...capital mistake to theorize before one has data
/‘“It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts” says Sherlock Holmes.
Arthur Conan Doyle through the character Sherlock Holmes reflected on this common mistake in A Scandal in Bohemia. The statement reflects the 19th century version of evidence based decision making. The present article also is an allusion to the importance of facts before findings. We try to demonstrate the historical link between data and decision making in the context of Cantonment Towns.
What is common between COVID-19 and Cantonments? Not just that they both start with the letter C! There is indeed a historical link connecting the current catastrophe and this form of human settlement that traces its history back to the eighteenth century. The commonality is public health. There are currently 62 cantonments in India and most of them were inherited from the British rule. Just 8 new cantonments were added in independent India, the last one being Ajmer in 1962.
COVID-19 and Cantonments lie at the two ends of the process of planning cities, one at the beginning and one at the end. While COVID-19 has initiated a process, globally, of rethinking the way cities should be planned in future, Cantonments in India evolved as planned human habitations after careful considerations of the link between topographies and diseases. However, COVID-led planning is a global call for saving humanity, whereas planning for cantonments was a prudential exercise in furthering colonial designs.
Three key lessons from Cantonment planning
While the intention of the British was to ensure a healthy army to support the extractive imperial expansion, it laid the foundation of scientific enquiry into the relationships between human habitation and the physical or environmental aspects of the habitation. Cantonments represented a key form of planned settlements for the British through the 18th and 19th centuries and in the same period, led to some of the major developments in public health and medicine.
A knowledge lens to understand, historically, the disciplines that were studied and the outcomes that were desired in cantonments can provide instructive lessons while we think of the future of cities. One is the centrality of the public health function as the defining element of planning and managing cities. Second is the importance of contextual and micro level documentation as the basis of evidence based planning. Third is the role of various actors who can support the first two.
Public Health as the defining element of planning cities
Cantonments provide important lessons for integration of public health in city planning. Shorn of the imperialist and racist elements of the British Cantonment planning, they represent well-defined planning and public health processes. Cantonments were enclaves carved out in different physical and geographical areas keeping the interests of their residents at the centre of planning. Malaria and other diseases were seen as a key impediment in achieving human efficiency, especially for the troops. Hence, elaborate measures were taken to deal with the outbreaks. Preventive medicine, tropical medicines, and medical topography emerged as fields in their own and helped counter some of the deadliest diseases of the time.
“It is necessary for a Physician when entering a city of which he knows nothing, to examine its exposure, the predominant winds, the seasons, the nature and elevation of the soil, the quality of the waters of which the inhabitants make use, and the kind of life they follow.”
This is a note by Hippocrates, the Greek physician and ‘Father of modern medicine’ at the beginning of his treatise on ‘air, water and places’. This note was borrowed by James Ranald Martin in his “Notes on the Medical Topography of Calcutta”. Much of the British thinking about public health during the time was derived from the belief that the cause of a disease is linked with the environment of the place. These beliefs in a way led to the disciplines of preventive medicine and medical statistics.
Martin was a military surgeon working for the East India Company. He was instrumental in researching links between the health of humans and that of their lived environments. He insisted that the medical community in India, especially those in the Army, should keep detailed records of the medical topographies i.e. the records of the kinds of diseases and the geographical features of their locations so as to establish the link between diseases and the environments. Martin emphasised on ensuring the right location for the military cantonments by carefully examining the physical features of proposed sites, sources of water, quality of drinking water, prevalence of diseases and other such facts.
The solutions created at the time are still amongst the most effective ones and are used even today. The wisdom that the most effective strategy to counter malaria is to kill the mosquito that transmits it, is still visible in the form of vector borne disease control departments in municipalities.
Contextual and Micro-level documentation as the basis of evidence based planning
The evolution of military cantonments in India is a valuable lesson in documentation. The British made laborious attempts to document every aspect of their living world, though primarily to ensure their sustenance in an alien country. There are numerous memoirs, commission enquiries, correspondences, biographies, detailed accounts along with detailed disaggregated statistics related to public health and environmental conditions in and around the cantonments. Many of these documents eventually fed into an institutional process such as enactment or amendment of Acts or changes in organisational structures.
The legal process of registering births and deaths (vital statistics), a function still performed by Indian city governments, has its antecedents in the Central Births, Deaths and Marriages Registration Act of 1886 (though births and death registration is now under another Act from 1969). Such statistics, along with reporting on illnesses and diseases was already being compiled and published by the British Army’s medical division for its various cantonments.
Today, proactive, institutionally collected, periodic and authenticated knowledge coming out of city governments is limited. Annual budgets, administrative reports and other compliance based reporting is what one may find in the public domain put out through the city governments. This knowledge is also usually available for the bigger city governments. Vital statistics is a function entrusted half-heartedly with most municipalities and most cities have varied roles in recording births and deaths. Many of the cities don’t even have access to their maps.
Role of actors in public health planning and documentation
This effort to create contextual knowledge needs to be also seen in the light of the human capacity required to create this data. The role of documentation and recording was at the heart of British policy, not just in Cantonments but in most administrative entities. While formal divisions existed for recording statistics, officers at various levels were also responsible for recording and documenting. Documentation in the medical field was not dependent on large scale and expensive surveys but also came from the various actors involved in the profession of documenting their routines and environments. The medical condition commonly known as burning feet syndrome is also known as Grierson-Gopalan syndrome, after the names of James Grierson and Coluther Gopalan, the two individuals who documented and explained the condition as part of their routines. While Gopalan was a trained nutritionist, James Grierson was a British Medical officer in its army. Grierson's name remains a literal footnote in the available literature around the disease but his documentation proved as the stepping stone to further research on it more than 100 years later.
With the availability of technology and more platforms that can enable capturing knowledge, there is a need to capture more of it –not only data and statistics but a rich variety of contextual knowledge that can help make better decisions. The emphasis on local knowledge needs to also be paired with proximity of city governments to their physical environments and empowering a larger number of functionaries who can invest their knowledge back in the functioning of the government.