to the first thunderstorms of April. Malaria is as bad in spots which are open, elevated and free from jungle (such as Koraput) as in those (like Jeypore town) which lie low in situations shut in by hill and jungle. Black-water fever is common among European residents in the hills. The hill people themselves seem to suffer little from malaria. If they ever do contract the disease they take no medicine, but fast and offer sacrifices to the local deity, beginning with fowls and going upwards through pigs to goats and at last to buffaloes, until either the fever leaves them or they realize that it is their fate to have to bear it.
Cholera has usually been most severe when the seasons have been most adverse. In 1866 the deaths from it numbered 11,695; in 1877, 6,923; in 1878, 4,456; in 1889, 7,065; in 1892, 3,229; and in 1897, 5,103. In 1906, on the other hand, though the season was good the disease was particularly virulent, 9,685 deaths (a record) occurring up to the end of August. Doubtless on the plains the general increase in sanitary knowledge has much to do with the general decline in mortality from cholera which has ocourrod, but in the hills things differ, and villagers have been known to propose the imprisonment of the neighbouring wizard as the only method of checking an epidemic.
Mortality from small-pox, as elsewhere, fluctuates violently in accordance with no very obvious principles. The worst years in recent times have been 1884-86, 1889, 1892-93 and 1898, the deaths in which averaged about 1,200. Vaccination is compulsory only in the four municipalities and in nine of the unions.
Statistics of the recorded rates of births and deaths in the plain taluks in recent years will be found in the Appendix. Registration of these events is compulsory in eleven of the fifteen unions and in sixteen other villages.
The medical institutions of the district comprise 31 hospitals or dispensaries, of which only three contain no accommodation for in-patients. Of these, three — those at Gunupur, established in 1869, Rayagada, opened in 1887, and Bissamkatak (1888)-are in the Agency and are maintained by the Parvatipur taluk board; four — those at Jeypore (1887), Naurangpur (1890), Malkanagiri (1899) and Padwa (1904)— are similarly in the Agency but are kept up by the Koraput District Board; three — those at Bimlipatam (1871), Anakapalle (1879) and Vizianagram (1901) — are maintained by the respective municipalities; five — two each at Vizagapatam (1845 and 1894) and Vizianagram (1860 and 1905) and one at Bobbili (1896) — are supported partly or wholly from private benevolence; while the remaining 16 in the margin are financed by the taluk boards. Statistics of the attendance at, and cost of, those of these institutions which are managed officially will be found in the Appendix to this book.
Of all of them, the oldest and the most important is te civil hospital at Vizagapatam. This began with a dispensary originated in 1845 under leave from the Court of Directors, and was at first located in a rented house ' nearly in the centre of the town ' and adjoining ' the building now occupied as a military hospital '. By the end of 1857 it was removed to a new building costing Rs. 17,200, of which sum Rs. 10,225 had been made up by public subscription (the Rajas of Vizianagram and Bobbili and the Gode
Palkonda . . . 1860
Salur ........ 1875
Parvatipur '
Bobbili 1876
Yellamanohili
Narasapatam
Chodavaram 1878
Chipurapalle
Srungavarapukota 1879
Gajapatinagaram 1882
Jami 1890
Nakkapalli
Razam 1891
Viraghattam 1892
Ponduru 1899
Kurupam 1901 family figuring prominently) and Rs. 6,975 had been given by Government.
Up to 186 the poor ward in the dispensary seems to have been maintained at the cost of Government, but in that year the then Rája of Vizianagram gave the institution Rs. 20,000 in public securities, the interest on which together with contributions from local funds (Rs. 2,800) and the municipality (Rs. 2,600), is still utilized for its upkeep. It now blossomed into a civil hospital and was placed under the care of a local committee of which the Collector was ex-officio President and the District Surgeon ex-officio member. This body still controls its destinies. Subsequently several small detached cottages were constructed round the main building by private benefactors, a dispensary has been recently erected by M.R.Ry. A. V. Jagga Rao, and Government has added a septic room, an operation theatre and a maternity ward. A medical school is now connected with the institution and Maháráni Lady Gajapati Rao has promised to erect a building for this. The foundation stone was laid not long back by Lord Ampthill.
The next oldest dispensary is that at Bimlipatam, which was established in 1832 on the motion of the European residents in the town. The building for it cost about Rs. 5,300, of which half was subscribed and half granted by Government, and the cost of upkeep was similarly shared. A committee of residents managed the institution at first, but it was vested in the municipal council in 1876.
The Pálkonda hospital was opened in 1869 on the motion of the manager to the renters of that taluk, Messrs. Arbuthnot &Co.
Of the five institutions which have been mentioned as being kept up partly by private benevolence, one is the civil hospital at Vizagapatam already referred to. The Victoria Gosha Female Hospital at the same town is located in a building bought for it by the late Mahárája Sir Gajapati Rao, who also contributed largely to the maintenance of the institution during his lifetime.
The two hospitals at Vizianagram are kept up respectively by the Rája and his adoptive sister. The former seems to have been started as far back as 1860 as a dispensary for the Rája's own followers, and has gradually been raised to its present excellent condition. The latter, which is for gosha women and children, is one of the best buildings of its class in the mufassal, stands in a large,stone-walled compound with an imposing gateway on and over which is inscribed the name of the founder, consists of four wings and cost over Rs. 40,000. The women and children's hospital at Bobbili was built by the present Mahárája in 1895, entirely at his own cost, and was handed over by him to the local board together with an endowment of Rs. 20,000 in securities, the interest on which is utilized for its maintenance.
The Lunatic Asylum at Waltair originated in the accidental fact that in 1862 seven non-criminal lunatics had been committed to custody all at once. There being no proper place for them, the District Magistrate was allowed to rent a small house for them, wherein they lived, guarded by constables and waited on by convicts. The question of providing mufassal asylums was thus raised; and one was sanctioned for Vizagapatam among other places. Meanwhile a larger building was rented, which became a recognized asylum for the Northern Circars and had a regular board of visitors.
The existing buildings at Waltair were completed in 1871. At present they contain accommodation for 96 patients, while the daily average strength is 76.