COLONIAL STATE HEALTHCARE IN TRINIDAD, 1845-1916.

BRITISH COLONIAL HEALTHCARE IN

A POST-EMANCIPATION PLANTATION SOCIETY: CREOLISING PUBLIC HEALTH

AND MEDICINE IN TRINIDAD, TO 1916.

By

LAURIE JACKLIN, B.A. (Hons.), M.A.

A Thesis

Submitted to the School of Graduate Studies

in Partial Fulfillment of the Requirements

for the Degree

Doctor of Philosophy

McMaster University

© Copyright by Laurie Jacklin, July 2009

 PhD Thesis - L. Jacklin. McMaster - History

DOCTOR OF PHILOSOPHY (2009) McMaster University

(History) Hamilton, Ontario

TITLE: British Colonial Healthcare in a Post-Emancipation Plantation Society:

Creolising Public Health and Medicine in Trinidad, to 1916.

AUTHOR: Laurie Jacklin, B.A. (Hons.) (McMaster University),

M.A. (University of Waterloo).

SUPERVISOR: Dr. Juanita De Barros.

NUMBER OF PAGES: 194

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 PhD Thesis - L. Jacklin. McMaster - History

ABSTRACT

This study examines the advent of state public health and medical services in
Trinidad in the post-emancipation colonial period, to 1916. Britain's sugar-producing
plantation societies were structured to allow the small white Creole plantocracy to
exploit the labour of the African and East Indian lower orders and keep the people in a
perpetual state of poverty. Trinidad established the Government Medical Service (GMS)
in 1870 in response to an edict from the Colonial Office. The civilising mission had
clearly gone awry and state-provided western medical services would henceforth be
mandatory to mitigate the excessive mortality and morbidities amongst the subject
peoples.

The GMS rapidly evolved into a major provider of medical care services.
However, the form and function of the GMS remained contested terrain, due to the
enduring disagreements about the causes of the widespread impoverishment and ill­
health amongst the people. The Creole plantocracy used the poverty and poor health of
the Africans as proof of their regression into barbarism after emancipation. Conversely,
some British officials believed that plantation society colonialism created adverse
conditions of life, thus obligating the state to alleviate its effects. The Afro- and Indo­
Trinidadian people emerged as a powerful force in the process of creolising the colonial
state's social policies, as tens of thousands of sufferers sought assistance from the
government doctors each year. The GMS thus developed as a distinctly creolised West
Indian entity providing western public health and medical services to the African and
East Indian residents.

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 PhD Thesis - L. Jacklin. McMaster - History

ACKNOWLEDGEMENTS

The development of this doctoral thesis has been possible through the assistance
and support of my mentors and friends in the academy during the past five years. I
would like to thank my supervisory committee members for their guidance. Juanita De
Barros introduced me to Caribbean studies and shaped the course of this study. Ruth
Frager stimulated my interest in human rights and racism several years ago, for which I
am eternally grateful. James Alsop continually encouraged my academic development in
innumerable ways and persuaded me to pursue graduate studies in the history of
medicine. My external examiner, Susanne Klausen, provided valuable commentaries and
suggestions on the future manuscript version of this thesis. Helen Creedon of
Interlibrary Loan sourced materials for me from the ends of the world. Wendy Benedetti
in the History Department helped me in so many ways and always made me laugh. Helen
and Wendy, you are the consummate professionals. York University's Caribbean History
Reading Group, and especially Michele Johnson and Robert Stewart, provided extensive
critiques of early versions of Chapters 3 and 6, and constantly challenged me to consider
alternative ways to interpret the materials.

I have been fortunate to receive major scholarships during each year of my

graduate studies. I would like to acknowledge the generosity and support of the Social
Science and Humanities Research Council, McMaster's Harry L. Hooker fellowship,
Associated Medical Services/Hannah Institute for the History of Medicine, and the
Rockefeller Archive Centre.

My doctoral studies have involved my entire family and especially my husband,

Heinz, and my parents, Bob and Diane. I simply could not have made this journey alone.

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 PhD Thesis - L. Jacklin. McMaster - History

TABLE OF CONTENTS

Abstract iii

Acknowledgements iv

List of Illustrations, Charts, and Tables VI

Chapter 1 Introduction, Historical Context, Historiography,

and Thesis Overview 1

Chapter 2 Population Manipulations: To Neither Blacken

nor Whiten Trinidad 27

Chapter 3 Maritime Public Health: Imperial Values and

Migrant Bodies, 1840-1872 51

Chapter4 "Take up the White Man's burden ... And bid the sickness cease":

Creolising Trinidadian Colonial Healthcare, 1870-1880 79

Chapter 5 Imperial Trusteeship and Colonial Healthcare, 1880-1891 107

Chapter 6 The Civilising Mission: GMS Policies and Patients, 1891-1916 134

Chapter 7 Conclusions 157

Appendices 2.1 to 2-4 - Population Vital Statistics

Bibliography 173

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 PhD Thesis - L. Jacklin. McMaster - History

List of Illustrations, Charts, and Tables

Figure 2.1 ­ Population Growth in Trinidad 1881 to 1920, comparing total Natural
Increase (the excess of births over deaths) to
Net Migration (the excess of immigration over emigration).

Figure 2.2 ­ Population Growth by Natural Increase in Trinidad, 1881 to 1920,

comparing the Growth of the East Indian and West Indian Sectors.

Figure 2.3 ­ Population Growth by Net Migration in Trinidad, 1881 to 1920,

comparing the West Indian and East Indian Sectors.

Figure 2-4. ­ Population "Leakage" of East Indians, 1891 to 1920.

Figure 3.1 ­ Trinidad: "Coolies on arrival from India, mustered at depot" [n.d.].

Figure 3.2 ­ British Guiana: "Medical examination of New Arrivals" [n.d.].

Figure 3.3 ­ British Guiana: "The Depot Hospital. Accommodation

for 94 patients" [n.d.].

Figure 3-4 ­ British Guiana: "The Emigrants at their meals" [n.d.].

Figure 3.5 ­ Annual Average Voyage Loss Rates (VLR). Government ships for
East Indian and Australia migration, and self-paid British migration
to North America. 1850-51to1872-73 seasons.

Figure 3.6 ­ Crude Death Rates (maritime) for 284 Coolie Ships sailing to
the West Indies. 1850-51to1872-73 seasons.

Figure 4.1 ­ Colonial Hospital, Port-of-Spain, circa 1880s.

Figure 4.2 ­ San Fernando Colonial Hospital, circa late in the century.

Figure 5.1 ­ "East Indian who walked 60 miles to be treated."

Figure 5.2 ­ St. Marie Estate Hospital.

Figure 5.3 - Cedros District Hospital.

Table 5-4 ­ Comparative GMS Expenditures, 1886-87.

Figure 6.1 ­ Private Ward at the Port-of-Spain Colonial Hospital.

Figure 6.2 ­ Male Ward at Port-of-Spain Hospital [n.d. probably 1914-16]

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 PhD Thesis - L. Jacklin. McMaster - History

Figure 6.3 - Ratepayer's Association - Mass Meeting at Queen's Park, 21 March 1903.

Figure 6-4 - Citizens assembled outside Government House, 23 March 1903.

Figure 6.5 - The Burning of Government House (the 'Red House'), 23 March 1903

Table 6.6 - Poverty and Pauper Certificates Issued, 1895-1915.

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 PhD Thesis - L. Jacklin. McMaster - History.

- Chapter 1 ­
Introduction, Historical Context, Historiography, and Thesis Overview

This study investigates the development of the colonial state's policies and services for
public health and medical care in the post-emancipation British West Indian colony of
Trinidad, to 1916. In 1870, in response to a Colonial Office edict to its plantation
colonies, Governor Arthur Gordon enacted several health-related ordinances to mitigate
the conditions causing high mortality amongst the indentured East Indian population.
Since 1845, the government had sponsored the migration of Indians each year to replace
the formerly enslaved labourforce on the sugar estates. 1 Gordon's reforms created
Trinidad's Government Medical Service (GMS), which rapidly developed into a large
two-tiered system. The secondary tier provided medical care to indentured Indian men
and women in the private hospitals on the plantations. The primary tier provided
institutional and out-patient health care to a notable percentage of the free Indo- and
Afro-Trinidadian residents each year. 2 The constantly increasing costs and number of
public GMS patients stimulated protracted struggles between the white Creole
plantocracy and sojourning British officials about the colonial state's obligation to be
involved in maintaining the health of the free Africans and Indians, who embraced state
healthcare and relentlessly demanded services from the GMS doctors.

Plantation societies were purposefully organised to allow the small Creole

plantocracy to retain the wealth created through the exploitation of its subject peoples.
This form of colonialism created poor living and working conditions, which had
profoundly negative effects on the health and well-being of the people.3 The Colonial
Office's edict signified that Britain's mission to civilise its subject peoples would
henceforth require its plantation societies, including Trinidad, to provide western public
health and medical services to the people. However, the terms of the form and function
of the GMS were nebulously defined in the metropole and without precedent in the
Empire, and thus subject to interpretation. This study examines the tensions shaping the
evolution of Trinidad's policy on state public health and medical services: the lower
classes demanded assistance to relieve their poverty and ill-health, which the Creole elite
insisted was proof of the Africans' regression into barbarism, while some British officials
and the GMS doctors insisted that the problems were rooted in the plantation economy.

Trinidad's Coolie Immigration Ordinance 13of1870 stipulated extensive healthcare and

medical measures to be provided by the plantation owners to the indentured East Indians.
Gordon also introduced several other Ordinances related to public health and medical care.
Ordinance 2of1869 created the Surgeon-General's department. Ordinance 15of1870 empowered
the governor to hire District Medical Officers. Ordinance 5 of 1869 and 1870 defined the
management for the Port-of-Spain Hospital and San Fernando Hospital.
2
The 'Indo-Trinidadians' or 'East Indians' include the locally-born people and the
immigrants brought to the colony under indenture. The terms 'African' or 'Afro-Trinidadian' refer
to the peoples of African ancestry, including those of pure and mixed parentage, who were born in
the colony or migrated to Trinidad as slaves or as free migrants after emancipation.
3 De Barros, Palmer, and Wright recently argued that these adverse conditions
characterised the circum-Caribbean region and the health of the people. This thesis establishes
that plantation society colonialism created the poor health conditions in Trinidad and then
struggled to define its obligation to deal with the effects. Juanita De Barros, Steven Palmer, and
David Wright, "Introduction," in idem, eds., Health and Medicine in the circum-Caribbean,
1800-1968 (New York: Routledge, 2009), 2.

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 PhD Thesis - L. Jacklin. McMaster - History.

The amalgam of the peoples of African, Asian, and European ancestry makes the
history of the circum-Caribbean region extremely interesting, but complex. Many
different peoples brought their cultures of healing and medical practices to the Americas
and adapted their healthcare strategies to the existing resources and local customs.
Steven Palmer, Juanita De Barros, and David Wright recently established that the
diverse inhabitants throughout the region commonly combined creolised and traditional
forms of healthcare during the colonial period. They encouraged scholars to investigate
these histories, which are in their infancy for this region, while suggesting the need for
studies of institutional healthcare: little is yet known about the organisation and
operation of the numerous large medical institutions created by the various colonial
governments.4 This study addresses this historiographic lacuna by investigating the
state's social policies and its GMS organisation in post-emancipation Trinidad, to 1916.
The GMS provided public health and medical services in the community and through its
institutional network, caring for poor Trinidadians gratuitously, or for token sums.
Although the Colonial Office mandated the creation of the GMS, the medical service did
not replicate Britain's model of state healthcare, although some commonalities did
materialise, nor did it displace traditional medical practices. The GMS evolved through
conflicts, negotiations, and adaptations, while coexisting with a vibrant marketplace of
traditional Afro- and Indo-Trinidadian cultures of health and healing.

Plantation Colonies and Imperialism's Civilising Mission

From the seventeenth century, Britain established or acquired sugar-producing

plantation colonies in the British West Indies and Indian Ocean, including Trinidad,
Jamaica, British Guiana, Natal, and Mauritius. The prosperity of the imperial plantation
colonies had historically depended on slave labour and protective tariffs on sugar. As
part of the post-Enlightenment reforms, the Imperial parliament dismantled these
artificial constructs, abolishing slavery, in 1838, and disbanding the tariff protections on
sugar as part of the introduction of free trade in the 184os.s The high profits from sugar
dissipated, requiring Britain to resuscitate its economically ailing plantation societies,
until the colonies regained their economic viability through agricultural diversification
late in the century. 6 For the duration of the century, the West Indian colonies made
decreasing economic contributions to the Empire until they represented an insignificant
portion of Britain's trade.7 Despite the on-going economic troubles in the sugar­
producing colonies, the structures of their politico-economies did not change in any

4 De Barros, Palmer, and Wright, "Introduction," Health and Medicine, 2, 11.

s Walton Look Lai, Indentured Labour, Caribbean Sugar. Chinese and Indian Migrants to
the British West Indies, 1838-1918 (Baltimore: Johns Hopkins Univ. Press 1993), 3.
6 Curtin argued that the Sugar Duties Act of 1846 did not cause the decline in prosperity in
the West Indian colonies. The Act eliminated protection against market forces, but the
"technological backwardness," the development of the foreign beet sugar industry, and the West
Indian failure to organize a free labour market after emancipation contributed to the
uncompetitive nature of these economies. Philip D. Curtin, "The British Sugar Duties and West
Indian Prosperity," The Journal ofEconomic History, 14, 2 (1954): 158.
7 Porter calculated that the West Indian colonies represented 17.6% of Britain's economic
trade in 1815, valued at £15A million. By 1913, West Indian products had declined to -47% of
Imperial trade, worth £6.6 million. Andrew Porter, ed., The Oxford History ofthe British Empire,
Volume 3, The Nineteenth Century, (Oxford: Oxford University Press, 1999), 5.

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 PhD Thesis - L. Jacklin. McMaster - History.

meaningful way in the nineteenth century. The plantations remained the fundamental
unit of production, designed to create and channel the increasingly elusive wealth into
the hands of the exceptionally small white elite.

During slavery, the estates were considered the primary agency to civilise the
Africans and continued to be deemed the locus of civilisation for the African and East
Indian populations in the post-emancipation period. 8 Thomas C. Holt argued that
Malthusian and Wakefieldian ideals framed the structure of the post-emancipation
societies. Officials believed that free labourers needed to be directed to the production of
staple and export products. The colonies created the conditions whereby the subject
peoples would remain landless labourers, available to toil in the plantation economy,
purposefully keeping the people nearby the agricultural estates and, therefore, within the
realm of civilisation.9 Planters in the British West Indies insisted that the Africans would
otherwise regress into barbarism: the ex-slaves needed to be "'civilised' and conditioned
to accept the status quo." 10 Historians have consistently argued that each colony's
government enacted many policies to limit the opportunities for people to survive
beyond the plantations. The restrictions on land and labour clearly favoured the planters
by keeping the people poor and landless, which precluded the emergence of a large-scale
sector of peasant proprietors. 11 Post-emancipation colonies could not use overt coercion
to keep the people near the estates, but the purposeful restriction of their alternatives
attempted to force the peoples into waged labour, rationalised as a civilising measure:
the lower classes would develop the British values of industry and thrift by labouring on
the estates. 12 This form of colonialism, therefore, kept the mass of the people within the
plantation economy, which impoverished them, while channelling wealth to the small
elite strata of the plantocracy.

The planters' deeply-rooted racial ideologies continued to shape the colonies:

8 Marshall argued that officials in London accepted "for no very good reason" the planters'
argument that the survival of civilization depended on the estate structure: government policies
henceforth restricted the growth of peasantries in the colonies, to protect the ex-slaves from
lapsing into barbarism. Woodville K. Marshall, "Peasant Development in the West Indies Since
1838," in H. Beckles and V. Shepherd (eds.) Caribbean Freedom: Economy and Society form
Emancipation to the Present (Princeton: Markus Wiener, 1993), 104.
9 Holt provided an insightful analysis of the genesis of many of Jamaica's far-reaching
policies. Thomas C. Holt, The Problem ofFreedom. Race, Labor, and Politics in Jamaica and
Britain, 1832-1938 (Maryland: Johns Hopkins Univ. Press, 1992), 73-6.
10 Brian Moore, "The Culture of the Colonial Elites of Nineteenth-Century Guyana," in
Howard Johnson and Karl Watson, eds., The White Minority in the Caribbean (New Jersey:
Markus Wiener, 1998), 95-6. Patrick Bryan, "The White Minority in Jamaica at the end of the
Nineteenth Century," in Johnson and Watson (eds.), The White Minority in the Caribbean, 123-4.
11
Donald Wood, Trinidad in Transition. The Years after Slavery (London: Oxford
University Press, 1968), 91-2. Madhavi Kale, "'Capital Spectacles in British Frames': Capital,
Empire and Indian Indentured Migration to the British Caribbean," International Review of
Social History, 41 (1996): 114. Look Lai demonstrated that Trinidad's Legislative Council
continued to control and depress the wage rates in the colony, setting the indentured wage rates
below the subsistence level and only slightly higher for free labourers on the estates. Look Lai,
Indentured Labour, Caribbean Sugar, 8-9, 171. The situation was similar in British Guiana. Brian
Moore, Cultural Power, Resistance, and Pluralism. Colonial Guyana, 1838-1900 (Montreal:
McGill-Queen's University Press, 1995), 9.
12
Wood, Trinidad in Transition, 92.
 PhD Thesis - L. Jacklin. McMaster - History.

these were not egalitarian societies. 13 The colonial structures allowed the relative handful
of white planters to maintain their privileged economic, social, and political ascendancy
over their large populations of non-white residents. 14 These racial beliefs were not
restricted to the British West Indies. Andrew Porter argued that they dominated the
Empire: official racial thinking during the century asserted that the indigenous peoples
failed to progress. 1s Scholars have unequivocally established that racist policies and tense
racial relations characterised Trinidad. 16 Patrick Bryan succinctly defined the basis of
this form of racism: "a status quo ideology that favoured progress within order, moral
reform, hierarchy and 'obligation.' Britain's paternalist rule over the 'subject people' of
the empire, served the function of 'uplifting' the subject people." 17 Scholars concur that
colonial rule in plantation societies was predicated on the difference between colonial
"savagery" and metropolitan "civilisation": colonial elites portrayed the need to preserve
their dominance in the struggle against "black barbarism. "18 The civilising mission
intended to keep the African peoples labouring on the plantations as a measure to pre­
empt their otherwise inevitable regression, while maintaining the labourforce so
desperately needed to preserve the economy. Plantation society colonialism was thus
predicated on the professed racial superiority of the white Creoles and Britons, who were
intent on maintaining this exploitative society. A central argument of this thesis is that
these deeply-rooted racial ideals and the narrowly defined civilising mission
underpinned the struggles over the government's obligation to maintain the health and
well-being of its subject peoples. This study defines the post-emancipation imperial

13 Historians concur that the comparatively small sectors of white Creole elites functioned
as oligarchies during the century, enacting many laws to restrict the livelihood of the African and
Indian populations. For instance, Brereton argued that the policies of Trinidad's white Creole elite
were clearly rooted in racist ideals. Bridget Brereton, Race Relations in Colonial Trinidad 1870­
1900 (Cambridge: Cambridge University Press, 2002), 1-63. Bryan demonstrated that Jamaica's
white plantocracy used its governmental powers, laws, and economic control to ensure its
continued domination of all facets of the colony. Patrick Bryan, The Jamaican People 1880-1902.
Race, Class and Social Control (Jamaica: Univ. of West Indies Press, 2000), ix-xi. Moore and
Johnson extended Bryan's argument in their investigation of the strategies for social and cultural
control instituted by Jamaica's elite to preserve its hegemony. Brian Moore and Michele Johnson,
Neither Led nor Driven. Contesting British Cultural Imperialism in Jamaica, 1865-1920
(Jamaica: Univ. of West Indies, 2004), 1-5.

1
4 Bolland argued that much of the conflict between the ex-slaves and planters resulted from

the policies imposing restrictions on land acquisition by the lower orders. 0. Nigel Bolland,

"Systems of Domination after Slavery: The Control of Land and Labor in the British West Indies

after 1838," Comparative Studies in Society & History 23, 4 (1981): 591-619. Johnson provided

an alternate view of the forms of domination exercised by the oligarchy in the Bahamas. Howard

Johnson, The Bahamas from Slavery to Servitude, 1783-1933 (Florida: Univ. of Florida, 1996).

1
s Porter, "Introduction: Britain and the Empire in the Nineteenth-Century," 23-4.

16 The racial tensions are the central theme in many monographs. See, for instance,

Brereton, Race Relations. Kelvin Singh, Race and Class Struggles in a Colonial State. Trinidad

1917-1945 (Jamaica: University of West Indies Press, 1994). Wood, Trinidad in Transition. Holt,

The Problem ofFreedom, 215-306, especially 307-9. For a Marxist interpretation, see Dennison

Moore, Origins and Development ofRacial Ideology in Trinidad. The Black View ofthe East

Indian (Canada: NYCAN, 1995).

1
7 Bryan, "The White Minority in Jamaica," 124.

18 Catherine Hall, Civilising Subjects: Metropole and Colony in the English Imagination,

1830-1867 (Chicago: University of Chicago Press, 2002), 10. Moore and Johnson, Neither Led

Nor Driven, 1-5.

 PhD Thesis - L. Jacklin. McMaster - History.

project in Trinidad to include a broad range of initiatives to maintain the ailing economy,
while reinforcing the status quo and power of the white elites. The term 'imperialist' is
periodically used to refer to the white British and Creole elites when they were unified in
their objectives and acting within a shared worldview of white racial superiority.
However, during the numerous conflicts between the two elites over state healthcare,
each faction is referred to as either the British or Creole elite.

The need for non-white labourers remained central to plantation societies.

Madhavi Kale recently admonished scholars for failing to challenge the imperial rhetoric
of the post-emancipation "labour shortage," arguing that Trinidad's planters failed to
form working relationships with the free African population, despite their claims that the
Africans had regressed, after 1838. 19 However, the Imperial government believed the
latter and accepted the responsibility to find a large supply of cheap labourers for the
estates. The Imperial, Indian, and colonial governments collaboratively agreed to
sponsor the immigration of East Indians to work as bonded labourers on the plantations.
Between 1845 and 1916, this multi-governmental program of migration redeployed about
1.3 million East Indians to the plantation colonies. 20 One-third of the so-called "Coolies"
travelled to the British West Indies, chiefly to British Guiana and Trinidad, and a fewer
number to Jamaica. 21 Trinidad sponsored the immigration of 143,939 indentured men
and women during this period, although women continually represented a minority of
the migratory East Indians. The majority settled in Trinidad, with only a mere 29,448
people returning to India. 22 In addition to providing bonded workers for the plantations,
the Indian diaspora changed Trinidad's demographics. By 1921, as the last indentured
worker left the colony, Indo-Trinidadians constituted 33% of the population. 2 3 Chapter 2
investigates this ethno-demographic transformation, arguing that indentured migration
formed the central axis of Trinidad's policy for the growth of its population, based on the
continual importation of expendable labouring bodies, while discouraging the conditions
for the natural increase amongst the Indians and Africans.

Although historians of indenture have not focused their lenses on health, per se,
they continually connect the adverse conditions oflife, endemic diseases, poverty, and

1
9 Kale, "Capital Spectacles in British Frames," 109-33. See also, Curtin, note 12 (above).
20
David Northrup, Indentured Labor in the Age ofImperialism (New York: Cambridge
Univ. Press, 1995): 3.
21
The East Indians were distributed as follows: 238,909 to British Guiana, 143,939 to
Trinidad, and 36,412 to Jamaica. Grenada, St. Vincent, and St. Lucia each received less than
4,400 immigrants. Trinidad received 11,391 indentured Africans, 379 Madeirans, and 1,152
Chinese people. The recruitment of the Chinese occurred between 1852-53 and 1861-65. G.W.
Roberts and J. Byrne, "Summary Statistics on Indentured and Associated Migration Affecting the
West Indies, 1843-1918," Population Studies 20.1 (1966): 127, 13i. Indentured labourers also
travelled to other colonies and countries: 453,309 journeyed to Mauritius, 152,184 to Natal in
South Africa, 26,507 to Reunion, 60,965 to Fiji, 34,304 to Dutch Guiana (Suriname), 39,771 to
Kenya and Uganda, 6,351 to Seychelles, 25,509 to Martinique, and 42,326 to Guadeloupe. Clem
Seecharan, 'Tiger in the Stars.' The Anatomy ofIndian Achievement in British Guiana 1919-29
(London: Macmillan, 1997), 4.
22
Roberts and Byrne, Population Studies, 127, 131.
2
3 In 1921, the population of 366,733 included 122,605 East Indians. Census ofthe Colony of
Trinidad and Tobago, 1921 (Port-of-Spain: Government Printer, 1923).

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 PhD Thesis - L. Jacklin. McMaster - History.

harsh labour to the poor health amongst the Indians. 2 4 Most scholars have concentrated
on the troublesome question of the restricted freedoms of the people. One debate has
dominated the literature for more than thirty years, although the usefulness of
continuing it is now in question. In 1974, Hugh Tinker criticised the redeployment of
Indians throughout the globe as a new form of slavery. 2 s P.C. Emmer acknowledged the
exploitation, but argued that the people exercised agency. Women, in particular, used
migration to their advantage in what Emmer termed the "Great Escape," emancipating
themselves from India's restrictive social and caste systems. 26 Social and gender
historians investigated the factors motivating Indians to migrate and examined their
post-indenture lives in the colonies. The evidence of the exercise of agency supported the
counter-argument of the "Great Escape" and the "material benefits" of migration. 2 7

With the emergence of diaspora studies and the new imperial history during the
1990s, scholars criticised the importance of this debate, while encouraging the adoption

24 Bridget Brereton, "The Experience of Indentureship, 1845-1917," in John LaGuerre (ed.),

Calcutta to Caroni. The East Indians ofTrinidad (Trinidad: Longman Group, 1974), 31.
Laurence's monograph on indenture in Trinidad and British Guiana devoted a chapter to the
health of the immigrants, comparing the regulations and conditions between the two populations.
K. 0. Laurence, A Question ofLabour. Indentured Immigration into Trinidad and British

Guiana.1875-1917(Jamaica: Ian Randle Publishers, 1994), 197-228. Seecharan's analysis of

Indian resistance and adaptation, between 1919 and 1929, briefly highlighted the problems of

poor sanitation and health at the end of the indenture system. Seecharan, Tiger in the Stars, 65­
87. India imposed similar requirements for housing and medical care on the foreign colonies.

Hoefte's study of Suriname established that the colonial officials instituted the minimal measures

to satisfy India's requirements. I would suggest that this minimalist approach was consistent

throughout the colonies sponsoring indentured immigration. Rosemarijn Hoefte, In Place of

Slavery. A Social History ofBritish Indian and Javanese Laborers in Suriname (Gainesville:

University Press of Florida, 1998).

2
s Hugh Tinker, A New System ofSlavery. The Export ofIndian Labour Overseas 1830­
1920 (London: Oxford Univ. Press, 1974). Hoefte, In Place ofSlavery. Verene Shepherd,

"Emancipation Through Servitude: Aspects of the Condition of Indian Women in Jamaica, 1845­
1945,'' in H. Beckles and V. Shepherd (eds.) Caribbean Freedom: Economy and Society form

Emancipation to the Present (Princeton: Markus Wiener, 1993): 245-50.

26 P.C. Emmer, "The Great Escape: The Migration of Female Indentured Servants from

British India to Surinam, 1873-1916,'' in David Richardson (ed.), Abolition and its Aftermath: The

Historical Context, 1790-1915 (London: Cass, 1985): 245-66.

27 East Indians emigrated for many reasons. Seecharan provided a concise summary of the

historiography on the motivations of the immigrants. Seecharan, Tiger in the Stars', 28-36.

Reddock argued that women acted independently to improve their lives, but that these actions

challenged gender ideals and caused officials to attempt to curtail their actions. The majority of

the material benefits evidence involving women offers similar arguments. Rhoda Reddock,

"Indian Women and Indentureship in Trinidad and Tobago 1845-1917: Freedom Denied,''

Caribbean Quarterly 32, 3/4 (1986): 27-49. Verne Shepherd, "Gender, Migration and Settlement:

The Indentureship and Post-indentureship Experience oflndian Females in Jamaica, 1845-1943,"

in Verne Shepherd, Bridget Brereton, Barbara Bailey (eds.), Engendering History. Caribbean

Women in Historical Perspective (New York: St. Martin's, 1995): 233-57. Lomarsh Roopnarine,

Inda-Caribbean Indenture: Creating Opportunities out ofAdversity, unpublished Ph.d. thesis,

State University of New York, 2002. Patricia Mohammed, "Writing Gender into History: The

Negotiation of Gender Relations among Indian Men and Women in Post-indenture Trinidad

Society, 1917-47,'' Verne Shepherd, Bridget Brereton, Barbara Bailey (eds.), Engendering History.

Caribbean Women in Historical Perspective (New York: St. Martin's, 1995): 20-47.

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 PhD Thesis - L. Jacklin. McMaster - History.

of current analytical frameworks. David Eltis, for instance, suggested the need to ask
penetrating questions about the socio-cultural values of the societies sponsoring this
global diaspora. 28 David Northrup argued that scholars need to conduct rigorous studies
prior to asserting that the oppression of indenture approached slavery. 2 9 Verne Shepherd
agreed and, along with Madhavi Kale, focused on the politics of Imperial expansion
involving the Indians.3° Certainly, indenture was an oppressive system. However, many
historians have simply perpetuated a version of the historical debate between the anti­
slavery reformers and the plantocracies. These recent scholarly criticisms have
influenced this study of state healthcare in Trinidad. While historians have investigated
the health of the enslaved Africans, and their post-emancipation colleagues have alluded
to the prevalence of ill-health amongst the indentured East Indians, there is very little
information on the health of either sector once they were released from their different
forms of bondage. This analytical framework situates the health experience of the African
and East Indian sectors in relation to each other to compare the experience between
different populations living side by side, with the objective of understanding the broad
implications of colonial state healthcare in plantation society colonialism.

India ended indentured migration in 1916, unilaterally terminating the flow of

Indians to British colonies and foreign countries, due to rising nationalist and anti­
British agitation.3 1 Historians concur that three factors guided India's decision: the
unfree state of the Indians abroad, their poverty, and the immoral life of Indian women
caused by the profound gender disparity within the post-indenture Indian populations
overseas. 32 Until that time, indentured migration had formed a vital component of the
imperial project in Trinidad for seventy-one years, providing the plantocracy with a
consistent supply of bonded workers, justified within the rhetoric of the labour shortage
and professing to civilise the Indians. However, the conditions oflife and labour had
been difficult for the Indians and, in fact, outright perilous to their health and longevity
in the early years. James Patterson Smith argued that the Colonial Office recognised that
the imperial project's civilising mission was encountering difficulties in the mid-186os.
In 1865, the African population rose up to challenge colonialism at Morant Bay in
Jamaica, while Whitehall faced heightened political pressures about the adverse
conditions of the indentured Indians in the host colonies. The Colonial Office recognised
the need to change its approach to civilising the colonial "barbarian." One important
reform forced the colonial governments to accept the responsibility for the health of their

28 David Eltis, "Introduction. Migration and Agency in Global History," in idem, ed.,
Coerced and Free Migrations. Global Perspectives (California: Stanford Univ. Press, 2002), 2-4.
2
9 Northrup, Indentured Labor in the Age ofImperialism, 4-6.
3o Kale, "'Capital Spectacles in British Frames," 109-33. Verene Shepherd, Maharani's
Misery. Narratives ofa Passage from India to the Caribbean (Jamaica: University of West
Indies Press, 2002).
31 On 29 March 1916, the Secretary of State telegraphed Trinidad stating that India had
decided to abolish indentured immigration. 1916 LC #46, Abolition ofIndentured Emigration.
32 Look Lai argued that India's decision was not related to any particular circumstances in
the West Indies, but the result of rising nationalist sentiments. Reddock argued that the condition
of the expatriate Indian women, during indenture and as free colonial residents, formed an
important part of the agitation. Nationalists believed that the men had been enslaved and the
women were prostituted. Laurence noted all three factors. Laurence, A Question ofLabour, 457­
8,469, 471. Look Lai, Indentured Labour, Caribbean Sugar, 175-8. Reddock, "Indian Women and
Indentureship," 27-49.

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 PhD Thesis - L. Jacklin. McMaster - History.

indentured labourers and to create GMS organisations.33 Each colony had a great deal of
flexibility organising its GMS. Some colonies, such as Jamaica, integrated ailing and
injured East Indians into their system of public hospitals and exercised significant
control over their care.34 Trinidad's Coolie Immigration Ordinance 13 of 1870 required
the planters to provide a rudimentary level of health services to the immigrants, while
the government absorbed the responsibility to provide travelling GMS physicians to
service the estates.3s The government's commitment to employ the doctors benefited the
planters: the white Creole elite henceforth supported the state's obligation to provide the
medical resources for this secondary tier of the GMS.

Conversely, the colonial state's involvement in providing medical services to the

free or non-indentured public became a point of contention and the root of the many
protracted struggles to 1916, as explored below (in Chapters 4, 5, and 6). From its
inauspicious beginning in 1870, the GMS grew to become one of the government's main
annual expenditures, while subsuming the meagre forms of state-provided relief within a
rather convoluted introduction of selected tenets of preventive medicine in Trinidad and,
after 1899, Tobago.36 By 1870, Trinidad had established the Port-of-Spain and San
Fernando Hospitals, Lunatic and Leper Asylums, and Coolie Depot Hospital.37 The
number of institutions and patients increased substantially in the next six decades. By
the 1921 census, in addition to the lunatic, leper, orphan, convict, and police populations,
the GMS treated a substantial number of poor Trinidadians gratuitously or for a token
sum: 14,594 patients in nine hospitals, with 41% being paupers, and a further 40,064
poor people as out-patients at twenty-three government dispensaries and health
offices.3 8 Large Public Health, Quarantine, and Port Health departments then existed as
adjuncts to the GMS. This study establishes that this large primary tier of government
healthcare for the African and East Indian public became the subject of momentous
controversy between the white Creole elite, the British officials in Trinidad and London,
and the Trinidadian public. While the elites disagreed on the obligation of the state to
provide these resources, the public remained a major force in ensuring the survival of the
GMS through their tenacity to use the state's medical resources to address their health

33 James Patterson Smith, "Empire and Social Reform: British Liberals and the 'Civilizing

Mission' in the Sugar Colonies, 1868-1874," Albion, 27, 2 (1995): 253, 270.

34 Bryan, The Jamaican People, 166-7. James C. Riley, Poverty and Life Expectancy. The

Jamaica Paradox (New York: Cambridge Univ. Press, 2005), 49.

35 BPP 1872 [c.523]. The Present State ofHer Majesty's Colonial Possessions. For the Year

1870, 70-2.

36 Tobago was subsumed within Trinidad as a ward. The GMS annexed Tobago's medical
districts in 1899. CO 295-391 (1899) #4024. Tobago Medical Service. Tobago was not an equal
partner with Trinidad in the GMS structure, which is consistent with Luke's analysis of Tobago's
status as a ward from 1897 to 1924. Learie B. Luke, Identity and Secession in the Caribbean.
Tobago versus Trinidad, 1889-1980 (Jamaica: Univ. of West Indies Press, 2007), 101-24.
37 The Cocorite Leper Asylum was the first medical facility on the island, established in
1845. The 200-bed Port-of-Spain Hospital and 120-bed Belmont Lunatic Asylum opened in 1858.
The San Fernando Hospital opened a year later. Daniel Hart, Trinidad and the other West India
Islands and Colonies, 2nd edition (Trinidad: Chronicle Publishing Office, 1866), 104, 199. 1877 LC
#1. Lunatic Asylum. Annual Report ofthe Medical Superintendent for 1876, 1.
38 1922 LC #65. Administration Report ofthe Surgeon-Generalfor the year 1921, 2, 7, 14.
[Hereafter, Surgeon-General AR.] In 1921, the GMS also treated 828 lunatics and 643 lepers in
the asylums, plus 642 inmates at the House of Refuge.

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 PhD Thesis - L. Jacklin. McMaster - History.

conditions, despite the many obstacles placed in their way.

Methodology: Juxtaposing the Process ofCreolisation and "Tensions ofEmpire"

As an entity created by a plantation society in the British Empire, Trinidad's GMS was
perpetually shaped by pressures from within the colony, the pan-Caribbean region, the
metropole, and distant territories, such as India. In the past decade, historians have
criticised studies that do not account for the complex connections between the colony
and the larger world. At the same time, scholars of the British West Indies have
continued to ascertain the uniqueness of these creole societies. This study integrates
both approaches in order to recognise the importance of the Trinidad's global
interconnectedness, while concurrently establishing how the process of creolisation
created this distinctly British West Indian system of state medicine and public health.

The recent literature has identified several challenges in studying the local and
global experiences within a single analytical framework. Scholars of the new imperial
history, such as Ann Laura Stoler and Frederick Cooper, argue that the influences from
multiple locations created many "tensions of empire." They have criticised historians
who fail to look beyond the axis of the colony to metropole and recognise that people,
ideas, and knowledge travelled on many different routes before arriving in the colony.39
Scholars in diverse specialist areas offer similar critiques of the insularity of colonial
histories. Barry Higman has argued that scholars have been too intent on rewriting
colonial histories which extract the British West Indies from the British Empire. He
anticipated a historiographic shift as historians started to account for the numerous
viewpoints and contexts of life in the Caribbean region which created the "vital creole
culture ambiguously rooted in Empire."4° Certainly, the history of the British West Indies
cannot be explained in isolation from the metropole. David Arnold recognised the
opposite problem in some histories of health and medicine in the imperial world, and
admonished historians who produced narratives of "Europe's medical adventures
overseas." Western medicine was not a static and value-free body of knowledge, which
simply radiated from the metropole across the Empire. Arnold directed historians to
probe the trans-national linkages shaping medicine in the tropical Empire.41 Scholars
examining different imperial world locales thus agree that ideas and knowledge changed
and adapted as they moved throughout the Empire, as did many of the people who
influenced their development.

David Lambert and Alan Lester recently argued that it is important to maintain
the historical relations between the people within the vast imperial world, along with
their connections to the places and contemporary events beyond the borders of the

39 Ann Laura Stoler and Frederick Cooper, "Between Metropole and Colony: Rethinking a
Research Agenda," in Ann Laura Stoler and Frederick Cooper, eds., Tensions ofEmpire. Colonial
Cultures in a Bourgeois World (Berkeley: Univ. of California Press, 1997), ix, 1, 26.
4° B.W. Higman, "The British West Indies," in Robin W. Winks, ed., The Oxford History of
the British Empire. Vol. V. Historiography (Oxford: Oxford Univ. Press, 1999), 136-7, 144.
41 David Arnold, "Tropical Medicine before Manson," in David Arnold, ed., Warm Climates
and Western Medicine: The Emergence ofTropical Medicine, 1500-1900 (Amsterdam: Rodopi,
1996), 11-13.

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 PhD Thesis - L. Jacklin. McMaster - History.

colony. They argued that multiple colonial projects existed in tandem, linking the colony
to the metropole and other locations in and beyond the Empire, within what they
characterise as a "networked or webbed imperial space." A framework of an
interconnected imperial world allows multiple locations to be considered at once,
without privileging any particular locality.42 This model allows historians to recognise a
colony's place in the universality of imperialism: each colony functioned as one of many
nodes on the global networks, receiving, modifying, and transmitting ideas, attitudes,
and practices at the same time.

Two recent monographs on colonial Jamaica provide excellent examples of the

richness of studies that reveal the complexities of colonialism and relate the events to
broader developments occurring within inter- and intra-Imperial networks. During
Jamaica's transition from slavery to free labour, Diana Paton established the mutually
constitutive nature of the changing definitions of crime and punishment, through
Jamaica's interactions with other circum-Caribbean colonies and the metropole. Paton
encouraged colleagues to conduct detailed studies of the daily struggles in the colonies,
while situating the analysis within the broader context of the Imperial and Atlantic
worlds.43 Similarly, Catherine Hall's Civilising Subjects identified many multi-directional
forces operating in the imperial world, while bringing Jamaica and Birmingham into one
analytical frame. Hall's examination of Governor Edward John Eyre's imperial career in
several colonial nodes of the imperial network, from Australia to Jamaica, encapsulated
the global nature of the influences which changed the thinking about race during his
colonial career.44 The scholarship by Paton and Hall provides admirable examples of the
productive results derived from connecting the universal and the local: the complexities
of the struggles within Jamaica were shaped by the flow of ideas from the Imperial and
Atlantic worlds, in addition to the metropole.

The histories of the West Indian colonies in the context of global forces are
clearly significant but, as demonstrated by Paton and Hall, the developments within each
colony continue to merit intensive interrogation. Scholars of the colonial Caribbean have
established the historical importance of the processes of contestation and negotiation
between the European-descended elites and African majorities, as they forged new and
distinctly creole societies during the colonial period. Since the seventeenth century, the
term 'creole' has described a diverse range of Caribbean-born entities with non-native
ancestry or heritage, including the peoples, cultures, languages, ways of life, music,
styles, flora, and fauna.4s In the 1970s, Kamau Brathwaite's pioneering studies of the
development of West Indian societies challenged the model of plural societies, wherein
the remnants of African traditions were situated alongside the European cultures.46 To

42 David Lambert and Alan Lester, "Imperial Spaces, Imperial Subjects," in David Lambert

and Alan Lester, eds., Colonial Lives across the British Empire: Imperial Careering in the Long

Nineteenth Century (Cambridge: Cambridge University Press, 2006): 4-5, 9-10.

43 Diana Paton, No Bond but the Law. Punishment, Race, and Gender in Jamaican State

Formation, 1780-1870 (Durham: Duke University Press, 2004), 1-5.

44 Hall, Civilising Subjects: Metropole and Colony in the English Imagination, 1830-1867.

45 Carolyn Allen, "Creole: The Problem of Definition," in Verene A. Shepherd and Glen L.

Richards, eds., Questioning Creole. Creolisation Discourses in Caribbean Culture (Kingston: Ian

Randle, 2002), 48. B.W. Higman, Writing West Indian Histories (London: Macmillan, 1999), 6.

46 Brathwaite was challenging M.G. Smith's construction of the British West Indies colonies

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 PhD Thesis - L. Jacklin. McMaster - History.

the contrary, Brathwaite conceived of the uniqueness of creole societies, forged through
centuries of struggle. He defined creole society as:

... a complex situation where a colonial polity reacts, as a whole, to external

metropolitan pressures, and at the same time to internal adjustments made
necessary by the juxtaposition of master and labourer, white and non-white,
Europe and colony, European and African, ... in a culturally heterogeneous
relationship.47

Thus, in Brathwaite's definition, while Africans were forced to acculturate to European

norms, Europeans also assimilated African cultures, and inter-acculturation between
both groups proceeded apace.48

Scholars consistently recognise the importance of the creolisation thesis, while

they debate the optimum theoretical constructs for their studies.49 Nigel Bolland, for
instance, agreed that Africans did not passively accept the European cultures and that
they actively exercised agency. Bolland criticised the dualism in Brathwaite's conception,
and instead proposed a dialectical analytical framework, but nonetheless agreed that the
creolisation is key to understanding that Caribbean societies were built by "contention,"
rather than homogeneity.5° Subsequently, scholars such as Michele Johnson and Brian
Moore criticised the dialectical framework's intrinsic polarisation of the conflicts, such as
the struggles between hegemony and resistance or domination and subordination. Their
study demonstrated the efficacy of the forces of creolisation in negotiating cultural
imperialism and its "civilising mission" in Jamaica, through the complex contestations
between the conservative planter elite, British reformers, and the Afro-Jamaican lower
ranks. Johnson and Moore established that conflict prevailed within the elite factions
and the fact that, by virtue of the sheer numbers of lower class Afro-Jamaicans, the
presumed "subordinate" Afro-Creole culture dominated the landscape.51 Similarly, other
scholars have confirmed that the complex creole societies cannot be comprehensively
explored within the limitations of the dialectical or dualist models: creolisation often

were plural societies. Michael Garfield Smith, The Plural Society in the British West Indies
(Berkeley: Univ. of California Press, 1965).
47 Edward Kamau Brathwaite, Contradictory Omens: Cultural Diversity and Integration in
the Caribbean (Jamaica: Savacou, 1974), 11. Brathwaite's earlier work offered a similar definition
for the societies prior to emancipation. Edward Brathwaite, The Development ofCreole Society in
Jamaica 1770-1820 (Oxford: Clarendon Press, 1971), xvi.
48 Brathwaite, Contradictory Omens, 11.
49 Verene A. Shepherd and Glen L. Richards, "Introduction," in idem, eds., Questioning
Creole. Creolisation Discourses in Caribbean Culture (Kingston: Ian Randle, 2002): xi-xxvi.
so The emphasis is in Bolland's essay. Bolland has repeatedly criticised Brathwaite's
dualistic conception of the interaction and blending of "creole" and "colonial'' elements. He
proposed a dialectical analytical framework, to recognise the mutually constitutive nature of the
competing forces: there can be no whiteness without blackness, masters without slaves, or
resistance without systems of domination. 0. Nigel Bolland, "Reconsidering Creolisation and
Creole Societies," in Gad Heuman and David Trotman, eds., Contesting Freedom: Control and
Resistance in the Post-Emancipation Caribbean (Oxford: Macmillan, 2005), 179-82. Idem,
"Creolisation and Creole Societies: A Cultural Nationalist View of Caribbean Social History,"
Caribbean Quarterly, 44, 1-2 (1998), 3.
s1 Moore and Johnson, Neither Led nor Driven, xiv-viii, 322.

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 PhD Thesis - L. Jacklin. McMaster - History.

involved other ethnic and racial groups, such as the settled East Indians and Chinese,
and there was on-going inter-acculturation amongst the diverse groups of white elites.52
Thus, while the burgeoning scholarship clearly establishes how creolisation created
distinctly West Indian societies, the methodological approaches continue to evolve as
scholars expand their purview of the process and effects of creolisation.

Historians have not yet considered how the forces of creolisation influenced the
development of governmental social policies, legislation, and institutional structures,
which had a direct bearing on the development of the West Indian societies. A central
thematic argument in this study is that the forces of contestation and negotiation
creolised the government's polices on public health and medicine in colonial Trinidad
and shaped the contours of the GMS organisation and the services which it delivered to
the residents. To be clear, the theories and praxis of western medicine in Trinidad were
the same as in the metrbpole and there is no evidence that the GMS doctors integrated
indigenous or local therapeutics into their medical practices: doctors in Trinidad
practiced British medicine. The process of creolisation influenced the state policies on
western medicine and, more specifically, if and how the treatments provided by the GMS
would be delivered to the Trinidadian people. In this plantation society, the GMS
employed the majority of the colony's European-trained medical practitioners, operated
all the medical institutions, and functioned as the state authority on public health. The
government therefore established and maintained almost exclusive control over the
dispensation of western public health and medical care services, albeit often reluctantly,
while the state's obligation to maintain the health and well-being of the subject peoples
remained contested terrain.

Three distinct factions negotiated Trinidad's colonial healthcare policies: the

white Creole elite, sojourning British officials, and the Trinidad public. Racial and class
ideals permeated the worldview of the white elites: their discourse portrayed the Africans
as failing to embody civilisation and regressing into barbarism. However, the white
Creoles considered the prevalence of ill-health and poverty as proof of their claim, while
some, but not all, sojourning white Britons believed that the state needed to address the
poverty and ill-health created by plantation society colonialism. The alliances between
the white Creoles and Britons often changed each time new officials arrived in the
colony. The subject peoples were not invited to participate in the debate over the colonial
state's obligation to assist them. However, the power of the lower classes devolved from
the same factor identified by Moore and Johnson in Jamaica: their sheer numbers. In

s2 For the Indians, see for instance, Rhoda Reddock, "Contestations over Culture, Class,
Gender and Identity inTrinidad and Tobago. 'The Little Tradition,"' in Verene Shepherd and G.
Richards, eds., Questioning Creole. Creolisation Discourses in Caribbean Culture (Kingston: Ian
Randle, 2002). Patricia Mohammed, "The 'Creolisation' oflndian Women in Trinidad," in
Shepherd and Richards, eds., Questioning Creole, 130-47. For the Chinese, C. Ho, "'Hold the
Chow Mein, Gimme Soca': Creolization of the Chinese in Guyana, Trinidad and Jamaica,"
Amerasia, 15, 2 (1989): 3-25. In his study of white creole culture in Barbados, Lambert argued
that the controversies over slavery and emancipation creolized the identities of the white planters,
while creating important "tensions of empire" between the elites in and the anti-slavery reformers
and officials in the metropole. Similar to this study of the struggles between Trinidad's white
elites, in Lambert's monograph it is often difficult to delineate between the dominant and
subordinate dialectic amongst the white elites. David Lambert, White Creole Culture, Politics and
Identity during the Age ofAbolition, New York: Cambridge University Press, 2005, 5, 37-9.

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 PhD Thesis - L. Jacklin. McMaster - History.

the case of healthcare in Trinidad, tens of thousands of poor people relentlessly sought
medical assistance from the GMS doctors each year. The elites often distained and
disparaged these lower-class sufferers, but the non-white masses remained a force to be
reckoned with, because of their cumulative tenacity, and an important factor in
creolising state healthcare.

This study investigates the system of state healthcare in Trinidad by examining

the struggles in the colony, while situating the developments within the interconnected
network spanning the metropole, pan-Caribbean region, and other imperial locations,
such as British India. Trinidad creolised its social policies and the GMS as it alternatively
acculturated, accommodated, and rejected pressures from within the colony and from far
beyond its borders.

The Historiography ofHealth and Medicine in the British West Indies

To-date, historians of the post-emancipation British West Indies have not investigated
each colony's formal involvement in public health and medical services, the growth of
their GMS organisations and institutions, or the health of the peoples who used the
system.s3 The meagre literature on the history of colonial health and medicine is
consistent with what Johnson and Moore have repeatedly identified as the lack of social
and cultural histories for the post-1865 colonial period.54 In general, the scholarship is
more extensive for the period of slavery. This trend is evident in the history of health and
medicine, and the literature on slave health is exceptionally useful to contextualise the
attitudes of the plantocracy about the health of its non-white subjects. A central thematic
argument of this thesis is that slavery era attitudes continued to prevail throughout the
period, which had a major effect in defining the politico-economy of health and shaping
the contours of state healthcare in Trinidad.

Philip Curtin's seminal 1969 monograph on the Atlantic slave trade initiated
vigorous scholarly interest in the health of the enslaved peoples. Curtin established that
the British West Indian slave populations had never become self-sustaining populations,

53 Laurence considered the public health and medical services prior to 1873 in Trinidad and
British Guiana. While this was an important contribution to the early post-independence
literature, it provided only a brief comparative summary. K.O. Laurence, "The Development of
Medical Services in British Guiana and Trinidad 1841-1873," Jamaican Historical Review 4
(1964): 59-67. Riley's study oflife expectancy in Jamaica included an informative summary of the
public health initiatives, the GMS services, and social welfare to 1920. Riley, Poverty and Life
Expectancy, 48-68. The absence of studies on the GMS organisations and their patients in the
West Indian colonies is part of a larger deficiency in the literature on the GMS organisations
throughout the imperial world. Crozier's recent monograph on the colonial government doctors in
British East Africa analyses the backgrounds and careers of the doctors, without delving into the
patient interactions within the medical service. Anna Crozier, Practicing Colonial Medicine: The
Colonial Medical Service in British East Africa (New York: Tauris, 2008).
54 Brian L. Moore and Michele A. Johnson, 'Squalid Kingston' 1890-1920. How The Poor
Lived, Moved And Had Their Being (Jamaica: Univ. of the West Indies, 2000), viii-ix. For
Jamaica, the largest British West Indian plantation colony, they qualify the sparse nature of the
socio-cultural literature between 1865, the year of the Morant Bay uprising, and 1938, a time of
renewed violence in Jamaican society. Moore and Johnson, Neither Led nor Driven, xi-xiii.

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 PhD Thesis - L. Jacklin. McMaster - History.

and decreased in size, while slaves in the United States reproduced their numbers by
natural means.ss This revelation piqued the interest of historians, who uncovered a
wealth of data about the health of the slaves. The British Parliament wanted to ensure
that planters complied with the 1807 legislation abolishing the slave trade and thus
mandated annual censuses of the slaves,s6 while the Colonial Office made Trinidad a test
colony for the abolition of the trade.s7 The Colonial Office's distrust of the plantocracies
created a large number of primary sources, which historians of slavery and historical
demographers meticulously analysed to ascertain the reasons why the populations
decreased in size. Their studies established that excessively high mortality rates and
extremely low fertility rates caused the unnatural decrease in the number of slaves.s8

With the advent of social history, historians began to scrutinise the daily living
conditions and the widespread ill-health amongst the slaves. Their examinations
established clear connections between the high rates of mortality and morbidities and
the brutality of the system, malnutrition, and deprivation, which persisted within the
racialised political economies of health in the colonies.s9 Historians also questioned the
effectiveness of the legislation enacted by Britain, in the 1820s, to ameliorate the
conditions of the slaves. These scholars argue that, although the health of slaves on some
plantations may have improved, the conditions tended to become worse for the majority,
as emancipation drew near. 60 Unfortunately, some studies tend to use medicine to

s5 Philip Curtin, The Atlantic Slave Trade: A Census (Madison: University of Wisconsin
Press, 1969), 69.
s6 For slave registration and the use of the data, see Barry Higman, Slave Populations ofthe
British Caribbean, 1807-1834 (Jamaica: Univ. of West Indies Press, 1995), 6-36, 164. Slave
registration created censuses of the slave population, which provided statistical information to
Whitehall and Britain's anti-slavery movement.
57 Gelien Matthews, "Trinidad: A Model Colony for British Slave Trade Abolition,"
Parliamentary History 26 (2007): 84-96.
58 Higman, Slave Populations ofthe British Caribbean. B.W. Higman, Slave Population
and Economy in Jamaica, 1807-1814 (New York: Cambridge Univ. Press, 1976). Richard B.
Sheridan, Doctors and Slaves: A Medical and Demographic History ofSlavery in the British
West Indies (Cambridge: Cambridge Univ. Press, 1985). A. Meredith John, The Plantation Slaves
ofTrinidad, 1783-1816: A Mathematical and Demographic Inquiry (New York: Cambridge Univ.
Press, 1988). Barbara Bush, Slave Women in Caribbean Society 1650-1838 (Kingston:
Heinemann Caribbean, 1990): 120-50. Hilary McD. Beckles, Natural Rebels: A Social History of
Enslaved Black Women in Barbados (NJ: Rutgers Univ. Press, 1989).
59 K. Kiple, The Caribbean Slave: A Biological History (Cambridge: Cambridge Univ. Press,
1984). K. Kiple and V. Kiple, "Deficiency Diseases in the Caribbean," Journal ofInterdisciplinary
History, 11, 2 (1980): 197-215. Richard S. Dunn, "'Dreadful Idlers' in the Cane Fields: The Slave
Labor Patterns on a Jamaican Sugar Estate, 1762-1831," Journal ofInterdisciplinary History, 17,
4 (1987): 795-822. Jerome S. Handler, "Diseases and Medical Disabilities of Enslaved
Barbadians, From the Seventeenth Century to around 1838 (Part I)," Journal ofCaribbean
History, 40, 1(2006):1-38. Idem, "Diseases and Medical Disabilities of Enslaved Barbadians,
From the Seventeenth Century to around 1838 (Part II)," Journal ofCaribbean History, 40, 2
(2006): 177-214. Jennifer L. Morgan, Laboring Women: Reproduction and Gender in New
World Slavery (Philadelphia: Univ. of Pennsylvania Press, 2004).
60 J.R. Ward, British West Indian Slavery, 1750-1834: The Process ofAmelioration (New
York: Oxford Univ. Press, 1988), 224-5. Richard B. Sheridan, "From Chattel to Wage Slavery in
Jamaica, 1740-1860," Slavery & Abolition, 14, 1 (1993): 13-40. Barbados remained anomalous in
the British West Indies, as it was the only slave colony where the population reproduced its

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 PhD Thesis - L. Jacklin. McMaster - History.

critique slavery, which detracts from this important topic, and appears out of place
within a literature where it is difficult to identify any current-day scholars defending the
system of slavery.61 Overall, these studies provide substantial insight into the challenges
faced by the slaves in their daily lives. They establish the plantocracy's brutal treatment
of their slaves: these behaviours were well-accepted amongst the whites. Chapters 2 and
3 establish that these ideologies permeated the planters' consciousness as they
extrapolated the notion of expendable and replaceable African bodies to the new Indian
population. The prevalence of these attitudes amongst the white elite controlling the
healthcare resources affected the conditions of health of the subject peoples in Trinidad.

In contrast to the active scholarly interest in the health of enslaved Africans, little
attention has been devoted to the health of the colonial peoples in the post-emancipation
British West Indies. Several influential scholars have noted this deficiency in the
literature, including Shula Marks and Diana Paton. 62 The literature is indeed sparse and,
until recently, generally restricted to a limited number of studies on selected aspects of
public health, 6 3 the practice of medicine, 6 4 and the ecology of certain diseases. 6 5 The
literature thus lacks a composite analysis of health or western medicine in any colony,
although ill-health may have been endemic everywhere: social and cultural historians
allude to the peoples' struggles with adverse health conditions. For instance, Bryan
established that widespread poverty and ill-health strained the resources of the
Jamaican lower classes, forcing them to seek government assistance, but sufferers often
had difficulty reaching the GMS facilities and obtaining poor relief. 66 This study reveals

numbers by natural increase. However, this should not be construed as confirmation of a

healthier population. Inniss recently argued that the infant mortality rate remained high during
the ameliorative period. Tara A. Inniss, "From Slavery to Freedom: Children's Health in
Barbados, 1823-1838," Slavery & Abolition, 27, 2 (2006): 251-60.
61 The informative essays by Gosse and Jabour on the ameliorative period tend to be
overshadowed by this tendency. David Gosse, "Health Conditions on Selected Plantations in
Jamaica," The Journal ofCaribbean History 40, 2 (2006): 215-34. Anya Jabour, "Slave Health
and Health Care in the British Caribbean: Profits, Racism and the Failure of Amelioration in
Trinidad and British Guiana, 1824-1834," Journal ofCaribbean History, 28, 1 (1994): 1-26.
62 Shula Marks, "Presidential Address. What is Colonial about Colonial Medicine? And what
has Happened to Imperialism and Health," Social History ofMedicine, 10, 2 (1997): 207, passim.
Paton, No Bond but the Law, 12. See also, De Barros, Palmer, and Wright, "Introduction," 2-3.
63 Rita Pemberton, "Water and Related Issues in Nineteenth-Century Trinidad," Journal of
Caribbean History, 40, 2 (2006): 235-52. Rita Pemberton, "A Different Intervention: The
International Health Commission/Board, Health, Sanitation in the British Caribbean, 1914-1930,"
Special Issue of Caribbean Quarterly, 49, 4 (2003): 87-103.
64 Laurence, "The Development of Medical Services," 59-67. Nadine Joy Wilkins, "Doctors
and Ex-slaves in Jamaica 1834-1850," Jamaican Historical Review 17 (1991): 19-30. Although
Clyde is a medical doctor and amateur historian, he illuminated several interesting aspects of the
practice of medicine in a colony that has not received much scholarly attention. David F. Clyde,
Two Centuries ofHealth Care in Dominica (Lucknow: Prom Printing, 1980).
65 Kenneth Kiple, "Cholera and Race in the Caribbean," Journal ofLatin American Studies
17 (1985): 157-77. Kenneth Kiple and Brian T. Higgins. "Cholera in Mid-nineteenth Century
Jamaica," Jamaican Historical Review 17 (1991): 31-47. David Killingray, "The Influenza
Pandemic of 1918-1919 in the British Caribbean," Social History ofMedicine 7, 1 (1994): 59-87.
Susan Watts, "Dracunculiasis in the Caribbean and South America: A Contribution to the History
of Dracunculiasis Eradication," Medical History 44, 2 (2000): 227-50.
66 Bryan identified the GMS and Poor Relief services as important health resources for the

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 PhD Thesis - L. Jacklin. McMaster - History.

that Trinidadians similarly exerted significant effort to obtain GMS assistance, which
was the only form of relief in a colony that refused to institute a Poor Law system.

While the analytical categories of race and class have naturally dominated the few
extant works, scholars have only recently started to consider the implications of gender,
in the slavery and post-emancipation periods. 67 In the first anthology devoted to health
and medicine in the circum-Caribbean region, published in 2009, the contributions of
the four historians of British colonies concentrated on women's health, infant welfare,
and midwifery. 68 These essays established that freedom and enslavement and their
legacies, along with colonialism's civilising mission, determined how women experienced
health, as patients and practitioners in the medical marketplace. 6 9 These authors
provided long overdue investigations into the importance of race, class, and gender in
influencing the development of social policies and state control over female bodies, and
the actions and reactions of women in the British West Indies. Chapter 3 contributes to
the gender scholarship, in one area where the state healthcare archival sources provided
relevant data, by introducing the efficacy of gender, race, and class in defining the health
conditions aboard the ships transporting indentured East Indians to the Caribbean.

The generally thin scholarly literature on health and medicine the colonial British
West Indies is a curious anomaly. Historians agree that medicine played an important
role in the imperial project elsewhere in the Empire.7° However, there has been a notable

Jamaican people. As established in this thesis, Trinidad did not institute a similar system of Poor
Relief, which caused the GMS to evolve to a system of medicalised relief, housing many sufferers
in medical institutions, who would have been candidates for almshouses or out-door relief in
other colonies. Bryan, The Jamaican People 1880-1902, 161-90.
67 While earlier studies may have acknowledged gender, the use of gender as the central
analytical category has only recently appeared in the literature. See, for instance, Pedro Welch,
"Gendered Health Care: Legacies of Slavery in Health Care Provision in Barbados over the period
1870-1920," Caribbean Quarterly, 49, 4 (2003): 104-20. Churchill examined British physician
Hans Sloane's medical practice during his visit to the West Indies, analysing the early gendered
and racial ideals in medical diagnoses and treatments. Wendy D. Churchill, "Bodily Differences?
Gender, Race, and Class in Hans Sloane's Jamaican Medical Practice, 1687-1688," Journal ofthe
History ofMedicine & Allied Sciences, 60, 4 (2005): 391-444.
68 De Barros, Palmer, and Wright, Health and Medicine in the circum-Caribbean.
69 Inniss considered the professionalization of midwifery during slavery, introducing the
implications of freedoms and race in the competition between white, African, free, and enslaved
midwives. Challenger contributed to the scholarship on Contagious Diseases Acts by analysing the
former slave colony of Barbados, while McCollin considered women's struggles for health in
Trinidad and Tobago's changing post-war landscape. De Barros established the influence of
gendered and racial ideals in the quest of officials to supplant traditional childbirth practices with
medicalised western approaches, as early-twentieth-century reformers insisted that non-white
women from the lower orders had failed to adopt civilised maternal behaviours, which resulted in
high rates of infant mortality. Tara A. Inniss, '"Any elderly, sensible, prudent woman.' The
Practice and Practitioners of Midwifery during Slavery in the British Caribbean,'' in De Barros
et.al. eds., Health and Medicine in the circum-Caribbean, 40-52. Denise Challenger, "A Benign
Place of Healing? The Contagious Diseases Hospital and Medical Discipline in Post-Slavery
Barbados," in ibid, 98-120. Debbie Mccollin, "World War II to Independence: Health, Services,
and Women in Trinidad and Tobago, 1939-1962," in ibid, 227-48. Juanita De Barros, "'Improving
the Standards of Motherhood.' Infant Welfare in Post-Slavery British Guiana," in ibid, 65-94.
7° The comprehensive literature reviews by Marks and Anderson confirm an extensive

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 PhD Thesis - L. Jacklin. McMaster - History.

change in the conception of the contribution of western public health and medicine from
the time when Roy McLeod first argued, in 1988, that they functioned as powerful "tools
of Empire," becoming a trademark of imperialism.71 David Arnold responded that
biomedicine became more than a mere tool, gaining the dubious honour as "one of the
most enduring and, indeed, destructive or distorting legacies of colonial rule."72 Scholars
have increasingly separated the rhetoric from the reality to determine the extent of
medicine's influence. Continuity is evident in the literature spanning diverse imperial
territories: while the rhetoric promoted public health and medicine to tame the
environment and civilise the people, the politico-economy restricted the scope of these
initiatives. Mark Harrison, for instance, argued that the priority of maintaining stable
rule in India required extensive collaboration between the British and Indian elites,
which precluded the introduction of any public health policies that would stimulate
negative responses from the people.73 The actions of colonisers and colonised alike
meant that western medicine did not replicate the forms from the United Kingdom.74
Arnold established that India generally reacted, rather than introducing preventive
medicine or addressing endemic ill-health, because the government was disinterested or
unable to assume the responsibility for so many people.75 Although colonial medicine
developed as part of imperialism's "mission and mandate," many factors limited its
scope and influence: Michael Warboys encouraged historians to look beyond the

scholarship on the integration of colonial medicine in the development of the imperial world.
Warwick Anderson, "Postcolonial Histories of Medicine," in John Harley Warner and Frank
Huisman, eds., Locating Medical History. The Stories and Their Meanings (Baltimore: Johns
Hopkins Univ. Press, 2006): 285-306. Marks, "What is Colonial about Colonial Medicine?" The
recent essays by De Barros are some of the few exceptions where health in the British Caribbean is
considered within a more contemporary analytical framework. Her studies demonstrate that
professionals integrated British and Guianese ideals into the practice of medicine and public
health. This resulted from the entry oflocally-born black and coloured residents into the medical
profession and the non-white middle class adopting the rhetoric of "sanitary enlightenment" as
part of their initiative to "uplift" the lower classes. Many other health personnel plausibly blurred
the racialised boundaries and functioned as active medical agents in the colonial project. Juanita
De Barros, '"Spreading Sanitary Enlightenment': Race, Identity, and the Emergence of a Creole
Medical Profession in British Guiana," Journal ofBritish Studies 42 (2003): 483-504. Juanita De
Barros, "Sanitation and Civilization in Georgetown, British Guiana," Special Issue of Caribbean
Quarterly 49, 4 (2003): 65-86. Juanita De Barros, "'To Milk or Not to Milk?' Regulation of the
Milk Industry in Colonial Georgetown," Journal ofCaribbean History, 31, 1-2 (1997): 185-208.
71 Roy MacLeod, "Introduction," in Roy MacLeod and Milton Lewis, eds., Disease,
Medicine, and Empire. Perspectives on Western Medicine and the Experience ofEuropean
Expansion (London: Routledge, 1988), x, 1-2.
72 David Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-
Century India (Berkley: Univ. of California Press, 1993), 3-4, 7-8.
73 Mark Harrison, Public Health in British India. Anglo-Indian Preventive Medicine 1859­
1914 (Cambridge: Cambridge Univ. Press, 1994), 3-4, 60-98.
74 Harriet Deacon, "Racial Segregation and Medical Discourse in Nineteenth-Century Cape
Town," Journal ofSouthern African Studies, 22 (1996): 293-6.
75 David Arnold, "Disease, Medicine and Empire," in David Arnold, ed., Imperial Medicine
and Indigenous Societies (New York: St. Martin's Press, 1988): 13-15. De Barros and Stillwell
identified a similar disinterest in the British Caribbean, arguing that colonial elites were unwilling
to invest in public health measures: medical resources were scarce in the colonies. Juanita De
Barros and Sean Stilwell, "Public Health and the Imperial Project," Colonialism and Health in the
Tropics. Special Issue of Caribbean Quarterly 49, 4 (2003): 2-3.

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 PhD Thesis - L. Jacklin. McMaster - History.

"tropical medicine" campaigns to understand how the people used both indigenous and
western medicine as part of their usual health regimes.76 The distorting legacies were not
restricted to unwelcome interventions, but also included the discriminatory exclusion of
colonial residents from participating in the systems of western medicine.

The colonial state's attempt to restrict the public's access to western medical
services is clearly evident in this study, which poses a challenge in determining how to
explore the struggles. Waltraud Ernst recently criticized scholars for continuing to frame
medicine as a tool of imperialism, thematically stressing resistance to colonial
hegemony, or using the history of medicine to critique colonialism. She argued that
scholars have failed, for more than 20 years, to answer Roy Porter's simple question:
"What is colonial about colonial medicine?"?? Ernst suggested examining medicine's
relationship to other social debates, such as the contention over Britain's Poor Laws. She
posited that these policies, "although not specifically 'medical'," shaped how decision
makers treated society's disadvantaged at both ends of the Empire.78 Ernst's suggestion
is relevant to the analysis of a plantation society, where the structure of the colony
sustained a culture of poverty and did not foster the growth of the "mixed economy of
welfare," which was so important to the metropolitan model.79 While Britain's 1601
Elizabethan Poor Laws (as amended over time) declared the obligations of the state to
provide for the poor, and created its network of health-related organisations, plantation
slave societies had never instituted similar systems. During the advent of Chadwickian
public health reforms, from the 1840s, plantation colonies were consumed with their
arduous socio-economic readjustments after emancipating the slaves. 80 Nonetheless,
many British officials attempted to introduce the metropolitan ideology on the state's
obligation to maintain the health of the public and build the infrastructure to deliver the
services. This created many conflicts between the white Creole and British elites over the
obligation of the state to provide medical services and the control over those resources. 81

76 Michael Worboys, "The Colonial World as Mission and Mandate: Leprosy and Empire,
1900-1940," Osiris, 15 (2001): 207-8.
77 Waltraud Ernst, "Beyond East and West. From the History of Colonial Medicine to a
Social History of Medicine(s) in South Asia," Social History ofMedicine, 20, 3 (2007): 505-24.
Ernst explained that Porter asked the question at the Society for the Social History of Medicine
(SSHM) meeting in 1986. The SSHM president reiterated the question in 1997. See, Marks, "What
is Colonial about Colonial Medicine?"
78 Ernst, "Beyond East and West," 507-11.
79 Historians of the British welfare state for the metropole have established the importance
of the "mixed economy of welfare" in providing medical and economic relief services to the poor,
through a combination of the Poor Law infrastructure, voluntary charity, and the informal sector.
Bernard Harris, "Introduction: The 'Mixed Economy of Welfare' and the Historiography of
Welfare Provision," in Bernard Harris and Paul Bridgen, eds., Charity and Mutual Aid in Europe
and North America since 1800 (New York: Routledge, 2007), 1, 6.
80 Historians have established that there were many readjustment struggles in the unsettled
period following emancipation. David Vincent Trotman, Crime in Trinidad. Conflict and Control
in a Plantation Society 1838-1900 (Knoxville: University of Tennessee Press, 1986), 35-69.
Donald Wood, Trinidad in Transition. Holt, The Problem ofFreedom.
81 Cunningham and Andrews established that colonial elites and indigenous peoples could
choose to adopt, ignore, or contest western medicine. Andrew Cunningham and B. Andrews,
"Introduction: Western Medicine as Contested Knowledge," in idem, eds., Western Medicine as
Contested Knowledge (Manchester: Manchester Univ. Press, 1997), 1-23.

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 PhD Thesis - L. Jacklin. McMaster - History.

The editors of the anthology on healthcare in the circum-Caribbean, discussed

above, argued that the on-going and diverse conflicts over western medicine differed
from the resistance identified by historians in other parts of the British Empire. Western
medicine had become firmly rooted in the Americas several centuries earlier than in Asia
or Africa. The increased medical activities accompanying nineteenth-century colonialism
were not a "colonizing imposition" in the Caribbean. The conflicts between the local
elites and colonisers were struggles for control, rather than resistance. 82 Trinidad's GMS
was created in this conflictive environment. It was not a simple colonial variant of the
system in the metropole, but an amalgam of practices and ideas from the Caribbean,
Europe, and India, influenced by the doctors' training in British medical schools and
their sojourns in other colonies.

Trinidad's system of state healthcare did not adopt indigenous medical practices,
but the system was predicated on the assumption that the public would use traditional
forms of healing outside the realm of the GMS healthcare. In as much as this is the first
study of post-emancipation state healthcare in a British West Indian colony, there is a
similar dearth in the historical literature on indigenous medical practices although, for
several decades, anthropologists and sociologists have been studying the continuity of
African systems of health and healing, from slavery to the present day. 8 3 Perplexingly, in
light of the importance of the Indian diaspora, these studies overlook the history of
Indian systems of healing and medicine. 84 Nonetheless, despite this long-standing
interest of social scientists in Afro-Caribbean systems of healing, few historians have
turned their attention to indigenous medical practices during slavery, 8 s although post­
emancipation social and cultural historians have established the resilience of these
traditional systems. 86 The colonial medical marketplace may have been much more
complex than the literature leads us to believe. This study concentrates on the colonial

82 De Barros, Palmer, and Wright, "Introduction," 5-6.

83 Laguerre's monograph on the persistence of African folk medicine in the Caribbean is
recognised as initiating the multi-disciplinary interest in the topic. Michel Laguerre, Afro­
Caribbean Folk Medicine (Mass: Bergin and Garvey, 1987). Payne-Jackson and Alleyne's recent
study concluded that many modern-day Jamaicans seamlessly integrate Jamaican "folk" medicine
and western therapeutics into their health regimes. Arvilla Payne-Jackson and Mervyn C. Alleyne,
Jamaican Folk Medicine. A Source ofHealing (Jamaica: Univ. of West Indies Press, 2004). Brian
M. du Toit, "Ethnomedical (Folk) Healing in the Caribbean," in M. Fernandez Olmos and L.
Paravisini-Gebert, eds., Healing Cultures. Art and Religion as Curative Practices in the
Caribbean and its Diaspora (New York: Palgrave, 2001): 19-28.
84 De Barros, Palmer, and Wright, "Introduction," 12, passim. For one of the few studies
available to-date, see Noor K. Mahabir, Medicinal and Edible Plants used by East Indians of
Trinidad and Tobago (Trinidad: Chakra, 1991).
8s Juanita De Barros, '"Setting Things Right': Medicine and Magic in British Guiana, 1803­
1834," Slavery and Abolition (2004): 28-50. Jerome Handler and J. Jacoby, "Slave Medicine and
Plant Use in Barbados," Journal ofthe Barbados Museum and Historical Society, 41 (1993): 74­
98. Handler argued that the white residents viewed the indigenous slave medical practices with
scepticism. Jerome S. Handler, "Slave Medicine and Obeah in Barbados, Circa 1650 to 1834,"
NWIG, 74, 1-2 (2000): 57-90.
86 For instance, Johnson and Moore demonstrated the complexity of Obeah's intertwined
spiritual, cultural, and medical belief system and practices, and the dependence of many
Jamaicans on Obeah. Johnson and Moore, Neither Led Nor Driven, 14-95. Similarly, Bryan
described the persistence of the Afro-Jamaican indigenous systems of healing, which he argues
were often the healthcare preferred by the people. Bryan, The Jamaican People, 177-87.

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 PhD Thesis -L Jacklin. McMaster - History.

state's system of western healthcare services which, by definition, are outside the realm
of indigenous practices. However, as concluded below (in Chapter 6), Trinidadians relied
extensively on non-western therapeutics: the GMS system often functioned as the
alternative source of healthcare. Traditional African and Indian systems of healthcare
served an important function in colonial society, although the absence of scholarly
studies precludes an understanding of how the residents used these systems to maintain
their health and relieve their suffering.

White Elites, Crown Colony Rule, and Trusteeship

Many of the struggles over state healthcare in Trinidad occurred within the upper strata
of colonial society. Each British West Indian colony had two white elites: the native-born
Creoles and the sojourning British colonial officials and bureaucrats. 87 The locally-born
white Creoles are referred to as the 'Creoles' or the 'white Creole elite,' which embodies
their socio-economic standing and biological moniker of 'colour' within one definition,
including whites of European descent from France, Spain, Britain, Germany, and other
countries. 88 In the immediate post-emancipation period, ethnic rivalries often divided
the elite, such as the struggle between the Roman Catholic French-Creoles and
Protestant British-Creoles over religious ascendancy, although Bridget Brereton
established that the divisions had dissipated by the end of the century. 8 9In the numerous
struggles over the GMS, there was no discernable difference in the attitudes amongst the
influential members of Creole society, who were remarkably united in matters involving
state healthcare. Instead, the struggles usually pitted some, but not necessarily all,
British officials and GMS doctors against the Creoles. These two factions maintained a
complex relationship, which ranged from collaborative to adoptive to conflictive at times,
although consensus usually prevailed on economic and political matters, which makes
the enduring struggles over the GMS an important anomaly during the century.

The white Creole elites remained the dominant minority, controlling the
economy, capital, land, and labour in the colonies. Despite their power to determine the
fate of so many people for centuries, Howard Johnson argued that the white elites have
been marginalised in the historiography and invited historians to write the upper classes
back into the colonial histories.9° The essays by scholars of Jamaica, British Guiana, and

87 The composition of the elites differed between the colonies. For instance, British Guiana's
Creole elite was mostly of British descent. Moore, "The Culture of the Colonial Elites," 96.
88 Bridget Brereton, "The White Elite of Trinidad, 1838-1950," in Johnson and Watson
(eds.), The White Minority in the Caribbean, 33. To simplify the terminology in this study, the
taxonomy of hyphenating 'Creole' has not been adopted, although historians of Trinidad often use
French-Creole, African-Creole, and Inda-Creole. The decision to restrict the use of the term
'Creole' to the native-born white elite is meant to be a simple method of differentiating the elite
Creoles from the white British expatriate colonial officials and bureaucrats.
89 Brereton argued that the animosities between the French and English Creoles were
muted by 1870 and blurred by the end of the century. Brereton, Race Relations, 44-6. Similarly,
Singh showed that cohesion and agreement prevailed on policy matters between the ruling class
elites (the commercial barons, planters, and government administrators) during the period of his
study, beginning in 1917. Singh, Race and Class Struggles in a Colonial State, xx.
9o Howard Johnson, "Introduction," in Howard Johnson and Karl Watson (eds.), The White
Minority in the Caribbean (New Jersey: Markus Wiener, 1998), ix-xvii.

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 PhD Thesis - L. Jacklin. McMaster - History.

Trinidad identified many similarities in the worldviews of the white elites. Patrick Bryan
and Brian Moore characterised the white elites in Jamaica and British Guiana as
wielding extraordinary power, which was the inverse of their insignificant numbers.
These elites never constituted more than 2.8% of the population in their colonies: their
numbers declined to below 2.0%, between 1841and191t.91 Trinidad's white elite is
estimated to be about t.5% of the total population in 1907, which is consistent with the
statistics provided by Moore and Bryan.9 2

The white Creole elites developed culturally rich societies.93 Whiteness remained
the inalienable criterion for membership. Bryan concluded that Jamaica's elite formed a
closed and caste-like society to isolate themselves from the "'combustible' coloured
people," ostracising anyone who showed sympathy to non-whites or their causes.
Ostracism represented social death in a society where the Creoles controlled the social
and cultural institutions.94 Brereton described Trinidad's white elite in a similar manner,
stating that their worldviews reflected pride in their aristocratic traditions, with
membership in their closed society restricted by social and racial purity.9s Keith
Laurence concurred with Brereton that the plantocracy was not only self-interested, but
also disinterested in the well-being of its subject peoples.9 6

The Colonial Office believed that the Creole elites would not rule impartially and
interjected its own white elite into each colony: the British rulers and administrators.
This set the conditions for an extraordinarily complex relationship, although the Creoles
and Britons were hypothetically unequal partners. Britain instituted direct rule, from
1831to1925, designating Trinidad a Crown Colony with a nominated legislature.97 As
stressed by Brereton, Crown Colony rule was predicated on the principle of trusteeship:
the Crown would protect the masses from exploitation by the landed class.9 8 However,
the ability to sustain plantation society colonialism required significant complicity
between the Creole elite, British administrators, and the senior trustees: the governor
and Colonial Office.99 Porter argued that London realised that it needed to collaborate

91 White Jamaicans represented i.88% of the population in 1911 and the white Guianese

were i.6% in 1891. Bryan, "The White Minority in Jamaica," 116-32. Moore, "The Culture of the

Colonial Elites," 97, 111.

92 Trinidad's censuses and vital statistics did not enumerate residents by ethnicity or colour,

which makes it difficult to quantify precisely the number of white residents in the colony.

However, in response to a question in the House of Commons in 1908, the Colonial Office stated

that a "liberal estimate" of the resident Europeans (whites) was 5,000 people during 1907. Based

on the Registrar-General's statistics of about 344,000 colonial residents that year, white

Trinidadians would have constituted i.5% of the population. 1908 LC #110, Vital Statistics.

Annual Report ofthe Registrar-General for 1907-08, 3. [Hereafter, Registrar-General AR.] CO

295-455 (1909) #10150, Indentured Labourers. Minutes.

93 Brereton, Race Relations, 53-5, 60-i. Moore, "The Culture of the Colonial Elites."

94 Bryan, "The White Minority in Jamaica," 119-21.

95 Brereton, Race Relations, 53-5, 60-1. Brereton, "The White Elite of Trinidad," 32-70.

96 Brereton, Race Relations, 30-i. Laurence, "The Development of Medical Services," 60-2.
97 Hewan Craig, The Legislative Council ofTrinidad and Tobago (London: Faber & Faber,
1951), 1.
98 Bridget Brereton, Law Justice and Empire. The Colonial Career ofJohn Gorrie 1829­
1892 (Jamaica: University of West Indies Press, 1997), xiv-xv.
99 Selwyn D. Ryan, Race and Nationalism in Trinidad and Tobago: A Study of

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 PhD Thesis - L. Jacklin. McMaster - History.

with the local elites, but this cooperation did not preclude many tensions. While
differences prevailed, the elites were united by their shared belief in their racial
superiority. 100 However, Bryan and Brereton agreed that the Creoles resented the British
officials, who symbolised the "visible embodiment of imperial domination." 101
Nonetheless, the powerful Creoles often drew the sojourning Britons into their elitist
culture. According to Bryan, as a rule, "however open-minded the bureaucrat was at the
time of his arrival in colonial society, his attitudes came to resemble closely those of the
dominant local white segment, especially with regard to the black and coloured ·
population."102 If careering Britons did not share these racist opinions, they risked being
ostracised from society. As established in this study, the governor often set the pace in
determining the alliances between the Britons and Creoles and they changed regularly.
The shifting power remained important in the struggles over the GMS, to 1916.

Brereton purposefully dispelled the illusion that Crown Colony rule protected the
people from oppression. She characterised the "great myth" that "Governors and officials
were impartial administrators, and at the same time, the special protectors of the poor."
Many formed close relationships with prominent Trinidadians, "making it improbable
that any but the strongest-willed Governor would oppose them." 103 David Trotman
echoed this sentiment: "The herculean task of defying both implicit ideology and explicit
social and economic power in order to protect the powerless required an individual with
exceptional qualities." To Trotman, the governor had to "rise above the insidious racism"
at the root of the system. 104 Brereton and Trotman stressed that the Creole elite's
worldview continued to be framed by the traditions of slavery and plantation society. 10s

This study establishes that autocratic governors and crusading officials and
doctors periodically emerged to challenge the status quo in matters involving the health
of the people. As such, the protracted struggles of several careering officials are often at
the centre of this study: the conflicts over the function of the GMS were an important
part of the creolisation of state healthcare. The Colonial Office constantly transferred
colonial governors and administrators to new posts in the Empire. Hall's study of
Edward Eyre's career demonstrated the way in which historical actors were a product of
the imperial system and their experiences in many different colonies, as much as the
colonies were influenced by the ideas which officials brought with them. Lester and
Lambert argued that careering officials connected diverse locations in the Empire as they
transported ideas to and through the colonies. 106 These individuals could choose to
introduce new ideas and extend their work from previous colonies, or simply acculturate
to the local society and have a trouble-free administration. Numerous careering officials
passed through Trinidad, influencing the development of the GMS over the years, as they

Decolonization in a Multiracial Society (Toronto: Univ. of Toronto Press, 1972), 18-19.

100
Porter, "Introduction: Britain and the Empire in the Nineteenth-Century," 17. Porter

made this argument in the context of the British Empire, including the West Indies.

101 Bryan, "The White Minority in Jamaica," 129. Brereton characterised the tensions as an

"estrangement" between the Creole elite and British officials, Brereton, Race Relations, 43-7.

102
Bryan, "The White Minority in Jamaica," 129. Johnson, "The White Minority," xv.

10
3 Brereton, Race Relations, 24-6, 35-6.

10
4 Trotman, Crime in Trinidad, 32-3.

10
s Brereton, Race Relations, 24-6, 35-6. Trotman, Crime in Trinidad, 35-69.

106
Lambert and Lester, "Imperial Spaces, Imperial Subjects," 2, 8-13.

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 PhD Thesis - L. Jacklin. McMaster - History.

imported different ideas from other colonies about state healthcare.

Trinidad's government was a single-chamber nominated Legislative Council, with

the seats evenly divided between "Official" and "Unofficial" representatives. 107 The latter
were private citizens from the propertied and wealthy class, appointed by the Colonial
Office for a fixed term on the recommendation of the governor, and these men retained
their seats at the pleasure of the governor. These men were almost exclusively white. 108
The "Officials" were senior career civil servants and usually British. The governor had
limited authority over senior civil servants, lacking the power to hire or fire them, but he
could suspend a senior employee pending an inquiry by the Colonial Office. 109 Officials
and Unofficials remained subordinate to the governor and were expected to support his
wishes. In the event that Unofficials attempted to pass any unpalatable legislation, the
governor could veto the measure, or cast his dual vote to give the Britons a majority.n°
However, the tendency for the Creoles and Britons to cooperate meant that the veto
powers were rarely used in Trinidad. 111 The Colonial Office maintained the ultimate
control through its power to disallow any law which an errant governor may have
approved.11 2 As established below (in Chapter 5), on rare occasions individual governors
acted counter to the wishes of Whitehall, necessitating Colonial Office intervention.

Perhaps due to the conflicts surrounding the GMS, the Surgeon-General function
did not include a seat on the Legislative Council, until the early 1890s. With no formal
authority in the government, the Surgeon-General relied on the governor to represent
the GMS. Senior Unofficial Dr. Louis de Verteuil spoke with authority on medical
matters: he was a critic of the GMS and long-standing nemesis of the longest serving

107 The constitutional structure for each government in the British Empire is summarised
annually in The Colonial Office List. See, for instance, The Colonial Office List for 1881, Rules and
Regulations for Her Majesty's Colonial Service, 272-3.
108 The two non-white appointees on the Legislative Council were coloured barrister Henry
Alcazar, appointed in 1894, and black Cyrus Prudhomme David, appointed in 1904. "Mr. David's
Appointment," The Mirror, 15 April 1904. Samaroo's short biography of David and his legal and
political career analysed David's many struggles with the Legislative Council. Brinsley Samaroo,
"Cyrus Prudhomme David - A Case Study of the Emergence of the Black Man in Trinidad
Politics," Journal ofCaribbean History, 3 (1971): 73-89.
10 9 The Colonial Office List for 1881, 272.
110
The Colonial Office List for 1881, 272-3. By the end of the century, Legislative Council
members had grown to eleven Officials and eleven Unofficials, with the governor retaining a
double vote. Craig, The Legislative Council, 28.
111
Moore stated that Trinidad's governor did not need to veto any Legislative Council
decisions. However, as established below (in Chapter 5), Whitehall intervened on several
occasions to overturn decisions regarding the GMS. Additionally, a brief analysis of Trinidad's
ordinances reveals several that the Colonial Office disallowed at least seven laws, between 1842
and 1858. Most of these ordinances involved immigration or master-servant laws. After 1858,
Whitehall did not cancel any legislation, which suggests a more collaborative relationship by
Trinidad's Legislative Council and the Crown trustees. For the detailed list oflegislation, see, Law
Commission of Trinidad, Laws of Trinidad and Tobago. Chronological and Alphabetical Lists of
Ordinances and Acts 1832-1983 (Trinidad: Law Commission, 1985). Moore, Racial Ideology, 146.
Bryan argued that Jamaica's governors did not use their veto power to overrule that colony's
white oligarchy. Bryan, "The White Minority," 118.
112
The hierarchy of authority was printed each year in The Colonial Office List.

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 PhD Thesis - L. Jacklin. McMaster - History.

Surgeon-General, Samuel L. Crane (1871-93). 113 Creole society could make an

uncooperative expatriate socially unwelcome and their colleagues in the Legislative
Council could make the official economically insecure by reducing his salary. 114 Council
thus possessed the political and social power to marginalise disobliging Britons. This
control will be shown to be important during the struggles to institute medical and
health reforms in Trinidad.

Overview ofthe Chapters

Throughout this study, the imperial project in Trinidad continued to be controlled by the
white Creole and British decision makers, who alternatively cooperated or disagreed
about the government's involvement in the health and well-being of its subject peoples.
These struggles were constantly reshaped by trans-national forces from India, London,
other colonies, and the Atlantic community. Chapters 2 and 3 examine the ideological
underpinnings of Trinidad's policies for the health of its peoples, Chapters 4 ands
consider the struggles over the form and function of the GMS, and Chapter 6 considers
how the Trinidadian peoples interacted with the GMS doctors and system.

Chapter 2, Population Manipulations: To Neither Whiten nor Blacken Trinidad,

explores the plantocracy's valuations of the bodies of its African and East Indian subject
peoples, which remained at the root of the tensions over the state's involvement in their
health and well-being, to 1916. Many legacies of siavery continued to define this
plantation society and particularly the notion that non-white labouring bodies were
expendable commodities. Trinidad's planters historically dealt with the slaves'
inordinately high mortality rates by purchasing new bodies, in lieu of maintaining their
human chattel in a state of health and breeding the next generation of labourers within
the colony. The plantocracy's penchant to import the next generation oflabourers, rather
than investing in the health of the people, was facilitated by making the program of
indentured immigration the central axis of the colony's policy for developing the future
colonial population. This policy had significant repercussions for the East Indian and
African populations, which are ascertained by a quantitative analysis of the demographic
growth of each sector. This analysis addresses an important deficiency in the literature
by establishing the point in time when the East Indian and African sectors recovered,
demographically, from the brutality of enslavement and indenture, and overcame the
systemic barriers to natural growth created by the imperial project, to become self­
sustaining populations.

The migratory indentured East Indians were one of many nineteenth-century

diasporas of millions of British subjects, who hoped to better their lives by travelling to
new homelands. However, the ocean voyages were so perilous and unhealthy that the
Imperial government legislated health protections to increase the oceanic survival rates.
Trinidad's responsibility for the health of its indentured East Indians began half way
across the globe in the Coolie Depots in Calcutta and Madras. Chapter 3, Maritime
Public Health: Imperial Values and Migrant Bodies, 1840-1872, compares the health

n3 L.A.A. de Verteuil, Trinidad: Its Geography, Natural Resources, Administration, Present

Conditions and Prospects, 2nd ed. (London: Cassell and Company, 1884), 207-10.
n4 Brereton, Race Relations, 27, 29, 31, 43-4.
 PhD Thesis - L. Jacklin. McMaster - History.

policies enacted for two populations of assisted migrants, white Britons and indentured
East Indians, as they travelled as wards of the Imperial government to the colonies. The
conflation of Imperial ideas about each race's level of civilisation and capability for
improvement became inexorably intertwined with the medico-moral sanitary order
enacted aboard the different fleets of ships. This chapter establishes the profound
difference in the attitudes of the colonial governments about the bodies of their
migrants, depending if they were white British settlers or indentured Indians, and the
direct connection between racial ideals and the public health frameworks aboard the
ships. A quantitative mortality analysis confirms that many Indian bodies continued to
be sacrificed during the journeys, as the public health measures failed to protect the
health of this seaborne population.

After establishing the nature of the colonial state's attitudes regarding the health
of its subject peoples, the subsequent three chapters explore the contested evolution of
the Government Medical Services and the public health and medical services that it
provided to the residents. Chapter 4, "Take up the tt'hite Man's Burden ... and bid the
sickness cease": Creolising Trinidadian Colonial Healthcare, 1870-80," considers the
tumultuous creation of the GMS during the 1870s, as the government struggled to define
its involvement in the health and well-being of its subject peoples, amidst pressures from
Imperial world governments and the Atlantic community. Trinidad accepted the Colonial
Office's dictate to assume the responsibility to provide medical care for the indentured
workers on the estates, as part of Britain's civilising mission. However, the plantocracy
vigorously contested the imperial White Man's Burden to introduce western medical
services for its population of impoverished free African and (non-indentured) East
Indian peoples. The irreconcilable worldviews of the British and Creole elites and the
constantly shifting alliances between them forced the GMS to evolve as a negotiated
entity, which never fully satisfied the elite decision makers or the Inda- and Afro­
Trinidadian public.

The economic strife caused by the severe global depression in the sugar markets
and rampant ill-health motivated tens of thousands ofTrinidadians to seek government
healthcare services each year during the 1880s, which increased the government's
expenditures substantially. The desire to reduce the GMS's expenses heightened the
tensions over the state's obligation to address the endemic ill-health and poverty
amongst the people, which plantation society colonialism had created. The turmoil over
the GMS and the question of Poor Relief turned into a nasty conflict amongst the white
elites. Chapter 5, Imperial Trusteeship and Colonial Healthcare, 1880-1891, investigates
the escalation of these conflicts, to the point where the Colonial Office intervened and
used its infrequently exercised powers of trusteeship to protect the subject peoples from
arbitrary rule. The trustee's unusual intrusions resulted from the actions of two
crusading officials within the colony, who challenged the status quo. Surgeon-General
S.L. Crane's crusade is juxtaposed beside Chief Justice John Gorrie's campaign to reform
the justice system. As careering imperial officials, each man's worldview and enthusiasm
for the imperial trusteeship to protect the subject peoples had been shaped by their
experiences in the Empire. While the form of plantation society colonialism remained
unchanged, the reforms to state healthcare continued to deal with the effects of ill-health
and poverty, rather than eradicating the causes.

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 PhD Thesis - L. Jacklin. McMaster - History.

Chapter 6, The Civilising Mission: GMS Policies and Patients, 1891-1916,

considers the patients who were the object of the western medical initiatives in the
civilising mission. It is possible to reconstruct some experiences of the caregivers and
patients to ascertain the nature of their medical encounters with the colonial state's GMS
organisation and its doctors. As many of these sufferers were extremely poor, this
investigation probes how they obtained medical attention from government doctors by
qualifying as pauper, poverty, or fee-for-service patients. While the colonial officials
continually portrayed the GMS patients as paupers who had failed to embrace British
civilisation and its influences, the Indian and African residents demonstrated
remarkably civilised behaviours, integrating western and traditional healthcare into their
strategies to cope with the effects of plantation society colonialism.

Archival and Primary Sources

The research for this project was conducted at the National Archives of Britain, Trinidad,
and Scotland (Edinburgh), the Commonwealth Institute in London, England, and the
Rockefeller Archives in New York. The archival collection for the Colonial Office
provided extensive files of the correspondence between officials and citizens in London,
Trinidad, and other colonies. The colonial administrative structure required each senior
official to submit lengthy annual reports. The reports by each Surgeon-General,
Registrar-General, and Protector of Immigrants recorded the major events and
developments during the year and often revealed the anxieties of each administration.
Trinidad's Legislative Council published voluminous reports each year on many diverse
topics relevant to colonial governance. These and other archival sources have been
interrogated with the knowledge that they are exceedingly useful, but often problematic.
The records continually mute the voice of the Trinidadian public and patients in the
GMS system, while privileging the view of the colonial officials and the Creole elite.

The British Parliamentary Papers have been an invaluable source of information

about the local and global struggles which heightened to the point of meriting imperial
intervention or parliamentary interest. These papers also contain the annual reports of
the Colonial Land and Emigration Commission and the annual series of Blue Books. The
proceedings of the numerous commissions and formal inquiries convened by the India
or Imperial governments, and their associated digests of testimony by witnesses, provide
many insights, often inadvertently, into the day-to-day living conditions and health of
the Trinidadian public and the indentured East Indians.

The Trinidad and British commercial newspapers offered the commentaries and
editorials of a diverse group of people over time. Two Trinidadian newspapers have been
used at length, the anti-government paper, The Mirror, and the pro-government Port-of­
Spain Gazette. GMS and private physicians often corresponded with the medical and
commercial press on issues of Atlantic or imperial significance, including The British
Medical Journal, The Lancet, and The Times. Although not numerous in quantity, the
publications of residents, doctors, travellers, and other interested parties have provided
important revelations on health and medical matters in the colony.

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 PhD Thesis - L. Jacklin. McMaster - History.

-Chapter2­
Population Manipulations: To Neither Blacken nor Whiten Trinidad

After the end of slavery in 1838, the Imperial, India, and colonial governments
collaborated to sponsor the migration of indentured East Indian labourers to Britain's
tropical sugar-producing colonies. Verene Shepherd recently reminded historians that
this diaspora changed the ethno-racial composition in the host colonies and, in
particular, Trinidad and British Guiana. 1 The transformation of Trinidad's population in
a mere seven decades was significant. In 1825, Trinidad's residents consisted of 8% white
and 92% black and coloured persons. 2 Between 1845 and 1916, the plantocracy
sponsored the immigration 143,939 East Indians.3 By 1907, the African sector had
decreased in relative numbers to represent a mere 68.5%, whites had become a smaller
minority at i.5%, and the East Indian diaspora accounted for 30% of the population.4 To­
date, little scholarly attention has been directed to understand how migration and
natural increase contributed to the changes in the Afro- and Indo-Trinidadian sectors.
This chapter addresses this historiographic lacuna by exploring the policies of the white
Creole elite about the development of its subject peoples, followed by a quantitative
analysis of the policy outcomes, comparing the natural increase and migration of the
Africans and East Indians in the forty-year period between the 1881 and 1921 censuses.s

Trinidad's plantocracy demonstrated little interest in encouraging the long-term

growth of the African and Indian sectors. This chapter's central argument is that the
colony's policies for population development intended to neither whiten nor blacken
Trinidad, by concentrating on creating the East Indian sector exclusively by immigration,
while marginalising Afro-Caribbean immigration, and placing obstacles in the way of
natural increase for both sectors, which contravened the known principles for
establishing self-sustaining populations. The traditional economic justification of slavery
continued to underpin Trinidad's policies, and indentured immigration functioned as the
new mechanism to satisfy the planters' insistence that it was cheaper to buy expendable
labouring bodies, rather than breeding the next generation of estate workers, although
planters now purchased the East Indians' capacity for labour, rather than their bodies.
The white Creole elite's disinterest in investing in the health and well-being of its subject
peoples is a thematic argument in this study. This chapter establishes one of the major
ideological underpinnings of that disinterest, demonstrating how the political will to
neither whiten nor blacken Trinidad was codified in many legal ordinances.

Verene Shepherd, Maharani's Misery. Narratives ofa Passage from India to the
Caribbean (Jamaica: University of West Indies Press, 2002), 5.
2
John enumerated 3,214 white and 38,960 black and coloured Africans in Trinidad in
1825. A. Meredith John, The Plantation Slaves ofTrinidad, 1783-1816: A Mathematical and
Demographic Inquiry (Cambridge: Cambridge Univ. Press, 1988), 39.
3 G.W. Roberts and J. Byrne, "Summary Statistics on Indenture and Associated Migration
affecting the West Indies, 1834-1918," Population Studies, 20, 1 (1966): 127.
4 Trinidad's census did not record "race" or colour, making it difficult to quantify the size of
the white minority. In 1908, the Colonial Office staff estimated the white residents at 5,000, or
i.5% of the population. Trinidad's vital statistics enumerated 344,000 residents that year. 1908
LC #no, Registrar-General AR, 3. CO 295-455 (1908) #10150, Indentured Labourers. Minutes.
s The availability of annual reports by the Registrar-General, Surgeon-General, Protector of
Immigrants, and the censuses determined the start date of 1881. The analysis ends at the 1921
census, which is the year when the last indentured East Indian left the colony.

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 PhD Thesis - L. Jacklin. McMaster - History.

This chapter makes two new contributions to the scholarship, responding to the
critics of those who debate if indenture was neo-slavery or if East Indians benefited
materially, as introduced above (in Chapter 1). David Eltis, for instance, counselled
historians to question the values of the host colonies, while David Northrup argued that
rigorous studies must be performed before claiming that the brutality of indenture
approached slavery. 6 This analysis of natural increase establishes that Trinidad's East
Indian sector was constituted with an even larger gender disparity than the slave
population which it replaced. The slaves' inability to become self-sustaining populations
had been an important reason to end slavery, but emancipation did not eradicate the
problem. Afro-Trinidadians required five decades of freedom to recover from the gender
imbalance and the trauma of slavery, before experiencing a natural increase. However,
Indo-Trinidadians surmounted their sexual disparity and begin to increase by natural
means during the 1890s. Considerable differences existed between the two populations
living side by side in one colony: East Indians and Africans had strikingly different rates
of births and deaths. This study concludes that the trauma of slavery adversely affected
the African bodies' capacity for natural increase for a comparatively longer period than
the one experienced by the East Indians during and after indenture. Second, this study
establishes that a substantial number of so-called 'free' East Indians illegally escaped
from Trinidad each year. Although colonial and metropolitan officials claimed that their
civilising mission created a contented and prosperous Indo-Trinidadian population,
while the Africans regressed into barbarism, the migration patterns prove otherwise.
Africans and East Indians alike surmounted the barriers and migrated at will, despite the
laws enacted by the colony to restrict the immigration of Afro-Caribbean peoples and
prevent the emigration of East Indians. Much of the wealth accumulated by the Indians
was earned after their escape to other locations, notably the Spanish Main.

Ideological Underpinnings ofTrinidad's Post-Emancipation

Population Policies

Richard Sheridan and Philip Curtin established that slavery had been predicated on the
planters' belief that importing new bodies was the cheapest way to acquire labourers,
rather than breeding a population of labourers locally.7 Despite the pressure for pro­
natalist measures during the ameliorative period in the British West Indies, Barbados
was the only colony to record a positive natural increase amongst its slave population. 8
The tenet of importing new bodies to replenish the labourforce continued to dominate
the plantocracy's consciousness in the post-emancipation period. Brian Moore identified

6 David Eltis, "Free and Coerced Migrations from the Old World to the New," in David
Eltis, ed., Coerced and Free Migrations. Global Perspectives (California: Stanford Univ. Press,
2002), 37-9, 48. David Northrup, Indentured Labor in the Age ofImperialism (New York:
Cambridge Univ. Press, 1995), 4-6.
7 Richard B. Sheridan, Doctors and Slaves: A Medical and Demographic History of
Slavery in the British West Indies (Cambridge: Cambridge Univ. Press, 1985), 140. Philip D.
Curtin, "Epidemiology and the Slave Trade,'' Political Science Quarterly, June 1968: 215-16.
8 Hilary McD Beckles, Natural Rebels. A Social History ofEnslaved Black Women in
Barbados (New Jersey: Rutgers Univ. Press, 1989), 90-114. Heather Cateau, "'A Question of
Labor': British West Indian Plantations, 1750-1810," Plantation Society in the Americas, 6, 1
(1999): 65-94.

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 PhD Thesis - L. Jacklin. McMaster - History.

the resultant effects of the persistence of this idea in his study of British Guiana. He
argued that the Guianese-born African sector did not have the ability to reproduce its
numbers and thus progressively decreased in size during the five decades after
emancipation. Moore attributed this unnatural depletion of the population to the policies
instituted by the plantocracy, based on "antediluvian slavocratic ideas that labour was
expendable and easily replaceable by large numbers of fresh importations."9 Trinidad's
white Creole elite never relinquished its similar belief that African bodies were
expendable commodities, which had a direct bearing on their post-emancipation policies
regarding the African and East Indian populations.

In their quest to explain the universe as a series of natural laws, Enlightenment

thinkers identified the two factors determining how populations increase their numbers:
net migration and 'natural increase.' Natural increase is a population's ability to
reproduce its numbers naturally, by having an excess of births over deaths. This is
normative and usually occurs, except in crises such as prolonged dearth and natural
disasters. Thomas Malthus was an important Enlightenment intellectual who influenced
Britain's nineteenth-century ideologies on developing its populations in the age of
imperial expansion. InAn Essay on the Principle ofPopulation in 1798, Malthus argued
that civilisation's recent progress and prosperity had allowed some populations to out­
pace the laws of natural increase and grow too rapidly, with a detrimental effect if too
many people competed for limited resources. He called for governments to take action
when the rapid pace of progress pre-empted nature's checks and balances on excessive
growth. 10 He supported the redeployment of free populations within the Empire, but
stressed that equal numbers of men and women needed to be moved to destinations
where they could better their lives.11 As argued below (in Chapter 3), these tenets
influenced government-sponsored migration programs during the century, but would be
selectively applied at times, depending on the race of the people. 12 Malthus was incensed
when the pro-slavery faction used his treatise to justify slavery. He used the West Indian
slave populations' inability to reproduce their own numbers as evidence that slave
owners contravened the natural laws of the universe in two important ways. The
planters' demand for males had purposefully degraded the moral conditions of the slaves
by creating unnaturally male-dominated populations. l3 The slave owners then forced
their human possessions to live below normal levels of subsistence: this interfered to an

9 Moore connected the broader policies on land and labour to the problems in the growth
of the population and the African Guianese-born population's decrease in size, between 1841 and
1891. Brian Moore, Cultural Power, Resistance, and Pluralism. Colonial Guyana, 1838-1900
(Montreal: McGill-Queen's University Press, 1995), 8, 11, 18.
10
T.R. Malthus, An Essay on the Principle ofPopulation, as it Affects the Future
Improvement ofSociety (London, 1798), 1-18, 279-302.
11
For an insightful explanation of the influence of Malthusian policies in defining the
complex nature of "freedom," see, Thomas C. Holt, The Problem ofFreedom. Race, Labor, and
Politics in Jamaica and Britain, 1832-1938 (Maryland: Johns Hopkins Univ. Press, 1992), 71-9.
12
As argued below (in Chapter 3), the program of assisted-migration to send white Britons
to the Australian colonies was predicated on equal numbers of male and female migrants, while
the programs sending East Indians to the West Indies included a minimal number of women.
1
3 T.R. Malthus, An Essay on the Principle ofPopulation; Or, A view ofIts Past and
Present Effects on Human Happiness with an Inquiry into our Prospects Respecting Future
Removal or Mitigation ofEvils which it Occasions, Vol. II, first American ed. (Washington:
Roger Chew Weightman, 1809), 540-1.

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 PhD Thesis - L. Jacklin. McMaster - History.

"excessive and unusual degree" and inhibited the slave populations' ability to grow. 14

Historians have confirmed that Malthus was indeed correct, in their arguments
that slave owners created a slave society where life was unnaturally short and that the
people who survived could not reproduce their numbers. David Northrup quantified the
extent of the problem in the British Caribbean. There were 775,000 slaves when the legal
slave trade was abolished in 1807. In 1834, the population had declined by 14% (110,000
people), because planters could not buy new bodies to replace the slaves who had died.
The slave populations decreased by about 25% in Britain's newly acquired colonies of
Trinidad and British Guiana, despite the extensive immigration of planters and the
corollary influx of their slaves, who the planters could legally import. 1s After Curtin
established that slave populations had not sustained their numbers by natural means,
historical demographers questioned if this resulted from low birth rates or high death
rates: Trinidadian slaves suffered from both problems. 16 Meredith John found the
mortality rates "extremely high" and the reproduction rates low. 1 7 A myriad of factors
contributed to the poor survival rates, including the brutality within the system, the lack
of disease immunities, and poor nutrition, health, and living conditions. 18 For slaves
born in Trinidad, John calculated their average life expectancy to be a mere seventeen
years at birth. 19 Historians have identified several factors contributing to the slave
populations' unnatural decrease in size. Planters inhibited the patterns of reproduction
in several ways. Curtin argued that planters believed that it was cheaper to buy slaves,
rather than breeding the next generation. Their preference for male slaves resulted in
imbalanced gender ratios amongst the slaves who they purchased, which affected the
potential for family formation and reproduction. 20 Women were not valued for their
reproductive roles. Owners commonly interfered with family formation and sexually
abused slave women. 21 Barry Higman estimated that only about half of the enslaved
people in the Caribbean lived in family units in 1813. 22 The planters were disinterested in
creating the conditions to allow the slaves to reproduce their numbers.

1
4 The emphasis is in the original. Malthus, The Principle ofPopulation, Vol. II, 540-1.
1
s Northrup, Indentured Labor, 18.
16 As discussed above (in Chapter 1), many historians have investigated the unnatural
decrease in the British West Indian slave populations. For Trinidad, see, John, Plantation Slaves
ofTrinidad. B.W. Higman, "African and Creole Slave Family Patterns in Trinidad," Journal of
Family History, 3, 2 (1978): 163-80. Curtin, "Epidemiology and the Slave Trade," 213-4.
1
? John, Plantation Slaves, 163-4, 168. John indicated that high rates of infant and child
mortality rendered the overall reproduction rate very low.
18 John, Plantation Slaves, 101-8. Gelien Matthews, "Trinidad: A Model Colony for British
Slave Trade Abolition," Parliamentary History, 26 (2007): 91-2. Higman, "Slave Family
Patterns," 171-2. K. Kiple, The Caribbean Slave: A Biological History (Cambridge: Cambridge
Univ. Press, 1984), 53. Jerome S. Handler, "Diseases and Medical Disabilities of Enslaved
Barbadians, From the Seventeenth Century to around 1838 (Part I)," Journal ofCaribbean
History, 40, 1(2006):1-38. Jerome S. Handler, "Diseases and Medical Disabilities of Enslaved
Barbadians, From the Seventeenth Century to around 1838 (Part II)," Journal ofCaribbean
History, 40, 2 (2006): 177-214.
19 A. Meredith John, "Plantation Slave Mortality in Trinidad," Population Studies, 42, 2
(1988): 172.
2
° Curtin, "Epidemiology and the Slave Trade," 214-5.
21
Higman, "Slave Family Patterns," 170. Shepherd, Maharani's Misery, xxi.
22
Higman, "Slave Family Patterns," 170.

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 PhD Thesis - L. Jacklin. McMaster - History.

There is no evidence to suggest that the planters changed their attitudes about
their non-white labourers in the post-emancipation period. This commoditisation of the
labouring bodies as expendable continued, despite the changes to the "race" of sugar
estate workers, from African to East Indian, and the modified legal relationship between
workers and estates, from enslavement to indenture. Replenishing bodies continued to
depend on the arrival of the next ship, although the Legislative Council now hired the
ships and brought East Indians instead of Africans. In lieu of buying a slave body,
planters now purchased highly-subsidised contracts of indenture from the government.
For a plantation economy attuned to buying labourers, indentured migration thus
became the new alternative to accomplish these transactions.

Northrup identified the importance of racial ideals in the many programs of

indentured migration during the nineteenth century. He argued that officials
manipulated the identities of migrants, depending on whether they were white or not, to
define who would migrate freely and who would be bonded labourers. Rather than
merely connecting reservoirs oflabour to places of scarcity, governments jointly
supervised the migration and contracts of indenture in the host colonies. 2 3 Madhavi Kale
augmented Northrup's argument in her study of indenture in Trinidad, establishing that
the identity constructed for the East Indians depended on the similarly engineered
African identity. 2 4 Historians agree that the plantocracy portrayed the Africans as the
cause of their post-emancipation labour problems: officials claimed that the Africans had
shunned British civilisation and regressed into barbarism when they refused to work on
the estates. 2 s Walton Look Lai characterised indentured migration as the central policy
in an arsenal of weapons used by the planters to control the labour market and colonial
subjects. Although the emancipated Afro-Trinidadians had reflexively withdrawn from
the plantations, he found the next generation to be willing and steady workers by 1877. 26
Kale agreed, but demonstrated that officials in London and Trinidad continued to uphold
the African identity of unreliable and unwilling workers. This assertion of the racial
defectiveness was important to the claim of a shortage of labourers, which remained the
fundamental justification to import Indians for the plantations. Without unresponsive
Africans, there would be no labour shortage, and the plantocracy would not have been
able to replenish its workforce with new East Indians each year. 2 1 There was no labour
shortage, per se, but a shortage oflabourers who would work for subsistence wages
under arduous conditions.

The impermanent East Indian identity as temporary sojourners allowed the

program of indentured immigration to address the labour question in the short-term,
with little regard for the long-term development of the population. The program to send

2
3 Northrup, Indentured Labor, 1-15

2
4 Madhavi Kale, "'Capital Spectacles in British Frames': Capital, Empire and Indian

Indentured Migration to the British Caribbean," International Review ofSocial History, 41

(1996): 110, 118-21.

2
s Bridget Brereton, Race Relations in Colonial Trinidad 1870-1900 (Cambridge:

Cambridge University Press, 2002), 9. Kale, "Capital Spectacles," 110, 118-21. Donald Wood,

Trinidad in Transition. The Years after Slavery (London: Oxford Univ. Press, 1968), 62-3, 239.

26 Walton Look Lai, Indentured Labour, Caribbean Sugar. Chinese and Indian Migrants to

the British West Indies, 1838-1918 (Baltimore: Johns Hopkins Univ. Press, 1993), 12-13, 174.

2
1 Kale, "Capital Spectacles," 110, 113, 120.

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 PhD Thesis - L. Jacklin. McMaster - History.

East Indians to the former slave colonies upheld the plantocracy's desire for male
workers. Despite the governmental anxiety about the gender imbalance in the former
slave population, the program for the Indians created an even larger gender disparity.
The minimum quota of female immigrants was initially 30 women to 100 men but, in
1868, after much debate, the Colonial Office decreed that ships could not depart from
India without 40 women for every 100 men. 28 The female quota resulted from ideas
about the morality of the Indians abroad: London officials asserted that Asian migration
was immoral without this number of women. 2 9 However, the gender disparity amongst
the East Indians at the point when they boarded the ships to Trinidad in India was much
larger than that for the earlier slave population. For instance, in 1813, Trinidad's resident
slave population had about 30% more women, when compared to the quota established
by the government for the female East Indian immigrants in 1868.3°

Northrup argued that the 1868 increase in the quota, from 30 to 40 women per
100 men, reflected the decision to change the policy of the program to permanent
colonisation.3 1 However, the rhetoric of 'permanent' needs to be questioned in light of
the gender imbalance created by the quota. Rhoda Reddock argued that the gender
disparity reflected the unwillingness of planters to encourage female migration, because
of their disinterest in investing in the local reproduction of the next generation of
labourers.3 2 By importing 40 women for every 100 men, the government continued to
create a population with unnatural sex ratios, which reduced the opportunities for family
formation and the potential birth rates. Curtin calculated that the slave trade's two to
one gender ratio translated to a 33% lower potential in the overall per capita birth rate.33
By comparison, the Indian ratio of ten men to four women reduced the potential birth
rate below that number. Although the slave populations were unable to increase
naturally, even fewer Indian women were redeployed half way across the globe in the
program of indenture. The governments had therefore collaboratively engineered a new
population that would be less successful than the slaves in reproducing their numbers or
establishing a society with a modicum of morality, according to the Enlightenment's
natural laws of the universe. The quantitative analysis on natural increase, below,
introduces the multi-decade struggles of the East Indians and the descendants of the
formerly enslaved peoples to overcome these systemic barriers to natural increase,
knowingly constructed at different times by Trinidad's plantocracy.

28 BPP 1874 #314. Mr. Geoghegan's Report on Coolie Immigration, 52. Northrup,

Indentured Labor, 76-7. The controversy over the gendered quota in relation to health conditions

aboard the emigrant ships is discussed below (in Chapter 3).

2
9 BPP 1866 [3679], Twenty-Sixth General Report ofthe Emigration Commissioners, 22.

Despite all the anxiety over the gendered quota, as discussed below (in Chapter 3), the sources do

not state how the government determined that 30 or 40 women alleviated their concerns about

the moral condition of the Indian population overseas.

3o John calculated the slave population to be 60% male and 40% female in 1813 (for slaves

over age 15). John, Plantation Slaves, Table A-7, 190-1. With 40 East Indian women per 100 men,

the ships left India with about 30% fewer women than the resident female slaves in 1813.

31 Northrup, Indentured Labor, 76-7.

32 Rhoda Reddock, "Indian Women and Indentureship in Trinidad and Tobago 1845-1917:
Freedom Denied," Caribbean Quarterly 32, 3/4 (1986): 27-8.
33 Curtin, "Epidemiology and the Slave Trade," 215.

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 PhD Thesis - L. Jacklin. McMaster - History.

Relational Identities and the 1909 Sanderson Commission

Northrup and Kale argued that the governments manipulated the identities of the East
Indians as part of the justification of their programs of indentured immigration. The
relational identities constructed for the Africans and East Indians continued to form the
basis of the Trinidadian plantocracy's assertion of its success in civilising the foreign race
of indentured East Indians and the concomitant failure of the Africans to respond to
civilisation. The 1909 Sanderson Commission provides extensive evidence of the way
that officials from the metropole and plantation colonies articulated strikingly unified
and consistent evaluations of how each race fared in its march to civilisation. This
analysis of the testimony of the witnesses at the commission reveals the mature phase of
relational identities constructed for the African and Indian subject peoples, after the
program of indenture had been in effect for more than fifty years: these identities were
integral to Trinidad's policies for developing its population sectors.

In March 1909, the Colonial Secretary of State, the Earl of Crewe, appointed Lord
Sanderson to review the system of indentured East Indian migration to the Crown
Colonies and report on the advantages derived from the system by India and the
plantation colonies. After hearing the testimony of eighty-three witnesses during
seventy-three days of hearings, the commission concluded that the program benefited
the colonies and India.34 Trinidad's plantocracy and officials turned out in force in
London to testify at the hearings.3s Although the terms of reference for the commission
did not ask the commissioners to ascertain if the migrants benefited from the program,
witnesses commented on the progress of the East Indians and the Africans' concomitant
failure to embody the values of British civilisation.

The witnesses attested to the success of the program, claiming that the
immigrants improved both morally and physically after arriving in Trinidad.3 6 Reverend
John Morton, the head of the Canadian Presbyterian Mission in Trinidad, described by
the commissioners as an expert witness on East Indians, insisted that indenture changed
the Indians in a positive way, causing them to bear children of a "stronger and more
vigorous race," with substantively more civilised habits.37 Witnesses further construed an
inter-generational effect of the positive British influences, pronouncing Trinidad-born

34 EPP 1910 [cd 5192]. Report ofthe Committee on Emigration from India to the Crown
Colonies and Protectorates, 4-5, 24-5. [Hereafter, Sanderson Report.]
35 EPP 1910 [cd 5193], Report ofthe Committee on Emigration from India to the Crown
Colonies and Protectorates. Part II. Minutes ofEvidence. [Hereafter, Sanderson Evidence.] EPP
1910 [cd 5194], Report ofthe Committee on Emigration from India to the Crown Colonies and
Protectorates. Part III. Papers Laid before the Committee.
36 EPP 1910 [cd 5193], Sanderson Evidence, 331. Trinidad Surgeon-General H.L. Clare.
37 EPP 1910 [cd 5193], Sanderson Evidence, 1, 339. The Canadian Presbyterian mission to
Trinidad, 1868 to 1917, operated many of the schools and attempted to Christianise the East
Indians. The missionaries lived in the Indian communities. The two monographs by the
missionaries detail their religious activities, but do not provide any information of consequence
about the health or living conditions of the East Indians. Sarah E. Morton, John Morton of
Trinidad. Pioneer Missionary ofthe Presbyterian Church in Canada to the East Indians in the
British West Indies (Toronto: Westminster, 1916). Kenneth James Grant, My Missionary
Memories (Halifax: Imperial Publishing, 1923).

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 PhD Thesis - L. Jacklin. McMaster - History.

Indians to be even more racially improved than their parents.38 The coveted British
values of industriousness and thrift remained at the forefront of the comparisons.
Trinidad proprietor, imperial parliamentarian, and anti-indenture proponent Norman
Lamont encapsulated the prevailing sentiments plainly: "It is often said in the West
Indies that while the [African] Creole can do twice as much as the Indian, the Indian will
do twice as much.as the [African] Creole."39 The testimony resonated with the ideals of
the civilising mission. Lamont assured the commissioners that the health and living
conditions of the immigrants were far better than in India.4° The long-serving president
of the powerful West India Committee, Sir Nevile Lubbock, compared the lives of Indo­
Trinidadians to the people in India's large and over-populated districts, where he
insisted that the people barely survived and starved during the famines. He proclaimed
that the Indians lived in "comparative luxury" in Trinidad.41

The commissioners spent a significant amount of time trying to ascertain if the

East Indians prospered while in the colonies. Colonial reports consistently portrayed the
immigrants as contented and prosperous people.42 Several witnesses insisted that the
majority of this population benefited, as evidenced by their ability to accumulate large
sums of money andjewellery.43 In the commission's report, Lord Sanderson concluded
that the East Indian immigrants in Trinidad (and British Guiana) were well-treated, had
"undoubtedly" prospered, and had "excellent prospects of acquiring competence and
even wealth" after completing their sojourn of indenture.44 The portrayal of the East
Indians as prosperous people resonated as a major theme throughout the testimony.
However, as established above (in Chapter 1), India would subsequently terminate
indentured migration in 1916, a mere seven years after the Sanderson Commission. The
Indian government based its decision on the poverty of the East Indians overseas, along
with its concerns that the gendered disparity created immoral conditions of life for the

38 BPP 1910 [cd 5192], Sanderson Report, 32, 69-70. Evidence of Sir H. Johnston,
Stipendiary Magistrate Henry Huggins, and Reverend John Morton, with reference to the 1893
report by Surgeon-Major D.W.D. Comins.
39 BPP 1910 [cd 5193], Sanderson Evidence, 301.
4° Lamont claimed that estate conditions were "much better than they [East Indians] are
accustomed to in their own homes, and certainly far better than they provide for themselves when
they become free." BPP 1910 [cd 5193], Sanderson Evidence, 301.
41 Lubbock was the Chairman of the New Colonial Company, which operated large estates in
Trinidad and British Guiana, and Past President of the West India Committee (1884-1909). BPP
1910 [cd 5193], Sanderson Evidence, 86. The plantocracy routinely used India as the comparison
for the improvement in the lives of the East Indians. Trinidad's Dr. Louis de Verteuil stressed that
their lives improved in his 1884 monograph and then articulated the same sentiments at the
commission: East Indians were racially inferior, but responded to the civilising agency in
Trinidad. Louis de Verteuil, Trinidad: Its Geography, Natural Resources, Administration,
Present Condition, and Prospects, 2nd ed. (London: Cassell, 1884), 23-4.
42 See, for instance, 1899 LC #54, Protector ofImmigrants AR, 7. 1902 LC #63, Protector of
Immigrants AR, 9. Other colonies similarly claimed that their East Indian populations prospered.
For instance, as part its justification to abolish return passages to India, British Guiana's Court of
Policy passed a resolution extolling the wealth amassed by the East Indians and the beneficial
effects of the civilising influences on the people. 1891 LC #20. Immigration. Minutes ofa Meeting
ofthe Standing Committee on Immigration.
43 BPP 1910 [cd 5193], Sanderson Evidence, 25, 295, 297, 347. Testimony of O.W. Warner,
Protector Coombs, and Lord Stanmore. Witnesses from other colonies gave similar evidence.
44 BPP 1910 [cd 5192], Sanderson Report, 99-101.

-34­
 PhD Thesis - L. Jacklin. McMaster - History.

expatriate Indians.45 Although the decision-makers in India detected little evidence of

prosperity and wealth, the testimony of the colonial and metropolitan witnesses at the
Sanderson Commission illustrates the ubiquitous discourse on East Indian prosperity.

The progress of the East Indians was contrasted to the failure of Africans to
respond to the civilising influences. Trinidad's Surgeon-General, Dr. Henry L. Clare,
described the Afro-Trinidadians as much more muscular than East Indians, but "lazy"
and disinclined to work.46 Colonial Secretary S.W. Knaggs characterized the people as
lacking the instincts of materialism and frugality: although Africans could be "splendid"
workers when their low subsistence-level needs stimulated irregular waged labour, their
hand-to-mouth existence meant that these paupers became an immediate charge upon
the government when they became ill.47 When asked to compare the racial vigour of the
Africans to the former slave population, witnesses spoke of racial deterioration. Estate
manager Peter Abel insisted that slaves were "finer" physical specimens and steadier
agricultural labourers, but the current-day black and coloured Africans had weakened.4 8
Physiological and psychological deterioration went hand in hand. The entire race had
developed a love of living so profound that it made Africans disinterested in work.49

Arthur Gordon, Lord Stanmore, was oµe of the few dissenting voices about the
Africans' failure to become civilised. This witness had extensive experience as the
governor of several plantation colonies, including his sojourn in Trinidad from 1866 to
1870. Laurence Brown characterised Gordon as a senior careering official in the imperial
world, responsible for reforming and refashioning indentured migration in Trinidad,
Mauritius, and Fiji, between 1866 and 1880.5° In his testimony at the Sanderson
Commission, Stanmore did not conceive of any innate racial failure in the Africans.
Instead, he believed that they would not work for Trinidad's planters because they were
offered the trifling subsistence wages paid to the indentured Indians.5 1 Stanmore was one
of the few witnesses to deviate from the rhetoric of the Africans' regression since
emancipation and the representation of East Indians as happy and prosperous.

Despite Lord Stanmore's contradictory opinion, the relational identities had

become universal in the elite discourse of Trinidad's officials and planters. These
identities were crucial to the justification of indentured migration and Trinidad's policy

45 K. 0. Laurence, A Question ofLabour. Indentured Immigration into Trinidad and

British Guiana.1875-1917(Jamaica: Ian Randle Publishers, 1994), 457-8,469, 471. Look Lai,
Indentured Labour, 175-8. Reddock, "Indian Women and Indentureship," 27-49.
46 BPP 1910 [cd 5193], Sanderson Evidence, 331, 334.
47 BPP 1910 [cd 5193], Sanderson Evidence, 272-3. Testimony of Samuel William Knaggs.
48 BPP 1910 [cd 5193], Sanderson Evidence, 410-11, 417.
49 Jamaica's Governor Sir Sydney Oliver stressed the innate psychological difference
between the East Indians and the Afro-Jamaicans: the latter were the dominant labour force in
Jamaica. BPP 1910 [cd 5193], Sanderson Evidence, 291-2.
so Laurence Brown, "Inter-colonial migration and the refashioning of indentured labour:
Arthur Gordon in Trinidad, Mauritius and Fiji (1866-1880)," in David Lambert and Alan Lester,
eds., Colonial Lives across the British Empire: Imperial Careering in the Long Nineteenth
Century (Cambridge: Cambridge University Press, 2006), 204-27. Chapman's earlier biography
of Stanmore is much less critical of Gordon. J.K. Chapman, The Career ofArthur Hamilton
Gordon, first Lord Stanmore, 1829-1912 (Toronto: Univ. of Toronto Press, 1964).
51 BPP 1910 [cd 5193], Sanderson Evidence, 347.

-35 ­
 PhD Thesis - L. Jacklin. McMaster - History.

on population growth. A quantitative analysis of the outcome of the policy to neither

whiten nor blacken Trinidad establishes the effects of the legacy of the slavery era ideals
on the expendability and impermanence of plantation labourers in determining the
demographic fate of the African and East Indian populations in Trinidad.

Population Growth by Natural Increase and Migration, 1881 to 1920.

Trinidad's program of indentured migration changed the colony's demographic

composition fundamentally by introducing East Indians to the colony and then
augmenting their numbers each year. By 1891, Indo-Trinidadians accounted for about
one third of the colony's residents. The people under indenture represented a minority of
this sector at just over 5% of all residents and about 15% of the East Indian sector.s2 The
colony continued to import a disproportionate number of males each year, maintaining
the planters' preference to acquire a minimum number of females. Thus, the Indo- and
Afro-Trinidadian sectors had been resolutely created with significant disparities in their
sexual demographics. The effect of Trinidad's policy is examined by considering the
growth of the total colonial population and then examining and comparing the details of
natural increase and migration between the African and East Indian sectors. This
comparison of growth by migration and natural increase reveals several different
patterns for the two populations who lived side by side in Trinidad.

Figure 2.1 - Population Growth in Trinidad 1881 - 1920.

Comparing total Natural Increase (the excess ofbirths over deaths).

to Net Migration (the excess ofimmigration over emigration).

Data source: appendix 2.1.

45,000

40,000

35,000

Q)
Q. 30,000 -··

0
Q)
c. 25,000 ­
0
..
Q)
..Q
20,000
E
:J
c:
15,000 ·­

10,000 -- -- ­

5,000 ­

0 . ­ ·-- - -­

1881 - 1890 1891 - 1900 1901 - 1910 1911-1920

•net natural increase 4,666 26,713 34,219 32,396
0 net migration
- ---- ---
42,234 29,062 28,612 786

s2 This calculation is based on the census data of 200,028 residents in Trinidad, including
70,242 Indo-Trinidadians. The annual report of the Protector of Immigrants recorded 10,405
indentured East Indians in Trinidad on 31 March 1891. 1891 LC #68, Protector ofImmigrants
AR, 2. Census ofthe Colony ofTrinidad, 1891 (Port-of-Spain: Government Printer, 1892).
 PhD Thesis - L. Jacklin. McMaster - History.

Figure 2.1 illustrates the decennial growth in the colony's total population between 1881
and 1921, comparing the results of net natural increase to migration. The reversal in the
method by which the population grew within this short forty-year period is striking. In
the first decade, Trinidad's growth resulted almost exclusively from migration, while the
population barely sustained itself naturally. This pattern reversed itself within four
decades: the growth from migration rather quickly plummeted to a negligible number,
while the population's capacity for natural increase reached unprecedented levels.

The profound change in the population's natural increase, starting in the 1890s,
is evident in Figure 2.1. The detailed analysis of natural increase, below, identifies the
decade of the 1880s as the point when the African sector recovered demographically
from the traumas of slavery and its sexual disparity and began to reproduce naturally. It
also identifies the 1890s as the time when the disproportionately male East Indian sector
started to reproduce its own numbers, despite the on-going sexual imbalance inflicted on
the population by the government's immigration program, along with the harsh
conditions of indentured labour.

While the changes in natural increase made a positive contribution to the

colony's population, the changes in migration patterns had the opposite effect. Figure 2.1
confirms that migration accounted for about 90% of decennial growth between 1881 and
1890. Three decades later, from 1911to1920, the net growth from migration plunged to a
paltry 24%. Three factors contributed to this change: voluntary circum-Caribbean
immigration declined after 1901, India terminated indentured migration in 1916, and
World War I impeded travel when Britain commandeered commercial ships for the war
and enemy ships patrolling the Caribbean waters made travel unsafe.53

The new century thus represented an important turning point when the primary
historical means of growth, by migration, reached its zenith, arrested, and then declined
to become a negative factor, while the resident population's enhanced capacity to
reproduce itself by natural means stopped the total population from shrinking in size.
However, these changes did not occur uniformly in the African and East Indian sectors.

Growth by Natural Increase in Trinidad, 1881-1920.

The inability of slave populations to grow by natural increase had captured the attention
of Enlightenment thinkers, abolitionists, and British reformers. As demonstrated above,
historians and historical demographers have actively investigated this unusual state of
being and skilfully quantified the extent of the problem. However, little attention has
been devoted to identify when the formerly enslaved peoples and their descendants,
along with the newly established East Indian sector, began to grow by natural increase.
Brian Moore is one of the few historians to address this question for an Afro-Caribbean
population. In his study of post-emancipation British Guiana, Moore identified that the
native-born African population decreased in size between 1841 and 1891.54 The
experience of the Afro-Guianese people is a troublesome revelation in the context of the
prolific growth of other world populations during the century. This analysis of the

53 1915 LC #154, Surgeon-General AR, 10. 1915 LC #109, Protector ofImmigrants AR, 6.
54 Moore, Cultural Power, Resistance, and Pluralism, 11, 18.

-37­
 PhD Thesis - L. Jacklin. McMaster - History.

patterns of natural increase establishes that Trinidad's populations faced the same plight
as the Afro-Guianese peoples, but that the Afro-Trinidadian sector recovered during the
1880s and the Indo-Trinidadians in the following decade.

The comparative statistics on the growth of the population by natural increase

are presented in Figure 2.2 and net migration in Figure 2.3. The terms used in these
charts to describe the populations require clarification. Trinidad's census classified the
population as either East Indian or the "general" population.ss The term "East Indian" is
· self-explanatory, including any person of East Indian descent, whether of pure or mixed
parentage. These statistics are precise, because this sector was distinctly enumerated in
the vital statistics. The "general" population is referred to as "West Indian" in the
following charts. The West Indian sector includes the tiny white minority and the Afro­
Trinidadian majority. As established above, white Trinidadians constituted only i.5% of
the total population by 1907.s6 Although the West Indian sector includes the white
residents, their numbers were so insignificant that it should not have a measurable effect
on the data on migration (Figure 2.3, below) or this comparison of the patterns of
natural increase between the West Indian and East Indian sectors.s7

Figure 2.2 - Population Growth by Natural Increase in Trinidad, 1881to1920,

Comparing the Growth ofthe East Indian and West Indian Sectors.

Data sources: Appendix 2.1, 2.2, 2.3.

25,000 ---- -- ------ fiC.::::::Cilt___ --- --­

'ii)
QI
=g 20,000 . -­ -­ --­ - ­ - - ­ ---­ -----­ - ­ -
e
15,000 --­

10,000 -

5,000 ----r==t-­ ·­
·----.....LJ
0
1881-1890 1891 - 1900 1901 - 1910 1911 - 1920
• East Indians - net natural increase 60 5, 109 10,573 12,873
0 West Indians - net natural increase 4,606 13,494 23,646 19,523

Figure 2.2 illustrates two remarkable changes in the patterns of natural increase during
this period. First, in the 1880s, the West Indian sector, the vast majority of who were
Afro-Trinidadians, began to increase in size naturally, just slightly ahead of the time

ss Registrar-Generals named this sector the "General" population, but this analysis uses the
term "West Indian." Reverend John Morton suggested the nomenclature of 'West Indian' and
'East Indian' at the Sanderson Commission. BPP 1910 [cd 5193], Sanderson Evidence, 339-40.
s6 Op.cit. See note 4, above.
s7 For instance, in 1907, the West Indian sector included the estimated 5,000 white people
(I.5% of the population) and about 234,000 Afro-Trinidadians (68.5% of the population). The
number of white residents was so small that it is doubtful that the handful of births, deaths, and
net migration would have had a significant effect on the data in the following figures.
 PhD Thesis - L. Jacklin. McMaster - History.

identified by Moore for the Afro-Guianese people. This establishes that the Afro­
Trinidadians required more than two generations of freedom, or about five decades, to
recover from the trauma of slavery and begin to reproduce their numbers naturally.
Second, the East Indian sector began to reproduce itself naturally in the 1890s, despite
the government's policy to continue to import 40 women per 100 men and the harsh
conditions of life under indenture. Although the systemic barriers to natural increase
remained current amongst the East Indians, this sector required a much shorter period
of time to recover demographically, when compared to the African peoples. By the end of
the century, both sectors had thus overcome the systemic barriers to natural increase,
which had been purposefully constructed within the systems of labour that had
commoditised their bodies as expendable and replaceable.

The generally improving trends shown in Figure 2.2 establish that the aggregate
results of natural increase were positive during these four decades. However, this more
natural state of being resulted from different factors within the West Indian and East
Indian sectors. Each population had dissimilar crude birth and death rates, which
measure the incidence of births or deaths per 1,000 living persons. The available
statistics allow the crude birth rate (CBR) and crude death rate (CDR) to be calculated
for each population: these statistics are detailed in Appendix 2.3 for the West Indian
sector and Appendix 2-4 for the East Indians. In the forty years depicted in Figure 2.2,
fewer West Indians died per capita,s8 but they also bore fewer children.s9 This sector's
improved rate of growth thus resulted from the large decline in the crude death rates.
Conversely, the East Indians experienced a nominal increase in their death rates, 60 but
the prolific increase in their crude birth rates more than compensated for the slightly
higher death rate. 61 Despite the on-going perpetuation of the demographic sexual
disparity, the East Indian growth was due to the increase in the birth rate. In other
words, during this forty year period, fewer West Indians died, while the East Indian
death rate increased: the West Indian CDR declined by 15.1% at the same time that the
East Indian CDR increased by 3.1%. Simultaneously, the West Indian crude birth rate
declined by 12.6%, while the East Indian CBR increased significantly, by 17.1%. These
two populations living side-by-side experienced life in appreciably different ways. If such
trends had continued ad infinitum, beyond the period of this study, East Indians would
have eventually become the majority in the colony.

58 Between 1891and1920, the West Indian crude death rate declined during each decade,
starting at 26.97 (1891-1900), dropping to 24.61 (1901-1910), and then to 22.89 (1911-1921). This
represented a net decrease of 15.1% in the CDR between the first and last decades. For the
detailed calculations of the crude rates, see Appendix 2.3.
59 The average West Indian crude birth rate declined by 12.6% during this thirty year period
between 1891and1920. The average of the annual West Indian CBRs remained relatively
constant at 36.00 in the first decade (1891-1900) and 36.18 between 1901and1910. It then
declined to 3i.48 (1911and1920). For the detailed crude rates, see Appendix 2.3.
60 Between 1891 and 1920, the average East Indian crude death rates increased slightly each
decade: 25.53 (1891-1900), 25.76 (1901-1910), and 26.31 (1911-1920). This represented a net
increase of 3.1% in the CDR between the first and last decades. For the detailed crude rates, see
Appendix 2.4.
61 The East Indian CBR increased by an average of 17.1% from 1891to1920. Between 1891
and 1900, the average of the annual East Indian CBR was 32.02. This CBR average increased to
36.60 (1901-1910) and then to 37.50 (1911-1920). For the crude rates, see Appendix 2-4.

-39­
 PhD Thesis - L. Jacklin. McMaster - History.

Residents produced enough children after the 1890s to change the historical
patterns of unnatural decrease. Unfortunately, there are no extant studies to help explain
why these changes occurred at this time. The creation of the Government Medical
Service (GMS) organisation in 1870 plausibly had a significant effect on helping to
mitigate the death rate at times, but the provision of maternal and infant healthcare
services was not a priority during the period of this study. While the different sectors
finally managed to surmount the unnatural condition of not being able to reproduce
their numbers, it is indeterminate at what point the colony would be poised to make a
major health transformation that would have a pronounced affect on the birth and death
rates. The scholarship for Jamaica and British Guiana identifies that those colonies
started to make major changes around 1920, which would have had a major influence on
important indicators, such as live births, infant mortality, and life expectancy. Juanita
De Barros established that British Guiana pioneered the British West Indian reforms for
infant and maternal health in the 1910s, which were then used by the other colonies.
Trinidad did not adopt the Guianese reforms until 1918. 62 In his study oflife expectancy
in Jamaica, James Riley argued that there had been no improvement in the trends for
survivorship and life expectancy before 1920. Officials knew what needed to be done to
reform public health and the GMS, but the government continually lacked the resources
to put the plans into action. 63 During the period of this study, Trinidad's GMS did not
tend to pioneer innovations in health and medical care, which suggests that while the
GMS may have helped to mitigate the death rates somewhat, this would have only helped
the Trinidadian people finally start to achieve the more natural rates of increase
experienced by many other populations elsewhere.

Population Growth by Migration in Trinidad, 1881-1920.

A population's growth from migration is positive when the location has more immigrants
than emigrants. Negative net migration is usually caused by a crisis, such as famine or
war. Figure 2.1 established that Trinidad's net migration statistics changed significantly
between 1881and1920, which suggests that unusual circumstances prevailed during this
period. However, the migration literature for Trinidad provides little information on the
emigration of the West Indian and East Indian sectors, or the inter-colonial immigration
of the West Indian population. Figure 2.3 provides statistics on the aggregate migration
for the West Indian and East Indian sectors.

62 Juanita De Barros, "'Improving the Standards of Motherhood.' Infant Welfare in Post-

Slavery British Guiana," in Juanita De Barros, Steven Palmer, and David Wright, eds., Health and
Medicine in the circum-Caribbean, 1800-1968 (NY: Routledge, 2009): 170-2. The initiation of
infant welfare programs occurred in other colonies around 1920. See, for instance, Margaret
Jones, "Infant and Maternal Health Services in Ceylon, 1900-1948: Imperialism or Welfare?"
Social History ofMedicine, 15 (2002): 263-89.
63 James C. Riley, Poverty and Life Expectancy. The Jamaica Paradox (NY: Cambridge
Univ. Press), 48.
 PhD Thesis - L. Jacklin. McMaster ~History.

Figure 2.3 -Population Growth by Net Migration in Trinidad, 1881-1920,

Comparing the West Indian and East Indian Sectors.

Data Sources: Appendix 2.1, 2.2, 2.3.

25,000 -­

20,000
CD
Q.
0
CD 15,000
.....0c.
...CD
.c 10,000 --­
E
::I
r::
5,000

0 -­
1881 - 1890 1891 - 1900 1901 - 1910 1911 - 1920
------ ------------- ----- -------- -- -- -

20,872 24,570 --- 12,_020 --- ___2,320 -- __,

21,362 13,817 19,352 6,506

Figure 2.3 illustrates changes in the net migration of the West Indian and East
Indian sectors each decade, which culminated in both sectors contributing rather
negligible numbers of new migrants after 1911. The nature of these migrations differed
between the two sectors. West Indians generally made voluntary migration decisions. In
the first two decades, these choices helped the population to grow. Conversely, after
1901, fewer people in the West Indian sector decided to migrate to Trinidad or to remain
in the colony. Between 1911 and 1920, the net growth from voluntary migration
plummeted to a mere 11% of the volume three decades earlier. The major change in East
Indian migration during the same decade, 1911 to 1920, occurred when India terminated
the program of indentured migration in 1916. Government ships then stopped bringing
the thousands of new indentured labourers who had continually replenished the
plantation labour force each year during the previous eight decades. Migration between
Trinidad and India then became a unidirectional outflow of repatriations to India.

Trinidad did not make any sustained attempts to "whiten" the colony. Other
colonies, such as British Guiana, instituted programs to encourage white immigrants
from locations such as Madeira, Cape Verde, and the Azores. 64 Between 1834 and 1918,
British Guiana received 32,216 white migrants from these locations, while a mere 897
arrived in Trinidad. 6s Trinidad's meagre attempts to stimulate migration over the years

64 Moore argued that British Guiana's program to encourage the Portuguese immigrants
was an initiative to whiten the population. Brian Moore, Race, Power and Social Segmentation in
Colonial Society. Guyana after Slavery, 1838-1891 (NY: Gordon and Breach, 1987), 139-41.
6s Trinidad's brief attempts to promote indentured migration from the United States
brought 1,333 people to the colony between 1835 and 1867, but the sources do not define the
ethnicity and colour of these migrants. Roberts and Byrne, Summary Statistics, 127, 129, 131.
Look Lai stated that 1,298 immigrants arrived from Madeira, Cape Verde, and the Azores. Look
Lai, Indentured Labor, Caribbean Sugar, 16-18. For British Guiana, Wood stated that 21,811
people from Madeira arrived between 1841 and 1861, initially under indenture, but they soon
 PhD Thesis - L. Jacklin. McMaster - History.

were unsuccessful. For instance, in 1889, upon learning that many countries were
encouraging Azorean immigration, Governor William Robinson attempted to sponsor a
program. The British Consulate for the Azores and Madeira explained that countries,
such as Hawaii, offered free passages and land grants. The Legislative Council, led by Dr.
Louis de Verteuil, informed the Colonial Office and British diplomats that they preferred
foreign labourers to Afro-Caribbeans, who were still too degraded from slavery.
However, Trinidad's offer of free land grants required the people to work as indentured
labourers for up to seven years. Secretary of State Henry Holland, Lord Knutsford,
responded that the Azorean people were disinterested in migrating to Trinidad. 66

Trinidad's Legislative Council rarely encouraged Afro-Caribbean migrants from

other colonies and, in fact, often tried to discourage them. The mid- and late-century
policies changed from the immediate post-emancipation period, when Bonham
Richardson demonstrated that there were significant movements of migrants from St.
Kitts and Nevis to Trinidad. 67 However, Trinidad's interest in this and other inter­
colonial migration arrested when indentured East Indian migration was instituted. Many
other colonies welcomed Afro-Caribbean migrants. For instance, in 1885, Antigua and
British Guiana provided assistance to Barbadians and offered free land. Trinidad
proposed indenture, which was emphatically declined by the Barbadian government on
behalf of its people. 68 Trinidad's other rare schemes were similarly unsuccessful. Unlike
other colonies, Trinidad offered little in the way of assistance to potential immigrants. 69
In his testimony to the Sanderson Commission, black lawyer and Legislative Council
member C.P. David complained that his government colleagues would never encourage
the migration of Afro-Caribbean peoples while indentured migration continued.7°
Trinidad's planters had developed an addiction to bonded Indian labour: its program of
indentured migration remained the colony's central policy for population growth.

became free migrants. Wood, Trinidad in Transition, 101-6.

66 1890 LC #83. Immigration. Correspondence relative to Immigration from the Azores

and to the encouragement ofVoluntary Immigration from the Mainland and neighbouring

Colonies. Acting Governor Henry Fowler stated that the planters only wanted East Indian or

Chinese labourers. 1891 LC #32. Despatchfrom the Secretary ofState with reference to

Immigration from the Azores. The few instances where Trinidad attempted to encourage white

migration ended unsuccessfully. CO 384-152 (1884) #3694. Immigration from Madeira. Ryan

argued that the Portuguese were not considered 'white' in Trinidad, but were still more desirable

to the Trinidad elite than the Africans already in the colony. Selwyn D. Ryan, Race and

Nationalism in Trinidad and Tobago: A Study ofDecolonization in a Multiracial Society

(Toronto: Univ. of Toronto Press, 1972), 19.

67 Bonham C. Richardson, Caribbean Migrants. Environment and Human Survival on St.

Kitts and Nevis (Knoxville: Univ. of Tennessee Press, 1983), 81-92.

68 1885 LC #71. Papers Relating to Emigration from Barbados. Trinidad's Select

Committee on emigration from Barbados stated that the planters refused to consider non­

indentured Barbadian immigrants. 1886 LC #36. Report ofSelect Committee on Emigration

from Barbados.

69 For instance, in 1898, Legislative Council member A.P. Marryat attempted to recruit

labourers from hurricane-ravaged St. Vincent and Barbados. British Guiana had significant

success recruiting these people, because the colony offered them liberal assistance. Marryat's

scheme failed as the potential immigrants were disinterested in Trinidad's restrictive terms. 1898

LC #185. Agricultural Labourers from St. Vincent and Barbados.

7° BPP 1910 [cd 5193], Sanderson Evidence, 197-8, 216.

-42 ­
 PhD Thesis - L. Jacklin. McMaster - History.

Nonetheless, the consistently strong flow of voluntary pan-Caribbean migration

had a major effect on Trinidad. Thousands of migrants entered and left the colony each
year. Although the colony welcomed people with capital and professionals, the official
attitude differed about Afro-Caribbean immigrants. "Deckers" were poor people
travelling on the lowest fares, on the decks of the ships, in search of work.7 1 Officials
developed a fastidious interest in the deckers, who they believed would capitalise on the
healthcare services offered by its GMS organisation. In 1882, Trinidad enacted the
Infirm Pauper Ordinance to prohibit the immigration of undesirable immigrants,
including those who appeared to be "vicious," criminal, poor, or infirm.72 This law
allowed the Harbour Master, police, doctors, and quarantine officials to reject
immigrants by making subjective decisions on a person's "likely" future potential to seek
assistance from the government hospitals, asylums, or almshouse.73 The Imperial world
policy of free trade dictated the free movement of people and precluded the Legislative
Council from erecting overt barriers to immigration. However, the ordinance provided
officials with a great deal oflatitude to turn away immigrants deemed as undesirable.74

Similar to the "head tax" imposed on Asians by the anti-Chinese immigration

laws, which emerged in the imperial world during the 1880s, the Infirm Pauper
Ordinance required undesirable immigrants to deposit the extraordinarily large sum of
£20 with the government, in this case, to be drawn upon if the immigrant used the GMS
or other government services.75 The £20 fee functioned as an expensive deterrent, rather
than a reasonable deposit for future medical care. As argued below (in Chapter 6), the
GMS rarely ever convinced patients to pay for their treatments at the colony's medical
institutions. The ordinance also imposed hefty fines on any ship that transported pauper
migrants to Trinidad.76 Over the years, articles and editorials in the local media
complained that the law was vigorously enforced at some times and quite lax at other

71 BPP 1910 [cd 5193], Sanderson Evidence, 223.

72 First enacted by Ordinance 5 of 1882, An Ordinance relating to the introduction of
Paupers likely to become chargeable to the Colony was amended by Ordinance 11 of 1895, 19 of
1897, and 186of1905, and then repealed by Ordinance 4of1936. The short title of the law was
the Infirm Pauper Ordinance.
73 Infirm Pauper Ordinance 186of1905.
74 Critics of indentured migration said that the ordinance was a device to inhibit the
immigration of free workers. Colonial Secretary S.W. Knaggs claimed that it kept out
undesirables. BPP 1910 [cd.5193], Sanderson Evidence, 274. The Infirm Paupers Ordinance 5 of
1882 required paupers to deposit £20 on arrival in Trinidad, or have a resident agree to be
responsible for the immigrant's expenses for a year. CO 384-186 (1893) #20843, Emigration
Despatches. By 1909, the deposit had been reduced to £5, but it is not clear when this change
occurred.
75 For instance, in 1885 Canada imposed a $so "head tax" on Asians attempting to enter the
country. Canada's restrictions on immigration remained in force from 1858 to 1968. For a
summary of Canada's exclusionary laws, see James W. St. G. Walker, "Race," Rights and the Law
in the Supreme Court of Canada. Historical Cases Studies (Waterloo: Wilfred Laurier University
Press, 1997), 12-31. Xiaoping Li and Jo-Anne Lee, "Chinese in Canada," in C.R. Ember, M. Ember,
and I.A. Skoggard, eds., Encyclopedia ofDiasporas: Immigrant and Refegee Cultures around
the World (Springer, 2004), 646.
76 The Ordinance allowed the ship master to be fined £50 and the owner of the vessel £100
for each rejected immigrant. The ship could be subjected to a maritime lien enforced by the Royal
army and navy.

-43­
 PhD Thesis - L. Jacklin. McMaster - History.

times.77 However, in response to queries by a committee of the British parliament in

1909, Harbour Master J.B. Saunders and Governor Le Hunte had no qualms advising the
parliamentarians that this law targeted "Coloured West Indians of the labouring class":
the law was readily invoked if the immigrant's "general appearance conveys the
impression" that they might one day need medical or social assistance.7B While Trinidad
could not construct overtly racialised barriers to immigration, the active discouragement
of Afro-Caribbean immigration and the Infirm Paupers Ordinance helped officials
maintain their long-term objective of not blackening the colonial population.

Illegal Emigration and the "Leakage" ofEast Indians

In direct contrast to the attempts to discourage the growth of the colony's African
population, Trinidad instituted laws to try and keep Indo-Trinidadians within the
colony. For the Indians who migrated under indenture, and any children born in the
colony, freedom had a particular definition. To be free meant freedom from indenture,
but they were not free to leave the colony unless returning to India. The Immigration
Ordinance 13 of 1870 made it a criminal offence for Indians to leave for any destination
other than India without obtaining a passport from the Protector of Immigrants.79
Trinidad's longest serving Protector of Immigrants, William Coombs, made it difficult
for applicants to obtain passports and proudly proclaimed his success discouraging the
majority of applicants.Bo A further amendment to the ordinance, in 1878, made it illegal
for anyone to entice, recruit, or assist an Indian to leave Trinidad.B 1 India formalised this
restriction in the Indian Emigration Act of 1883, which prohibited foreign countries from
recruiting her subjects without its approval. India obligated the Colonial Office and
Foreign Office to deal with any nation that recruited Indians from a colony that

77 "The Landing of Paupers," The Mirror, 10 September 19oi. "Day by Day," The Mirror, 2
September 1905. "Detained on board the Statia," Port-of-Spain Gazette, 20 July 1905.
7B CO 295-452 (1909) #32738. Distressed British Subjects. Governor Le Hunte to Secretary
of State.
79 The Coolie Immigration Ordinance 13 of 1870 and all subsequent amendments defined
the need for a passport. See, for instance, BPP 1904 [cd 1989], Coolie Immigration, Immigration
Ordinances ofTrinidad and British Guiana, 44-5. Jamaica and British Guiana also required East
Indians to obtain passports before departing for foreign countries or any British territory other
than India. BG Sessional Papers 1880, Registrar-General AR, 12. JCA Sessional Papers 1898-99,
Report ofthe Immigration Department for the year ended 31st December 1899.
Bo Coombs' actions to discourage East Indians from leaving Trinidad would have been
consistent with the elite attitude that the people of this inferior "race" needed to be protected
from their own actions. Moreover, the Protector's job was to keep Indians labouring on the
estates. LC #68, Protector ofImmigrants AR. Coombs' predecessor, Charles Mitchell, issued
significantly more passports, while stating that most East Indians did not bother to obtain
passports. 1895 LC #108, Protector ofImmigrants AR, 5. In reporting the low number of
passports issued each year, Coombs confirmed that there were numerous opportunities for people
to "escape" to the Spanish Main and Demerara. 1906 LC #74, Protector ofImmigrants AR, 8.
1907 LC #91, Protector ofImmigrants AR. Yet, in 1906, in response to questions from the House
of Commons about the conditions of life for East Indians, Coombs insisted that the passport laws
were strictly enforced. CO 295-436 (1906) #20098. Indentured Coolie Labourers. Report by
Protector oflmmigrants W.H. Coombs. BPP 1906 #357, Coolie Labour.
81 Ordinance 21 of 1878 made it illegal to recruit or assist an East Indian to leave the colony.
BPP 1904 [cd 1989], Immigration Ordinances, 44-5.
 PhD Thesis - L. Jacklin. McMaster - History.

sponsored indentured migration. 82 The laws of India and Trinidad thus allowed the
colony to restrict the movements of Indians to attempt to keep them in Trinidad.

Nonetheless, many people left the colony, usually for the Spanish Main. Each
Registrar-General expressed significant frustration with the large volume of free East
Indians who emigrated illegally each year. 8 3 They called this well-known problem the
"leakage" in the population. Officials confirmed that the high volume of leakage rendered
the colony's vital statistics grossly inaccurate in the years between each census. The
"leakage" involved a large number of people who surreptitiously departed on boats
destined on a short eight-mile journey to Venezuela, the gateway to the Spanish Main, or
on longer trips to other Caribbean ports and the Panama Canal zone. 8 4 The constant
volume of legal maritime traffic afforded travellers numerous transportation options to
many destinations. Consequently, the large volume of people boarding small boats at
unknown locations to avoid surveillance and venturing into the often perilous ocean
waters suggests that the residents who leaked out of Trinidad took purposeful steps to
avoid being apprehended by officials.

As an island dependant on maritime trade, Trinidad's administration at the ports

managed the high volume of traffic, monitoring the thousands of people entering and
leaving the colony each year. The Indians who decided to escape from Trinidad wreaked
havoc with the colony's statistics. Officials continually expressed confidence in the
reliability of their statistics on the number of immigrants arriving in Trinidad. 8 5
However, officials could never manage to account for the total number of Indians who
left the colony. 86 Each Registrar-General invested considerable time in downwardly
revising his annual estimates of the total number of residents in an attempt to account
for this leakage. 8 7 Each subsequent census confirmed that far more people had leaked
out of Trinidad than they had estimated, leaving the resident population much smaller
than anticipated. Figure 2.4 depicts the decennial volume ofleakage and compares it to
the net migration of the West Indian sector and the legal East Indian migration to India.

82 CO 295-375 (1896) #25430. Coolies enlistedfor labour in Columbia.

83 See, for instance, 1921 LC #91, Registrar-General AR, 3.
84 1893 LC #92. Protector ofImmigrants AR, 3. 1894 LC #73, Registrar-General AR. 1895
LC # 55, Protector ofImmigrants AR.
85 Each Registrar-General ex;pressed his lack of confidence in the accuracy of the emigration
statistics, except for the statistics on migration from Trinidad to India. See, for instance, 1902 LC
#118, Registrar-General AR, 3. 1922 LC #86, Registrar-General AR, 3.
86 Registrar-General A.C. Robinson quantified the discrepancies between the estimated and
actual population in the censuses from 1891 to 1921. He confirmed that the annual estimates were
"greatly exaggerated" by 6% to 10.3%. 1922 LC #86. Registrar-General AR.
87 Registrars tried many methods to compensate for the inaccurate inter-colonial
emigration numbers. However, they were continually unsuccessful in generating estimates that
were more precise. 1891 LC #45, Registrar-General AR, 3-5. 18. 1898 LC #115, Registrar-General
AR, 2. 1914 LC #31, Registrar-General AR, 3. 1921 LC #91, Registrar-General AR, 3.

-45 ­
 PhD Thesis - L. Jacklin. McMaster - History.

Figure 2.4. - Population "Leakage" ofEast Indians, 1891-1920.

Data Source: Appendix 2.1

25,000 - --­

20,000 - ---­

-a
0
15,000 -­

~ 10,000
0...
~ 5,000 -­ -
E
~ 0 -

(5,000) -­ - ------------­

(10,000) - ­
1891 - 1900 1901 - 1910 1911 - 1920

•West ln_cii_a'!_ n~tA1fi2ra_tiE_n 3_4_,5_70________ __ 12,020 2,320

-------

r:]_l_f)_dent_uf"_9£l_~a~t Indian net Mi_g_~ation_ ________ _!_3_,8_17_ _______ __19,352 _ 6,506

-------------

D "Leakage" of East Indians to non- (5,430) (2, 760) (8, 040)

jn_dia_q~tin_at_i<J_n_s (to_tf31_for__~cade_)__ __ __________ _

The net volume of East Indian leakage is striking in comparison to the indentured
migration during the first and third decades in the chart. Between 1891 and 1900, the
number of East Indians who escaped from Trinidad was equivalent to about 40% of their
total net legal migration between Trinidad and India. This number decreased to about
14% in the next decade. Then, between 1911 and 1920, Trinidad lost more East Indians
through leakage than it imported during the final decade of indenture. Several thousand
East Indians simply disappeared from the colony each decade. As established below,
many escapees commuted between Venezuela and Trinidad frequently, which suggests
that the net number in Figure 2-4 would not have been the total traffic in a given decade
but, instead, the net quantifiable number on the date of each census.

The official rhetoric insisting that plantation society colonialism created a

prosperous and contented East Indian population rationalised that these deserters had
been well-treated in the colony, but that foreigners had successfully deluded the people
and convinced them to leave. Protector Coombs insisted that the stimulus for escape was
"the golden vision of El Dorado that lies only a few hours journey across the narrow belt
dividing Trinidad from the Spanish Main." Coombs attempted to deter East Indians from
leaving the colony by creating a fear of foreigners from the Spanish Main. He told the
Indians that these outsiders were "evil-disposed persons anxious to take them [away],"
who would then steal their possessions. 88 Coombs also insisted that many escapees
returned from Venezuela as "physical wrecks" and in "a very feeble and needy
condition."8 9 Trinidad's GMS was constantly portrayed as the main reason why the
escapees would want to return to Trinidad; they required the GMS's superior medical

88 1906 LC #74, Protector ofImmigrants AR, 10.

89 1913 LC #154, Protector ofImmigrants AR. 1908 LC # 109, Protector ofImmigrants AR.
 PhD Thesis - L. Jacklin. McMaster - History.

care after their bodies had been harmed by foreigners.9° Some former residents did in
fact periodically reappear in Trinidad "in a pitiable condition" and officials publicised
their misfortune in the Spanish Main to discourage others from escaping.9 1 However, the
Surgeon-General's annual reports never referenced any problem with large numbers of
repatriated patients arriving in pathetic condition.

Official reports confirmed that the majority of people never returned. Many
escapees found their El Dorado in the Spanish Main, earning the high wages that
enabled them to acquire tracts of land in the foreign countries.92 While plantation society
colonialism in Trinidad purposefully attempted to keep the population as impoverished
landless labourers, and rationalised these policies within its civilising mission, many
Indians rejected these constraints and ventured to their own El Dorado. In another
surprising revelation, Coombs confessed that the majority of money deposited by East
Indians in Trinidad's government bank had been earned through their labours in
Venezuela.93 The prosperity of many East Indians, which featured prominently in the
discourse of the benefits of the civilising mission, thus represented wealth amassed after
they escaped from Trinidad. These escapees also commuted between the Spanish Main
and Trinidad to use the Port-of-Spain Hospital: "The distance is short and the treatment
in Hospital, as a coolie described it, is 'bahut achcha' (very good)."94 Former Indo­
Trinidadians travelled, undetected; back and forth between their El Dorado and Trinidad
at will, suggesting that these people were not the deluded souls portrayed by Coombs.
These revelations introduce a new dimension to the debate over the "material benefits"
counter argument to the neo-slavery thesis, if indeed a significant portion of the wealth
possessed by East Indians had been generated outside of the colony.9s

The notion of escapees visiting Trinidad to make deposits at the bank and seek
medical attention at the Port-of-Spain Hospital confirms the ineffectiveness of the
government's surveillance mechanisms. Nonetheless, the traditions of slavery and
bonded labour meant that the colony had a great deal of experience dealing with
absconders and escapees as the plantation society attempted to keep people in their
proper places.9 6 This constant volume of people leaking in and out of Trinidad is
remarkable in light of the colony's purposeful measures to apprehend them. Protector
Coombs admitted that he dispatched boats to patrol the coast and placed guards on
shore.97 At other times, delegations travelled to Venezuela or Columbia to retrieve
expatriates, but these foreign relations could become quite complex.98 For instance, in

9o For instance, see, 1908 LC #109, Protector ofImmigrants AR.

91 1900 LC [no number], Protector ofImmigrants AR, 6. 1913 LC #154, Protector of

Immigrants AR, 8.

92 1895 LC #108. Protector ofImmigrants AR, 4. 1896 LC #175, Protector ofImmigrants

AR, 8. 1921 LC #55· Protector ofImmigrants AR, 4.

93 1896 LC #175, Protector ofImmigrants AR, 6.

94 1896 LC #175, Protector ofImmigrants AR, 6.

9s The debate by historians if indentured migration represented neo-slavery, or if

immigrants derived "material benefits," is discussed above (in Chapter 1).

96 In the immediate post-emancipation period, Northrup indicated that planters in Trinidad

and Jamaica complained that absenteeism reduced the productivity of the 'free' black labour force
by almost two thirds, when compared to the slavery. Northrup, Indentured Labor, 19-22.
97 1904 LC #78, Protector ofImmigrants AR, 8.
98 As early as 1866, Daniel Hart reported the problem with many East Indians escaping to
 PhD Thesis - L. Jacklin. McMaster - History.

1896, the Colonial Office directed Trinidad's officials to retrieve a large number of East
Indians from Columbia. Columbia and Britain did not have extradition treaties:
Columbia respected the East Indians' claims to be free people. Despite the rhetoric that
East Indians were reduced to poor and unhealthy souls without the protection of
Trinidad's government, the escapees were found to be healthy and prosperous in their
new homeland.99 This initiative to repatriate the former Trinidad residents failed
miserably. These interactions illustrate the tension between the residents who went to
great lengths to avoid officials and a government that attempted to stop or retrieve
persons who clearly did not want to live in Trinidad.

Officials dealt with this challenge to the rhetoric of happiness and prosperity in a
very pragmatic way, by generally failing to admit to the problem in public forums.
Nonetheless, the continued volume ofleakage brought the reliability of emigration
statistics into question and tormented generations of Registrar-Generals. 100 All inter­
census vital statistics that depended on an accurate count of the total population are
erroneous in the historical records. These statistics include all crude birth and death
rates and the rates of natural increase and migration. Officials had to await the results of
the next census to quantify the magnitude of the perpetual under-estimation of the
leakage and the concomitant over-estimation of the population. 101 Censuses allowed the
Registrar-Generals to quantify, retrospectively, the total number of bodies that had
leaked out during the decade. However, they did not amend their previously published
and vast collection of vital statistics that depended on an accurate count of the
population. As such, many published statistics in the historical records remain incorrect

Venezuela. The planters had difficulty retrieving these "fugitive apprentices," because Trinidad
did not have an extradition treaty with Venezuela. Daniel Hart, Trinidad and the Other West
India Islands and Colonies, 2nd ed., (Trinidad: Chronicle Publishing Office, 1866), 74. Forty years
later, in 1903, Governor Henry Jackson indicated, in his Blue Book report, the government's
intention to attempt to stop the leakage to Venezuela. BPP 1905 [cd 2238-19], Colonial Reports ­
Annual. No. 442. Trinidad and Tobago, 3.
99 In 1896, the Colonial Office and Foreign Office became concerned about the aggressive
recruiting of Indians in Trinidad and Jamaica by Columbians, because this recruitment had upset
the Indian government. Over the next two years, Trinidad enlisted the support of the British
Legation in Venezuela to attempt to retrieve at least fifty escapees. TDAD Confidential Despatch
#247, 30 September 1896. CO 295-375 (1896) #25430. Coolies enlisted for labour in Columbia.
Report by Attorney-General Vincent Brown. CO 295-375 (1896) #23257. Coolies enlistedfor
labour in Columbia. Acting Colonial Secretary C.C. Knolleys to Secretary of State Chamberlain.
CO 295-393 (1897) #8533. Return ofCoolies from Columbia. Acting Protector oflmmigrants
H.C. Stone reported a similar problem had occurred in 1893, although the Indians had been
found to be happy and prospering in Venezuela. 1894 LC #102, Protector ofImmigrants AR, 6.
100
See, for instance, 1891 LC #45· Registrar-General AR, 5. 1911 LC #162 Registrar-General
AR, 3. 1922 LC #86 Registrar-General AR, 3-4.
101
Despite each Registrar's attempt to account for this annual population leakage, each
census confirmed an under-estimation of emigration. As a result, the annual vital statistics
reports consistently over-estimated the population by 7% to 10% during each of the decades of
this study. The 1901 census, for instance, counted 255,148 residents, although officials anticipated
a population of 277,651 (an error of 8.8% or 22,503 people). This problem continued during the
subsequent decades. The 1911 census enumerated 333,552 residents, which was 10.3% less than
the estimate of 368,014. The 1921 census enumerated 365,913 persons, compared to the
estimated 391,279. 1902 LC #118, Registrar-General AR, 3-4. 1911 LC #162, Registrar-General
AR, 3. 1922 LC #86, Registrar-General AR, 3-4.
 PhD Thesis - L. Jacklin. McMaster - History.

to 1921. Appendices 2.1 to 2-4 provide a detailed calculation of the population leakage
and tables of recalculated vital statistics to revise the erroneous vital statistics published
by the Registrar-Generals, which they admitted were incorrect due to the population
leakage. Updated vital statistics are provided for migration and natural increase
(including crude birth and death rates) statistics in the appendices, and used throughout
the quantitative analysis, above.

Conclusions

Although Britain's abolition of slavery redefined Trinidadian society, many ideologies

remained current amongst the members of the Creole plantocracy. Africans could no
longer be enslaved, but were not considered equal citizens. Sugar workers would no
longer be human chattel, but still would be a foreign race. The form of bonded labour
changed from slavery to indenture, but these bodies were not those of free migrants and
labourers. All these changes proceeded apace, as Trinidad continued to look beyond its
borders to satisfy its demands for labour. This had major repercussions for generations
of residents, not the least of which involved the questions if they would be born, die, and
bear children in Trinidad.

Imperial-world intellectual currents upheld the ideals that commoditised non­

white labouring bodies as both expendable and replaceable. During slavery, Trinidad's
plantocracy had advanced this commoditisation philosophy to an extreme level. The
Coolie Immigration Ordinance 13 of 1870 penalised planters who wantonly sacrificed too
many East Indian bodies each year through poor health conditions or by working the
people to death. However, the discourse on the expendability oflabouring bodies simply
made room for a new race of Asian labourers and then marginalised the African bodies
which had once been of vital importance, but had suddenly become inconsequential to
the plantation economy. The policies privileging the plantocracy's desire for a population
of bonded Indian labourers put obstacles in the way of the natural growth of all sectors,
as the long-standing axiom persisted that the next generation oflabourers would not be
born in Trinidad. These manipulations ensured that the system of indenture would
continue to allow planters to buy the labour of vital importance to the plantation
economy, rather than buying the bodies themselves.

The plantocracy achieved its objective of manipulating the colonial demographics

to neither whiten nor blacken Trinidad. Nonetheless, the lived lives of the people
proceeded in spite of the official will. For growth by natural increase, many residents
hurtled the barriers to family formation and reproduction that had been put in their way.
In terms of migration, innumerable people made personal decisions about immigration
and emigration. Although Trinidad's elite portrayed the colony as the El Dorado for East
Indians, many residents thought otherwise and sailed or leaked out of Trinidad because
they conceived their El Dorado to be elsewhere across the Gulf of Paria in the Spanish
Main or in the circum-Caribbean area.

The quantitative analysis of natural increase established the different decades

when each sector became a self-sustaining population. For the East Indian sector, the
gender imbalance was a surmountable obstacle, and natural increase began although
 PhD Thesis - L. Jacklin. McMaster - History.

approximately 15% of its people still laboured under indenture, and the equivalent
number of people were precluded from leaving Trinidad during the other five years of
their contracts of industrial residency. By contrast, with a slightly lower sexual disparity,
enslaved Africans had experienced a profoundly unnatural decrease in their numbers.
Free Africans and their descendants in the post-emancipation period needed five
decades to become a self-sustaining population. The difference between the indentured
and formerly enslaved peoples suggests that the barrier to natural increase was much
more complex than freedom and the gender ratio for the Afro-Trinidadian peoples.
Certainly, the legacies of slavery continued for many decades hence, suggesting that
historical demographers should continue their studies into the post-emancipation
period, to examine the development of the African populations in the British West
Indies, and compare those results to the other populations in the colonies. Although the
unnatural decrease in the slave populations was central to the abolitionist discourse, as
Brian Moore established, the problem did not end at emancipation.

The legacies of slavery continued to influence the ideologies and attitudes of the
powerful white Creole decision makers in Trinidad, to 1916. By repositioning indentured
immigration as the central axis of the policy on population growth, and then measuring
the outcomes, this study established the disinterest of the ruling class in investing in the
long-term growth of the subject peoples. This attitude had a direct correlation to the
struggles over the function of the GMS organisation and the services that it provided to
the public, as discussed below (in Chapters 4, 5, and 6): the Creole elite continually
disclaimed the state's obligation to invest in the health of its subjects. The genesis of this
disinterest is evident in the broader policies on the development of the population.

Chapter 3 continues to explore the attitudes of Trinidad's white elites, in regards

to the health conditions aboard the ships transporting the Indians to the West Indies.
Between 1840 and 1872, the Colonial Land and Emigration Commission supervised the
state programs of assisted migration and regulated the conditions aboard the ships. In
addition to indentured East Indians journeying to the Caribbean, many Britons travelled
to white settler colonies at the same time, as wards of the Imperial and colonial
governments. This period provides a rare opportunity to investigate how race and gender
influenced the construction of very different public health and medical conditions
aboard the ships carrying white settlers and indentured East Indians.

-50 ­
 PhD Thesis - L. Jacklin. McMaster - History.

-Chapter3­
Maritime Public Health: Imperial Values and Migrant Bodies, 1840-1872.

While it is difficult to quantify precisely the number of migrants during the period of
imperial expansion, statisticians estimate that about fifty million Europeans emigrated
internationally, between 1846 and 1924. 1 Many migrants sought to improve their lives,
despite the health risks associated with ocean travel. Philip Curtin characterised the
"epidemiology of migration" as the movement of people between different disease
environments, usually resulting in heightened mortality and morbidities amongst the
migrants. He recently lamented that studies of migrant health begin after the people
arrived at their destination. At present, little is known about the health of travellers
during their lengthy oceanjourneys. 2 This omission in the literature on migrant health is
intriguing in light of the Imperial government's frenzied activities to mitigate the health
risks of ocean travel, by imposing health and safety legislation on ships embarking from
or arriving in British ports, to protect the health of the migrants who were so vitally
important to populate the Empire.

In 1840, Lord John Russell established the Colonial Land and Emigration
Commission (CLEC) to reform the conditions of maritime health and safety for
passengers from the lower classes, using the regulatory device of the Imperial
Passengers' Act.3 The commissioners promoted their regulations as vitally important to
protect the "health, comfort, and good conduct" of the emigrants.4 During the CLEC's
regulatory tenure of 1840 to 1872, about 6.4 million continental Britons emigrated to the
white settler colonies and United States.s 325,587 of the poorest of these people travelled
gratuitously to the Australian colonies in government-assisted migration programs. 6 At
the same time, another half million British Indians travelled from India to the sugar­
producing plantation colonies in the British West Indies and Mauritius, to labour under
indenture for five years.7 These two populations of impoverished white Britons and East
Indians journeyed aboard ships chartered and supervised by the CLEC. A direct
comparison is possible, and enlightening.

This study establishes that each population's racial and gender demographics
resulted in the creation of two different public health frameworks for assisted migrants.
The regulations dictating "good conduct" conflated the migrants' behaviours, which
correlated to one's predisposition to disease and ill-health, with a broader attempt to

Walter F. Wilcox, ed., International Migrations. Statistics. Vol. I (New York: Gordon and
Breach, 1969 ed.), 82.
2
Philip D. Curtin, "The Epidemiology of Migration," in David Eltis, ed., Free and Coerced
Migrations from the Old World to the New. Global Perspectives (California: Stanford Univ.
Press, 2002): 94, 106.
3 BPP 1840 #35, Colonial Land Board. Copies ofCommissions appointing T.F. Elliot and
Robert Torrens, Esquires, and the Hon. Edward E. Villiers, Land and Emigration
Commissioners, 1-12.
4 BPP 1850 [1204], Tenth General Report ofthe Colonial Land and Emigration
Commissioners, 6. [Hereafter, CLEC Tenth AR.]
s BPP 1873 [c.768], CLECThirty-ThirdAR, 47-9, 68-9.
6 The Australian colonial sponsors included New Zealand, New South Wales, Victoria, West
Australia, South Australia, and Queensland.
7 BPP 1873 [c.768], Thirty-Third CLEC Report, 47-9, 68-9.

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 PhD Thesis - L. Jacklin. McMaster - History.

civilise the future colonial residents. The medico-moral sanitary order legislated for
ships transporting white Britons intended to build a better and more moral class of white
settlers during the journey, while the regime for East Indians consisted of a program to
civilise a foreign race. This study explores the period of ocean travel, when the Imperial
and colonial governments were directly responsible for the health of the East Indian and
white British assisted-migrants, to ascertain the relationship between public health and
the civilising mission. Whereby Chapter 2 established the attitudes of Trinidad's white
Creole elite about the long-term development of its subject peoples, this study considers
how those outlooks influenced the maritime health protection polices for the Indians.

After reviewing the extant literature, this study establishes the connection
between the Chadwickian health reforms introduced in continental England and the
CLEC's numerous reforms to the Imperial Passengers' Act, beginning in the early 1840s.
The investigation of the different medico-moral sanitary orders aboard the Australian
and East Indian ships reveals the extent to which the definition of public health
protections depended on the race and gender of the specific population. The outcomes of
the two diverse medico-moral sanitary orders are then evaluated through a quantitative
comparison of the shipboard mortality rates for each population. The legislator's zealous
enforcement of the medico-moral sanitary order, to protect the morality of the future
wives and mothers of the Australian colonies, resulted in low mortality rates aboard their
ships. By contrast, the majority of these health protections were not instituted on the
ships carrying East Indians, concentrating instead on civilising the coolie body. Many
ships disregarded the requirements to provide life sustaining necessities, resulting in
very high mortality rates aboard many ships travelling to Trinidad and British Guiana.

Historical Continuities: Middle Passage and Coolie Ship Mortality

Indentured East Indians travelled to their host colonies aboard ships chartered and
supervised by the CLEC and their colonial sponsors. They journeyed aboard so-called
"Coolie Ships," which were purpose-built boats constructed to meet the legislated
standards of passenger health and safety. To-date, few historians have investigated the
migrants' experience on the lengthy voyage to the West Indies, and the health of the
migrants has not been their primary concern. 8 Hugh Tinker identified a symptom of
unhealthy Coolie Ships when he highlighted a few random years of excessive deaths.
Tinker argued, for instance, that the 1864-65 mortality of 29. 7% of passengers on the
8 Shepherd confirmed that historians have not studied the seaborne phase of migration
extensively. Verene Shepherd, Maharani's Misery. Narratives ofa Passage from India to the
Caribbean (Jamaica: University of West Indies Press, 2002), xviii. The literature involving the
migrant voyages is restricted to a handful of historians. Verene A. Shepherd, "The 'Other Middle
Passage?' Nineteenth-century bonded labour migration and the legacy of the slavery debate in the
British-colonised Caribbean," in idem, ed. Working Slavery, Pricing Freedom. Perspectives from
the Caribbean, Africa and the African Diaspora (NY: Palgrave, 2001), 343-76. David Northrup,
Indentured Labor in the Age ofImperialism, 1834-1922 (NY: Cambridge Univ. Press, 1995), 80­
103. K.O. Laurence, A Question ofLabour. Indentured Immigration into Trinidad and British
Guiana 1875-1917 (Jamaica: Ian Randle, 1994), 78-103. Basdeo Mangru, Benevolent Neutrality.
Indian Government Policy and Labour Migration to British Guiana 1854-1884 (London:
Hansib, 1987), 109-37. M.D. Ramesar, Indian Immigration into Trinidad 1897-1917
(unpublished Master's Thesis, University of West Indies, Trinidad, 1973), 79-103.

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 PhD Thesis - L. Jacklin. McMaster - History.

Coolie Ship Golden South would have triggered an Imperial crisis, if these travellers had
been (white) English migrants, instead of East Indians.9 This mortality appears excessive
when compared to the frenzy elicited during the anti-slavery parliamentary debates,
when William Wilberforce proffered of the unacceptable 12.5% mortality rate on Middle
Passage voyages. 10 In 1788, the Imperial government enacted "Dolben's Act" to mitigate
the deaths aboard the slave ships. 11 This contentious legislation triggered intense debates
about the ship conditions, which historians interpret as the quest to assign culpability
and moral responsibility for the deaths of so many slaves. 12 Pro-slavery proponents
attributed the mortality to the Africans' pre-existing health, while critics blamed the
slave traders for horrific conditions and brutal treatment of their human cargos. 13

Following Tinker, scholars unfailingly noticed the high mortality, particularly in

1856-1857 and 1864-1865. 14 Basdeo Mangru and Keith Laurence questioned the death
rates in light of the myriad of complex regulations created by the India, Imperial, and
colonial governments. 1s Laurence chronicled ever-changing and confusing rules at the
immigration depots and on the ships, which leaves no doubt about the governmental
activity. 16 Ralph Shlomowitz and John McDonald commended Tinker for identifying the
problem, while criticizing his lack of systematic quantification. Their study demonstrated
a sustained pattern of high mortality, but failed to provide explanations for the deaths. 17
The literature has thus established that the governments were actively involved in
regulating the shipboard conditions, but many immigrants did not survive the journey.

The voice of the travelling subaltern East Indian had not been heard until Verene
Shepherd investigated the brutal rape and death of female migrant Maharani in October
1885. The Colonial Office insisted that British Guiana's Governor Henry Irving inquire
into Maharani's death, as part of its campaign to prove that ship conditions did not
replicate the atrocities of the Middle Passage. 18 Shepherd argued that Coolie Ships were
sites of "(s)exploitation," where many women endured abuse: sexual, physical, mental,
and otherwise. Maharani and others clearly lacked confidence in Dr. Hardwicke, the
government's Surgeon-Superintendent, who Shepherd suspected was the rapist. 19 Her

9 Hugh Tinker, A New System ofSlavery. The Export ofIndian Labour Overseas 1830­
1920 (London: Oxford Univ. Press, 1974), 163.
10
Herbert Klein, Stanley Engerman, Robin Haines, and Ralph Shlomowitz, "Transoceanic
Mortality: The Slave Trade in Comparative Perspective," William and Mary Quarterly, LVIII, 1
(2001), 97.
11
Dolben's Act was formally entitled An act to regulate,for a limited time, the shipping
and carrying ofslaves in British vessels from the coast ofAfrica. Richard H. Steckel and Richard
A. Jensen, "New Evidence of Slave and Crew Mortality in the Atlantic Slave Trade," Journal of

Economic History, XLN (March 1986), 76.

12
Klein, et.al, "Transoceanic Mortality," 93, 97.

1
3 Steckel and Jensen, "New Evidence of Slave and Crew Mortality," 57-8.

1
4 Laurence, A Question ofLabour, 92, 95. Mangru, Benevolent Neutrality, 110-12, 116, 119­
20. Shepherd, Maharani's Misery, 23.

1
s Basdeo Mangru, "The Depot and the Voyage," Benevolent Neutrality, 109-37.

1
6 Laurence, A Question ofLabour, 78-103.

1
7 Ralph Shlomowitz and John McDonald, "Mortality oflndian Labour on Ocean Voyages,

1843-1917," Studies in History, 6, 1 (1990), 36, 38-40.

1
s Shepherd, Maharani's Misery, xxv.

1
9 Shepherd, Maharani's Misery, 74-5.

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 PhD Thesis - L. Jacklin. McMaster - History.

illumination of the gendered exploitation confronted a major problem characterising

Coolie Ships, which can be missed in the cryptic references by both officials and current­
day historians. 20 Shepherd's corrective illuminated the surgeon's questionable medical
skills and the failure of British justice, thus raising questions about the effectiveness of
the multi-governmental apparatus which should have protected the emigrants.

The scholarly neglect of this maritime phase of migration presents a stark

contrast to the robust interest in the diaspora of enslaved Africans on the Middle
Passage, who preceded East Indians as the labour force of choice in the plantation
colonies. However, consistent with diaspora studies, historians studying the nineteenth­
century expansion of the Empire are at present expanding their analytical frameworks.
David Eltis and Robin Cohen have encouraged scholars to adopt a framework that
situates the migratory peoples as the central objects in their studies and contextualises
the migrations in a global setting. Eltis further counselled historians to consider the
values which guided the actions of each participating community. 21 This analysis of the
health conditions aboard the emigrant ships draws upon the quantitative methods
established by the historians of Middle Passage mortality, but contextualises the
outcomes within a comparative study of the colonial sponsors' valuation of the bodies of
their immigrant populations. As suggested by Eltis, the guiding values of the various
governments had a direct bearing on the maritime public health protections enacted to
protect those bodies on the different fleets of emigrant ships.

Chadwickian Public Health and Maritime Reforms

Following the precedent of Dolben's Act for the slave ships, Britain enacted the 1803
Imperial Passengers' Act to protect the poor classes of British travellers during their
journeys in steerage class aboard commercial ships. In 1839, John George, Earl of
Durham, complained that the antiquated Act had failed to protect the health of seaborne
migrants: he identified a major problem with the unhealthy and mortality-inducing
conditions on the emigrant ships. 22 Durham reported that about 5% of the British
immigrants travelling to Canada died during the voyages, while 20% of the survivors
required hospitalisation when they arrived. These sickly and ailing immigrants drained
the resources of the host colonies and imperilled the health of the settled populations. 2 3

20
Laurence, A Question ofLabour, 87-8. Surgeon-Superintendent Laing directed novices to
beware of ship masters who exhibited "antagonistic" interests to East Indian well-being and
health. CO 885-5 (1889) #75, Hand Book for Surgeons [sic] Superintendent ofthe Coolie
Emigration Service by James M. Laing, MA. and L.R.C.S.E., 9, 43-6.
21
Robin Cohen, ed., The Cambridge Survey of World Migration (Cambridge: Cambridge
Univ. Press, 1995), 1-2. David Eltis, "Free and Coerced Migrations from the Old World to the
New," in David Eltis, ed., Coerced and Free Migrations. Global Perspectives (California: Stanford
University Press, 2002), 37-3, 48. David Eltis, "Introduction. Migration and Agency in Global
History," in idem, ed., Coerced and Free Migrations, 2-4, 17-8.
22 Durham was investigating rebellions in Upper and Lower Canada when he revealed this
major problem with the ship conditions. BPP 1839 #3, Report on the Affairs ofBritish North
America from the Earl ofDurham, Her Majesty's High Commission, 11February1839, A2.
[Hereafter, Lord Durham's Report.] Stanley Johnson, A History ofEmigration from the United
Kingdom to North America 1763-1912 (London: Frank Cass, 1966, 1913 reprint), 22, 107.
2
3 BPP 1839 #3, Lord Durham's Report, 87-9. BPP 1839 #3-II, Lord Durham's Report,

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 PhD Thesis - L. Jacklin. McMaster - History.

Britain's initiative to redistribute labouring peoples to populate the Empire faltered

every time shipboard conditions killed prospective immigrants, or when the ships
arrived laden with diseased and emaciated passengers. Durham's message was clear: the
commerce of migration was thwarting the progress of Imperial expansion.

In the spirit of the Benthamite reform era, Britain established the CLEC in
response to Durham's expose, intending to solve many problems in peopling the North
American and Australian colonies. 2 4 Despite the advent of free trade, which included the
free movement of people throughout the Empire, the Imperial government realised that
it needed to intervene to protect the health of the migratory labouring classes. The CLEC
henceforth reformed and managed the Passengers' Act to regulate the conditions in
steerage class, so that migrants would arrive in their destinations in a healthy state.
During the CLEC's regulatory tenure, about 6-4 million persons emigrated from the
British Isles. 2 s Over 5.5 million emigrants paid their own fares to North America, with
the majority destined for America, and 14% arriving in British colonies. 26 An additional
600,000 people paid the higher fares and journeyed to the Australian colonies. 2 7 These
lower class migrants could afford to pay their own fares, deciding on their destination,
and then travelling aboard private commercial ships regulated by the Passengers' Act.
Conversely, the other 325,587 assisted British migrants had a different relationship with
the regulators and the Australian colonial governments, because they were too
impoverished to afford to migrate. After passing rigorous screening tests to determine
their desirability and suitability to be settlers, they travelled gratuitously as wards of
colonies aboard CLEC-chartered ships. 28 The assisted-migration programs helped the
Australian colonies attract white settlers, who were otherwise deterred by the heightened
health risks of the longer journey and the higher cost of the ship fares.

The Imperial government expanded the CLEC's mandate when the post­
emancipation labour problems erupted in the sugar-producing colonies in Mauritius and
the West Indies. As established above (in Chapters 1and2), the formerly enslaved
peoples refused to accept the exploitative conditions of labour on the estates and the
colonial planters relentlessly predicted imminent economic disaster, unless they
immediately found large numbers of labourers. Malthusian ideals facilitated the solution
of redeploying indentured East Indians, which appeared utilitarian to the colonies,
Colonial Office, and India. However, as the CLEC took the reins of control, the India
government had recently terminated the short-lived 1836 and 1837 redeployment of the
"Gladstone Coolies." India's ensuing inquiry identified the poor conditions on the ships
and predicted that maritime mortality would soon approach the levels formerly
experienced by the slaves on the Middle Passage. 2 9 The Indian government insisted on

Appendix (A), u. BPP 1839 #3-III, Lord Durham's Report, Appendix (BJ, 35.

2
4 Oliver MacDonagh, A Pattern ofGovernment Growth 1800-1860. The Passenger Acts

and their Enforcement (London: MacGibbon and Kee, 1961), 129-37.

2
s BPP 1873 [c.768], CLECThirty-ThirdAR, 48-9.

26 BPP 1873 [c. 768], CLEC Thirty-Third AR, 48-9.

2
7 BPP 1873 [c.768], CLECThirty-ThirdAR, Appendix 1and10.

28 BPP 1873 [c.768], CLEC Thirty-Third AR, Appendix I and 10.

2
9 I.M. Cumpston, Indians Overseas in British Territories 1834-1854, 2nd ed. (London:

Dawson of Pall Mall, 1969), 24, 52. BPP 1874 #314, Mr. Geoghegan's Report on Coolie

Emigration from India, 5-8.

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 PhD Thesis - L. Jacklin. McMaster - History.

active civil and medical superintendence of the indentured Indians before it would
reinstate immigration. Thus, in 1845, the British Parliament mandated the CLEC to
supervise the transportation of the Indians aboard the Coolie Ships. This program
redeployed 146,257 East Indians to the British West Indies and 352,785 to Mauritius
during the CLEC's tenure, until 1872.3° The CLEC was therefore responsible for the
maritime health of two populations of sponsored migrants at the same time: poor
Britons travelling to the Australian colonies and poor East Indians destined to be bonded
workers in the sugar-producing plantation colonies.

To-date, historians have not investigated how the rapidly changing ideas on
poverty and public health during the 1840s informed the Passengers' Act's emergent
health protection regulations for the impoverished British subjects who migrated during
the CLEC's term as the Imperial regulator.3 1 At the same time that the anti-slavery
reformers succeeded in their quest to abolish slavery, several other reforming factions
were interested in the health of the labouring classes, including the Benthamite
reformers, Chadwickian public health disciples, and the framers of the New Poor Law.
The literature on public health reform in England provides insights into the significant
changes underway in Imperial world conceptions of disease causation and poverty. This
was an important time in the formulation of the embryonic "sanitary idea," which
characterized Britain's health reform movement for the duration of the century.32 In
1842, the Poor Law Commission's secretary, Edwin Chadwick, released his lengthy study,
The Sanitary Condition ofthe Labouring Population ofGreat Britain.33 Chadwick
employed a vast array of statistics to establish a firm connection between morbidity and
mortality and the living and working conditions of the lower classes. Dirty and
overcrowded living conditions were identified as the causes of inexorably intertwined
physical and moral health problems.34 Anne Digby compared Chadwick's report to a
modern-day ''best-seller," with an estimated 100,000 copies sold to the public.35 The
British public was interested in the condition of the labouring classes.

Chadwick's report launched Benthamite disciples into a campaign to sanitize and

rectify the overcrowded conditions of England's labouring and poor classes.3 6 The
sanitarian discourse connected overcrowding to ill-health: too many closely-knit bodies
impeded the ventilation necessary to allow fresh air to diffuse the hazardous effluvia

3o BPP 1873 [768], CLEC Thirty-Third AR, 68-9.

31 The two extant monographs consider the legislation within the genre of political history,

stressing the growth of administrative government. Fred Hitchins, The Colonial Land and

Emigration Commission (London: Oxford University Press, 1931). MacDonagh, A Pattern of

Government Growth 1800-1860.

32 Pelling qualified the key period in the development of new public health ideas as the years

spanning 1838 to 1850. Margaret Pelling, Cholera, Fever and English Medicine 1825-1865

(Oxford: Oxford Univ. Press, 1978), 34.

33 BPP 1842 #006, Report to Her Majesty's Principal Secretary ofState for the Home

Department, from the Poor Law Commissioners, on an inquiry into the Sanitary Condition of

the Labouring Population ofGreat Britain.

34 Anthony S. Wohl, Endangered Lives. Public Health in Victorian Britain (Mass.: Harvard

Univ. Press, 1983), 287.

35 Anne Digby, British Welfare Policy: Workhouse to Workfare (London: Faber and Faber,

1989), 40.

36 Pelling, Cholera, Fever and English Medicine, 7.

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 PhD Thesis - L. Jacklin. McMaster - History.

known to cause ill-health and created the conditions where immoral behaviour
flourished. The reformers' interest in free flowing fresh air remained central to the health
tenets for the duration of the century, causing Anthony Wohl to characterise it as a
"national obsession."37 In Great Britain, reformers recognised the connection between
dearth, dirt, and ill-heath. They henceforth directed their attentions to the public sphere
and the structures of working-class homes, including sewerage, drainage, ventilation of
the homes, and potable drinking water.

The Imperial government published Chadwick's epoch-making study and enacted

the CLEC's first major reforms to the Imperial Passengers' Act in 1842: the CLEC's
reforms adapted this developing corpus of public health knowledge to the maritime
environment, but only for the people who travelled in steerage class. Passengers in
transit on emigrant vessels spent most of their time in the below-ship decks, where
hundreds of strangers lived together in the exceptionally cramped steerage deck, and
often did not see the light of day. The turbulent waters caused widespread seasickness,
especially during the first several weeks of the voyage.3 8 Below-deck amenities did not
include privies or washing facilities. Healthy and ailing emigrants alike attempted to
survive within the confines of the dark, damp, ill-ventilated, and generally filthy
passenger deck. The maritime officials recognised the connection between this captive
passenger environment and the high rates of ill-health amongst the travellers. Port
officials watched apparently healthy people board ships, only to be ravaged in-transit by
the outbreaks of diseases. The CLEC decided that the migrants' heightened susceptibility
to the diseases resulted from their weakened conditions, sea sickness, malnourishment,
the inability to partake of fresh air, and from a general state of post-departure "alarm."39
The CLEC accumulated extensive statistics, which confirmed its concerns about the
unhealthy environment on the migrant ships.4°

The CLEC enacted its first set of reforms in 1842, which introduced health
protections forcing the ship owners to provide passengers with food, water, and
rudimentary medical comforts, and include these health-sustaining necessities within
the cost of the fare.41 However, the CLEC's obsession with keeping fares as low as
possible, so not to deter intending migrants, resulted in the stipulation that ship owners
had to provide only a minimal amount of food and water, and could not adequately
address the overcrowding.42 The merchant ship operators would have liked to fill their
vessels with more passengers, rather than supplies, but the Passengers' Act now
mandated that each "statute adult" would receive a bread and water diet; children
received half rations and infants had no entitlements.43 This health innovation targeted

37 Wohl, Endangered Lives, 285-6.

38 BPP 1854 [1833], CLEC Fourteenth AR, 20.
39 BPP 1854 [1833], CLEC Fourteenth AR, 20-i.
4° BPP 1850 [1204], CLEC Tenth AR, 8. MacDonagh' s monograph meticulously describes
how the CLEC accumulated knowledge and became experts. MacDonagh, Government Growth.
41 An Actfor regulating the Carriage ofPassengers in Merchant Vessels, 5&5 Vic., c.107.
42 Passengers previously provided their own food. Many emigrants had difficulty paying the
fare and could not afford to purchase enough food to last several months. BPP 1842 #567, CLEC
Second AR, 15. BPP 1853 [1647], CLEC Thirteenth AR, 25. BPP 1842 [355], Report ofthe Land
and Emigration Commissioners on the necessity ofamending the Passengers' Act, 3-6.
43 Britons became statute adults at age fourteen and Indians at twelve. Children counted as
half an adult and infants were not counted. BPP 1842 #116, A Bill (as amended by the Committee)
 PhD Thesis - L. Jacklin. McMaster - History.

the high incidence of disease vulnerability due to starvation and dehydration.

The regulations attempted to minimize the shipboard overcrowding in order to

ensure that the passenger deck had a supply of fresh air, as officials implicated the putrid
odours, rather than the human filth, as the root of the poor health conditions. 44 The
compulsion with free-flowing fresh air initiated a long debate about overcrowding. Ship
owners maximized profits by putting as many people as possible into steerage class, but
critics insisted that the overcrowding was "one of the worst evils" on ships.4s They
correlated the excess numbers of people on the ships to the subsequent progress of major
health problems during the voyages, believing that the presence of too many people
impeded the ventilation and the fetid air caused ill-health.46 Regulators thus limited the
number of emigrants who could legally travel on a ship, to a certain extent, by specifying
a statute amount of space per passenger. Ship owners naturally increased the fares.47

The Passengers' Act basic health protections introduced a restricted number of

the fundamental mechanisms of British healthcare by requiring ships to carry medical
chests and, over time, to construct rudimentary hospitals. A debate raged for decades
whether the Act should compel private ships to employ a surgeon. The pragmatic
problem of a lack of medical men interested in the high-risk and low status job convinced
the CLEC that it was impractical to require all ships to hire a surgeon: many people,
including the regulators, feared that the ships would be delayed or grounded due to a
lack of medical men. 48 A matrix of changing regulations thus specified which private
ships did and did not require surgeons, while the Imperial government employed
physicians in Great Britain's major ports to seek out unhealthy emigrants. Pre-boarding
medical screening was difficult. Inspectors were fully aware that many migrants did not
exhibit signs of ill-health, or would conceal their medical conditions, but the prevailing
medical knowledge recognised that people carried the "seeds of disease" and "latent"
illnesses.49 Officials admitted that these external examinations for the invisible seeds of
disease were ineffective, especially as the inspectors did not know the medical histories
of transient passengers, and travellers knew better than to admit to ill-health.so

for regulating the Carriage ofPassengers in Merchant Vessels, 18 March 1842, 3, 5, 23.
44 The sources are rife with descriptions of the putrid odours on ships. Durham claimed that
residents could smell the emigrant ships before they arrived. BPP 1839 #3-III, Lord Durham's
Report, 87. When the smell became unbearable, crews were sent below-deck to shovel out the
filth and excrement. BPP 1851 #632, Reportfrom the Select Committee on Passengers' Act, xxvi.
45 BPP 1842 [355], Passengers' Act, 15-16.
46 BPP 1854 #349, Second Report from the Select Committee on Emigrant Ships, iv, viii.
47 Engerman argued that the regulations caused the ship owners to increase the fare prices,
which decreased the number of migrants. Stanley L. Engerman, "Changing Laws and Regulations
and Their Impact on Migration," in David Eltis, ed., Free and Coerced Migrations from the Old
World to the New. Global Perspectives (California: Stanford University Press, 2002), 87.
48 The CLEC estimated that private ships departing from Liverpool required about 100
surgeons during each quarter of the calendar. The commissioners stated that it would be
impossible to find that many competent surgeons. BPP 1842 [355], Passengers' Act, 5-6, 20.
49 BPP 1854 [1833], CLEC Fourteenth AR, 20-i. BPP 1857 [2249], CLEC Seventeenth AR,
47. BPP 1874 #314, Geoghegan's Report, 45. BPP 1854 #349, Second Report from the Select

Committee, vi. Cholera and India's typhus gaol fever were stated to be difficult "latent" diseases to

detect amongst emigrants. Laurence, A Question ofLabour, 94.

so BPP 1854 [1833], CLEC Fourteenth AR, 20-1.

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 PhD Thesis - L. Jacklin. McMaster - History.

Regulators were cognizant of the connection between migrants' exposure to epidemics

and subsequent shipboard appearances of disease, usually in an "aggravated form."s 1
Officials had the power to halt departures during epidemics, but this rarely happened,
due to the disruption to commercial shipping and the problems created by detaining the
emigrants, who continually streamed into crowded and disease-infested ports.s 2

The reforms to the 1842 Passengers' Act thus embodied many tensions between
the medical knowledge of the day, the cost of health protections, and the CLEC's
mandate to keep the migrants flowing to the colonies. These struggles resulted in the
reformed Passengers' Act instituting a rudimentary level of health protections for
passengers travelling in steerage class aboard the majority of ships in the Imperial world.
Nonetheless, the provision of basic food and water, the reduction in overcrowding,
medical chests, and the pre-boarding medical screening helped to alleviate some of the
worst conditions aboard the vessels. These stipulations applied to passengers travelling
in steerage class throughout the Empire. Although these basic maritime health reforms
seem insufficient to the modern-day observer, they represented a significant
improvement over the previous conditions experienced by the seaborne travellers. The
migrants were not asked their opinions: the expectation was that they would be the
passive, improved, recipients of the reforms.

The Medico-Moral Sanitary Order for Government-Sponsored Migrants

The conditions of maritime travel were different for the poor emigrants who travelled as
guests of the colonial governments in the programs of sponsored migration. The CLEC­
chartered ships facilitated a unique relationship between the lowest classes of emigrants
and the nineteenth-century state. The colonial sponsors assumed the responsibility for
the welfare of their passengers and they directly controlled the conditions aboard the
ships. These ships invoked auxiliary health regulations, which intended to transform the
passengers by instilling the racially and gender-specific behaviours inherent in "good
conduct."s3 Ships transporting assisted migrants afforded an unprecedented opportunity
for officials to reform the behaviours known to cause ill-health.

Acting on the orders of the colonial sponsors, shipboard officials had several
months during the time at sea to reform the behaviours of their wards. Impoverished
Britons sailing to the Australian colonies were aboard the ship for about twenty-two
weeks.s4 The journey was a similar length for East Indians sailing to the West Indies.ss

51 BPP 1857-8 [2395]) CLEC Eighteenth AR, 13-4. MacDonagh, Government Growth, 140-2.

52 Ships departing from epidemic-infested ports would usually be cleared for departure if no

new cases of diseases appeared on the scheduled date of departure. BPP 1854 #349, Second

Report from the Select Committee, vi.

53 BPP 1850 [1204], CLEC Tenth AR, 6.

54 The voyage was twenty weeks to West Australia and twenty-four to New Zealand. BPP

1852 #348, Passengers Act Amendment Bill (as amended in committee), 15 Victoria, 11.

55 The voyage from Calcutta to the West Indies took twenty to twenty-two weeks. BPP 1854

[1833]. CLEC Fourteenth AR, 67. BPP 1852 #348, Passengers Act Amendment Bill.

55 The voyage from Calcutta to the West Indies took twenty to twenty-two weeks. BPP 1854

[1833]. CLEC Fourteenth AR, 67.

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 PhD Thesis - L. Jacklin. McMaster - History.

The medical knowledge of the day indicated that it was perilous to human health to make
long sea journeys and traverse tropical climates.56 The supplementary sanitary
regulations aboard these ships thus dictated mandatory emigrant behaviours, ranging
from routine schedules for eating, exercising, and taking fresh air, to the compulsory use
of privies, laundry, and bathing.57 The similarities in the moral-sanitary order then
deviated sharply, depending upon whether ships carried white Britons or East Indians.
The regulations reflected the sponsors' views of the status of each migrant population in
the hierarchy of civilisation and savagery and their capabilities for improvement.

One of the few similarities between the fleets involved the officer responsible for
passenger health and enforcing the sanitary order: the Surgeon-Superintendent. The
different objectives of building better Britons for Australia and civilising the East Indians
necessitated the creation of two different cadres of medical men for the ships. Historians
offer brief but wide-ranging portrayals of Surgeon-Superintendents aboard Coolie Ships
as diverse men, ranging from the consummate hero to the tragically incompetent,
medically, morally, and otherwise.58 The literature contrasts the lucrative remuneration
paid to surgeons working on Australia-destined ships to the low pay scales offered to
Coolie Ship surgeons.59 Low pay and status, along with the working conditions,
attracting sub-standard medical men, is thus implicitly a causal factor in explaining the
disparity in healthiness aboard the different fleets of ships.

The cause of this remunerative disparity, however, can be interpreted as

symptomatic of the value placed on the different responsibilities associated with each
corps of medical men, as the job function and the employers deviated substantially
between the two fleets. Both cadres of surgeons tended to passengers' medical needs.
However, on Australia-bound ships, the CLEC recruited and employed these men
directly. The Australian colonies placed a high monetary value upon this job. The
Surgeon-Superintendent functioned as the seaborne Imperial representative and fully­
empowered Medical Officer of Health. The CLEC spent considerable time recruiting and
equipping Surgeon-Superintendents to perform their expansive role, and in publicizing
the job as vitally important. 60 The CLEC routinely credited all beneficial ship health to its

56 The Passengers' Act invoked special requirements for ships travelling on long journeys
and those which passed through the tropics. One of the main requirements was an adjustment in
the number of superficial feet allocated per passenger, which meant that fewer people could be
carried on the ships. BPP 1842 [355] Passengers' Act, 15-16.
57 Orders specified that all passengers were out of bed by 7.00 am and in bed by 10.00 pm.
Before breakfast, passengers dressed, rolled up their beds, swept the berths, and disposed of all
dirt. Each day, adult men (five per 100 emigrants) swept, scraped, and holy-stoned decks, and
cleaned the ladders, round-houses, and hospitals. The men were prohibited from entering
women's quarters. BPP 1850 [1163], Papers Relative to the Emigration to the Australian
Colonies. Papers Relative to Instructions for Surgeons ofEmigrant Ships sailing under the
Superintendence ofHer Majesty's Colonial Land and Emigration Commissioners, 224-33. BPP
1847-1848 [916], CLEC Eighth AR, 58.
58 Shepherd argued that the competency of the surgeon was recognised to be crucial to the
success of the voyage, but difficulties recruiting surgeons resulted in use of incompetent surgeons.
Shepherd, Maharani's Misery, 19, 24-9.
59 Shepherd, Maharani's Misery, 19. Mangru, Benevolent Neutrality, 36. Tinker, A New
System ofSlavery, 151.
60 BPP 1850 [1204], CLECTenthAR, 8-10. BPP 1870 [196], CLECThirteenthAR, 13. BPP

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 PhD Thesis - L. Jacklin. McMaster - History.

elite corps of physicians. 61 These hand-picked surgeons were essential to the job of
enforcing a broadly-conceived moral-sanitary order, stipulating a regime of mandatory
behaviours to ensure the cleanliness of the individual's body, mind, and morals.

In contrast, Surgeon-Superintendents on Coolie Ships had only an arms-length

relationship with the Imperial and colonial governments, as the government contracts
required ship owners to hire their own surgeons. This posed quite a challenge, due to the
well-known and acute dearth of British-trained surgeons available at the embarkation
depots in India. Historians assert that a surgeon's "availability" often functioned as the
employment criteria. 62 Captains boarded newly-graduated students, or those without
formal training.63 Ships travelling elsewhere in the Empire periodically hired medical
staff without formal credentials. However, a much larger ratio of non-accredited doctors
worked on the Coolie Ships. 64 The CLEC constructed the job in a way that was less
appealing to potential surgeons. Tinker characterised the job as "lonely, monotonous,
and at times arduous and dangerous," making this Surgeon-Superintendent function one
that would not attract "clever and ambitious candidates."6s The moral-sanitary order for
Coolie Ships tasked the medical men to civilize this race and ensure that healthy Coolies
were ready to labour in the sugar colonies. The significant disparity in the surgeon pay
scales between the two fleets, then, reflected different Imperial values on the
responsibilities assigned to the medical men, as the objectives and tasks of medico-moral
uplift differed substantially for the two migratory populations.

Building Better Britons for Australian Colonies

Australian colonies encouraged the immigration of healthy labourers, young families

with few children, and equal numbers of single men and women, in order to populate the
territories with productive and reproductive labouring family units. 66 Catherine Hall
described Australia's strategy for colonisation, based on Edward Gibbon Wakefield's
theories of the 1830s, that the country should be systematically colonised by young
English families. 67 Gendered ideals influenced the organisation of this colonisation. Lisa
Chilton argued that white women were of vital importance to Britain's project to
"domesticate the dominions" and civilise the inhabitants of the Empire. Chilton
established that officials and female emigration societies collaborated to attract the

1850 [1163], Instructions to Surgeons, 102-3.

61 BPP 1850 [1204], CLEC Tenth AR, 7. BPP 1857 [2249]. CLEC Seventeenth AR, 14. BPP

1870 [c.196]. CLEC Thirtieth AR, 13. Tinker, A New System ofSlavery, 149.

62 Mangru, Benevolent Neutrality, 123. Tinker, A New System ofSlavery, 163.

63 BPP 1874 #314, Geoghegan's Report, 26-7.

64 · BPP 1854-55 #293, Return ofthe Number ofHer Majesty's Ships and Vessels now in

Commission on Home and Foreign Service. BPP 1875 #240, Return ofNames, Ages, and

Nationalities ofPersons who have service in the British Merchant Service during the last Two

Years as Surgeons and whose Names do not Appear in the Medical Register. BPP 1876 #316,

Ship Surgeons. Return ofNames, Ages, and Nationalities ofPersons who have Served in the

British Merchant Service as Surgeons whose Names do not appear in the Medical Register.

65 Tinker, A New System ofSlavery, 148.

66 BPP 1842 #567, CLEC Second AR, 18.

67 Catherine Hall, Civilising Subjects: Metropole and Colony in the English Imagination,
1830-1867 (Chicago: University of Chicago Press, 2002), 27-42.

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 PhD Thesis - L. Jacklin. McMaster - History.

"right" type of female migrants and then instituted programs to improve these women
during their voyage to the white settler colonies. 68 Unmarried female migrants would
perform a vital role, forming family units and then producing the next generation of
colonial residents. 6 9

Imperial officials developed a fastidious interest in the conduct of the women,

who became the prime subjects in the governmental initiative to build a better class of
labouring white Britons through the CLEC's maritime medico-moral sanitary order. In
1846, the ever cost-conscious CLEC took the unprecedented step of hiring matrons to
work for the Surgeon-Superintendents as the "natural protector" of female morals.7°
Chilton defined the function of the matron as a chaperone, necessary to maintain the
respectability of the women during the voyage, and thus protect the public image of
female migration to the white settler colonies.71 Matrons had an extensive list of duties to
"improve" the women during the journey and prepare them for their future role
domesticating and civilising the Australian colonies.72 They conducted daily educational
classes for women and constantly inspected the cleanliness of the children.73 Passengers
could be mustered at all hours of the night to ensure proper moral conduct by verifying
that everyone slept in their proper and segregated places. Matrons were essential to the
sanitary order. They had to be firm and vigilant with their female charges, and watch for
misconduct from the male officers, crew, and passengers; officials continually expressed
their surprise that the matrons performed their jobs so well.74 The administrative
anxieties over the female passengers precluded these ships from developing into the
'(s)exploitative' environments which Shepherd found aboard the Coolie Ships.

In this initiative to improve the migrants and create a better class of Britons,
Australia ships appointed teachers and religious instructors to work under the direction
of the Surgeon-Superintendent. Clergymen conducted daily classes for adults and
children, Sunday services, and operated rudimentary lending libraries. Emigrants who
conformed to the medico-moral regime were rewarded with mattresses, linens, dishes,
and books for their new life.75 Those who defied risked imprisonment or fines: each ship
selected a cadre of male enforcement officers from the emigrant cohort, dressed them in
much-coveted uniforms, and directed the deputized men to heed the surgeon's directions
and enforce the sanitary order.76 Australia-bound government ships operated under the.

68 Lisa Chilton, Agents ofEmpire. British Female Migration to Canada and Australia,

186os-1930 (Toronto: University of Toronto Press, 2007), 9, 11, 71.

69 Marjory Harper, "British Migration and the Peopling of the Empire," in Andrew Porter,

ed., The Oxford History ofthe British Empire. Vol. III. The Nineteenth Century (NY: Oxford

University Press, 1999), 81.

7° BPP 1850 [1163], Instructions for Surgeons, 228-31.

71 Chilton, Agents ofEmpire, 57-61.

72 Chilton, Agents ofEmpire, 9-10, 57-61.

73 BPP 1850 [1163], Instructions for Surgeons, 228-31. The matron received a free fare and

small gratuity, if the authorities approved of her performance during the trip.

74 Matrons were appointed by the CLEC or Surgeon-Superintendent, recommended by the

British Ladies Female Emigration Society. By 1857, at least forty-three matrons were employed.

BPP 1857-58 [2395], CLEC Eighteenth AR, 20-i. BPP 1859 [2555], CLEC Nineteenth AR, 15-16.

75 BPP 1850 [1163]. Instructions for Surgeons, 226-31.

76 There was one constable for each fifty emigrants. BPP 1850 [1163], Instructions for
Surgeons, 225.

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 PhD Thesis - L. Jacklin. McMaster - History.

most comprehensive regulations, where the health protections intended to change the
immoral behaviours of the migrants, including their sexual habits, religiosity, parenting,
and advance their education. The work of the highly valued and empowered Surgeon­
Superintendent was augmented by a small army of matrons, clergymen, teachers, and
constables, who were not employed by the governments on any other ships.

The Australian ships instituted one additional regulatory restriction, which

differentiated this public health environment from other ships travelling in the Imperial
world. The CLEC analyzed its voluminous collection of mortality statistics and decided
that children and infants faced the most risk on sea journeys and were the main carriers
of disease.77 Current-day statisticians argue that these observations were correct.78 The
health risks caused the CLEC to restrict the number of infants and children allowed
aboard the ships to Australia. The gratuitous transportation offered to these migrants
was restricted to families with two children under seven years of age, or three children
under age ten.79 This form of demographic screening emerged, over time, as a central
tenet of health on these ships. Overall, Australia-destined ships were regulated by the
most comprehensive maritime public health regulations in the British Empire.

Maritime Public Health: Civilising Coolie Bodies

The medico-moral sanitary order developed for the Coolie Ships took on the decidedly
different character of civilizing a non-white race; it lacked the regulatory initiatives and
financial investment to build a better and healthier class of Britons. In lieu of moral
uplift, the commentaries by officials portray the enforcement of sanitary measures as
instilling British behaviours to civilise the East Indians. 80 However, the behaviours
expected from the Indians differed significantly from the other population of assisted
migrants. The extensive medico-moral measures to reform future Australians never
materialised for East Indians. There were no mandatory classes on childcare, sanitation,
education, or Christianity. No cadre of matrons protected the "good conduct" of the
women. Instead, the Surgeon-Superintendent may have stood alone in attempting to
keep his employer, the crew, and male emigrants from "(s)exploiting" the women. 81
Intense struggles ensued to get passengers to adapt to the basics of this alien sanitary
order, such as eating government-supplied food on a regular schedule. Unanswered
questions abound whether emigrants understood what they were being told to do, and
the amount of force used to encourage migrants to adopt these behaviours, as the ship
officers and surgeons were not required to know any Indian languages. 82 Not

77 During 1849-50, for instance, on the ships travelling to Australian colonies, 75% of the

recorded deaths were for infants and children. This pattern continued throughout the period of

this study. BPP 1850 [1204], CLEC Tenth AR, 8. BPP 1866 [3679], CLEC Twenty-Sixth AR, 22.

BPP 1854 [1833], CLEC Fourteenth AR, 20-21.

78 Shlomowitz and McDonald, "Mortality of Indian Labour," 38, 55, 65.

79 BPP 1853 [1647], CLEC Thirteenth AR, 18-19.

80 Laurence, A Question ofLabour, 87-90. BPP 1850 [1163], Instructions for Surgeons,

225-28. CO 885-5 (1889) #75, Hand Bookfor Surgeon Superintendents.

81 Shepherd, Maharani's Misery. Laurence, A Question ofLabour, 87-8. CO 885-5 (1889)

#75, Hand Bookfor Surgeon Superintendents, 9, 43-6.

82 In the 1860s, the regulations required ships to carry a third officer as an interpreter, if the

surgeon or captain did not speak any languages of India. BPP 1874 #314, Geoghegan's Report, 27.

 PhD Thesis - L. Jacklin. McMaster - History.

surprisingly, Surgeon-Superintendents found East Indians reluctant to seek medical

attention and needed to be vigilant in seeking out the sickliest passengers: they inflicted
punishments to force the patients to eat and take medicine. 8 3

Government officials believed that the East Indian body was inherently
unhealthy, although these bodies were concurrently regarded as the saviours of the
labour-intensive tropical sugar plantations. Officials had low expectations for the health
of the migrants during their ocean journeys. CLEC officials framed their regulations
based on their belief in the Europeans' more robust physical constitution, which had a
superior ability to adapt to seaborne life and withstand the rigors of the voyage: even in
their healthiest state, officials believed that the Indians had a "feeble constitution."8 4 The
government's instructions to the Surgeon-Superintendents reflected a remarkable
racialising of the prevailing health knowledge, predicated on the feebleness of these non­
European bodies. 8 5 They also ignored cultural differences, with the exception of the need
for a distinctly Indian diet. The Coolie Ship medico-moral sanitary order intended to
instil the routines of civilized behaviour and otherwise strengthen and rest their feeble
bodies during the voyage, such that the Coolie bodies would be in a fitful state of health
to perform the gruelling plantation labour.

The medico-moral sanitary initiatives for East Indians were overshadowed by a

dispute between the governments and their officials. As established above (in Chapter 2),
the Colonial Office insisted that the sponsors despatch a minimum quota of females on
each ship. Officials in London knew that women would not leave India without their
children, but were not prepared to allow this immigration to proceed without any
females, claiming it would be objectionable "on moral grounds." 86 The female quota
became one of the most contentious edicts in India and aboard the Coolie Ships. This
quota had significant implications for the health of the passengers, not necessarily from
the women per se, but because these women naturally brought along their offspring. The
officials at the depots in India drew attention to their statistics identifying the
relationship between the high shipboard mortality and the presence of a large number of
high-risk children. 8 7 A debate raged for decades between all parties over the appropriate
quota. 88 As established above (in Chapter 2), the quota was 30 women per 100 men until

83 Tinker, A New System ofSlavery, 148. The punishments are not documented in detail.

Tinker referenced comments by Dr. John Bury in his trip log to Trinidad in 1857.

84 BPP 1871 [c.369], CLEC Thirty-First AR, 10. BPP 1843 #621, CLEC Third AR, 29.

85 Pamphlets were issued to surgeons to instruct them on how to deal with the different

physical constitutions of the various emigrants. BPP 1843 # 621, CLEC Third AR, 32. BPP 1850

[1163], Instructions for Surgeons, 224-33. CO 885-5 (1889) #75, Hand Bookfor Surgeon

Superintendents. Other pamphlets provided instructions for the surgeons on treating diseases in

the maritime environment. For instance, India's Sanitary Commissioner Dr. J.M. Cuningham,

wrote a lengthy treatise on preventing and containing the contagious fever which plagued the

emigrant ships in the 1864-65 season, although its causes eluded the medical authorities. CO 318­
258 (1870) #8428, West India Immigration. Encl.: Instructions for the guidance of Surgeon­

Superintendents of Government Emigrant Ships regarding Contagious Fever and the Precautions

which should be adopted to prevent its spread, by J.M. Cuningham, M.D.

86 BPP 1866 [3679], CLEC Twenty-Sixth AR, 22.

87 BPP 1874 #314, Geoghegan's Report, 24.

88 BPP 1861 [2842], CLEC Twenty-First AR, 18. BPP 1874 #314, Geoghegan's Report, 26,

29, 52.

 PhD Thesis - L. Jacklin. McMaster - History.

1868, when the Colonial Office changed it to 40 women per 100 men. 8 9 Officials in
London ignored the implications for the potential of increased mortality aboard the
ships, as documented in the statistics of their experts, when they issued their directives
about the gendered female quota for the ships departing from India.

The demographic screening on the Australian and East India ships thus
represented two different processes. Australian colonies desired equal numbers of male
and female immigrants, to create a moral population and civilise the dominions. Officials
restricted the number of children who could board the ships as part of the public health
screening process. The West Indian colonies desired temporarily sojourning male
labourers and were disinterested in attracting women unless they would labour under
indenture. The Colonial Office set the quota as a measure to ensure morality amongst the
sojourners, but the refusal by the women to migrate without their children resulted in
many high-risk travellers being boarded on the ships. The female quota thus represented
a compromise between the objectives of creating a moral immigrant population and
containing the mortality rates aboard the ships.

Officials in London turned a blind eye to the related problem of recruiting female
indentured labourers.9° However, unlike Australian migration, where the "right" type of
women received free passages, West Indian colonies did not offer free passages to
encourage female migration. All adult immigrants were required to sign a contract of
indenture, which obligated them to perform arduous agricultural labour. In the constant
struggle to fill the quotas of women, agents in India often allegedly recruited the
"sweepings of the bazaars" and confessed to loading ships with prostitutes and women
they had rescued from "a life of degradation."9 1 The situation was quite different
compared to the moral screening of women destined for Australia. On one occasion, the
Melbourne Daily News reported that several local gentlemen were outraged to find that
six newly arrived female emigrants had disembarked from the ships and promptly went
in search of employment at the local brothels. The men lambasted the CLEC for sending
women who added to the local vice, rather than "good and useful members of society,"
who they could employ as servants.92 By contrast, the emigration agents in India
complained about the difficulty filling the quota, while doing whatever was necessary to
get the requisite number of women on the ships. These officials allowed many sickly
children aboard, because their mothers helped fill the quota.93

Historians have questioned if the women were indeed prostitutes and the dregs of
society.94 The Indian nationalists who agitated to end the system in the early twentieth
89 BPP 1874 #314, Geoghegan's Report, 52.

9o Shepherd, Maharani's Misery, 5-10.

91 CO 295-407 (1901) #42210, Class ofEmigrants dispatched from Agency, Trinidad Agent

Stewart to Colonial Office, 189. BPP 1872 [c.562], CLEC Thirty-Second AR, 19.

92 BPP 1850 [1163], Papers relative to the Emigration to the Australian Colonies,

Melbourne Daily News, 20 January 1849, 125.

93 The willingness of the officials in India to board large numbers of children is evident into

the 1880s. Shlomowitz and McDonald, "Mortality oflndian Labour," 57. Madhavi Kale, "'Capital

Spectacles in British Frames': Capital, Empire and Indian Indentured Migration to the

Caribbean," International Review ofSocial History, 41(1996),130.

94 Prabhu P. Mohapatra, '"Restoring the Family': Wife Murders and the Making of a Sexual

Contract for Indian Immigrant Labour in the British Caribbean Colonies, 1860-1920," Studies in

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 PhD Thesis - L. Jacklin. McMaster - History.

century claimed that the prostitution of women occurred after recruitment. Rhoda
Reddock argued that this sentiment gained currency and was one of the key reasons why
India terminated indentured migration in 1916.95 Certainly, during the period of this
study, the emigration agents in India claimed that many of the women had questionable
moral orientations.9 6 Officials admitted their desperation in recruiting these potentially
health-challenged mothers and their often demonstrably sickly children. As established
in the mortality analysis, below, the presence of health-challenged infants and children
aboard the Coolie Ships contributed to the continually high mortality rates. By ignoring
the precedents for demographic and pre-boarding medical screening, the imperial
regulators knowingly contradicted their public health policies mandated for other ships.
The conflicting objectives in two different initiatives resulted in this compromise: the
decision to use the quota to ensure the establishment of a moral expatriate population,
as opposed to the public health protection minimising the number of at-risk infants and
children on the ships.

There are no photographs available of the East Indian migrants during the
CLEC's tenure, but the following pictures show the Indians upon arrival in Trinidad and
British Guiana at about the end of the century. These pictures offer a glimpse into the
result of the process to civilise the East Indians and maintain their health, so that they
would be ready to labour on the agricultural estates. Figure 3.1 is a photograph of the
new arrivals at Trinidad's Coolie Depot, probably at the end of the century. By this time,
officials believed that the East Indians improved their health during the journeys under
the jurisdiction of the Surgeon-Superintendents.

History, 11 (1995): 227-60. Conversely, Lal argued that the official view that the women were of

"loose character" dominates the sources and was "repeated ad nauseam in virtually every

account." Brij V. Lal, "Understanding the Indian Indenture Experience," Journal ofSouth Asia

Studies, 21, 1 (1998): 230.

95 Rhoda Reddock, "Indian Women and Indentureship in Trinidad and Tobago 1845-1917:

Freedom Denied," Caribbean Quarterly, 3/4 (1986): 45-6.

96 Each colony's emigration agent in India complained to the Colonial Office. Jamaica's
W.M. Anderson claimed the women were of the "vilest character." Trinidad's agent, Thornton
Warner, said they were "sweeping up females of the lowest character and caste." CO 318-258
(1870) #4789. West India Immigration, 1-3. In 1909, at the Sanderson Commission, Colonel
Duncan G. Pitcher appeared as an expert witness on immigration, based on his 1882 role as
India's investigator of the system. His report criticised the quota and recommended alternatives,
so that the agents would not need to "sweep in the Bazaar women." He stated that nothing had
changed: recruiters in India were still sweeping the bazaars and paying little attention to the
character of the females. In 1909, Pitcher was the Deputy Director of Agriculture for Oudh and
the Northwest Provinces. BPP 1910 [cd 5193], Report ofthe Committee on Emigration from
India to the Crown Colonies and Protectorates. Part II. Minutes ofEvidence, 174-7.

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 PhD Thesis - L. Jacklin. McMaster - History.

Figure 3.1 - Trinidad: "Coolies on arrival from India, mustered at depot," [n.d.)97

Courtesy ofBritish National Archives. Reprinted with permission.

Figure 3.2 - British Guiana: "Medical examination ofNew Arrivals," [n.d.)98

Courtesy ofBritish National Archives. Reprinted with permission.

Figure 3.2 is a photograph of the East Indians mustered for their medical
inspection. There are few details available on the nature of this examination. The

97 British National Archives, CO Photogmphs, CO 1069/392/15. Undated [1890 to 1916].

98 British National Archives, CO Photographs, CO 1069/355/41. Undated [1870 to 1916.]
 PhD Thesis - L. Jacklin. McMaster - History.

inspection, shown in this picture, may have been rather rapidly performed for the
healthy immigrants. The healthy East Indians spent very little time at the depot. After
the medical inspection, they would be assigned to their estates and transported to their
new Coolie Barracks and jobs within a few days. Ailing new arrivals were sent to the
purpose-built hospitals in the depots, where they would convalesce before being allotted
to the estates.

Figure 3.3 - British Guiana: "The DepOt Hospital,for 94 patients," [n.d.)99

Courtesy ofBritish National Archives. Reprinted with permission.

Figure 3.4 depicts the new female immigrants and children receiving dinner at
the depot in British Guiana, segregated from the men. This picture suggests the colonial
standard of the appropriate level of civilised behaviours for East Indians when dining:
the women sit outside, with their bowls on the ground, awaiting the porter. It is doubtful
that the immigrant women destined for the Australian colonies were taught this form of
deportment and civilised behaviours on the ships.

99 British National Archives, CO Photographs, CO 1069/355/46. Undated [1870 to 1916],

possibly at the end of the century.

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 PhD Thesis - L. Jacklin. McMaster - History.

Figure 3.4 - British Guiana: "The emigrants at their meals," [n.d.]100

Courtesy ofBritish National Archives. Reprinted with permission.

In summary, from the 1840s, government-sponsored migrants travelled aboard

ships regulated by racialised and gendered maritime health initiatives, based upon the
objectives of developing two difference populations for their colonial futures. This
investigation now considers the results of these policies, by comparing the human costs
of relocation between the two migrant populations.

Quantitative Measurements to Analyse Oceanic Mortality

Historians use two different measurements to analyze seaborne shipboard mortality.

Contemporaries used the Voyage Loss Rate (VLR), which indicates the passenger's
probability of dying during the voyage. It is a simple ratio of the number of deaths
amongst the passengers who embarked on the voyage, sometimes presented as an
annual average VLR for the ships that sailed during the year. The CLEC reported death
rates using the VLR and historians of indentured immigration use this calculation. For
instance, Tinker piqued historians' interest in the seaborne mortality by referencing the
1864-65 VLR of 29.7% of the Indians on the Golden South. 101 However, historians who
study mortality on the Middle Passage criticised the impreciseness of the VLR, because it
does not allow for variances in the voyage durations, and a few low mortality trips will
significantly lower the annual average. 102 To eliminate the statistical effects of variable
voyage lengths, historians now prefer to calculate the maritime crude death rate (CDR)

100 British National Archives, CO Photographs, CO 1069/355/42. Undated [1870 to 1916],

possibly at the end of the century.

101 Tinker, A New System ofSlavery, 163.

102 Klein, et.al., Transoceanic Mortality, 107.

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 PhD Thesis - L. Jacklin. McMaster - History.

per 1,000 passengers at risk, per voyage month. 103 This model appeared in the 1980s as
scholars challenged the Whig assertion that the Middle Passage mortality declined as a
result of legislative progress and humanitarianism. To the contrary, studies using the
CDR found that the total mortality did indeed decline, but this resulted from the
decreased mortality of shorter voyages. 104

Emigrant Ship Mortality Analysis

This analysis of migrant health concentrates on twenty-three emigration seasons, from

1850-51 to 1872-73. Reliable mortality statistics begin with the 1850-1851 migration
season, by which time the CLEC had a decade of experience regulating ocean travel. It
had enacted the basic health protections for all ships and further instituted the medico­
moral sanitary orders for government migrants to Australia and the West Indies. The
Passengers' Act, however, was again in a state of flux as cholera pandemics affected
seaborne Imperial subjects, between 1847 and 1854. Emigrant ships arrived in colonies
carrying diseased and dying passengers. Imperial medical officials tracked the progress
of cholera,105 while it created mortality crises amongst the migrants. Concurrently, two
other health-related stimuli changed the patterns of migration. In India, the government
terminated indentured migration, from 1848 to 1850, due to the high mortality and the
concerns about the financial viability of the colonies over free trade. 106 In an unrelated
development, the 1846 onset of famine in Ireland caused emigration to skyrocket to
"gigantic proportions," as an estimated 25% of the people left their homeland. 107 British
politicians lavished attention on the major health problems accompanying this Irish
exodus. These concurrent crises resonated throughout the Imperial world.

The ships transporting white migrants to North America and the Australian
colonies had low mortality rates until the cholera pandemic and Irish famine. 108 CLEC
officials were convinced that they had contained the shipboard mortality. Reluctant to
discourage the migration of the suffering Irish people, the CLEC stayed the course with

10 3 ShlomO\vitz and McDonald define the "crude death rate per 1,000 per month" as the

number of deaths "divided by the average seaboard population at risk, ... dhided by the average

length of voyage (in '30-day' months), and expressed as a rate per 1,000. The average seaborne

population at risk is defined as the number of passengers embarked minus half seaboard deaths,

plus half the seaboard births." Shlomowitz and McDonald, "Mortality of Indian Labour," 37. This

formula assumes that births and deaths occurred at an even rate during the voyage.

10 4 David Eltis, "Mortality and Voyage Length in the Middle Passage: New Evidence from the

Nineteenth Century," Journal ofEconomic Hi.story, XLIV (June 1984), 301-8.

10
5 BPP 1854 #235. Cholera (Jamaica). Copy ofthe Report made by Dr. Milroy to the

Colonial Office, on the Cholera Epidemic in Jamaica, 1850-51, 2, 6-7.

106
BPP 1874 #314, Geoghegan's Report, 65.

10
- BPP 1854 [1833], CLEC Fourteenth AR, 1. MacDonagh, Government Growth, 22-3.

Wilcox quantified 2,088,000 Irish emigrants during these years. Walter F. Wilcox, ed.,

International Migrations. Interpretations. Vol. II (NY: Gordon and Breach, 1969 ed.), 264-7.

108
The CLEC reports indicate that, between 1841and1846, the 173,564 Britons emigrating

to North America and the Australian colonies experienced a mortality rate of less than .63%, on

the ships and in quarantine at their destination. This calculation is not a VLR, because the CLEC

included the subsequent post-voyage deaths. BPP 1847-48 [961], CLEC Eighth AR, 14-17.

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 PhD Thesis - L. Jacklin. McMaster - History.

its "bread and water" health protections on the private ships. 10 9 This mass exodus of too
many nutritionally deficient Irish and the prevalence of cholera, however, overtaxed the
merchant ship industry. The mortality on the ships travelling to North America became a
major concern when reports claimed that the 1847 mortality increased twenty-fold to an
unacceptable 16.3%.11° In fact, these allegations were overstated: 5.7% of the embarked
passengers perished in 1847. 111 Thus, the death rate in this purported crisis would never
reach the high East Indian mortality rates. Nonetheless, contemporaries believed that
16.3% of North America-destined migrants died during their journeys. Meanwhile, a
spate of shipwrecks and philanthropist Vere Forster's expose of his horrific incognito
emigrant ship voyage intensified the growing public relations disaster. 112

Parliament quickly formed a Select Committee, which reported its findings in

1851 and 1853.113 The prevailing health knowledge continued to insist on fresh air, water,
and food as the central preventive measures, but the Imperial Parliament legislated
increased quantities for the passengers travelling on private ships during the flurry of
major reforms, until 1855.114 New sanitary measures required the ship operators to
provide privies and hospitals on the vessels, issue cooked provisions, and provide
segregated sleeping quarters for single people.115 Several preventive measures from the
medico-moral sanitary order from the Australian program were thus adapted for private
ships. However, the CLEC was still not convinced of the value of forcing the private ships
to hire doctors for the journeys. The new regulations alternatively mandated and
exempted ships from carrying surgeons, until settling into a complex pattern.116

Figure 3.5 presents the annual Voyage Loss Rates aboard the Coolie Ships. Where
the data is available, the table includes VLRs for government ships carrying British

10 9 BPP 1847-48 [961], CLEC Eighth AR, 14-17.

110 MacDonagh, Government Growth, 166, 187. BPP 1847-48 [961], CLEC Eighth AR, 14-17.
111
The excessive mortality was restricted to ships bound for Canada and New Bruns"'ick, but
the media over-stated the numbers. Also, although VLRs only include deaths on the ships, these
numbers included post-voyage deaths in the hospitals in the colonies. There were 6,116 deaths
amongst 106,812 people, which is a loss rate of 5.7%. BPP 1847-48 [961], CLEC Eighth AR, 15.
112
BPP 1851 #198, Emigrant Ship Washington. BPP 1854 [1833], CLEC Fourteenth AR, 13.
11
3 BPP 1851 #632, Select Committee on Passengers' Act. BPP 1854 #163, First Report from
the Select Committee. BPP 1854 #349, Second Report from the Select Committee.
1
14 The new rules increased the space per passenger by 20% and mandated more nutritious
diets for the passengers and required ships to install the new technology for air ventilation. BPP
1850 [1204], CLECTenthAR, 11. BPP 1851 (1383], CLEC Eleventh AR, 6. BPP 1855 (1953], CLEC
Fifteenth AR, 25. BPP 1856 (2089], CLEC Sixteenth AR, 19-20. BPP 1854 #349, Second Report
from the Select Committee, viii. BPP 1852 #348, Passengers Act Amendment Bill, 9. BPP 1854
#255, A Return ofthe Names, Stations, Dates ofAppointment, and Salaries, 9.
11
s BPP 1852 #348, Passengers' Act Amendment Bill, 5, 8-9, 14.
116
Several factors determined whether surgeons \vere required on a private ship, including
the number of passengers, the size of the ship, and the length of the trip. Ships going to America
required a surgeon if they departed between October and January and met other conditions. In
effect, most North American ships were exempt from hiring a surgeon. BPP 1854 #255, A Return
ofthe Names, 17. BPP 1852 #348. Passengers Act Amendment Bill, 15. An Act to amend the
Passengers' Act and to make further Provision for the Carriage ofPassengers by Sea, 10&11
Victoria, c.103.AnAct to make further Provision/or one year, and to the end ofthe next Session
ofParliament,for the Cal'T'iage ofpassengers by sea to North America, 11&12 Vic., c.6. The
Passengers' Act, 1849, 12&13 Vic., c.33. The Passengers' Act, 1853, 15&16 Vic., c.44.

- 71­
 PhD Thesis - L. Jacklin. McMaster - History.

emigrants to Australia and private ships carrying the poor migrants to North America.

Figure 3.5 - Annual Average Voyage Loss Rates (VLR). Government ships for East

Indian and Australia migration, and self-paid British migration to North America.

1850-51 to 1872-73 seasons.

Source: statistics from the CLEC Annual Reports (BPP series).m 118

"O

-
Q)
.:£
iii
.0
E
Q)

0
::R
0
~
Q)
Cl

c
16%

14%

12%

10%
. __._

•
~

• •
Ill Q) 8%

Cf)
Ill
Cf)
.r:.
Cf)

Cf)

Ill
0.
6%

•
A • •
-roQ) 4%
•... ~
•• ••• • ••• •
~

.. .. ..
"O

• • ..
' 2%

•
Cl:'.
...J
> 0% • j j_aj_•~ _..._
--,,

1850 1855 1860 1865 1870

Emigration Seasons (1850-1851 to 1872-1873)
+_ C_o_
.-I ol-ie_S_h-ip_s_t_o_W
_e ___p_a-id-) -. - U-K- to North America (self-paid) A UK to Australia (govt-paid)
_s_t_ln-d-ie_s_(_go_vt I

Figure 3.5 reveals a significant statistical difference in the mortality rates

between ships carrying East Indian migrants to the West Indies and those conveying
white Britons to the colonies. An extremely fluctuating mortality pattern persisted
aboard the Coolie Ships, while the shipboard death rates for white colonists settled into a
predictable and generally low range, by 1854. By 1856, the regulators indicated that the
mortality problem had been brought under control on the North America-destined
ships.119 In summary, private ships thus recorded the lowest losses oflife, despite being
regulated only by the slightly enhanced, but still basic, health protection measures.

Figure 3.5 establishes that Australia-destined government ships experienced

slightly higher death rates when compared to the private ships travelling to North
America.120 The CLEC's explanation of the different mortality rates for these two white

11
7 The mortality statistics for the ships carrying migrants to North America are incomplete
in the CLEC reports. The data is incomplete for a few years of the Australia migration. Figure 3.5
presents the annual VLRs only for the years when the data sets are complete in the CLEC reports.
118 These VLRs are the annual averages of all ships sailing each season. Coolie Ship VLRs are
calculated for the 306 ships sailing from Calcutta and Madras to Trinidad or British Guiana,
between 1850-51and1872-73. The data to calculate the VLRs is extracted from the CLEC annual
report statistical appendices. The series of CLEC reports begins with EPP 1853 [1499], CLEC
Twelfth AR and includes all reports to EPP 1873 [c.768] , CLEC Thirty-Third AR.
u9 BPP 1857 [2249] , CLEC Seventeenth AR, 13-14. EPP 1857-58 [2395], CLEC Eighteenth
AR, 19.
120 The annual aYerage VLRs generally ranged from a high of i.5% (in 1850) to a low of
0.01% (in 1872). One exception occurred on the Australian ships in 1852, when the VLR reached
4.9%. The discovery of gold enabled the colonies to invest larger sums of money to encourage
emigration, resulting in "unprecedented" numbers of British emigrants. The CLEC claimed that it

- 72 ­
 PhD Thesis - L. Jacklin. McMaster - History.

populations confirmed its belief in the connection between the slight disparity in the
migrants' socio-economic standing and an acceptable mortality rate for each migratory
cohort. The officials consistently related the slightly higher mortality on their ships
transporting the assisted white migrants to their "inferior" class. 121 Although regulated by
the comprehensive medico-moral sanitary order, officials never expected their Australia­
bound ships to attain the slightly lower mortality associated with the slightly better class
of migrants who were able to pay their own fares.

The CLEC's use of the VLR to compare the shipboard mortality introduces the
methodological problem identified by the Middle Passage historians. The journey to the
Australian colonies took three times longer than the voyages to North America. 122
However, the CLEC reports do not provide the data to calculate the more precise CDR
for the private ships, which accounts for the variances in the lengths of the journeys.
Plausibly, the use of the CDR would produce equitable death rates on both fleets of ships.
Nonetheless, the point is that government officials believed that the slight differences in
the migrants' socio-economic classes resulted in different mortality rates.

Officials expressed similar attitudes about the East Indian population. It should
be noted that, while acknowledging the problems inherent in the VLR, the key variable of
voyage length is generally consistent between the Australian and East Indian ships, as
both journeys were about twenty-two weeks in duration. 123 Although the use of the VLR
is not a precise measurement, Figure 3.5 revealed the striking difference on ships
conveying Indians. Coolie Ship VLRs approached the low rates characteristic of white
migration only once, in 1870. The erratic pattern in the graph and the continued high
rates of mortality challenges the tendency of historians to concentrate on 1856-57 and
1864-65.12-i Indeed, the statistics in Figure 3.5 confirm that mortality was consistently
high. Nonetheless, these death rates did not stimulate comparable political anxiety and
public outcry in Britain. The ships transporting Indians experienced the highest
mortality rates of any ships regulated by the Passengers' Act. Figure 3.5 demonstrated
the comparatively long delay before the onset of improvement.125 The medico-moral
sanitary order designed to civilize this race did not protect the health of East Indians,

was not prepared for this onslaught of migrants. EPP 1852-53 [1647], CLEC Thirteenth AR, 12-20.
121 The commissioners correlated the diminutive gradations in the socio-economic class of
the migrants: the ability to pay a £14 passage fare related to different expectations of mortality.
EPP 1857 [2249]. CLEC Seventeenth AR, 13-14. EPP 1857-58 [2395], CLEC Eighteenth AR, 19.
BPP 1859 [2555], CLECNineteenthAR, 14-15. EPP 1860 [2696], CLEC Twentieth AR, 17. BPP
1870 [c.196], CLECThirtiethAR, 13.
122 In 1850, the journey by sail was thirty-five days from Liverpool to New York and forty-six
days to Quebec. The voyages to Australia were about twenty-two weeks. With the introduction of
steam ships to North America, by 1856 the journey from the United Kingdom to Canada was
twelve days. EPP 1850 [1250], CLEC Tenth AR, 1. BPP 1857 [2249], CLEC Seventeenth AR, 38.
12 3 For the Australian journeys, see the note above. The voyage from Calcutta to the West
Indies took twenty to twenty-two weeks. BPP 1854 [1833]. CLEC Fourteenth AR, 67.
12 4 Laurence, A Question ofLabour, 92, 95. Mangru, Benevolent Neutrality, 110-12, 116, 119­
20. Shepherd, Maharani's Misery, 23. Tinker, A New System ofSlavery, 162.
12s Mortality decreased to an average of about 1.7% between 1881and1891, according to the
data provided by D.W.D. Comins, Note on Emigration from India to Trinidad (Calcutta: Bengal
Secretariat Press, 1893), 29. Shlomowitz and McDonald argued that the CDRs decreased after
1873. Shlomo""itz and McDonald, "Mortality of Indian Labour," 45-8.

- 73­
 PhD Thesis - L. Jacklin. McMaster - History.

who clearly paid a higher health relocation cost than any other British population.

Mortality was not inevitable on Coolie Ships. The average annual mortality rates
depicted in Figure 3.5 conceal that four ships made the journey without any deaths and
another forty-six ships recorded rates below the 1.5% Australian average. Figure 3.2
eliminates the annual averages and presents individual CDRs for 284 Coolie Ships.

Figure 3.6 - CDRsfor 284 Coolie Ships sailing to the West Indies.
1850-51to1872-73· seasons.
Source: data from CLEC Annual Reports (BPP series). 126

a::
8 Q _L___i_--~llO-------'---'L-_:___~__.~--'-_._-----''---_._~___.~~~--"''--6-------_,.'----
1850 1855 1860 1865 1870
Coo lie 8nigration Season

•Individual Ships to Brrtish Guiana and Trinidad • Annual Average CDR (all ships)

The mortality documented in Figure 3.6 indicates a pattern of high losses, but
also confirms that mortality was neither inevitable nor consistently high. At the low end
of the range, four ships made the perilous journey without any deaths at all, although
two sailed during the highest mortality years. 12?

If mortality could sometimes be contained, the question then arises: why did high
death rates persist for several decades? The Imperial and West Indies governments did
not interpret the mortality rates on the Coolie Ships against the same standards for white
migration. For instance, in 1856-57, the average VLR exceeded 17% on the Coolie Ships.
As introduced, above, an alleged loss rate of this magnitude in the North American
migration had recently stimulated considerable Imperial attention, the Select Committee
reports of 1851 and 1853, and a series of legislative reforms. This death rate for the East
Indians did not garner similar attentions or actions in the Imperial metropole. Instead,

126
The data to calculate the CDRs is extracted from the CLEC annual report statistical
appendices on the passengers embarked and died during the year. This is the same data set used
to compute the VLRs for Figure 3.5. The data published by the CLEC allowed VLRs to be
calculated for 306 ships. However, CDRs can only be computed for 284 ships, as shown in Figure
3.6, because of missing data for certain ships, such as the duration of the voyage, the number of
infant deaths, and so on.
12
7 The five ships "'~th no deaths sailed in the 1852-1853, 1859-1860, and 1869-1870 seasons.

- 74­
 PhD Thesis - L. Jacklin. McMaster - History.

West Indies officials initiated an investigation and expediently exonerated their health
protection apparatus. British Guiana officials concluded with the status quo
condemnation of the officials in India and accused them of filling ships with "sickly and
unfit" Coolies. 128 The colonies sent the results of their inquiries to England, where the
CLEC heartily supported their conclusions.129 The commissioners rationalised the
mortality by blaming the uncivilised and feeble Coolie bodies: mortality was always high
because of endemic cholera, Indians' sickly physical constitutions, and because migrants
drank polluted water from Calcutta's Hoogley River. 13° The rhetoric emanating from
officials in Britain and the West Indies echoed that of the earlier anti-slavery debates,
when the pro-slavery faction attributed ship mortality to the slaves' pre-existing diseases
and the conditions in Africa, while vindicating ship conditions, as discussed above. In the
opinion of British officials in two corners of the Imperial world, they had done their job
and the culpability should be directed eastward to India. The CLEC commissioners sent
the mortality statistics to India, asking for a local inquiry, whilst doubting that the
government could find a medical officer qualified to conduct an investigation. 131

1857-58 represented a turning point in the history of health for Coolie Ships,
although the stimulus for change did not originate from the Imperial regulators or the
self-exonerating investigations in the West Indies. Instead, the change occurred as
Britain instituted direct rule in India after the Mutiny/Rebellion. 132 David Arnold and
Mark Harrison have each argued that the Mutiny/Rebellion affected a more cautious
government stance on some interventionist medical or public health reforms which
could have provoked negative reactions from the population. 133 Yet, in the instance of
public health for the Coolie Ships, officials zealously attacked the problem. The new Raj
initiated the first of several penetrating inquiries and surprised both the CLEC and West
Indian colonies by appointing well-regarded Dr. Mouat, Inspector of Gaols and
Dispensaries, to lead the first inquiry. Monat took the extraordinary step of spending
three weeks travelling on Coolie Ships, perhaps the first Imperial world regulator to
experience emigrant ship conditions first hand. 13-i

Monat identified many momentous problems, including the complete lack of

enforcement of all basic health protections. 135 Monat took particular exception to ships
filling their tanks with water from Calcutta's polluted Hoogley River. The colonial

128
EPP 1857-58 [2395], CLEC Eighteenth AR, 53-4. EPP 1874 #314, Geoghegan's Report,

24-6.

12
9 EPP 1857-58 [2395], CLEC Eighteenth AR, 53-4.

1
3° EPP 1857 [2249], CLEC Seventeenth AR, 46-47.

1 1
3 EPP 1874 #314, Geoghegan's Report, 24-6.
1 2
3 An Actfor the better govenzment ofIndia, 21&22 Victoria, cap. 106.
1
33 Arnold argued that political insecurity and fear of resistance caused the state to refrain
from compulsory vaccination. David Arnold, Colonizing the Body. State Medicine and Epidemic
Disease in Nineteenth-Centwy India (Berkley: Univ. of California Press, 1993), 158. Harrison
argued that the new Raj was reluctant to pursue public health programs which impinged on the
local culture. Sanitarians restricted their civilizing mission to education on matters of hygiene.
Mark Harrison, Public Health in British India. Anglo-Indian Preventive Medicine 1859-1914
(Cambridge: Cambridge Univ. Press, 1994), 60, 87-8.
i34 EPP 1881 [c.2995], Accommodation and Treatment ofEmigrants on Board Atlantic
Steam Ships, Encl. #9. Dr. Mouat to the President of the Board of Trade.
1
35 EPP 1874 #314, Geoghegan's Report, 24-7.

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 PhD Thesis - L. Jacklin. McMaster- History.

investigation blamed the East Indians for drinking this water, but failed to mention that
it was their ship personnel who provided it to the emigrants. Monat also identified other
significant problems, such as ships hiring newly-graduated surgeons, who did not speak
Indian languages or understand how to treat East Indians. 136 Monat concluded that these
and other problems were not unusual in 1856-57, but had persisted for some time. He
assigned fault for on-going high mortality to the ship conditions provided by the colonial
sponsors of this migration. 137 India's Governor General in Council and the Secretaries of
State in both the Colonial and India Offices accepted Mouat's conclusions. The CLEC
commissioners changed their stance and agreed with Mouat's evidence from the
Surgeon-Superintendents and ship personnel: many ships had never enforced the
sanitary orders. 1 3 8 Evidently, some ship surgeons and officers had their own ideas about
the civilising measures to be invoked for East Indians during the journey, which took
precedent over the enforcement of the government's well-documented preventive health
and disease containment measures.

Clearly, the CLEC and the Passengers' Act had not enforced the protections which
the regulations claimed to offer to the East Indians, so India instituted forceful local
regulations, requiring colonial sponsors to comply with the edicts or risk having their
ships stopped from embarking. The new rules embodied Mouat's recommendations. 139
From this point forward, East Indians were assured of the crucial health protections of
air, clean water, food, and sanitation. 14° Nothing would be left to the discretion of
colonial officers. India instituted its own protective apparatus to protect its subjects as
they travelled to distant colonies, including a staff of government emigration agents,
Protectors of Emigrants, and Medical Inspectors of Emigrants. India Acts controlled the
ship conditions and licensed the ships, recruiters, and depots.141 Another important
change reflected India's desire to address Mouat's finding that the sanitary discipline of
her subjects had not adhered to the government-issued directions. East Indians would
henceforth be appointed to police the conformity to the program. Similar to the
uniformed cadre of enforcement constables on the Australian ships, sanitary discipline
became the responsibility of the Sirdars or "Chief Coolies. "14 2 India now intervened to
ensure that the basic health-maintaining measures previously instituted on the other
fleets of migrant ships, fifteen years earlier, were rigorously enforced on the Coolie Ships.
The locus of control vaulted from one side of the Imperial world to the other, as India no
longer accepted fac;ades of pretended enforcement. Although the Passengers' Act
theoretically operated as a higher authority, officials in India simply stopped ships from
embarking if the sponsors failed to uphold the locally mandated health standards.
1
36 BPP 1874 #314, Geoghegan's Report, 26-7.
1
37 BPP 1874 #314, Geoghegan's Report, 24-6. BPP 1857-58 [2395], CLEC Eighteenth AR,
13-14.
1
38 BPP 1859 [2555], CLEC Nineteenth AR, 49-50.
1
39 "Government of India-Home Department-Public Consultation, 25th March 1859. No. 83­
Revised Rules for the Guidance of all Persons concerned in the Emigration of Native Labourers
from Calcutta to the West Indies," in BPP 1860 [2696], CLEC Twentieth AR, 174-87.
1
4° BPP 1860 [2696], CLECnventiethAR, 175-9. BPP 1874 #314, Geoghegan'sAR, 26-7.
14 1 India Act No. 13 of 1864, An Act to consolidate and amend the laws relating to the
emigration ofnative labourers. BPP 1865 [3526], CLEC Twenty-Fifth AR, 107-26. From 1862,
medical officers were appointed to monitor the health of the emigrants in depots. BPP 1863
[3199], CLEC nventy-Third AR, 45.
142 BPP 1860 [2696], CLEC nventieth AR, 176-7.

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 PhD Thesis - L. Jacklin. McMaster- History.

One of Mouat's most emphatic proposals, however, remained contentious for

decades, as he criticised the number of women and children aboard the ships. He wanted
the female quota limited to 25% and special rations for infants, children, and nursing
mothers. 1-i3 The Secretaries of State for India and the Colonial Office refused to sanction
Mouat's advice. East Indians in the West Indies had to be provided with women or
emigration would be halted on moral grounds, despite the health precedent limiting the
numbers of at-risk infants and children allowed on other ships. The direct tension
between the two policies on health and morality stimulated disagreement about the
number of women required. Mouat wanted 25 women per 100 male migrants, the CLEC
insisted on 50, and the Colonial Office set the new quota at 40. 1H The only concession for
this high-risk population involved rations of milk, at the surgeon's discretion.145 The
records do not indicate that any other measures were contemplated, such as hiring
matrons to inspect the children and educate the mothers on caring for their infants.

This analysis has identified strikingly different mortality rates for three migrant
populations, wherein a hierarchy of 'acceptable' mortality is evident. British emigrants
able to pay their own fares, and thus from a 'better' socio-economic class, were at the top
of the hierarchy. Australia bound government-assisted Britons occupied a nearby albeit
slightly lower rung. Indentured East Indians experienced vastly different mortality rates.
Imperial attitudes about the race, gender, and economic value of the bodies of these
migrants differentiated the two white British populations at the top of this hierarchy
from the East Indians at the bottom.

Conclusions

Nineteenth-century Imperial world expansion stimulated the mass migration of several

British populations at a time when many broadly-conceived and diverse reform factions
emerged to target the conditions of the labouring classes. The colonies sponsoring
assisted migration instituted demographic restrictions on the migrants who qualified for
free transportation, to ensure that their investments would attract the types of people
desired for the future development of their colonies. Australian colonies valued young
and healthy Britons who would form productive and reproductive family units.
Demographic restrictions precluded the migration of large families, multitudes of
disease-carrying children, and imbalanced gender ratios. West Indian colonies
sponsored migration for the expressed purpose of providing labouring immigrants to
perform the gruelling work under indenture. West Indian colonies thus valued the so­
called "Coolie" bodies as temporary sojourners performing exhausting labour, with
replacements for the feeble bodies on the next ship arriving from India.

Amidst these different and well-entrenched valuations of immigrant bodies, the

Imperial government recognized the need to reform the unhealthy conditions aboard the
emigrant ships. The emergent Chadwickian conceptions of public health underpinned

1
43 EPP 1874 #314, Geoghegan's Report, 24-6

1
44 EPP 1874 #314, Geoghegan's Rep01t, 52.

1
4s EPP 1859 [2555], CLECNineteenthAR, 49-50. EPP 1860 [2696], CLEC Twentieth AR,

180-1. Nursing mothers received a pint of milk daily. Infants and children under two years of age

received the milk ration if they were orphans or if their mothers could not nurse them.

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 PhD Thesis - L. Jacklin. McMaster - History.

the maritime regulations determining the health conditions for lower class British
subjects travelling throughout the imperial world. The controlled environment of the
seaborne vessels has provided a rare opportunity to compare the racialising and
gendering of a single corpus of public health knowledge. The racial and gendered
ideologies allowed several different maritime public health frameworks to coexist,
because the colonial sponsors valued the bodies of their immigrants differently. The
essence of the strategy to build a better class of Britons to settle the Australian colonies
diverged substantially from the scheme to civilize an alien race working as indentured
sojourners in the West Indies. The medico-moral sanitary orders designed to execute
these objectives resulted in different health outcomes. The regulators believed that the
mortality was higher on the Australian ships, when compared to the North American
migration. The use of the VLR to measure this mortality does not allow a firm conclusion
if this was, in fact, true. Nonetheless, this perception caused the governments to make an
unprecedented financial investment in the health conditions aboard the Australian ships,
augmented by the demographic screening program to reduce the number of infants and
children on the ships. In a striking contrast, the civilizing medico-moral sanitary order
aboard Coolie Ships created the conditions where excessive mortality rates prevailed.
East Indians paid a significant human health cost of migration, due to the decisions
made by the emigration sponsors and their health protection apparatus. High East
Indian mortality rates persisted long after the mortality problems had been addressed on
ships transporting the other migrant populations.

The gendered quota for the indentured labourers created a significant tension
amongst the Imperial, India, and colonial governments, due to the different objectives
for the program. West Indian planters continued to demand a predominantly male
labourforce. Officials in India were concerned about their ability to recruit women and
continued to object to the health perils associated with boarding so many children. The
Indian government and Colonial Office were anxious about the morality of the Indians in
the West Indies and this policy took precedent over the medical policies to decrease
mortality during the journey. Families and women may have been more inclined to
migrate if women were offered free passages or exempted from indentured labour. This
would have required the planters to pay wages above the subsistence level, to allow the
men to support their families, which contravened the fundamental purpose of the system
of supplying cheap labour for the troubled sugar industry. By 1916, when India
terminated the system of migration, the government recognised that the gendered quota
had not allowed moral populations to establish themselves in the colonies.

The intervention by the India government to reduce the shipboard mortality rates
sent a clear message to the colonies that excessive deaths would not be tolerated. By
licensing all personnel and the emigration depots, India took control over some
preventable problems affecting the shipboard conditions. The planters in Trinidad had
no choice but to accept the rules in India. However, the situation changed once the
Indians arrived in Trinidad. Chapter 4 investigates the advent of Trinidad's Government
Medical Services, created in 1870 as the result of an edict by the Colonial Office, as a
response to the pressures over the excessive death rates amongst the indentured workers
on the plantations. The tensions in the Empire emanating from half way across the world
in British India regarding the health of the East Indians overseas had a direct effect on
the form and function of state healthcare created in Trinidad.
 PhD Thesis - L. Jacklin. McMaster - History.

-Chapter4­
"Take up the White Man's burden ... And bid the sickness cease"1 :

Creolising Trinidadian Colonial Healthcare, 1870-80.

This chapter investigates Trinidad's contested entry into the provision of healthcare
services for the public through the creation of the Government Medical Service (GMS) in
the 1870s. The British and Creole elites, representing two powerful factions of white
decision makers, each possessed well-entrenched ideas about the state's obligation to
shoulder the burden of responsibility for the health and welfare of its colonial subjects.
During this decade, Trinidad established two different variants of the GMS in succession,
pulled in one direction by the traditions of slavery and plantation society, 2 and pushed in
another by its responsibilities as a tropical British colony. The first variant of the GMS
(1870-74) upheld the treasured values and traditions of the influential members of
Creole society, who retained control over health and medical matters. During Henry
Irving's governorship, from 1874 to 1880, the pendulum swung decidedly in the opposite
direction, as he energetically forced the plantocracy to confront his view of the state's
obligations to provide western public health and medical services to the non-white
subject peoples, as part of imperialism's civilising mission.

This analysis spans the reigns of three governors: Arthur Gordon (1866-70),
James R. Longden (1870-74), and Henry Irving (1874-80). Longden's unremarkable
governorship could otherwise go unnoticed, if his predecessor and successor had not
been autocratic governors, both of whom made important changes to state healthcare.
Prior to his departure for Mauritius, Gordon enacted several ordinances establishing the
GMS and defining the government's healthcare services for indentured East Indians,
while setting a preliminary direction for the form of state medical services for the public
at large.3 On his arrival in Trinidad, Longden lost no time acculturating to Creole society
and facilitating the plantocracy's desire to structure the GMS in a way that retained the
planters' cherished customs and values.4 The initial variant of the GMS was thus created
and flourished during his administration. His successor, a former staff member at the

Rudyard Kipling, The Writings in Prose and Verse ofRudyard Kipling (Charles Scribner,
1903), 78.
2 Brereton and Trotman concurred that the history of slavery, patriarchy, and plantation
society framed the white elite's worldview. Bridget Brereton, Race Relations in Colonial Trinidad
1870-1900 (Cambridge: Cambridge University Press, 1979), 35-6. David Vincent Trotman, Crime
in Trinidad. Conflict and Control in a Plantation Society 1838-1900 (Knoxville: University of
Tennessee Press, 1986), 35-69.
3 The public at large is defined to include all residents, including people born in Trinidad,
immigrants, and post-indenture (free) East Indians. Indentured East Indians are excluded from
the definition of the public at large, because the 1870 Coolie Immigration Ordinance 13 restricted
their freedoms and chil liberties.
4 CO 295-342 (1892) #6356. Application for Directorship ofSanitary Dept. Egypt. During
Longden's absences, interim administrators upheld his policies, including W.H. Rennie (1872 to
1873), W.W. Cairns (1874), and the Creole J. Scott Bushe (1874). G. William Des Voeux stated
that it was a well-accepted precedent that acting administrators would not approve legislation
inconsistent ''ith the wishes of the permanent governor. G. William Des Voeux, My Colonial
Service in British Guiana, St. Lucia, Trinidad, Fiji, Australia, Newfoundland, and Hong Kong
with Interludes (London: .John Murray, 1903), 297-8. The list of acting governors is prO\ided in
The Trinidad Official and Commercial Register and Almanackfor 1882, 37.

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 PhD Thesis - L. Jacklin. McMaster - History.

Colonial Office, Governor Irving, reformed the GMS into a structure that reflected his
view of the colonial state's obligations to the poor.

Trinidad began the long process to creolise state healthcare during these
protracted struggles during the decade. The influential Creoles believed that the poverty
amongst the Afro-Trinidadians signified their regression into barbarism: the people
failed to respond to the civilising initiatives, which meant labouring at subsistence wages
and using their meagre earnings to maintain their health and pay for healthcare. The
Colonial Office and some of its officials insisted that poverty and environmental factors
stimulated ill-health: this had been proven by public health reformers in Britain. At the
same time, the mass of poor residents demanded state assistance and used the GMS in
increasing numbers each year. The GMS healthcare emerged as a negotiated entity which
ultimately satisfied none of the factions, but began to address the demand from the lower
class Trinidadians.

Governor Arthur Gordon: Estate Healthcare and

the Creation ofTrinidad's Government Medical Services in 1870.

In the wake of the Afro-Jamaican uprising at Morant Bay in 1865, the Colonial Office
realised that its civilising mission was encountering severe difficulties in the plantation
colonies. James Patterson Smith argued that Whitehall recognised the need to change its
approach to civilising the colonial "barbarian" and to respond to the heightened political
pressures about the adverse conditions of the indentured East Indians. The Colonial
Office directed its governors to create GMS organisations and make their governments
responsible for the health of the labourers.s As one of the few healthcare-related edicts to
originate from the metropole during the century, this directive did not lay out a master
plan, but allowed each governor a great deal of flexibility to organise the colony's GMS
and set the parameters of government care for the indentured Indians.

In Trinidad, Governor Gordon addressed Whitehall's dictate, enacting the new

Coolie Immigration Ordinance 13 of 1870, which defined the conditions of work and life
for the East Indians and the parameters of state involvement in their medical care. 6
Laurence Brown argued that Gordon's strong political support in Britain allowed the
autocratic governor to codify his reforming ordinance in the colonial statutes, despite the
objections from the local elite.7 An independently wealthy and politically well-connected
member of Britain's upper ranks, Gordon did not need to cultivate the support of the
local Creoles. Leading French-Creole and Unofficial member of the Legislative Council,
Dr. Louis de Verteuil, commented on Gordon's tenacity: "Sir Arthur was not the man to

5 James Patterson Smith, "Empire and Social Reform: British Liberals and the 'Chilizing
Mission' in the Sugar Colonies, 1868-1874," Albion, 27, 2 (1995): 253, 270.
6 The 1870 Immigration Ordinance was not modified substantially until the next
consolidating ordinance, Ordinance 19of1899. BPP 1904 [cd.1989], Immigration Ordinances of
Trinidad and British Guiana.
Laurence Brown, "Inter-colonial migration and the refashioning of indentured labour:
Arthur Gordon in Trinidad, Mauritius and Fiji (1866-1880)," in Da"id Lambert and Alan Lester,
eds., Colonial Lives across the British Empire: Imperial Careering in the Long Nineteenth
Century (Cambridge: Cambridge University Press, 2006), 207, 210-11.

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 PhD Thesis - L. Jacklin. McMaster - History.

desist from measures which he considered just and fair. Unable to tame his opponents
into acquiescence, he did not hesitate to crush them." 8

Historians of indenture consider the 1870 Coolie Immigration Ordinance an

important piece oflegislation.9 Until this time, Gordon and the Protector of Immigrants,
Dr. Henry Mitchell, 10 had not been too successful convincing planters to address the high
mortality rates voluntarily. The ordinance thus obligated planters to provide many basic
health measures, such as supplying food to the new arrivals and constructing their
barracks housing to a minimum standard. 11 Many planters had not bothered to hire
doctors to tend to their ailing or injured workers, so Gordon made medical care
mandatory: the government henceforth employed Medical Visitors of Plantations to
travel to each estate hospital twice a week to care for the East Indians. 12

One of the most important health-maintaining clauses in the ordinance

established a severe penalty for planters who allowed more than 7% of their indentured
workers to die during the year. These planters would not be allowed to request new
immigrants to replace the deceased workers.13 This punitive measure had an immediate
effect. Mitchell reported that the mortality rate declined to an unprecedented 4.8% in
1870, although the results were not consistent throughout the estates. Mitchell refused to
supply new East Indians to twenty estates in 1870, or about 17°/o of the total sugar
plantations in Trinidad, because their mortality rates exceeded 7%. 14 The following year
he imposed the penalty on about 9% of the estates, 1s suggesting that some planters did
not embrace the principle that East Indian bodies were not expendable. The literature
review, above (in Chapter 1), confirmed that high death rates had prevailed amongst the
predecessors to the indentured Indian labourforce: enslaved Africans. This phenomenon
re-emerged amongst the East Indians during the early years of the program of indenture.
However, the immediate decline in mortality following Mitchell's enforcement of the
8 L.A.A. de Verteuil, Trinidad: Its Geography, Natural Resources, Administration, Present
Conditions and Prospects, 2nd ed. (London: Cassell and Company, 1884), 465.
9 Laurence stated that the passing of the ordinance was the start of the "mature" phase of
the system and started his monograph coincident \vith the ordinance. K.O. Laurence, A Question
ofLabour: Indentured Immigration into Trinidad and British Guiana 1875-1917 (Kingston: Ian
Randle, 1994), x. Look Lai's Appendix 2 reprints the consolidated summaries of major changes to
Trinidad and British Guiana's ordinance, using the 1870 law as the starting point. Walton Look
Lai, Indentured Labor, Caribbean Sugar. Chinese and Indian Migrants to the British West
Indies, 1838-1918 (Maryland: Johns Hopkins University Press, 1993), 303-13. Brown, "Inter­
colonial Migration," 210-11.
10 Mitchell was appointed Protector in 1853. The Colonial Office List, 1881, 385.
11
Planters had to provide each person over age ten with food rations for the first two years
of their indenture. The recipients paid the cost of the rations. BPP 1872 [c.523], The Present State
ofHer Majesty's Colonial Possessions.1870. 70-5. [Hereafter, Blue Book for 1870.]
12 BPP 1872 [c.523], Blue Bookfor 1870, 70-1.
1
3 Immigration Ordinance 13 of 1870, BPP 1872 [c.523], Blue Book for 1870, 70-5.
14 Few statistics survive for the 1870s. However, the 1877 estate inspection report recorded
118 estates in operation. The estimate of the percentage of estates which were refused new
immigrants assumes that at least 118 estates were operating in 1870 and 1871. 1877 LC #22.
Immigration. Abstract ofthe Quarterly Returns for the year ending 30th September, 1876. BPP
1872 [c.523], Blue Bookfor 1870, 70, 74-5.
1
s Eleven estates were refused immigrants in 1871. BPP 1872 [c.523], Blue Book for 1870,
74-5.

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 PhD Thesis - L. Jacklin. MeMaster - History.

ordinance confirmed that a large proportion of these deaths could indeed be prevented.

After dealing with the Colonial Office edict to address the conditions of the
indentured workers, Gordon turned his attention to the associated order to establish a
colonial GMS. As one of his final acts before leaving Trinidad, Gordon pleaded with the
Colonial Secretary of State, the Earl of Kimberley, to appoint a Surgeon-General in
England and send him to the colony at once. Creole physicians would not be suitable for
this senior position in the civil administration. Gordon considered the only English
candidate in the colony, Medical Officer of Health Dr. R.H. Bakewell, unsuitable because
Bakewell was "at war with many of his own colonists." In Gordon's eyes, Bakewell had
committed the unpardonable sin of allowing a disagreement with coloured physician Dr.
J. Espinet to escalate into a public racial conflict. The Legislative Council did not share
this sentiment and held Bakewell in high regard, having appointed him Medical Officer
of Health and Vaccinator-General. Bakewell continued his work, enforcing contentious
public health measures, while sporting a government-issued firearm for protection, after
being tarred and feathered on the steps to Government House early in 1870. 16 As this
drama played out in the streets of Port-of-Spain, Gordon expressed a sense of urgency to
fill the newly created senior civil service position of Surgeon-General. 17

On the recommendation of the Colonial Land and Emigration Commissioners,

the Colonial Office hired Dr. Samuel Leonard Crane, a sixteen-year veteran Surgeon
Superintendent aboard the government's emigrant ships. 18 Crane's maritime experience
managing racial relations and the health of East Indians appeared to be the salient
factors in his appointment, but these workers subsequently captured a minimal amount
of his attention during his twenty-two year tenure. Planters recognised the value of
having government doctors attend to their labourers at no cost to the estate. However,
the much larger primary GMS tier of healthcare for the public at large quickly emerged
as an object of contention. The influential in Creole society rejected the Colonial Office's
reformed outlook and new mandate to include western medicine in its mission to civilise
the colonial barbarian. Surgeon-General Crane and his successors devoted the vast
majority of their professional attention to this primary tier of government healthcare
serving the impoverished public at large, which rapidly grew in cost and size, placing
many Surgeon-Generals in conflict with Trinidad's Legislative Council.

Colonialism and Poverty: "'The Poor Ye Have Always With You'"1 9

The Colonial Office's directive to the plantation colonies to institute GMS organisations

16 CO 295-254 (1870) #8800 [Crane appointed Surgeon General]. CO 295-259 (1871)

#2696 [Bakewell and the Justice System], 335-38.
17 Ordinance 4of1869 created the Surgeon-General Department. It was repealed and
redefined by Ordinance 17 of 1872 and again by Ordinance 12 of 1893.
18 CO 295-254 (1870) #8800 [Crane appointed Surgeon General]. CO 295-342 (1892)
#6356. Application for Directorship. 14 .Jan 1892.
19 This quotation introduced a letter to the editor on the problems of poor Trinidadians
accessing GMS healthcare. The letter was written three decades after the period of this chapter,
confirming that many conflicts continued. However, by that time, the public and press vocally
criticised the government's negative attitudes about the poor. The Mirror, 22 April 1903.

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 PhD Thesis - L. Jacklin. McMaster - History.

as part of its civilising mission did not dwell on the details of the public health and
medical services to be provided to the people. In Trinidad, the colonial elite rejected any
sense of responsibility for the health and well-being of the impoverished Indian and
African lower orders, although widespread ill-health prevailed amongst these poor
residents. Waltraud Ernst alluded to the notion that the relationship between poverty
and the advent of colonial medicine may be more prevalent than the scholarship leads
one to expect. She encouraged researchers to examine the policies which had a bearing
on medical initiatives, such as the state's attitudes to the poor and the mechanisms to
deliver healthcare services. 20 The official policies about the poor remained vitally
important in plantation society colonialism, which purposefully allowed the white
minority to control the political economy. Trinidad's plantocracy had historically
considered labourers to be expendable commodities, which necessitated the
government's intervention with the 1870 Coolie Immigration Ordinance. By contrast, the
Colonial Office and its expatriate officials had been conditioned by England's Poor Law
tradition and related ideas on the responsibility of the economically secure classes to
provide for the poor. These divergent worldviews set the stage for an on-going struggle
over the primary tier of the GMS healthcare services for the public at large.

Historians of Britain's social welfare system have argued that major changes
occurred in the beliefs on the causes of poverty and its relationship to ill-health, between
1834 and 1867. The Poor Law Amendment Act of 1834, commonly called the New Poor
Law, required the poor to enter the workhouse in order to obtain relief. This policy was
based on the principle ofless-eligibility: in-door relief offered a standard ofliving lower
than the lowest class oflabourers could achieve. Able-bodied persons would naturally
prefer any other alternative to the miserly conditions in the workhouse. 21 Less-eligibility
would thus deter the able-bodied from seeking relief, while stimulating habits of thrift
and industriousness, to teach the workers to provide for themselves in sickness and old
age, rather than depending on the parish for support. 22 However, the framers of the New
Poor Law failed account for the miserable conditions of the labouring poor. Anne Digby
argued that it rapidly became apparent to officials that a public program could not
reasonably reduce its citizens to living conditions below the subsistence level. 2 3
Nonetheless, the state enacted additional legislation to reinforce the New Poor Law's
attempt to stop out-relief. The Outdoor Relief Prohibitionary Order of 1844 prohibited
Poor Law Unions from relieving their poor anywhere other than the workhouse.
Historians concur that contemporaries disregarded the law. By the 1860s, the majority of
relief was provided by outdoor allowances. 2 4

20
Waltraud Ernst, "Beyond East and West. From the History of Colonial Medicine to a
Social History of Medicine(s) in South Asia," Social History ofMedicine, 20, 3 (2007), 505-24.
21
Anne Digby, British Welfare Policy: Workhouse to Workfare (London: Faber and Faber,
1989), 31-4.
22
M.A. Crm\ther, The Workhouse System 1834-1929. The History ofan English Social
Institution (London: Batsford, 1981), 6, 17.
2
3 Digby, British Welfare Policy, 31-4.
2
4 Crowther estimated that twice as many people received out-relief, as compared to the
people incarcerated in the workhouses. Crm\ther, ''The Workhouse System," 6. Anne Digby, ''The
Rural Poor Law," in Derek Fraser, ed., The New Poor Law in the Nineteenth Century (London:
Macmillan, 1976), 170.
 PhD Thesis - L. Jacklin. McMaster - History.

Society's view of poverty and its causes thus underwent a radical transformation
during these three decades. The New Poor Law had been based upon sentiments
characterised by Lynn Hollen Lees as a "virulent hatred of pauperism" and its
concomitant "faith in an ethic of self-help and individual responsibility." However,
contemporaries soon realised that the economy created poverty. Rather than seeing
poverty in terms of moral failure, it came to be recognised as a problem that society
needed to combat. 2 5 Public health reformers popularised new explanations of the causes
of poverty. Poor Law secretary Edwin Chadwick challenged the extant beliefs,
demonstrating that illness caused pauperism: disease, therefore, inflicted a profound
economic cost on society. 26 Sanitarians exposed how poor food, unsanitary conditions,
poor water supplies, and other environmental factors victimised the poor. 2 7 Chadwick's
'sanitary idea' captured the attention of public health reformers and guided their reform
campaigns, into the twentieth century. Derek Fraser argued that Chadwick "turned social
theory on its head," by demonstrating that unsanitary conditions created social evils and
moral problems ("intemperance, prostitution, delinquency, etc."). The prevailing wisdom
had traditionally asserted the inverse relationship. 28

The New Poor Law did not make provisions for the sick poor. M.W. Flinn stated
that reformers were obsessed with exterminating out-relief amongst the able-bodied
poor. He argued that a "remarkable" development occurred. The rapidly constructed
workhouses consistently included sick wards and infirmaries in the new buildings,
although these facilities were not mentioned in the Act. 2 9 The law was soon modified to
reflect the practices in the Poor Law Unions, and the provision of medical services was
formalised in the General Medical Order of 1842.3° Flinn concluded that the spontaneous
development of a national organisation of healthcare providers and facilities was "an
accident of history which only the most pressing social need could have engineered."31

At about the same time that the Colonial Office issued its edict for plantation
colonies to create GMS organisations, Britain's Metropolitan Poor Law Amendment Act
of 1867 formally recognised the importance of the massive network of medical
institutions and the District Medical Officers (DMOs) in the community. This law
established the state's obligation to provide hospitals and other specialised healthcare
institutions for the sick poor and separated these services from the workhouse system.
Flinn argued that the Act formalised "state medicine," as the workhouse infirmaries and

2
s Lynn Hollen Lees, The Solidarities ofStrangers. The English Poor Laws and the People,

1700-1948 (NY: Cambridge Univ. Press, 1998), 223.

26 Digby, British Welfare Policy, 40. Chad,vick recognised that Poor Law expenditures

would continue to increase until the government took action to resolve the problems of poor

water supplies, deficient sewerage, and unsanitary housing.

27
Lees, The Solidarities ofStrangers, 243.

28 Derek Fraser, The Evolution ofthe British Welfare State, 3rt1 ed., (Britain: Palgrave,

2003), 68-70.

2
9 Small workhouses created sick wards within their facilities, while larger institutions built

infirmaries and engaged full-time medical personnel. M.W. Flinn, "Medical Senices under the

New Poor Law," in Derek Fraser, ed., The New Poor Law in the Nineteenth Century (London:

Macmillan, 1976), 48-9, 51.

3° Flinn, "Medical Services under the New Poor Law, "48.

31 Flinn, "Medical Services under the New Poor Law," 49.

 PhD Thesis - L. .Jacklin. McMaster - History.

sick wards were converted to the new system of state hospitals.3 2 The workhouses had
transformed into a resource for institutional hospital treatments for sick and impotent
non-able bodied poor people and children. With so many sick people, able-bodied and
healthy paupers represented a mere 13.5% of the inmates.33 Steven Cherry provided
statistics which quantify the magnitude of this institutional care. In 1861, in England and
Wales, the voluntary hospitals offered 14,800 beds, while the workhouse infirmaries and
sick wards provided 50,000 beds.34 In light of the rapid transformation of punitive
workhouses into providers of healthcare services, the New Poor Law's fundamental tenet
of less-eligibility had been overruled by the actions and practices of officials in the
unions, who could not rationalise providing ailing patients with a lesser level of
healthcare than the standards offered in the voluntary hospitals.35

Although the New Poor Law system rapidly evolved to become an important
locus for both economic and medical relief services, residents in Britain also had other
alternatives for assistance. Bernard Harris established the importance of philanthropic
and charitable ideals in forming the British elite's view on their obligations to the poor.36
In the complex medico-social support network in England, an expansive suite of services
developed over several centuries, involving the parishes, social philanthropy, Poor Law
unions, charitable societies, and the national government. Scholars define this amalgam
of the "mixed economy of welfare" to include four sectors: the state, voluntary charity,
the informal sector, and the commercial organisations (pension plans, insurance
companies, and so on).37 In England, each of these sectors provided a variety of medico­
social services for the poor.

The resources available to sick or poor Trinidadians differed substantively from

the four pillars of the mixed economy of welfare in continental Britain. For instance, the
commercial sector was not active during the 187os.38 Although there are no existing
studies on the informal sector, anecdotal evidence suggests that the impoverished lower
orders relied extensively on families, friends, and their community during times of

32 The Metropolitan Poor Law Amendment Act of 1867 created the Metropolitan Asylums

Board. Flinn stated that a similar law for mral England ,,..-as enacted the following year. Flinn,

"Medical Sef\ices under the New Poor Law," 6, 64-5.

33 Fraser prmided Local Government Board statistics for 1874. Children represented 31% of

the workhouse inmates, while 53.5% were sick and aged persons. The able-bodied persons were a

minority at 13.5% of the residents. Fraser, The New Poor Law, 5.

34 Steven Cherry, Medical Services and the Hospitals in Britain, 1860-1939 (Cambridge:

Cambridge University Press, 1996), 45-6.

35 Fraser, The New Poor Law, 6. Flinn, "Medical Senices under the Nev.· Poor Law," 57.

36 Bernard Harris, "Charity and Poor Relief in England and Wales, Circa 1750-1914,"
Bernard Harris and Paul Bridgen, eds., Charity and Mutual Aid in Europe and North America
since 1800 (NY: Routledge, 2007), 19-42.
r Bernard Harris, "Introduction: The 'Mixed Economy of Welfare' and the Historiography
of Welfare Pro,ision," in Bernard Harris and Paul Bridgen, eds., Charity and Mutual Aid in
Europe and North America since 1800 (NY: Routledge, 2007), 1, 6.
38 The commercial sector of welfare senices included commercial pension funds, insurance
plans, and so on. These organisations were not active in Trinidad during the 1870s. One of the
first quasi-public pension funds was the Widow and Orphan Fund for chil sen'ants established by
Ordinance 25of1898. By 1901, 250 government employees made voluntary contributions to this
fund. 1902 LC #23, Widows' and Orphans' Fund.

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 PhD Thesis - L. Jacklin. McMaster - History.

medical and health troubles. In his 1884 monograph, the influential French-Creole and
long-serving Unofficial member of the Legislative Council, Dr. Louis de Verteuil,
tempered his racially-derogatory remarks by acknowledging the Afro-Trinidadian people
as "charitably disposed, and ever ready to assist the destitute."39 As concluded below (in
chapter 6), after the GMS had become firmly established in the 1880s, many
Trinidadians continued to use the informal sector and indigenous remedies extensively
before seeking the assistance of the GMS doctors. However, the extent of this sector
cannot be quantified from the surviving sources.

The voluntary sector in the mixed economy of welfare had not developed to any
extent in Trinidad by the 1870s. Harris discouraged scholars from attempting to
understand the motives of philanthropists, recommending that they attempt to ascertain
the tangible contributions of charities to society.4° In Trinidad, these charities were
relatively small. The Port-of-Spain Anglican Church operated the Daily Meal Society,
providing meals to about sixty people each day, including the aged, infirm, and patients
recently discharged from the hospital.41 The Protestant and Catholic churches operated
tiny asylums in town, but these facilities were so small that commentator Daniel Hart did
not realise that they existed.4 2 A few private philanthropic initiatives emerged in the late
1880s in Port-of-Spain.43 Charitable institutions otherwise remained scarce, to 1916.
These charities did not offer medical care or long-term relief and were so small that only
a few residents benefited from their services.44

The colonial state struggled with the most basic questions involving the provision
of any welfare services for decades, such as who should shoulder the burden of erecting
almshouses and maintaining their residents. The borough of Port-of-Spain operated a
small house of refuge with seventy-five beds, with admissions limited to those who could
prove their residency in town.45 The almshouse capacity remained severely insufficient,
in perpetuity, as the town refused to expand the facility. The Port-of-Spain Hospital
managed to extract a modest annual sum from the town to offset the cost of providing
care to the innumerable people who would have resided in its almshouse, if a large

39 de Verteuil, Trinidad: Its Geography, Natural Resources, 13.

4° Harris, "Introduction: The 'Mixed Economy of Welfare,"' 1, 6.
41 EPP 1866 [c.3719]. Blue Book for 1864, 78. Brereton, Race Relations, 57-8.
42 The 1866 Blue Book indicated that two small asylums existed in town, but they were so
small that commentator Daniel Hart thought that the Daily Meal Society was the only charity.
Hart, Trinidad and the other West India Islands, 129-33. EPP 1866 [c.3719]. Blue Book for 1864,
78. The Catholic Church maintained the sixteen-bed St. Vincent's Asylum for Incurable Patients.
Sadlier's Catholic Directory, Almanac and Ordo [sic], 1883, Part II, The Catholic Church in the
British Provinces ofNorth America, the West Indies, Central and South America (NY: D.J.
Sadlier, 1883), 75.

43 Brereton, Race Relations, 57-8.

44 In his 1897 report on a system of Poor Laws, Registrar-General C. Boume lamented the

lack of charitable organisations. He confirmed the presence of a few small charities and three old

age homes operated by the churches. The Daily Meal Society continued to operate, along with

"another similar dole Society." 1897 LC #188. Papers relating to the question ofPoor Relief, 3.

45 The almshouse had been in operation since 1866 (at least), but little is known about it. By

1877, it hosted 65 to 75 inmates. EPP 1878-79 [c.2273]. Blue Book for 1877, 31. EPP 1866 [c.3719].

Blue Book for 1864, 77.

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 PhD Thesis - L. Jacklin. McMaster - History.

enough facility had existed.46 The town promised to remove incurable and aged patients
from the hospital. This never happened.47 In terms of facilities to host the rest of the
colony's destitute, old, incurable, blind, or disabled residents, the Legislative Council
ignored the pressing need for a colonial House of Refuge until 1881.48 Trinidad did not
differentiate between able-bodied and non-able-bodied, deserving and non-deserving, or
the ill, infirm, and aged residents in the colony. As will be established, below, the poor
were an undifferentiated mass of subject peoples, whose poverty was proof of their
regression into barbarism.

Figure 4.1 - Colonial Hospital, Port-of-Spain, circa 1880s.

Reprinted with permission, Rockefeller Archive Center. 49

By the end of the century, the government freely admitted that the absence of a
system of Poor Laws had forced the medical institutions to absorb the function of
housing the aged, disabled, destitute, and hopeless cases.so Yet, contemporaries proudly

46 From 1840 to 1875, Port-of-Spain paid 1/- per person (daily) to the colonial treasury to
relieve its paupers in the hospital. Ordinance 27 of 1875 changed this to a token fixed sum,
reducing the town's costs from £1,500 to £750 annually. BPP 1875 [c.1183]. Blue Bookfor 1875,
86-7. 1886 LC #92. Poor Relief Letter from the Surgeon-General Relative to the Provision for
the Maintenance ofthe Indigent Sick in POS.
47 Incurable patients were to be removed from the hospital, but Crane complained that this
rarely occurred. He criticized the Borough for ignoring so many destitute patients, claiming the
municipality neglected this "universally recognized obligation." 1886 LC #92. Poor Relief
48 1889 LC #28. Surgeon-General AR, 69.
49 Rockefeller Archive Center, RF Photographs, 451/116/2286/6937
so 1897 LC #188. Papers relating to the question ofPoor Relief, 2-4.
 PhD Thesis - L. Jacklin. McMaster - History.

Figure 4.2 - San Fernando Colonial Hospital, circa late in the century.52

The hospital is the large complex occupying the large area and greenspace on the hill.

Reprinted with permission, British National Archives.

British Guiana's Chief Medical Officer recognised the similar pragmatic

limitations of the healthcare delivery mechanisms in his colony, the other major British
West Indian sponsor of indentured labour. Surgeon-General Robert Grieve's comments,
in 1888, suggested that the upper ranks of Guianese Creole society had not developed a
personal or government sense of responsibility for the lower orders. Grieve reminded his
government that it bore the entire cost of the colonial medical system because of the
failure of a philanthropic movement to develop.s3 Trinidad's influential Creoles similarly
rejected the responsibility, either as state-funded or philanthropic initiatives. The lack of
Poor Law institutions and infirmaries, charitable hospitals, and public dispensaries
restricted the options available to poor residents when ailing, disabled, or injured. If
these people needed assistance beyond what could be provided by friends and family in
the informal sector, their only hope was to engage with the GMS organisation.

Elite Creole Worldviews ofthe White Man's Burden:

The Government Medical Services (1870-74)

After Gordon's departure for Mauritius, the Creole plantocracy organised its GMS in a
manner which reflected its deeply-held traditions, while rejecting many tenets of
preventive medicine. The Creoles controlled all medical expenditures and institutions,

51 CO 295-279 (1877) #13574. Statements against Dr. Crane and the mortality in the
Colonial Hospital. Encl. Surgeon-General to Colonial Secretary, 4 June 1877. Longden attributed
the American comparison to W.G. Sewell, The Ordeal ofFree Labour in the British West Indies
(London: 1861). BPP 1871 [c.344]. Bllle Bnokfor 1869, 65. For the San Fernando Hospital, see
Des Voeux, My Colonial Service, ~~01-2.
52 British National Archives, CO 1069/392/20 [n .d_J View ofSan Fernando.
53 British Guiana Sessional Papers (1888), Surgeon-General AR, 3.

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 PhD Thesis - L. Jacklin. McMaster - History.

systematically retained all authority, and did not conceive of an obligation to provide
Poor Relief to the public at large. The plantocracy's priority continued to be reducing the
death rate amongst the indentured labourers on the estates, due to the perpetual
looming threat that India or the Imperial government could intervene and terminate the
flow of immigrants. Surgeon-General Crane arrived in Trinidad in the spring of 1871. He
subsequently claimed that his new position had been ill-defined, involving only nebulous
notions about caring for the police and indentured immigrants, and Governor Longden's
edict to reduce the costs at the medical institutions.54 Crane's complaint perhaps more
accurately reflected the disparity between his views and the Creole decision makers on
the function of state healthcare and the Surgeon-General's role. The Legislative Council
had in fact defined precisely how it wanted the GMS to function, which precluded
allowing a Surgeon-General sent by the Colonial Office to have any latitude to make
strategic decisions. Council had enacted several ordinances in advance of Crane's arrival,
specifying the management structure at the public hospitals and the appointment of
Medical Visitors of Plantations.55 Rather than being an ill-defined function, the
governor's direction to Crane and the ordinances made the Surgeon-General subordinate
to the wishes of the Legislative Council.

The medical care for indentured labourers took precedence in defining the
broader contours of the GMS system. The legislators insisted on retaining the existing
relationships between the planters and the handful of Creole doctors who had been
servicing some estates.56 The plantocracy drew on its historical precedent of engaging
doctors through part-time contracts. Longden issued contracts to twenty-one doctors,
including five patronage appointments of Medical Visitors of Plantations, and sixteen
part-time positions in the urban hospitals and asylums or delivering statutory services to
the public.s7 Crane's responsibilities were limited to organising the duties of the sixteen
doctors, excluding the Medical Visitors, and dealing with the corollary myriad of day-to­
day problems at the government hospitals and asylums, which continued to be the only
locus of institutional care for poor residents.

All twenty-one doctors insisted on residing in the urban centres of Port-of-Spain

and San Fernando, regardless if their contracts obligated them to work in distant rural
districts each week. This would not have been viewed as an unreasonable demand by the
Creole legislators, who likewise tended to be urban dwellers, although it posed a problem
for a Surgeon-General who wanted to make the GMS healthcare accessible to the public.
Both David Trotman and Keith Laurence established that few private physicians ever
ventured beyond the urban centres to establish practices in the rural districts, well into
the twentieth century.58 Crane tried to capitalise on the travels of the five Medical

54 CO 295-342 (1892) #6356. Application for Directorship, p.7.

55 Ordinance 15 of 1870 empowered the governor to hire District Medical Officers. BPP 1872

[c.523]. Blue Book/or 1870, 70-2. Ordinance 5of1869 defined the management at Port-of­

Spain's hospital, as did Ordinance 5of1870 for San Fernando's hospital. BPP 1871 [c.334] Blue

Book/or 1869, 65-6.

56 BPP 1872 [c.523] Blue Book/or 1870, 71.

57 BPP 1872 [c.523] Blue Book/or 1870, 71. CO 295-274 (1875) #8580. Scheme for
Reorganizing the Medical Services. Irving to Sec. of State, 6 July 1875.
58 Trotman, Crime in Trinidad, 227. Laurence identified the problem in the 1860s. K.O.
Laurence, "The Development of Medical Senices in British Guiana and Trinidad 1841-1873," The
 PhD Thesis - L. Jacklin. McMaster - History.

Visitors by giving them additional contracts to deliver specific statutory services to the
rural public while making their rounds: public vaccinations, post mortem examinations,
attending to paupers, and providing medical evidence when required by the justice
system. The GMS paid the doctors handsomely to deliver statutory services.59

Longden appointed the Medical Visitors to preserve the relationships between

the planters and physicians. 60 The doctors retained their contracts at his pleasure.
Longden required the Medical Visitors to report their activities each fiscal quarter to
Protector of Immigrants Henry Mitchell. 61 Gordon described Mitchell as one of the few
officials who had "never lost an opportunity when he saw it of turning the scale in favour
of the immigrant," which may have been a difficult task in Trinidad during this decade. 62
Mitchell had full control over the tier of the GMS which delivered services at the estates.
Crane's subsequent critique of this system of Medical Visitors revealed his powerlessness
to address the problems arising when some doctors blatantly disregarded their contracts
to provide statutory services to the rural public. 6 3 According to the statutes, the Surgeon­
General could not hire or fire these doctors, and he lacked the power to enforce any
system of accountability.

Crane was concerned that too few rural residents managed to capture the
attention of the travelling doctors. 6 4 A rough estimate of the public's access to the doctors
confirms the problem. The colony's obligation to India prioritised the care of the
approximately 11,000 indentured workers at 118 estates dispersed throughout the
island. 65 Each of the five doctors travelled twice-weekly to an average of twenty-four
estates, attending about 2,200 indentured East Indians each on their rounds. In light of
the difficult terrain and distances between estates, these duties undoubtedly occupied a
great deal of their time. After tending to the indentured workers, the supplementary
contracts paid the doctors to provide statutory services to the remaining 87,000 or so
rural residents. 66 It would have been impossible for each Medical Visitor to treat an

Jamaica Historical Review 4 (1964), 273.

59 CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State, 6 July 1875.

6o EPP 1872 [c.523]. Blue Book for 1870, 71.

61 EPP 1872 [c.523]. Blue Book for 1870, 71.

62 Gordon made this comment during his 1909 testimony to the Sanderson Commission.

EPP 1910 [cd.5193]. Report ofthe Committee on Emigration from India to the Crown Colonies

and Protectorates. Part II. Minutes ofEvidence, 343.

63 In 1904, when the elite Creoles were trying to reinstitute the long abolished system of

hiring doctors on contract, Surgeon-General .James de Wolf would remind the Legislative Council

that part-time doctors had no vested interest in carrying out their work on an efficient basis. Dr.

de Wolf started his GMS career in the 1870s as a contract DMO. CO 295-431 (1904) #25694.

Medical Service. Dr. J.A. De Wolf to Secretary of State. 19 July 1904.

64 1886 LC #104, Surgeon-General AR, 2.

65 Few statistics are available for the 1870s. However, the 1877 estate inspection report

indicated that 10,772 indentured East Indians resided on 118 estates. 1877 LC #22. Immigration.

Abstract ofthe Quarterly Returns, 1876.

66 The 1871 census enumerated 109,638 people, with 28,567 in Port-of-Spain and San

Fernando. By 1881, the total residents increased to 153,128, with 38,193 in the two towns. An

average of about 98,000 people thus lived in the rural districts. Census ofthe Colony ofTrinidad,

1891 (Port-of-Spain: Government Printer, 1892). 1, 7. This raw mean calculation of the 'free' rural

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 PhD Thesis - L. Jacklin. McMaster - History.

average of 2,200 indentured East Indians and another 17,400 poor rural residents
during his twice-weekly travels. As a point of comparison, in England, the 1842 General
Medical Order restricted the size of the population assigned to each DMO employed by
the Poor Law organisation, who attended to about one-third of the number of poor in a
district, when compared to Trinidad's rural Medical Visitors. 67

The tensions surrounding state healthcare involved the government's obligation

to assist the majority of the population, who did not labour under indenture, to maintain
or regain their health. The system of hiring part-time doctors for rural districts was
predicated on the assumption that the travelling doctors would be available to the public,
providing statutory services to the residents entitled to receive them, and then offering
their services to everyone else as private patients on a fee-for-service basis. 68 These
assumptions proved fallacious. After completing their estate duties, the GMS doctors
devoted little, if any, time to the public patients. 69 Many residents could not obtain any
GMS services in their communities and were drawn to the two large urban colonial
hospitals in great numbers.7° A phenomenon persisted for many decades whereby ailing
and destitute residents continually 'flocked' to the towns.71 These medically-motivated
pilgrimages to the San Fernando and Port-of-Spain institutions centred the plight of sick
people within the gaze of the urban dwelling Creole elite. Sufferers constantly arrived at
the GMS institutions and attempted to engage with the government doctors.

Crane's organisation of the GMS doctors' duties attempted to deal with this
onslaught of rural and urban patients seeking treatments. In this initial variant of the
GMS, sixteen part-time doctors received urban postings: twelve in Port-of-Spain and
four in San Fernando.72 Their assignments included duties at the institutions (hospitals,
asylums, and jails), maritime health services, and delivering statutory services, such as
vaccinations, caring for paupers, and post-mortem examinations. The urban
concentration of the GMS doctors did not necessarily mean that medical attention was
more accessible to the urban poor or the rural inhabitants who made the trek to the
towns. The part-time contracts restricted the time that doctors dedicated to their
government work. The GMS doctors working at the urban hospitals and asylums found
their terms of employment less lucrative when compared to their colleagues holding the
Medical Visitor patronage appointments. The urban doctors each earned an average of
about £380 annually, while their colleagues employed as Medical Visitors averaged £900

residents represents the number of rural residents, less the indentured population, with the result

averaged between the 1871 and 1881 censuses.

67 England's General Medical Order of 1842 defined that Poor Law districts could not

exceed 15,000 residents of all classes. Flinn estimated that middle- and upper-class residents,

who did not use Poor Law medical services, accounted for at least 50% of each district's

population. Thus, the DMO attended to about 7,500 residents who also had other alternatives for

assistance. Flinn, "Medical Services under the New Poor Law," 54.

68 CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.

69 CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.

70
1885 LC #15. Surgeon-General AR, 2.
71 1885 LC #15. Surgeon-General AR, 2. Chapter 5 investigates this phenomenon of people
flocking to the tm"ns seeking medical assistance. The problem became so pronounced during the
1880s that the GMS doctors agitated for the Legislative Council to create rural district hospitals.
72 CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.

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 PhD Thesis - L. Jacklin. McMaster - History.

from their contracts.73 Urban doctors meanwhile pursued their private practices,
possibly with great vigour, as they competed with private practitioners for paying
patients. As such, the urban medical markets offered Trinidadians the choice of many
practitioners, assuming that they could pay the doctors' fees. However, the majority of
the population could not afford to engage a practitioner of western medicine.7-l

The doctors working at the urban hospitals had little control over the number and
types of patients admitted to their institutions. In an attempt to reduce the costs of
operating the institutions, which increased each year, the Legislative Council instituted a
system of dual management, which rather expediently degraded to what is more
appropriately characterised as duelling management. The 1869 and 1870 Hospital
Ordinances appointed both medical and non-medical personnel to run the hospitals in
Port-of-Spain and San Fernando.75 The GMS House Surgeon functioned as the medical
head of each facility. Concurrently, a non-medical civil servant from the Colonial
Storekeeper Department was appointed Master of the Hospital, tasked with controlling
the quantity and types of supplies and provisions used within the hospital, along with all
expenditures.76 Storekeepers were expected to exercise "salutary control" over the
colony's "charitable" (medical) institutions.77 Presiding doctors had very little control
over the admission of patients, the resources available to treat them, and of the operating
efficiency of the institutions.

Longden claimed that this structure responded to suggestions made in an 1863­

64 Colonial Office circular.78 This despatch advised colonies of ways to improve the
administration of their hospitals and asylums. It addressed the problem whereby many
colonial governments assigned the responsibility to manage medical facilities to non­
medical personnel, who were often found to be "extremely ill qualified" to administer the
institutions. The circular encouraged each colony to appoint a senior Medical Officer to
preside over each institution, vested with "paramount powers," and responsible to the
colony's Chief Medical Officer (CM0).79 Although Longden professed to implement the
Colonial Office's suggestions, his administration had done the reverse by appointing
non-medical intermediaries to run the hospitals. Surgeon-General Crane did not receive
any "paramount powers" which would have made the doctors accountable to his office
and, in turn, made Crane a CMO responsible to the Legislative Council. The Surgeon­
General function thus remained powerless over the part-time doctors and no single
person shouldered the responsibility for medical and health matters in Trinidad.

At each facility, the medical department had little suasion over administration
and expenditures, which had a direct bearing on the quality and quantity of patient care

7
3 CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.

74 1886 LC #104, Surgeon-GenemlAR, 1-2.

75 Ordinance 5of1869 created the two departments at the Port-of-Spain Hospital, as did

Ordinance 5of1870 for the San Fernando Hospital. BPP 1871 [c.334] Blue Book, 1869, 65-6.

76 The only exception allowed the House Surgeon to purchase medicines and surgical
supplies. BPP 1871 [c.344]. Blue Book for 1869, 65. CO 295-311 (1886) #20601. Surgeon­
Geneml's Dept. Sub-encl. #1. Surgeon-General. 9 March 1886.
77 BPP 1872 [c.523]. Blue Book for 1870, 69.
78
BPP 1871 [c.344]. Blue Book for 1869, 65-6.
79 CO 295-311 (1886) #20601. Surgeon-Geneml's Dept. Sub-encl. #1. Surgeon-General.

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 PhD Thesis - L. Jacklin. McMaster - History.

available at the hospitals. Despite the incessant directive to reduce the expenditures, and
the patronage appointments of non-medical Creole officials to carry out that edict, the
costs soared. Direct hospital expenditures on patients (excluding salaries, buildings, and
capital costs) increased by 76%, from £11,116 in 1871 to £19,651in1874. 80 Doctors
meanwhile complained that the "manifest inability" of the non-medical managers caused
them a great deal of "alarm."81 Additionally, the system of dual management allowed
many abuses to prevail, as the doctors and non-medical managers remained continually
at odds with each other about the way that each hospital should be administered. 82

In summing up this initial form of the GMS, the patronage appointments of

Medical Visitors prioritised the desire to keep the planters and doctors content, as both
groups represented important sectors of society. The geographic organisation of the
GMS around the care of indentured workers had a broad implication in limiting the
accessibility to medical services for the public. Most Trinidadians could not obtain
gratuitous GMS medical attention and many could not afford to pay. The powerful in
Creole society would subsequently revere this form of the GMS, selectively forgetting
that costs had escalated, sick and destitute residents flocked to the towns, and the
institutions could not cope with so many patients.

Trinidad's Smallpox Epidemic of1871-72

Despite Creole society's complacency with the medical landscape, the international
community intervened to challenge the state's restricted involvement in the health of its
public. The stimulus for change involved the smallpox pandemic, which took hold of
Trinidad and reached epidemic proportions during 1871-72. Trinidad's maritime
partners and the Colonial Office exerted significant pressures on the colony to introduce
contemporary preventive health measures. The Legislative Council eventually responded
to these demands and expanded its limited set of public health measures to placate its
critics, but remained unwilling to change the broader parameters of state medicine.

Communities throughout the increasingly interconnected globe placed a priority

on containing the smallpox visitations of the early 1870s. Anne Hardy argued that a
discernable shift occurred in the accepted preventive measures in England, just prior to
the pandemic. After 1864, the generally adopted measures to prevent and contain
smallpox combined vaccination with the processes of early notification of cases, the
isolation of victims, and disinfection. 83 Trinidad continued to rely on its tradition of

8° CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General. The

institutional costs are recorded in 1893 LC #160, Surgeon-General AR/or 1892, 13.
81 Crane identified the "alarm" caused by the non-medical managers as the key reason to
abolish the system in 1875. The sources do not detail the problems. During the subsequent 1886
and 1891 inquiries, Crane devoted significant attention to problems with the hospital food, buying
supplies, and publishing objective medical criteria for admissions, suggesting that these were the
key problems. 1886 LC #104. Surgeon-General AR, 1-2. 1885 LC #15. Surgeon-General AR, 3.
82 CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General. 9
March 1886.
83 Anne Hardy, "Smallpox in London: Factors in the Decline of the Disease in the
Nineteenth Century," Medical History, 27 (1983), 122-3.

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 PhD Thesis - L. Jacklin. McMaster - History.

employing vaccination as the only measure to combat smallpox, often administered

reactively in response to an outbreak. For instance, when smallpox spread through the
Spanish Main in 1819, the colony mandated the vaccination of all residents, and levied a
£40 fine on evaders. 84 The government thereafter maintained the Vaccination Institute
in Port-of-Spain, but did not make it compulsory until 1864, when authorities realised
that only 7,000 residents had been vaccinated. 8 5 The immunisation rates did not
increase in the 1870s, although the GMS doctors had been contracted to vaccinate
residents. The popular local beliefs on smallpox transmission kept immunisation rates
low. Pharmacist Lewis Osborne Inniss stated the Afro-Trinidadian beliefs:

... it was the popular idea that if you visited all your acquaintances who got it and
were not afraid of it, you were safe, but if you tried to run away from it, you would
inevitably catch it, or rather it would catch you ... 86

The government's failure to institute measures for mandatory vaccination, disinfection,

and isolation allowed the smallpox visitation to reach epidemic proportions as the
African public pursued its own popular measures for smallpox prevention.

The epidemic attacked with such virulence that the colony's deficient health
practices became a matter of international importance. From London, The Times kept
readers informed as British colonies and foreign countries imposed quarantines, refusing
to allow ships from Trinidad to land or disembark passengers. 8 7 The quarantines
restricted the movements of goods and especially the sugar crop which was of vital
importance to the economy. High prices for sugar prevailed in Britain, and the planters
had hoped to maximize their financial returns. Their expectations were dashed when
ships refused to stop in Port-of-Spain and subject their cargos and passengers to
subsequent quarantine. 88 The potency of the epidemic confirmed that Trinidad's
preventive measures had not kept pace with contemporary practices. The epidemic
reached "grave proportions," with 12,351 cases and 2.449 deaths, or almost 20% of all
cases, during the lengthy visitation. 89 Trinidad appears to have fared slightly worse than

84 L.M. Fraser, History ofTrinidad from 1814to1839 (Trinidad: Government Printer,

1896), 95. Niklas Thode Jensen, "Safeguarding Slaves: Smallpox, Vaccination, and Governmental
Health Policies among the Enslaved Population in the Danish West Indies, 1803-1848," Bulletin
ofthe History ofMedicine, 83 (2009), 116.
85 Britain's 1853 Vaccination Act made vaccination compulsory for infants. The 1867 Act
included all children under age 14 and penalised parents who failed to vaccinate their children.
Dorothy Porter and Roy Porter, "The Politics of Prevention: Anti-Vaccinationism and Public
Health in Nineteenth-Century England," Medical History, 32 (1988), 231-3. Trinidad's law lagged
behind Britain by a decade, as vaccination was not compulsory until Ordinance 8 of 1864. Until
that time, rural residents were vaccinated only during an epidemic. BPP 1865 [c.3423]. Blue Book
for 1863, 31. BPP 1866 [c.3719]. Blue Book for 1864, 73. Smallpox epidemics occurred in 1837,
1849, and 1850. Hart, Trinidad and the Other West India Islands, 198-202.
86 L.O. Inniss, Trinidad and Trinidadians. A Collection ofPapers, Historical, Social and
Descriptive, about Trinidad and its People (Port-of-Spain: Mirror Printing, 1910), 77.
3- "The Mails," The Times, 30 October 1871, 4. "From the London Gazette of Tuesday, Nov.
21," The Times, 22 Nov 1871, 6. ''The Mails," The Times, 28 August 1872, 7. ''Transfer of Infection.
Letter to the Editor," The Times, 15 June 1872, 11.
88 ''The Mails," The Times, 30 October 1871, 4.
89 "Vaccination in Trinidad," British Medical Joumal, 3 April 1886, 652. CO 295-342 (1892)

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 PhD Thesis - L. Jacklin. McMaster - History.

London, which had one of the highest death rates in the England amongst the infected
population.9° Graham Mooney correlated London's high death rate to the haphazard
public health procedures and, in some locations, "blatant disregard" for the vaccination
legislation.91 Trinidadians suffered as a result of the same problems, although they
occurred for different reasons in the colony.

Crane had sixteen years experience as Surgeon-Superintendent aboard the

Colonial Land and Emigration Commission's (CLEC) emigrant ships in the Australian
and Coolie Medical Services, dealing with the most dreaded contagious diseases in the
less than optimum maritime environments. This portion of Crane's career exposed him
to the disease-containment measures instituted by many colonies and countries on the
maritime routes from the Australian colonies through the West Indies to England and
eastward to India. As discussed above (in chapter 3), the CLEC reformed the Imperial
Passengers' Act in an attempt to stop ships from transporting diseased passengers to and
from British ports. Crane garnered significant recognition for his professional abilities
and zealousness in tending to the health of the immigrants during his career as a
Surgeon-Superintendent.9 2 His medical acumen was possibly the reason why the CLEC
recommended him for the job in Trinidad. Crane understood how to contain dreaded
diseases in the challenging shipboard environment during medically perilous ocean
voyages. He would have also experienced, first-hand, the problem of attempting to find a
port amenable to landing a ship filled with passengers stricken by infectious diseases.

Regardless of Crane's experience, Longden and the government relied on the

medical expertise of Dr. R.H. Bakewell, the English gun-wielding medical officer who
Governor Gordon had refused to appoint as Surgeon-General. The Legislative Council
did not share Gordon's negative appraisal of Bakewell and upheld his key positions as
Medical Officer of Health and Vaccinator-General. Contemporaries and historians have
used Bakewell's racist deportment to illustrate the complexity of race relations in the
colony. Donald Wood described the public altercation between Bakewell and Espinet as
the "most outrageous" incident of the era, arguing that the racism at the root of the
struggle made the conflict legendary in its own time.93 Dr. Espinet became the hero in
this legend and Bakewell became an object of ridicule by the Afro-Trinidadians. Lewis
Osborne Inniss pronounced Bakewell a "Negrophobe," noting that everyone in the
community knew who had tarred and feathered the doctor, but that his assailants were
never accused.94 This very public altercation made its way into a local calypso:

#6356. Applicationfor Directorship ofSanitmy Dept. Egypt. 14 Jan 1892, 8.

9° Anne Hardy provided the mortality rates for victims admitted to the isolation hospitals:

13,139 admissions as the epidemic peaked in 1871-72, ''ith an 18.95% mortality rate. Trinidad had

only 800 fe\ver cases in about the same time, which equates to higher infection and mortality

rates per 1,000 population. For London's statistics, see Hardy, Smallpox in London, 134.

9i Graham Mooney, "'A Tissue of the most Flagrant Anomalies': Smallpox Vaccination and

the Centralization of Sanitary Administration in Nineteenth-Century London," Medical History,

1997, 41 (3), 262.

92 Basdeo Mangru, Benevolent Neutrality. Indian Government Policy and Labour

Migration to British Guiana 1854-1884 (Hartfordshire: Hansib, 1989), 124.

93 Donald Wood, Trinidad in Transition. The Years after Slavery (London: Oxford

University Press, 1968), 250-2.

94 Inniss, Trinidad and Trinidadians, 87-8.

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 PhD Thesis - L. Jacklin. McMaster - History.

Bakewell, Bakewell, what is de matter? Tree black man tar Papaf95

Bakewell's racist ideals had a much larger effect than simply being a "most outrageous"
incident, because his official medical actions imperilled the health of the public. Decades
after the 1871-72 epidemic had subsided, the GMS's Dr. Raoul Seheult cryptically alluded
to the disproportionately high mortality rates amongst the Africans.96

Trinidad's haphazard public health measures and the public's rationale to avoid
vaccination can be traced to Bakewell's actions in the community, which also helped to
create an international scandal. Correspondents from Trinidad informed The Times of
their wish for the local Board of Health to bring the epidemic under control swiftly, but
meanwhile doubted its ability to be successful. The Board encountered serious
difficulties in its house-to-house campaign to vaccinate residents.97 On 30 December
1870, while the pandemic made its way through Europe, Vaccinator-General Bakewell
published a report claiming that vaccination was a "useless" preventive measure. He also
blamed vaccinations for the person-to-person transmission of "the most loathsome
diseases," syphilis and leprosy.98 The Times stated that Bakewell's report had excited the
lower classes and caused widespread fear of vaccination.99

Officials had to find ways to surmount many objections to vaccination. In 1867,

an anti-vaccination movement emerged in England. Naomi Williams argued that the
compulsion in the laws remained contentious, as it sacrificed the tenet of individual
rights for the broader good: the health of the community. 100 In Britain's diverse
territories, governments encountered cultural and religious objections to vaccination.
Mark Harrison, for instance, found that authorities in India were sensitive to the local
religious taboos. Consistent with India's reluctance to institute health measures which
could provoke unrest amongst its subjects after the 1857-58 Mutiny/Rebellion, the
government embarked on a program to convince the people of the benefits of voluntary
vaccination during the pandemic, rather than using the law. 101 The resistance also
embodied the pragmatic fear of contracting syphilis. 102 Dorothy Porter and Roy Porter
quantified the veracity of the syphilis fear by demonstrating that England's 1871 Select
Committee on compulsory laws identified only two cases where syphilis had been
transmitted by arm-to-arm vaccination. 10 3 However, as metropolitan doctors disclaimed
the risk of contracting syphilis, Bakewell adopted the contrarian stance and heightened

95 Anthony de Verteuil, Surgery in Trinidad (Port-of-Spain: Litho Press, 1996), 4. Anthony

de Verteuil is a descendant of Dr. Louis de Verteuil and amateur historian. I disagree with his
conclusion that the tarring of Bakewell ended racial discrimination in the medical profession.
96 GMS employed Seheult from 1894 to the 1940s. R. Seheult, "On an Epidemic of Small­
pox of Irregular Type in Trinidad during 1902-4," Proceedings ofthe Royal Society ofMedicine,
1908 (1), 229-302.
97 "The Mails. Letter from Trinidad on the 10th of October," The Times, 30 October 1871, 4.
98 BPP 1873 [c.729] Report on Leprosy and Yaws in the West Indies. Gavin Milroy, 32-7.
99 "The Mails. Letter from Trinidad on the 10th of October," The Times, 30 October 1871, 4.
100
Naomi Williams, "The implementation of compulsory health legislation: infant smallpox
vaccination in England and Wales, 1840-1890," Joumal ofHistorical Geography, 20 (1994), 396.
101
Mark Harrison, Public Health in British India. Anglo-Indian Preventive Medicine 1859­
1914 (New York: Cambridge Univ. Press, 1994), 82-7.
102
Williams, ''The implementation of compulsory health legislation," 396.
10
3 Porter and Porter, ''The Politics of Prevention," 233-4.
 PhD Thesis - L. Jacklin. McMaster - History.

Trinidadians' fears of vaccination. By disclaiming the value of this preventive measure in

his report, Bakewell fuelled the objections of the anti-vaccination contingent, the
religious opposition of Indo-Trinidadians, and the popular Afro-Trinidadian beliefs.

Bakewell's claims also excited the upper ranks and created another racial
controversy. In his December 1870 report to the Trinidadian public, Bakewell insisted
that white persons could not contract leprosy by any means other than vaccination; in
his opinion, the four new cases ofleprosy on the island confirmed that vaccinators had
used the lymph from blacks to infect the upper class whites. 10 4 Bakewell had finally gone
too far, not only by publicly denying the value of vaccination, but by racialising the fear
of disease transmission and the broader white fears of diseased natives. The Colonial
Office, Royal College of Physicians, and several local Creole physicians refuted Bakewell's
allegations and attacked his lack of scientific evidence. 105 Dr. Thomas Murray (Sr.), who
had previously held the post ofVaccinator-General for forty years, rallied the Board of
Health to contradict Bakewell's claims publicly. At Longden's instance, Dr. Louis de
Verteuil waged a media campaign to discredit Bakewell. 106 Britain's Royal College of
Physicians urged the Colonial Office to enforce vaccination to protect the lower classes,
"who are too ignorant to protect themselves," dismissing Bakewell's allegations as
"merely speculative." The Colonial Office then sent a confidential circular to the
governors and chief medical officers in the West Indies, Sierra Leone, Ceylon, and the
Cape of Good Hope, advising them to beware of such erroneous claims. Medical officers
from many colonies responded to the Colonial Office and its emissary to Trinidad, Dr.
Gavin Milroy, discrediting Bakewell's allegations. 10 7

The reading public, parliamentarians, and colonial governments had been

informed that Trinidad's Vaccinator-General did not believe in vaccination and
knowingly attenuated the already tense racial relations with his unsubstantiated claims.
Bakewell was meanwhile preoccupied with verifying Venezuelan Dr. L.D. Beauperthuy's
cure for leprosy, rather than leading the campaign against smallpox expected from the
Medical Officer of Health and Vaccinator-General. 108 Correspondents to The Times
summarized the situation in Trinidad as absurd: "we have the extraordinary spectacle of
the paid Vaccinator-General of the island doing all in his power to discourage the
practice of vaccination, and yet allowed by the Government to retain his offices."10 9 The
colony's economy suffered, 110 while its deficient systems to prevent and contain diseases
became a known problem in the international community.

As the epidemic raged on, colonial decision makers put their trust in their Creole
medical colleagues, pitting Surgeon-General Crane in a battle with two Unofficial

10
4 BPP 1873 [c.729] Report on Leprosy and Yaws, 32-7.

10
s CO 295-259 (1871) #8260. Letter from Royal College ofPhysicians to Secretary ofState,

17 Aug. 1871. CO 295-259 (1871) #6817. Medical Dept. ofPrivy Council to Secretmy ofState, 11

July 1871. BPP 1873 [c.729] Report on Leprosy and Yaws, 32-7.

106
BPP 1873 [c.729] Report on Leprosy and Yaws, 33.

107
BPP 1873 [c.729] Report on Leprosy and Yaws, 33-7, 83-6.

108
Bakewell's support for Beauperthuy's cure prompted the Colonial Office to send Gavin

Milroy to investigate the claims. BPP 1873 [c.729] Report on Leprosy and Yaws.

10
9 "The Mails. Letter from Trinidad on the 10th of October," The Times, 30 October 1871, 4.

110
BPP 1873 [c.709-II] Blue Boakfor 1873, 76.

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 PhD Thesis - L. Jacklin. McMaster - History.

members of the Legislative Council, Dr. Louis de Verteuil and Dr. J.V. de Boissiere. 111
Crane finally marginalised his adversaries by justifying his disease-containment methods
as the lowest-price alternative.11 2 The epidemic had wreaked havoc with government
revenues and the personal fortunes of many in the upper strata of Creole society. The
total bill to deal with the epidemic would later be tallied up at £20,000, suggesting that
the drain on the colony's ailing treasury was an important consideration.113
Uncharacteristically, the government threw its support behind Crane.

Decisive steps had to be taken to regain credibility within the Atlantic

community. The Legislative Council enacted several laws in 1872 vesting the Surgeon­
General with the responsibilities which maritime partners expected to be in effect. These
included the public health functions of Medical Officer of Health and Secretary to the
Board of Health and Quarantine Authority. 11-i The government again mandated the
compulsory vaccination of infants and children and dissolved the Vaccination
Department formerly managed by Bakewell.11s This new expansive role vested the
Surgeon-General's office with the responsibility for many health-related statutory
services, including vaccination and the health concerns created by the maritime traffic.11 6
For these statute obligations, the Surgeon-General thereafter retained the
responsibilities, although it remained questionable, for some time, if the GMS had the
requisite manpower and authority to execute the functions in a meaningful way.

In this instance of a medical disaster reaching epidemic proportions, pressure

from the Colonial Office and the Atlantic community had allowed the Surgeon-General
to win the battle to direct medical matters, but the prognosis for the outcome of the
longer war to execute the necessary measures had not yet been decided. However, the
public health and medical fiasco associated with the epidemic set the process in motion
for extraordinary support from the Imperial world medical profession and the Colonial
Office for the embattled Surgeon-General during future altercations. The Colonial
Office's unusual intervention of sending the renowned Dr. Gavin Milroy to the West
Indies to investigate Bakewell's claims initiated a long-term friendship between Crane
and Milroy, based on their mutual respect of each other's medical prowess.117 In 1880,

111 CO 295-342 (1892) #6356. Application for Directorship, 8. Drs. de Verteuil and Boissiere
held appointments on the Legislative Council. Brereton stated that their ancestors were the
original French nobles in Trinidad. Brereton, Race Relations, 36-7.
112
CO 295-342 (1892) #6356.Applicationfor Directorship, 8.
11
3 EPP 1873 [c.709-II]. Blue Bookfor 1873, 86.
11 4 Ordinance 4of1869 created the Surgeon-General's department. Ordinance 17 of 1872
repealed it and reconstituted the Surgeon-General's duties. Crane later reminisced how the duty
of Medical Officer of Health came about in the midst of the epidemic at Longden's request. CO
295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General. 9 March 1886.
CO 295-274 (1875) #8580 Scheme for Reorganising the Medical Services.
11
s Ordinance 23of1873 abolished the Vaccinator-General office. It made parents
responsible to vaccinate children under age sixteen. It also defined vaccination as a statutory
service provided to the public, through government-appointed district vaccinators. BPP 1873
[c.709-II]. Blue Book for 1873, 79-80. CO 295-342 (1892) #6356. Application for Directorship, 8.
"Vaccination in Trinidad," British Medical Journal, 3 April 1886, 652.
116
CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.
117
When he left Trinidad, Milroy experienced the inconvenience inflicted on the travelling
public who passed through an infected port. After a four-day journey to Dominica, Milroy's ship

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 PhD Thesis - L. Jacklin. McMaster - History.

the Medical Times and Gazette would refer to Milroy's evaluation of Crane as "one of the
ablest practitioners in the West Indies." 118 The Colonial Office staff likewise held Crane's
professional abilities in high esteem, going to extraordinary lengths to support him
during the skirmishes between the Creoles and the GMS in the 188os.119 Nonetheless, it
was not a foregone conclusion that this plantation society would embrace British
preventive public health or address the metropolitan concerns about the health and well­
being of the lower classes. However, the socio-medico landscape would soon change,
with the arrival of the new governor, reform-minded Henry Irving.

Imperialists and the White Man's Medical Burden:

The 1875-76 Reforms to the Government Medical Service.

During the initial five years of Crane's tenure, Trinidad had constructed its medical
services organisation in a form that naturally reflected the traditions and values of Creole
society. The government demonstrated that it could reconsider its involvement in
matters of public health, but it tended to respond to the Atlantic community, rather than
the residents. Despite the changes wrought by the epidemic, Crane indicated that the
colony's poor could only access the services of the GMS medical officers in two or three
districts. 120 The poor needed to make their way to the hospitals in Port-of-Spain or San
Fernando, leaving many ill people to languish in their community. However, Governor
Irving had a different view of the colonial state's responsibility to its subject peoples.
Irving championed the Colonial Office's ideology on the importance of the GMS to the
civilising mission. Although the Colonial Office had a laissez-faire attitude when
Longden aligned with the Creole elite, the staff at Whitehall extended its full support to
the zealous new governor. The Secretary of State and Colonial Office staff would
subsequently attribute the success of Irving's governorship to his ability to resist the
imperatives of Creole society, pronouncing Irving as "one of the few who are wholly
indifferent to local popularity." 121

Irving turned his attention to restructuring the medical service so that it could
deliver on its mandated responsibilities. This new form of the GMS would remain intact
for the next half century, despite the relentless pressure from the Creole elite to change
the contours of the GMS back to its original structure and limited purpose. Crane and
Irving collaboratively reformed the GMS through four major initiatives in 1875-76,
publicly proclaimed to be a centralised structure to curtail the escalating costs and spend
the government's money in a more efficient and effective manner. 122 At the foundation of

was in quarantine for fourteen days because of the smallpox in Trinidad. David F. Clyde, Two

Centuries ofHealth Care in Dominica (Lucknow: Prom Printing, 1980), 80-1.

118 "Observations on Yaws (A Reply to Dr. Gavin Milroy) by Dr. H.A. Alford Nicholls, MD,

Medical Superintendent of the Dominica Yaws Hospitals," Medical Times and Gazette, 10

January 1880, 33.

11
9 This is investigated in Chapter 5.

120 1886 LC #104. Surgeon-General AR, 2. Crane did not specify which districts provided the
GMS services to the poor.
121 CO 295-281 (1878) #13202. Disreputable and inefficient state ofColonial Civil Service.
Minutes.
122 1885 LC #15, Surgeon-General AR, 3.

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 PhD Thesis - L. Jacklin. McMaster - History.

the reforms was the vesting of the Surgeon-General with the accountability and authority
for all health-related operations and expenditures. 123 In this way, the colony now had one
CMO responsible for medical matters and answerable to the Legislative Council's
executive, who were generally career civil servants sent to Trinidad by the Colonial
Office, rather than to the general Legislative Council filled with Creole appointees. 124 This
hierarchical system of accountability dispensed with the duelling medical and non­
medical administrations, placing the Surgeon-General in control of the institutions and
expenditures. 12s Crane appointed senior physicians to manage each facility, delegating
the responsibility for their "good order and management" to the head doctors. 126
Presiding medical officers were accountable for the institution's fiscal and medical
management, according to the new suite of GMS regulations. 127 Crane drew his
inspiration forthis hierarchical model from the Colonial Office's much earlier circular,1 28
which Longden had interpreted in an oppositional fashion to solidify the system of dual
management, now replaced by the reforms instituted by Irving in 1875 and 1876.

The second reform dispensed with the part-time medical officers and the
patronage appointment positions of commuting Medical Visitors of Plantations. The
twenty-one doctors became full-time salaried government employees, altering their
relationship with their employer and, as civil servants, making physicians accountable
for all duties assigned to them. Many doctors in specific functions, such as the DMOs,
retained the privilege of private practice, although the caveat remained that it could not
"interfere" with government duties. 129 The government's prior aversion to hiring doctors
into the civil establishment had cost the colony substantially more in contract fees than it
subsequently paid for doctors on permanent staff. 13°

Crane modeled the structure of the doctors' remuneration on the Indian Medical
Service, which he knew was well-liked by the British medical professionals employed by
the British government in India. This program was designed to compensate doctors

12
3 CO 295-432 (1905) #14856. Government Medical Dept. Enclosure 3 in Trinidad
Despatch #106, 19 April, 1905. Minute by Surgeon-General, 23 February 1905. BPP 1877 [c.1869].
Blue Book for 1876, 48. The Surgeon-General received paramount powers over the institutions
with the revoking of Ordinance 5of1869 forthe Port-of-Spain Hospital, and Ordinance 5of1870
for the San Fernando Hospital. These ordinances were replaced by the new Regulations for the
Colonial Hospital. CO 295-276 (1876) #1195. Return ofmedical appointments under the new
Scheme. Ends.: Regulations for Medical Attendance on the Poor. 1January1876. Regulations for
the Colonial Hospital Port-of-Spain. 31 December 1875.
124 The Executive Council consisted of the governor, Attorney-General, Colonial Secretary,
and the local Commander of Her Majesty's Forces. The Colonial Offi.ce List for 1881, 174. The
sources do not indicate the frequency of executive meetings during Irving's governorship.
However, Brown indicated that the executives rarely met during Gordon's tenure, and then only
to consider measures proposed by Gordon. Brown, "Inter-colonial migration,'' 208 and passim.
12s Crane later reminded the Legislative Council that Ining supported these reforms as a
means to bring the expenditures under control. 1885 LC #15, Surgeon-General AR, 3.
126
CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General.
12 7 1891 LC #46. Surgeon-General AR, 1.
128
CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General.
12
9 CO 295-432 (1905) #14856. Government Medical Dept. Enclosure #3 in Trinidad
Despatch #106, 19 April, 1905. Minute by Surgeon-General, 23 February 1905.
1
3° CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.

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 PhD Thesis - L. Jacklin. McMaster - History.

commensurate with the work they performed. 13 1 It introduced an equitable and

graduated compensation program as a measure to attract and retain physicians for the
medical service. All physicians joined the GMS "on the same footing" in terms of base
remuneration, while salary increments and pensions rewarded doctors for remaining
with the GMS over the years. 13 2 Crane addressed the problems of attracting British­
trained doctors to the colony and the propensity of the Creole elite to make patronage
appointments by formalising a system of career paths for the GMS doctors ..Junior men
worked as supernumerary surgeons at the hospitals during their probationary period,
receiving training from the senior doctors and temporary assignments to replace doctors
who had earned a leave of absence. Doctors showing promise would then be assigned to
increasingly responsible positions, starting in the rural districts, which remained the
least attractive placements due to their locations, "healthiness," responsibilities, and the
low potential for income from private practice. 133 Urban centres offered lucrative
postings for senior doctors, either managing large institutions or working as
metropolitan DMOs. These changes to the method of compensating the doctors had thus
fully inverted the previous structure: rural districts became testing grounds for junior
men, the profitable Medical Visitor appointments ceased to exist, and doctors who
served their time could merit profitable urban postings. Relatively junior doctors now
dispensed the GMS's healthcare services on the estates.

Senior GMS physician, and future Surgeon-General, Dr. James de Wolf believed
this structure allowed the medical service to attract "a desirable class of men." Doctors
now considered their employment in GMS as a career, based on the four mechanisms of
"a fair salary, service increment, prospects of promotion, and pension on retirement." 134
This system set the conditions for government physicians, many of whom were Trinidad­
born men, to join the ranks of the economically secure classes, and for white doctors to
consolidate their position in the upper ranks of Creole society. At the same time, it also
created an environment conducive to the emergence of a sense of occupational
consciousness, as doctors could allow medical considerations to guide their actions, as
opposed to the fear of subjective unemployment.

Civil service employment required DMOs to reside in their assigned districts. In

dispensing with the slavery-era model of Medical Visitors for the plantations, Crane
defined the role and responsibility for the DMOs to be very similar to the function in the
Poor Law Medical Service throughout rural England. 135 Crane set the geographic
boundaries of the districts by estimating the size of the resident population and their
potential health needs. 136 His stated objective was to balance the workloads equitably
1 1
3 CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General..
1 2
3 CO 295-274 (1875) #8580. GMS Reorganisation. Crane to Secretary of State, 4 July 1875.
1
33 CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State. CO 295-432
(1905) #14856. Govemment Medical Dept. Encl. #3 in Trinidad Despatch #106, 19 April, 1905.
Minute by Surgeon-General, 23 February 1905.
1
34 CO 295-432 (1905) #14856. Govemment Medical Dept. Encl. #3 in Trinidad Despatch
#106, 19 April, 1905. Minute by Surgeon-General, 23 February 1905.
1
3s The Poor Law DMO functioned as the key figure in the treatment of the poor in England.
Flinn stated that the districts were defined to ensure that patients and doctors could reasonably
traverse the distance to reach each other. Flinn, Medical Services under the New Poor Law, 49.
1 6
3 DMOs were assigned to twelve rural districts: St. Joseph, Tacarigua, Arima, Mayaro,
Chaguanas, Couva, Point a Pierre, North Naparima, South Naparima, Savanna Grande, Cedros,

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 PhD Thesis - L. Jacklin. McMaster - History.

between the DMOs. The contours of the medical districts thus took into account not only
the number of indentured East Indians, but also the other residents, along with the
distance to be traversed, acknowledging the onerous travel constraints in the rural
districts. 137 Although doctors could not always reach the patients and vice versa, 138 the
organisation of the medical districts attempted to make the GMS services more
accessible to the public at large.

After sorting out the roles and responsibilities of the Surgeon-General and the
GMS doctors, Irving's third reform, enacted on 1 January 1876, defined the conditions by
which the poor and pauper populations received the GMS services.139 This entitlement
had traditionally been implied, but never clearly defined or articulated in public
documents. Published widely as The Regulations for Medical Attendance on the Poor,
the rules thereafter remained remarkably consistent throughout the period of this study,
with only slight alterations in the schedule of fees for the small minority of patients who
paid a token sum for their treatments and medicine. 14° The government deputised
employees and respectable members of Creole society to certify impoverishment and
determine patient entitlements to the GMS healthcare in the absence of a system of Poor
Law officers tasked with determining entitlements. 141 Wardens in each rural district,
Port-of-Spain Medical Officers of Health, and the San Fernando Sanitary Inspector
issued Pauper Certificates entitling destitute persons to receive gratuitous medical
attention and medicines for a period of four weeks. In addition to these civil servants, the
burgesses or respectable ratepayers in the towns or wards could issue a Certificate of
Poverty, which was valid for a two-week period, entitling the bearer to medical attention
and medicines for one shilling apiece, payable in advance. 1 42 Any other people seeking
the services of the GMS doctors were considered private patients. The GMS published a
schedule of the times and places when the doctors attended to Poverty and Pauper
Certificate patients. 143

and Oropouche. CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Sec. of State.

13 7 CO 295-274 (1875) #8580. GMS Reorganisation. Crane to Secretary of State. These

criteria remained in effect when future changes were made to the GMS staffing when the colonial

population increased during the next decade. CO 295-316 (1887) #11453. Observations as to

creation ofnew medical districts.

138 Trotman described the roads as "atrocious" in the rainy season. Trotman, Crime in

Trinidad, 14.

i39 CO 295-276 (1876) #1195. Return ofmedical appointments under the new Scheme. Encl.:

Regulations for Medical Attendance on the Poor. 1January1876.

14° The regulations were reprinted each year in the Trinidad Almanac. See, for instance, The

Trinidad Official and Commercial Register and Almanackfor the year ofour Lord 1883.

14 1 Flinn indicated that the Poor Law Relieving Officer determined entitlements to medical

relief and treatments. Flinn, "Medical Services under the New Poor Law," 49.

1 2
4 The 1876 Regulations did not make provisions for poor patients to buy medicine, nor did

they indicate the length of time during which the certificate was valid. The provision for patients

to purchase low cost medicine was in the regulations by 1882. The two and four week validity

periods were added to the regulations by 1886. The Trinidad Almanack, 1882, 50. The Trinidad

Almanack, 1886, 86-7.

i43 The Port-of-Spain Hospital out-patient clinics treated patients between 11and12 o'clock,

Monday, Wednesday, and Friday. CO 295-276 (1876) #1195· Return ofmedical appointments

under the new Scheme. Encl. Regulations for the Colonial Hospital, Port-of-Spain. Made by the

Governor and Executive Council Under authority of Ordinance No. 18 of 1872. Henry T. Irving,

3is1 December, 1875.

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 PhD Thesis - L. Jacklin. McMaster - History.

The fourth major reform had remarkable staying power over time, plausibly due
to the pathetic state of many patients who presented themselves to the doctors. This
reform was tested by the GMS doctors in Port-of-Spain in 1876. The doctors began
providing a form of medicalised out-door relief to sufferers in this interesting adaptation
of the tenets of preventive medicine. Prior to this time, the colonial state's preventive
medicine had generally been limited to vaccinations. Concurrently, the laws required
boroughs to establish and maintain almshouses, while forbidding them to offer outdoor
relief. 144 However, as discussed above, the two small almshouses were woefully under­
capacity for the needs of the population. The Regulations entitled the poor to receive
medical attendance, but many of the people suffering from morbidities related to
destitution, or perhaps just from the effects of poverty, now had an avenue for non­
monetary relief, albeit very limited in scope. The GMS's new medicalised out-door relief
allowed the poor to obtain medical comforts without being admitted to an institution. 145
This new service resulted from the doctors' recognition of the number of sufferers who
needed attention to their destitute conditions. In the first year, doctors recorded that 566
recipients of medicalised out-door relief would have required institutionalisation under
the previous rules. Within a year, the GMS offered medical relief services throughout the
colony, which rapidly grew in popularity. 1.:i6 There is a remarkable parallel between the
actions of the GMS doctors to provide medical relief and what Flinn characterised as the
"spontaneous" development of medical services within the New Poor Law organisation in
the 184os.1.:i7 The pressing need amongst the inhabitants in both Trinidad and England
stimulated each organisation to provide a form of medical care that was not sanctioned
in the laws. In Trinidad, as in England, the doctors did not possess the resources to
alleviate the endemic destitution at the root of the pervasive manifestation of early stage
maladies, but they attempted to ease the worst of its symptoms in this unique adaptation
of preventive medicine.

By and large, the centralised reforms intended to instil the British idea of
efficiency into the system and furthered Irving's campaign to reconstitute the civil
service on the basis of accountability for job performance.1'18 Irving had no qualms about
enacting reforms striking at the heart of plantocracy control of colonial resources. He
described the reformed medical service to Secretary of State Lord Carnarvon, Henry
Herbert, as one designed to meet the needs of the people, rather than simply placating
the powerful estate proprietors. 149 The Surgeon-General became accountable to the
Executive Council and the non-medical persons had been removed from the decision
making structure. 15° Astute Irving positioned the reorganisation as a quest for efficiency

1
44 Ordinance 13of1852 required Wardens to establish almshouses, although Registrar-
General H. Clarence Bourne remarked in 1897 that this obligation had never been fulfilled in the
colony. Ordinance 10 of 1853 required Boroughs to maintain almshouses, but precluded the
provision of out-door relief. 1897 LC #188. Papers relating to Poor Relief, 4.
1
45 CO 295-279 (1877) #13574. Statements against Dr. Crane, Crane to Colonial Secretary.
1 6
4 CO 295-279 (1877) #13574. Statements against Dr. Crane. Crane to Colonial Secretary.
1 7
4 Flinn, "Medical Senices under the New Poor Law," 49.
14 8 EPP 1877 [c.1869]. Blue Bookfor 1876, 48.
1
49 CO 295-274 (1875) #8580. GMS Reorganisation. Ining to Colonial Seer.
1
5° All four members of the Executive Council were appointed by the Colonial Office,
suggesting their actions would have reflected the Colonial Office position on medical matters.
Executive Council members were the Governor, Colonial Secretary, Attorney-General, and the
Officer in Command oflocal troops. The Trinidad Qffieial and Commercial Almanack, 1882, 27.

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 PhD Thesis - L. Jacklin. McMaster - History.

and effectiveness, which was well-received by his colleagues at the Colonial Office. 151 This
variant of colonial medicine for a plantation society would subsequently be instituted in
other colonies: Irving and the Secretary of State looked so favourably upon the reformed
system that British Guiana would organise its GMS system on the same principles. 152

In terms of the 1875-76 GMS reforms in Trinidad, Irving and Crane had drawn a
definitive line between the patients who were, and were not, the government's
responsibility, but in doing so, inadvertently opened Pandora's Box. For the first time in
this colony, the widely-published Regulations for Medical Attendance on the Poor
definitively declared the government's obligation to the poor. At the same time,
mandating DMOs to reside within their districts situated the medical men closer to their
public, to deliver healthcare to the poor, indentured East Indians, and police, with their
services also being concurrently available to oth~r residents on a fee-for-service basis.
This remained important in the rural areas where the relatively small number of people
who could afford to pay for medical care discouraged private doctors from establishing
practices. 153 The reforms thus attempted to address a multitude of concerns involving the
public's accessibility to western medicine and the lack of poor relief. However, it is
unclear if anyone realised just how many residents would qualify for government
healthcare under the published rules. The number of poor residents legitimately eligible
for gratuitous or low-cost GMS healthcare doubled within a decade, 154 and then
continued to increase each year thereafter.

Conclusions

As Waltraud Ernst predicted, refocusing the investigative lens of colonial medicine to

include the policies and attitudes impinging on the medical landscape enhances our
ability to understand how the racial and class tensions inherent in plantation society
colonialism influenced the development of state medicine. In Trinidad, the process to
institute colonial medicine embodied all the other tensions generated by colonialism,
perhaps in a similar manner to the struggles experienced in other imperial world
plantation societies. Britain's state medicine 'at home' developed within its own
distinctly unique structure, as did Trinidad's GMS. Each government's view of its
obligations to the public and poor was predicated on historically divergent and
incongruous ideologies. Colonialism's inherent tensions heightened in each instance
where metropolitan decision makers and expatriate officials assumed the colony was in
the broadest sense British, when it remained distinctly Creole on matters of public health
and medicine.

In the metropole, the framers of the 1834 Poor Law Amendment Act equated

s
1 1
CO 295-274 (1875) #8580. GMS Reorganisation. Irving to Colonial Seer.

s
1 2
CO 295-313 (1887) #9405. Treatment ofMedical witnesses by chiefjustice. Enclosure

#5. Letter from Acting Surgeon-General B. Pasley. 30 April 1887.

l53 When the lucrative Medical Visitor arrangements shifted to government contracts, there

was no incentive for private doctors to establish practices, because the rural paying patient base

was so small. Laurence, "The Development of Medical Services," 67.

1
54 CO 295-316 (1887) #4669. Report ofCommission on Surgeon-General's Department.
Minutes.

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 PhD Thesis - L. Jacklin. McMaster - History.

poverty with moral failure and introduced measures to deter the poor from seeking
relief, but this principle had been overturned by the mid-186os. Officials recognised that
sickness and poverty often went hand in hand and that the labouring classes needed
relief from the effects of economic cycles. The Metropolitan Poor Law Amendment Act of
1867 removed the stigma from Poor Law medical services and stimulated the
construction of many diverse medical institutions to assist the chronically ill and
geriatric populations, while providing active-care medical treatments to regenerate the
labouring peoples. In Trinidad, the Creole elite never altered its attitudes about the
African population, using the widespread poverty amongst the people as proof of racial
regression into barbarism after emancipation. The mission to civilise the people
continued to be narrowly defined to attempt to force the Africans and Indians to labour
in the plantation estate economy. Paradoxically, plantation society civilisation created
poverty and then blamed the victims for their misfortune.

The Colonial Office did not develop an Imperial strategy or master plan for the
creation of the colonial healthcare systems in the unique environment of a plantation
society. Each colony had a great deal of latitude to organise its GMS. Thus, while officials
in Trinidad decided to implement distinct tiers of healthcare for the public at large and
indentured East Indians, their colleagues in Jamaica organised a single tier system for
their colony. In the absence of detailed studies on how and why each colonial
government structured its GMS system, and the outcome of those decisions, it is not
possible to compare the struggles in Trinidad with the other plantation societies. The
tensions in Trinidad during the 1870s over the form and function of the GMS may have
similarly occurred in other colonies and represented a natural evolution of a new system
of state welfare services.

One consistent pattern characterised the struggles over state medical services in
Trinidad, as the Colonial Office supported the desires of each governor, rather than
encouraging a consistent imperial policy and structure for colonial medical services in
plantation colonies. Within this decade, the governors who ruled Trinidad tended to
overturn the decisions of their predecessor on many fundamental matters of importance
to the organisation of the GMS. The governor wielded extraordinary powers and could
decide to use them. As discussed below (in Chapter 5), these powers were intended to be
a mechanism by which the trusteeship inherent in Crown Colony rule was used to protect
the subject peoples from arbitrary decisions. However, as was evident during Longden's
tenure, the gubernatorial powers could be used to for the opposite purpose. Nonetheless,
while the Colonial Office actively supported the policies of Gordon and Irving, it adopted
a laissez-faire attitude when Longden demonstrated an affinity for the Creole worldview.
Thus, during the first decade of the GMS, the colony's policy often reflected the personal
interests of the reigning governor, rather than a consistent colonial or imperial strategy.

The reformed GMS combined selected structures from the public hospitals and
Poor Law Medical Service in England, the Indian Medical Service, and Trinidadian
traditions, while addressing the unique racial and economic demographics of the lower
orders of free and bonded subject peoples in the colony. This organisation of state
healthcare services was the product of the tensions from both within the colony and the
interconnected network in the Imperial world. The creolisation of colonial medicine thus
occurred as the various elite factions continued to retain different conceptions of the

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 PhD Thesis - L. Jacklin. McMaster - History.

nebulously defined idea that the colony would shoulder the White Man's Burden of
providing medical services to its subject peoples.

The GMS's retention of authority over medical matters and the channelling of
government revenues into the well-being of the poorer classes remained contentious.
During the 1880s, the small Creole upper class periodically devoted remarkable energies
to attempt to regain control of the GMS. The Surgeon-General's ability to deflect those
campaigns depended on his own alliances and the prevailing and often fluid coalitions
between the current governor, Creole elite, and the increasingly socio-economically
secure class of the GMS doctors. Chapter s examines the evolution of state healthcare
during the tumultuous period between 1880 and 1891.

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 PhD Thesis - L. Jacklin. McMaster - History

-Chapter 5­
Imperial Trusteeship and Colonial Healthcare, 1880-1891.

During the 1870s, Trinidad had established the Government Medical Service (GMS)
amidst tensions between the various officials and the Creole elite about the state's
obligation to assist the poor in maintaining their health. During the economically
depressed 1880s, the GMS's costs and patient numbers increased dramatically. The
factions agreed that extreme measures were needed to reduce the costs, but disagreed on
the course of action. Surgeon-General Crane used the tenets of preventive medicine to
justify his demand for the legislators to implement a system of Poor Relief to mitigate the
conditions of poverty causing so many people to need state healthcare. The Legislative
Council rejected Crane's call to expand its commitment to the lower classes and instead
concentrated on the dire effects of the depression on the colony's revenues, attempting to
reduce healthcare spending, in 1887 and again in 1891. On both occasions, Governor
William Robinson's requests for the Colonial Office to sanction the legislation arrived in
Whitehall at the same time that Crane appeared in person to plead his case on behalf of
the people. In contrast to the normal collaborative relations between the Creole elite and
the British officials on government matters, the struggles over state healthcare and relief
forced the Colonial Office to exercise its infrequently used constitutional powers of
trusteeship and intervene into the disputes.

This chapter begins by reviewing the perspectives of historians and

contemporaries on Crown Colony rule in Trinidad, which was predicated on the principle
of trusteeship, wherein the governor and Colonial Office retained the power to abrogate
colonial decisions to protect the imperial subjects from arbitrary rule. However, this
power was rarely exercised, suggesting the unusual nature of the Colonial Office's
interventions into the colonial disputes regarding state healthcare and Poor Relief. This
study then establishes the connection between the economic depression and the demand
by the public for state assistance. The Regulations for Medical Attendance on the Poor
clarified the public's entitlement to healthcare services and the people exercised their
privilege with a vengeance: thousands of impoverished sufferers flocked to the urban
centres seeking medical care each year. Although the Legislative Council refused to adopt
preventive health and Poor Relief measures to reduce the number of GMS patients, in
1886-87 it agreed to construct a network of district hospitals to situate the remedial
medical care services closer to the rural population. Rather disingenuously, the
legislators sought Colonial Office approval to build the hospitals at the same time that
they launched their first attempt to retract the size of the GMS. This confused the
Colonial Office. Nonetheless, Whitehall did not intervene until pushed to act by some of
its sojourning officials and Trinidad's disgruntled Creole elite. This chapter concludes
with an analysis of these unusual interventions into Trinidad's medical affairs in 1886-87
and 1891, when Whitehall was forced to exercise its powers of trusteeship.

These local disputes over state healthcare and relief occurred in tandem with the
struggles of another career civil servant, Chief Justice John Gorrie. Bridget Brereton
explained the tensions caused by Gorrie's crusade to reform the justice system between
1886 and 1892: "Gorrie's unforgivable sin, in the eyes of the planter-merchant
community, was to administer justice impartially and to reform judicial proceedings in

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 PhD Thesis - L. Jacklin. McMaster - History

order to open up the courts to working-class suitors." 1 There are remarkable parallels
between the actions of Gorrie and Surgeon-General Crane. Both men campaigned on
behalf of the same population of poor African and East Indian subjects, believing that the
civilising mission obligated the colony to provide the people with British justice and
western medical services. The Creole elite vigorously attempted to marginalise Crane and
Gorrie. Brereton's chronicle of Gorrie's tumultuous time revamping the justice system is
periodically juxtaposed alongside this analysis of the controversies over state healthcare
and Poor Relief. In both instances, the Colonial Office reluctantly interceded to stop the
turmoil in the colony, albeit with different outcomes for each crusader. In 1887 and late
1891, the Colonial Office dictated that the GMS would remain intact and reinforced
Crane's authority. In early 1892, the Colonial Office's Select Committee ruled against
Gorrie and he was recalled to England. In losing the battle over the state healthcare, the
Creoles learned a valuable lesson on how to manipulate the Colonial Office's infrequent
interventions, allowing them to triumph over Gorrie. Trusteeship remained a fluid and
malleable entity in the imperialist project; Crane and Gorrie's struggles shaped the
course of history in this corner of the imperial world, momentarily, in as much as their
experiences in the Empire shaped their worldviews on colonialism.

Trusteeship and Crown Colony Rule

While Britain's civilising mission is commonly associated with the imperial attitudes
about the non-white subject peoples, British officials also believed that they needed to
manage their inherited populations of white Creole elites. Britain initially imposed
Crown Colony rule on Trinidad to minimize the potential for an independent legislature
run by the Creole elite to make any embarrassing decisions during the abolition of
slavery. 2 Trinidad remained a Crown Colony from 1831until1924. During this time, the
Colonial Office insisted that Britons needed to rule the colony to protect the African and
East Indian subjects from the actions of the self-interested and untrustworthy white
oligarchy.3 Direct rule did not simply allow the Crown to intervene, but obligated the
trustees to abrogate any troublesome colonial initiatives. However, post-colonial
historians have emphatically critiqued the rhetoric of Crown Colony rule and questioned
the efficacy of the trusteeship in their quests to explain the legacies of colonialism in
Trinidad.4 The Colonial Office rarely ever curtailed the actions of the reigning governor

Bridget Brereton, Race Relations in Colonial Trinidad 1870-1900 (Cambridge:

Cambridge University Press, 1979), 28. Bridget Brereton, Law, Justice and Empire. The Colonial
Career ofJohn Gorrie 1829-1892 (Jamaica: Univ. of West Indies Press, 1997), 227-314.
2
Hewan Craig, The Legislative Council ofTrinidad and Tobago (London: Faber & Faber,
1951), 16-17.
3 H.A. Will, "Problems of Constitutional Reform in Jamaica, Mauritius and Trinidad, 1880­
1895," The English Historical Review, 81, 321 (1966): 715. These sentiments were articulated by
many British officials, well into the twentieth century, including Colonial Secretary Hugh Clifford
in 1905, and Under Secretary of State for the Colonies E.F.L Wood in 1922. CO 295-435 (1905).
#17402 Colour Question in Trinidad. Memorandum on the E:dsting Condition ofRace-Feeling in
the Island ofTrinidad. Hugh Clifford to C.P. Lucas. BPP 1922 [cmd.1679]. Report by the
Honourable E.F.L. Wood, MP (Parliamentary Under Secretary ofState for the Colonies) on his
Visit to the West Indies and British Guiana, 7.
4 Brereton, Race Relations. Brereton, Law, Justice and Empire. David Vincent Trotman,
Crime in Trinidad. Conflict and Control in a Plantation Society 1838-1900 (Knoxville: University

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 PhD Thesis - L. Jacklin. McMaster - History

and usually sanctioned any resolution put forth jointly by the governor and Legislative
Council.s The senior imperial trustees, the governor and Colonial Office, thus tended to
collaborate with the Creole elite, rendering Whitehall's interventions into the intra­
colonial struggles over the GMS as anomalous events. On both occasions, in 1886-87 and
1891, the Colonial Office overrode the unanimous decision of Governor Robinson and the
Creole legislators at the behest of Surgeon-General Crane, when he demanded that
Whitehall act on its obligation to mitigate the conditions of its poor subjects.

Although Whig historian Hewan Craig argued that Trinidad's governor

functioned as an "impartial authority" protecting the interests of all sectors of society, in
the wake of decolonisation, historians vigorously attacked the rhetoric of impartiality. 6
Their analyses established the powerful alliances between the Creole elite and various
British officials over the years. In his 1972 study of race and nationalism in Trinidad,
Selwyn Ryan introduced that the Creoles and Colonial Office officials shared similar
economic objectives. These powerful men often acted in unison to pressure the governor
to implement policies privileging the planter-merchant community.? Brereton's 1979
analysis of the troubled race relations argued for the inherent power in these alliances:

It was the great myth of Crown Colony government that Governors and officials
were impartial administrators, and at the same time, the special protectors of the
poor. The Crown was the representative of the unrepresented masses; hence the
need to keep power and responsibility in the hands of the Governor. 8

The influential Creoles elites in the British West Indies mastered the art of drawing
sojourning British officials into their society. Patrick Bryan and Howard Johnson have
both argued that the white Creole plantocracies had great success convincing "open­
minded" officials to adopt their racist attitudes.9 For Trinidad, David Trotman and
Brereton stressed that this worldview continued to be framed by the traditions of slavery
and plantation society. 10 To Trotman, the governor had to "rise above the insidious
racism" at the root of the system, while Brereton doubted that many governors had the
strength to oppose the powerful Creoles. 11 Thus, while Crown Colony rule professed to
protect the people, historians agree that it more often protected the interests of major
stakeholders, as the Creoles and Britons cooperated and collaborated in an environment

of Tennessee Press, 1986). Dennison Moore, Origins and Development ofRacial Ideology in
Trinidad. The Black View ofthe East Indian (Canada: NYCAN, 1995). Selwyn D. Ryan, Race and
Nationalism in Trinidad and Tobago: a study ofdecolonization in a Multiracial Society
(Toronto: University of Toronto Press, 1972).

s Brereton, Race Relations, 27. Brereton argued that, on matters of finance, the Colonial

Office usually supported the wishes of the Creoles, because these men represented the colony's

wealthy class. Craig, The Legislative Council, 17. Moore, Racial Ideology in Trinidad, 146.

6 Craig, The Legislative Council, 26.

7 Ryan, Race and Nationalism, 18.

s Brereton, Race Relations, 25.

9 Patrick Bryan, "The White Minority in Jamaica at the end of the Nineteenth Century," in

Howard Johnson and Karl Watson (eds.), The White Minority in the Caribbean, (New Jersey:

Markus Wiener, 1998), 129. Howard Johnson, "Introduction," in Howard Johnson and Karl

Watson (eds.), The White Minority in the Caribbean, (New Jersey: Markus Wiener, 1998), xv.

10
Brereton, Race Relations, 24-6, 35-6. Trotman, Crime in Trinidad, 35-69.

11
Trotman, Crime in Trinidad, 32-3. Brereton, Race Relations, 24-6, 35-6.

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 PhD Thesis - L. Jacklin. McMaster - History

that perpetuated racial inequality and economic exploitation.

Several governors publicly acknowledged the significant demands exerted by

Trinidadian Creole society to acculturate to the dominant local values and influences. In
his testimony to the 1909 Sanderson Commission, Arthur Hamilton Gordon, Lord
Stanmore, reflected on the troubled times in Trinidad after his departure in 1870. He
criticised the weakness of governors who bowed to the wishes of the dominant
establishment, imperilling the equality and impartiality of British rule. Stanmore
described the "great danger" of powerful plantocracies ruling unchecked in pursuit of
their own interests, when "cowardly" Britons aligned with them, rather than exhibiting
the moral fortitude necessary to curtail those tendencies. 12

In his memoirs, G. William Des Voeux expounded on the pressure to conform to

the values of Creole society during his tenure as acting governor in 1877-78. He arrived
in Trinidad shortly after his testimony to the Royal Commission had substantiated the
widespread abuse of indentured Indians by British Guiana's planters. 13 Des Voeux
complained of the "frigid" reception by the Creoles and their attempts to undermine his
official status, viewing the strong extant relationships as an important reason why
Whitehall needed to appoint impartial non-Trinidadians to rule. 14 At the same time, Des
Voeux acknowledged that his tenure had been bearable only because of the excellent
social life, which pushed him to the brink of financial ruin from entertaining the
influential colonists and official visitors. Des Voeux claimed to balance his social
priorities with impartiality on governmental matters, rather than allowing the governor's
neutrality to become subordinate to the pressures exerted by the influential
Trinidadians. 1s Des Voeux described the unending social activities with charming and
intelligent gentlemen, such as Dr. Crane, as some of the most pleasant in his entire
colonial career. 16 Donald Wood juxtaposed Des Voeux hosting the elite at his posh roller
skating party at Government House alongside the entertainments of children from the
lower ranks, where the "bare-footed urchins" played in abysmally filthy streets in the
slums.17 Certainly, Des Voeux and other officials believed that their residencies could
become insufferable if ostracised from elite society. Roller skating with the rich would
always be preferable to the entertainments offered by the other classes.

Some British expatriates periodically personified the ethos of trusteeship and

challenged the entrenched status quo. As argued above (in Chapter 4), Arthur Gordon
and Henry Irving used their gubernatorial powers to negotiate their medical and health
12
BPP 1910 [cd.5193]. Report ofthe Committee on Emigration from India to the Crown
Colonies and Protectorates. Part II. Minutes ofEvidence, 346-53.
1
3 BPP 1871 [c.393], Report ofthe Commissioners Appointed to Enquire into the Treatment
ofImmigrants in British Guiana, 1-15. On 25 December 1869, Des Voeux wrote a complaint to
the Earl of Granville, alleging mistreatment of indentured East Indians in British Guiana, which
initiated a lengthy formal investigation. Many of Des Voeux's allegations were confirmed.
1
4 G. William Des Voeux, My Colonial Service in British Guiana, St. Lucia, Trinidad, Fiji,
Australia, Newfoundland, and Hong Kong with Interludes (London: John Murray, 1903), 293-7,
304, 310.
1
s Des Voeux, My Colonial Service, 297, 304, 310, 318-19.
1
6 Des Voeux, My Colonial Service, 307.
1
7 Donald Wood, Trinidad in Transition. The Years after Slavery (London: Oxford
University Press, 1968), 298.

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 PhD Thesis - L. Jacklin. McMaster - History

reforms, despite the local opposition. Trotman argued that officials had to possess
"exceptional qualities" to attempt the "herculean task of defying both implicit ideology
and explicit social and economic power in order to protect the powerless."18 This was
certainly true for any reforms contemplated for public health or justice for the people.
Brereton introduced Sir John Gorrie as one of these officials: "British imperialism threw
up from time to time men like Gorrie, maverick officials who tried to serve the interests
of the 'subject peoples' and to make a reality of the trusteeship doctrine." 19 Gorrie's
reforms on behalf of society's disadvantaged had encountered significant opposition
from the local Creole plantocracy in each of his colonial postings. 20 In Mauritius, from
1869 to 1876, the powerful Creoles considered Gorrie "Public Enemy Number Two,"
surpassed only by his reform-minded leader, Governor Arthur Gordon. 21 Brereton
summarized Gorrie's career as an untiring mission to champion the cause of plantation
society's lower orders. His reforms "inspired both bitter opposition from colonial elites
and intense admiration from the 'subject races' in each place where he served." 22 As a
careering civil servant, Gorrie's worldview was shaped by his colonial sojourns and
influential in redefining the contours of justice in the colonies where he served.

Gorrie's personal and professional motivations undoubtedly inspired Crane.

However, a senior administrator had difficulty introducing contentious reforms without
strong executive support. Crane had traditionally remained in the shadow of the ruling
governor, but, as argued below, surfaced as a vocal critic in his own right at the time
when Gorrie arrived in the colony. The plight of the destitute patients who sought
medical care from the government doctors every day provided Crane with a potent
reason to agitate to change the widespread suffering in the colony. The trusteeship
inherent in Crown Colony rule endowed the governor with significant powers to deal
with the situations arising when disharmony prevailed. As will be shown, the individual
crusades waged by the Chief Justice and Surgeon-General challenged the status quo
during Robinson's reign, rendering his governorship a chaotic period. The failure of the
trusteeship model then became an imperial issue, necessitating that the Colonial Office
exercise its power to intervene to protect the subject peoples. These struggles came to the
forefront during the latter part of the decade, when the economic depression heightened
the adverse conditions of the colony's endemically poor people, with definite
repercussions for their health and well-being.

Ailing King Sugar: The Economic Context ofIllness

Plantation colonies were structured to allow the small white elite to retain the wealth
generated by exploiting the labour of its non-white subject peoples, although wealth
creation was often fleeting during the nineteenth century. The numerous changes in the
global sugar markets wreaked havoc with the economies of the plantation societies and

1
s Trotman, Crime in Trinidad, 32-3.
1
9 Brereton, Law, Justice and Empire, xi-xii.
20
Gorrie's colonial assignments included Jamaica (1865-68) in the wake of the Morant Bay
uprising, and Mauritius (1869-76) and Fiji (1876-82) with Governor Gordon, and then the

Leeward Islands (1883-86) and Trinidad and Tobago (1886-92).

21
Brereton, Law, Justice and Empire, 88-9.

22
Brereton, Law, Justice and Empire, xi-xii.

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 PhD Thesis - L. Jacklin. McMaster - History

caused another major recession between 1884 and 1902. 2 3 The severe situation in the
West Indies became an imperial problem. In 1897, the West India Royal Commission
concluded that the crisis was immense and the sugar industry faced certain "extinction"
in many colonies: several colonies could no longer afford the costs to administer their
governments. The commissioners cautioned that these problems would amplify the
suffering of the labouring classes, especially as many colonies did not have the money to
provide any form of relief to the large numbers of poor people. They warned the
governments to refrain from attempting to resuscitate their failing treasuries by
introducing new taxes that heightened the distress amongst the poor. 2 4

Trinidad's recurring economic crises feature prominently in the literature.

Scholars have demonstrated that the plantation economy was purposefully organised to
promote endemic impoverishment amongst the lower classes. 2 s Trotman identified
systemic deficiencies and vulnerabilities, ranging from crop failures and natural
disasters to the "boom-and-bust cycles" of export markets. He correlated the crises to the
high rates of crime, while considering how they affected the masses of people who
existed on the margins of society. Trotman argued that the plantation economy created
an adverse quality of life, because the people who profited the most in times of prosperity
did little to mitigate the effects of cyclical and endemic dearth amongst the public at
large, allowing pathetic living conditions to prevail. The Creoles remained disinterested
in improving the GMS or any other services for the public, except for the apparatus of
law enforcement and punishment. Trotman summarized life in Trinidad as short and
"nasty."26 Kelvin Singh concurred and described the continued harsh conditions oflife,
to 1945. Singh argued that the elite consistently refused to recognize poverty as the cause
of the physical deterioration and high rates of sickness of the lower classes. The
prosperous tended to blame the victims for their misfortune, which Singh considered
was a trope to justify the long-standing policies to suppress wages. Officials investigating
the socio-economic conditions identified that subsistence diets and malnutrition
contributed to the adverse conditions of a generally unhealthy population, symbolising
the effects of a society rife with poverty and unemployment. 2 7

During the 1880s, Trinidadians suffered immensely from the economic turmoil
which would eventually culminate in the Imperial government's intervention with the
1897West India Royal Commission. Trotman found this to be a time of high
unemployment, wage reductions, and employers defaulting on wage payments. 28 In
August 1886, Governor Robinson appointed Chief Justice John Gorrie to chair
Trinidad's Trade and Taxes Commission, tasking the committee to recommend how to

2
3 Colonies in the British West Indies suffered from the effects of foreign competition by

producers of bounty-fed beet sugar and protective tariffs on cane sugar by foreign countries. BPP

1898 [c.8655] Report ofthe West India Royal Commission, 69.

2
4 BPP 1898 [c.8655] Report ofthe West India Royal Commission, 69. BPP 1898 [c.8657]

Report of the West India Royal Commission. Appendix C.

2
s Trotman, Crime in Trinidad, 103-4. Kelvin Singh, Race and Class Struggles in a Colonial

State. Trinidad 1917-1945 (Jamaica: University of West Indies Press, 1994), 36. Brereton, Law,

Justice and Empire, 325.

2
6 Trotman, Crime in Trinidad, 103-4, 146-56.

2
7 Singh, Race and Class Struggles, 36, 114-15.
2s Trotman, Crime in Trinidad, 105-6.

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 PhD Thesis - L. Jacklin. McMaster - History

increase trade and decrease the local cost of living. 2 9 Trinidad's revenues depended on
high duties on agricultural exports and imports. The highly taxed imported food
products and commercial goods made the cost of living 30% higher than other Caribbean
colonies.3° Robinson stressed the importance of lowering food prices. He was concerned
about the health of the labouring classes: "this is no small question when it is
remembered how such a change would affect our hospitals, poor houses and asylums."
Robinson directed the commission to find a way to help the people afford the
"necessaries oflife."3 1 Gorrie's recommendation to abolish import duties would have
reduced the cost of living, by exempting food and staple products from the high taxes.3 2

Incensed by Gorrie's proposal, planters and merchants circumvented Robinson

and petitioned the Colonial Office, insisting that, "the lower classes were prosperous and
well able to bear indirect taxes in the form of duties on imported food and other
necessities."33 H.A. Will stated that Whitehall indicated that the Legislative Council was
"'unmanageable"' on the proposal to eliminate the taxes on food. The government's
actions on this and several other matters caused the Colonial Office staff to decline
Trinidad's requests for constitutional reform, because they recognised that Whitehall
had to retain the power to veto legislation passed by Trinidad's Council.34 However, the
Colonial Office could have passed the necessary legislation to abolish the duties, but this
did not happen.3s Thus, as Gorrie and Robinson insisted that the people were suffering,
the influential Creoles disclaimed this assertion, and the Colonial Office retained its non­
interventionist tradition. The Legislative Council increased the import duties.

Destitution sent far too many people to the GMS. Institutions operated beyond
their patient capacities: doctors stuffed people in every available nook and cranny.36
Residents used the GMS services at a startling rate. By the 1891 census, the primary tier
for the public at large treated 47,162 patients annually:37 15,422 in hospitals, 30,768 out­
2
9 Brereton, Law, Justice and Empire, 241-2.
3° 1892 LC # 12. Despatch from Secretary ofState respecting Expenditure on Medical
Establishment and Institutions. Minutes of discussion, 2.
31 1887 LC #8. Report ofCommission on Trade and Taxes. Minute by Governor. Trade and
Taxes Commission, Trinidad. 1886. (Port-of-Spain: Government Printer, 1886).
32 Brereton, Law, Justice and Empire, 241-2.
33 The Colonial Office's C. Alexander Harris, Secretary to the West Indies Committee,
discounted the petitioner's claim that they represented a broad sector, recognizing that the 1,952
signatories were planters and merchants. Brereton, Law, Justice and Empire, 241-2.
34 Will made this argument in the context of his review of the Colonial Office's response to
the agitation for constitutional reform in Jamaica, Mauritius, and Trinidad. Other than
establishing the Finance Committee in 1885, no other changes were granted to Trinidad during
the period of Will's study (1880 to 1895). Will, "Problems of Constitutional Reform," 694, 715.
3s Will argued that the Colonial Office insisted on keeping Trinidad as a Crown Colony, so
that it could veto local laws and institute its own legislation if necessary. Will, "Problems of
Constitutional Reform," 715. It is indeterminate if the Colonial Office contemplated using its
powers to abolish the duties. Robinson and Gorrie would have plausibly supported the decision.
36 1885 LC #15, Surgeon-General AR, 3-4.
37 GMS reported its usage statistics by patients. The 15,422 in-patients represented the
number of admissions to the institutions. However, the out-patient numbers may not have been
exact. The Regulations for Medical Attendance on the Poor allowed certificate patients to use the
GMS for a two or four week period. The Regulations did not specify that each family member
required a certificate; assumedly a parent would bring several children to the doctor at one time.

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 PhD Thesis - L. Jacklin. McMaster - History

patients, plus 467 lunatics, 253 lepers, and 252 paupers in the House of Refuge.3 8 This
large volume of patients is remarkable in relation to the total population: the GMS
treated between 25% and 29% of Trinidad's residents in 1891.39 Innumerable other
people used indigenous healers, Obeah, and private physicians, but these encounters in
the private sector are not documented in the records of colonialism. The breadth of
impoverishment amongst the government's patients remained notable, with about 80%
(just over 37,000 people) qualifying for Pauper or Poverty Certificates according to The
Regulations for Medical Attendance on the Poor.4° In other words, the GMS treated
more than one-sixth of the residents as paupers during the year. One of Brereton's early
essays characterised the indentured East Indian sector as "a sick one."4 1 In that about
25% of the non-indentured population received healthcare within the public tier,
arguably Trinidad's public at large was sickly too, as well as impoverished.

Surgeon-General Crane used statistics on per capita hospital treatments to

compare the health of his residents to those in the metropolis. In London, 2.74 per 1,000
population obtained treatments as out-patients, while Trinidad's rate was an astounding
150, suggesting that many Londoners possessed the resources to engage private
physicians and avoid hospital clinics much better than the Trinidadians. The contrast for
in-patient treatments was similarly striking. London admitted 18.2 per 1,000 population,
while Trinidad admitted 62.9.4 2 Crane's statistics suggest a remarkable differential in the
health of the Trinidadians and the personal resources that they could devote to maintain
it. With almost three and a half times as many patients needing institutional assistance
in this colony, the GMS's resources remained perpetually strained and the hospitals were
continually plagued by overcrowded conditions.43

The onslaught of patients seeking GMS assistance drew the doctors into the
broader struggle between the British officials and the Creole elite, especially as the
Legislative Council constantly criticised the GMS about the overcrowded conditions of
the hospitals and the high institutional mortality rates.44 Doctors reflexively defended

38 1892 LC #113, Surgeon-General AR, 7-8, 11, 13-14.

39 The 1891 census enumerated 200,028 residents. All 10,782 indentured East Indians
received treatments during the year, along with 47,162 people from the public at large. Using a
mean annual population of 202,587 (from Appendix 2.2), GMS treated 28.6% of all residents. If
the indentured Indians are excluded, because they were compelled by law to be treated by the
doctors, the number of voluntary patients is high: GMS treated 24.6% of the public during the
year. Census of the Colony ofTrinidad, 1891 (Port-of-Spain: Government Printer, 1892).
4° 1892 LC #113, Surgeon-General AR, 7-8.
41 Bridget Brereton, "The Experience of Indentureship, 1845-1917," in John LaGuerre (ed,),
Calcutta to Caroni. The East Indians ofTrinidad (Trinidad: Longman Group, 1974), 31.
42 1892 LC #113. Surgeon-General AR, 7-8. Crane's statistics on London were obtained
from Burdett's Hospital Annual. This lengthy annual digest published extensive statistics on
hospital finances, patient treatments, and major trends in public, private, and Poor Law
institutions in the United Kingdom, the colonies, and the United States. Data of this nature
allowed Crane to make these comparisons. See, for instance, Henry C. Burdett, Burdett's Hospital
and Charities Annual 1895 (London: Scientific Press, 1896).
43 The overcrowding in the hospitals remained a problem throughout the period of this
study. Wood noted overcrowding as early as the 1860s. Wood, Trinidad in Transition, 29.
44 The Surgeon-General's annual reports summarised the admissions, overcrowding, and
mortality rates. However, for the approximately 31,000 out-patients each year, the reports do not

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 PhD Thesis - L. Jacklin. McMaster - History

their professional abilities and attributed the problems to the lack of political will to
address the conditions that created such a large patient population. This decade's
significant advances in medical knowledge, such as the germ theory of disease,
reinforced what doctors had known all along: ailments caused by deprivation needed to
be arrested before those cases progressed to the state where sufferers needed
institutional care. The doctors connected the patients' inability to obtain relief to the
increasing demands for medical care. "Destitution and sickness," Crane insisted, "follow
so quickly one upon the other that measures for their relief have to be considered
together."4s The GMS doctors knew that the hospital conditions facilitated the spread of
disease, increased the mortality rates, compromised the patients' medical conditions,
and increased the average length of stay by about 25%.4 6 Patients spent an average of 41
days in the hospitals.47 In effect, the physicians were fighting for the adoption of an
earlier corpus of preventive public health knowledge, which had long since been accepted
in the metropolitan hospitals and schools where they had trained.

The embattled doctors also faced criticisms from the Legislative Council over the
escalating expenditures. Crane reminded the legislators of the inherent economy in the
per capita cost of patient treatments, but argued that the expenditures would continue to
increase until residents could access earlier forms of relief. 48 The Regulations for
Medical Attendance on the Poor had clarified the public's entitlement to the services and
the decade's economic troubles caused more residents to exercise their claim. The
number of in-house patients doubled during the decade.49 The new system of hospital
management constituted by the 1875-76 reforms had resulted in a 15% decrease in the
per capita cost of maintaining in-house patients, while the quality and quantity of the
food, medical supplies, and clothing improved, at the same time that the GMS equipped
the facilities to the current British standards.so Nonetheless, the doctors did not receive
accolades for their efforts to treat the patients by more cost-effective means; the
Legislative Council wanted and needed to spend less on GMS healthcare, while critiquing
the institutional overcrowding and high mortality rates. The medical landscape in the
colony had become untenable for all parties by the middle of the decade.

Crusading on Behalfofthe Poor:

Surgeon-General Crane and Chief Justice Gorrie

Chief Justice John Gorrie arrived in Trinidad in 1886 and immediately embarked on his

indicate how many people were refused hospital admission because of the lack of facilities. Crane

confirmed that the GMS doctors did not maintain statistics of this nature. CO 295-279 (1877)

#13574. Statements against Dr. Crane and the mortality at the Colonial Hospital. Crane to

Colonial Secretary, 26 October 1877.

45 1885 LC #15, Surgeon-General AR, 2.

46 1882 LC [unnumbered], Surgeon-GeneralARfor 1881, 1.

47 1886 LC #7, Report by the Surgeon-General suggesting a scheme ofout-door Poor
Relief
48 1885 LC #15, Surgeon-General AR, 3.
49 CO 295-316 (1887) #4669. Report ofCommission. Minutes.
5o 1885 LC #15, Surgeon-General AR, 3, 7. The Colonial Office acknowledged the positive
results of the 1875-76 reforms that had vested the Surgeon-General with financial control. CO
295-316 (1887) #4669. Report ofCommission. Minutes.

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 PhD Thesis - L. Jacklin. McMaster - History

crusade to rebalance the scales of justice, opposing the upper ranks of Creole society at
every step along the way. The elite decided that Gorrie posed a serious threat to their
traditional control over Trinidad's society and economy.51 Brereton's conclusion
encapsulates the complexity of the racial tensions and the struggles of the handful of
officials who challenged the status quo in Crown Colonies .

... these Caribbean islands were long-settled communities composed mainly of

the descendants of slaves and slaveowners [sic], with entrenched white elites who
cherished racist traditions and had influential allies in Britain. Gorrie's belief in
equality before the law and his willingness to defy the opinions and values of the
local oligarchs generated strong and persistent opposition ... 52

Although the majority of the officials employed by the Colonial Office executed their
duties in an unremarkable manner, a handful of these men periodically created
substantial controversy during their imperial careers. In Trinidad, it was unusual to have
two reform-minded officials in the colony at the same time. Concurrent with Gorrie's
arrival, Crane increasingly elevated the question of the state's legal obligations to its
subjects to the forefront, demanding that the legislators act to relieve the ubiquitous
poverty causing so many people to need the GMS services. Crane and Gorrie acted on
their personal interpretation of their obligations as trustees of British rule. However, the
Chief Justice had the authority to dispense British justice as he wished, while the
Surgeon-General needed to solicit Legislative Council approval for his reforms.

In February 1886, Crane submitted a proposal to the Legislative Council to create

a system of out-door Poor Relief. He wanted the government to take action on the
symptomatic destitution that fostered the epidemiology of so many ailments, which
could have been prevented, but instead sent so many people to the GMS.53 Each district
would create a Poor Relief Board, staffed by a large employer of labour and existing
government officers, including the local Warden, Stipendiary Magistrate, and District
Medical Officer. The boards would dispense relief according to the English system,
subjecting the able-bodied poor to a labour test to ascertain their entitlement. The
government would arrange employment, at reduced wages, for the people who were
capable of performing manual labour, but unable to find work.54 This proposed system of
out-door workfare would have raised an important question in this plantation society:
why would Trinidad need indentured migration if the government put able-bodied
unemployed people to work on public works projects? The 'less-eligibility' wage rate
would have been the below-subsistence earnings paid to indentured East Indians, which
the free residents refused to accept.

Crane was unable to forge the necessary alliances and muster political support for
his contentious proposal to reduce the number of GMS patients by providing economic
relief. Crane's public statements began to reference Britain's statutes, arguing that the
authorities were legally obligated to address the conditions of the poor, because the

51 Brereton, Law, Justice and Empire, xvii.

52 Brereton, Law, Justice and Empire, 319-20.
53 1886 LC #104, Surgeon-General AR, 13. 1886 LC #7, ReliefofPoor.
54 As with the British precedents, the proposed system delineated between the infirm and
able-bodied. 1886 LC #7, ReliefofPoor.

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 PhD Thesis - L. Jacklin. McMaster - History

principles of the 1601 Elizabethan Poor Laws (as amended over time) applied to a colony
ruled by British laws. Crane insisted that the laws "established the principles 'that the
impotent poor have a claim to be maintained at the public expense, and that the able­
bodied poor have a claim to be employed by the public,' principles recognized down to
this day." It was the government's "manifest duty" to provide for the poor.ss The enabling
statutes were in place to allow the government to offer relief, but the urban and rural
wards refused to assist their destitute residents.s 6 The government's position was clear
through its inaction: it did not have an obligation to institute relief. Crane failed in his
quest to position the government's inaction on Poor Relief as a contravention of British
law. He then resorted to insulting the elite self-conception of the superiority of Creole
civilisation.57 The Surgeon-General's ill-fated attempt to interpret the law and his affront
to the upper class did little to further his cause. Crane clearly had no suasion over the
decision makers, but needed their support.

The elite would not imperil its system of indentured labour, nor would it accept
any responsibility for non-indentured residents. Legislators ignored Crane's proposal. A
year later, Robinson resuscitated the plan. He traced the high costs at the hospitals to the
absence of out-door relief.s8 Robinson blamed Port-of-Spain's town council for failing to
provide relief and refusing to expand its "miserably inadequate" almshouse.s9 The time
was at hand for the government to "make some provision for the sick and destitute
poor." Robinson justified the plan as an initiative to reduce costs. An expenditure of
£2,000 could either treat eighty-seven hospital in-patients or provide 263 people with
out-door relief in food, clothing, and medical comforts. 60 Robinson encouraged the
legislators to implement the system of relief, but they ignored his suggestion.

Finally, in 1890, Robinson used his authority to enact an ordinance to implement

the system and create local boards in each district. 61 The boards disregarded Robinson's
orders. 62 Dr. C. Burgoyne Pasley, a senior GMS doctor, reiterated that Crane's proposal
for rural poor relief could have been successful, "had the members of the District Boards
taken that earnest, personal, and real interest in the welfare and relief of the poor." The
disinterested officials justified their inactions by claiming that out-door relief would

5s 1886 LC #92, Poor Relief Letter from the Surgeon-General Relative to the Provision for
the Maintenance of the Indigent Sick in POS.
56 1886 LC #92, Poor Relief.
57 1889 LC #28, Surgeon-General AR, 5.
58 1886 LC #86. Minutes ofthe Finance Committee with reference to Estimates for 1887.
Minute by the Governor Suggesting that Provision be made for the Establishment ofa System of
Poor Relief
59 Port-of-Spain's government was in debt and Council deemed it too "irresponsible" to
receive further government money. 1886 LC #86, Minutes ofthe Finance Committee.
60 1886 LC #86, Minutes ofFinance Committee. Minute by Governor. Crane calculated the
cost of hospital care as three times higher than issuing food, clothing, and medical comforts by
out-door relief. It cost GMS from .24¢ to .30¢ daily to treat people in hospitals. Crane anticipated
that this would be reduced to .10¢ per day through out-door relief. 1886 LC #7, ReliefofPoor.
61 The Poor ReliefRegulation, 1890, established Poor Relief Boards in each district, along
with almshouses and the provision of out-door relief. BPP 1892 [c.6563-5], Trinidad and Tobago
Blue Book, 28.
62 1891 LC #46, Surgeon-General AR, 10.

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 PhD Thesis - L. Jacklin. McMaster - History

increase the incidence of pauperism and create a system fraught with abuses. 63 This
assertion would have had resiliency amongst those who supported the crusade against
out-door relief occurring in the metropole at this time. 64 However, Trotman argued that
the local opposition was based on the white elite's traditional and consistent portrayal of
the Africans' natural inclination for laziness. He found that "relief was given grudgingly
in time of crisis, but that the authorities considered pauperism a crime." 6s The GMS
doctors lamented the survival strategies forced upon their underprivileged patients and
challenged the official stance of blaming the poor for their destitute conditions. The GMS
instead issued medical comforts to out-patients. The doctors believed this intervention
would reduce the expenditures in the long run, by helping their patients remain healthy
and attempting to arrest maladies in the early stages. 66

Tensions thus heightened as the factions debated the relationship between state
relief, healthcare, and poverty, with the Creoles insisting that state healthcare pauperised
the population, and British-trained doctors retorting that poverty facilitated endemic
illness and thus necessitated state healthcare. The two polarised views showed no signs
of compromise. In the meantime, the problem of so many ailing poor people became an
increasingly large and visible problem in the colony.

Symptoms ofthe Problem: Medically-Motivated Urban Migrations

The rural poor routinely swelled the numbers of impoverished urbanites. Residents knew
that Port-of-Spain and San Fernando hosted the colony's medical establishments and
these towns attracted many poor people. 67 Crane described their medically-motivated
pilgrimages as a well-entrenched custom. 68 The 1875-76 reform situating District
Medical Officers (DMOs) in the districts helped reduce some of this migration by
providing decentralised services to tens of thousands of sufferers each year. The rural
out-patient system was believed to be "improving daily." 6 9 Rural DMOs continued to
send sufferers to the urban hospitals for lengthy and complex in-patient treatments,7°
but many people made the pilgrimage on their own volition. While the leper and lunatic
asylums treated specific types of patients, the hospitals continued to be the only major
institutions for social welfare support. Many residents competed for the restricted

63 CO 295-313 (1887) #9405. Treatment ofMedical witnesses by chiefjustice. Encl. #5.

Letter from Acting Surgeon-General B. Pasley. 30 April 1887.

64 England's Poor Law policies were in a state of flux in Britain at this time. Hurren and

Harris argued that the policy change in the retrenchment strategy, the "crusade against outdoor

relief' (1873-1900), reduced Poor Law expenditures and the investments needed for sanitary

infrastructures and disease control. Elizabeth T. Hurren, "Poor Law versus Public Health:

Diphtheria, Sanitary Reform, and the 'Crusade' against Outdoor Relief, 1870-1900," Social

History ofMedicine, 18, 3 (2005), 399-418. Bernard Harris, The Origins ofthe British Welfare

State. Social Welfare in England and Wales, 1800-1945 (New York: Palgrave, 2004), 53-6.

65 Trotman, Crime in Trinidad, 108-9.

66 1891 LC #46, Surgeon-General AR, 10.

67 Trotman confirmed the late-century migration to Port-of-Spain by many economically

dislocated rural Trinidadians. Trotman, Crime in Trinidad, 152.

68 1885 LC #15, Surgeon-General AR, 2.

69 CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General.

7° 1890 LC #35, Surgeon-General AR, 8.

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 PhD Thesis - L. Jacklin. McMaster - History

resources in the hospitals, including the destitute, homeless, aged, disabled, and blind.
The forms of relief they sought could have been provided more cost effectively in
purpose-built special care facilities, rather than in active treatment hospitals.71 However,
these unfortunates had nowhere else to go, as alternative institutions did not exist.

The political will languished to diversify the socio-medical support offered to the
public, with the exception of the construction of one new almshouse, which was woefully
under-capacity from the outset. In 1881, the government opened a colonial House of
Refuge in St. Clair, adding 150 beds to the capacity of the GMS system. In addition to
housing the destitute, inmates suffered from old age, chronic maladies, blindness, and
severe physical disabilities.72 The pent-up demand for the facility did not relieve the
overcrowding at the hospitals, as equally incurable cases filled the hospital beds as fast as
doctors transferred patients to the almshouse.73 Port-of-Spain and San Fernando
operated small almshouses, but the few hundred beds across the three facilities
remained insufficient for the population.74 Port-of-Spain's town council minimised its
expenditures on the poor by deflecting the problem to the colonial government. The
destitute residents did not disappear. They reflexively went to the hospital.1s The
municipal inactions cost the colonial treasury $5,694 annually to house the cases that
belonged in the town's small house of refuge.76 The GMS doctors put patients in every
possible bed in the hospitals and asylums. The problem continued throughout the
decade, causing The Lancet to report in 1889 that the continually overcrowded hospitals
functioned as poorhouses, which contributed to the high institutional death rates.77 The
quasi-almshouse hospitals continued to capture the attention of correspondents to The
British Medical Journal to the end of the century.78 The GMS doctors knew that they had
to find a way to redistribute these patients to facilities more appropriate to their needs.

The Trinidadian public contributed to the debate over state healthcare in a

pragmatic way, by constantly presenting their health-challenged bodies to the GMS
doctors. The tenacity of the residents to surmount many barriers is examined below, in
Chapter 6. While the records of medical colonialism tend to consolidate the patients into
aggregate statistical entities, Figure 5.1 provides a rare glimpse of one of the many
patients who exerted significant effort to seek medical attention.

11 1886 LC #7, ReliefofPoor. 1890 LC #35, Surgeon-General AR, 7-8. 1891 LC #46,

Surgeon-General AR, 10. 1882 LC [unnumbered], Surgeon-General AR, 1.

12 1889 LC #28, Surgeon-General AR, 69.

73 1882 LC #19, Surgeon-General ARfor 1881 (Half Year), 2.

74 The Port-of-Spain almshouse housed between 65 and 75 inmates. BPP 1878-79 [c.2273],

Papers Relating to Her Majesty's Colonial Possessions. 1877, 31.

75 As discussed above (in Chapter 4), during the 1875 reforms, it was decided the town

would pay £750 annually in order to reduce its costs and eliminate abuses in the system. [The

form of abuse was not documented.] Crane assumed that the town would transfer incurables from

the hospital to the poor house. This never happened. 1886 LC #92. Poor Relief

76 Doctors at the Colonial Hospital indicated that the average forty patients treated in-house
each day could have been cared for in a House of Refuge. This volume of patients cost GMS
$5,694 each year. 1886 LC #92. Poor Relief
77 "Health of Trinidad," The Lancet, 13 July 1889, 76.
78 See, for instance, "The West Indies as a Health Resort. Medical Notes of a Short Cruise
among the Islands," The British Medical Journal, 4 Sept. 1897, 611. "India and the Colonies.
Trinidad," The British Medical Journal, 10 June 1889, 1444.

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 PhD Thesis - L. Jacklin. McMaster - History

Figure 5.1 - "East Indian who walked 60 miles to be treated."

Courtesy ofRockefeller Archive Center. Reprinted with permission.79

This unidentified Indo-Trinidadian man suffered from hookworm. His sixty mile
trek, on foot, suggests that he traversed a significant part of the island seeking treatment.
This patient, and thousands of others, contributed to the debate amongst the elite
officials in a particular way, by persistently exerting extraordinary effort to obtain
medical care. During the 1880s, the congregation of sufferers in Port-of-Spain amplified
the visibility of the large number of ailing destitute people. According to pharmacist L.O.
Inniss, "Nearly everybody who was somebody, lived down in town." 80 The plight of the
rural and urban poor played out on the doorsteps of the Creole elite and the members of
the Legislative Council. Although Crane could not convince legislators to take action on
the causes of endemic destitution, he persuaded them to deal with the symptom: the
phenomenon whereby so many sick residents 'flocked' to the towns.

District Hospitals

Crane captured the attention of the usually inattentive Creoles by demonstrating that the
creation of a network of rural cottage hospitals would help to arrest the medically­

79 Rockefeller Archive Center, RF Photos, 451, Box 117, 2289, P3377

80 L.O. Inniss, Trinidad and Trinidadians. A Collection ofPapers, Historical, Social and
Descriptive, about Trinidad and its People (Port-of-Spain: The Mirror Printing, 1910), So.

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 PhD Thesis - L. Jacklin. McMaster - History

motivated pilgrimages of the destitute ill into the urban centres. Despite continually
ignoring the per capita cost savings of Crane's Poor Relief proposal, the notion of far
distant rural institutions gained political currency amongst the urban dwelling
legislators. Council agreed to spend the capital to build the hospitals, but the Colonial
Office subsequently refused, twice, to sanction the expenditures, due to the colony's poor
financial condition. Even well-justified projects were put on hold. 81 The influential
Creoles remained inflexible on their position regarding out-door relief, but momentum
increased to build the cottage hospitals. Thus, during a decade of economic strife and
unremitting criticisms over the GMS's increasing expenses, legislators dealt with one
problem by instituting expensive institutional alternatives. 82

During Irving's governorship, the colony had purchased land in Princes Town
with an eye to constructing a rural hospital. 8 3 The GMS started experimenting with
cottage hospitals, opening four facilities in 1881, which proved so successful that their
tiny capacities were quickly expanded. 8 4 These hospitals operated at a slightly lower cost
and their mortality rates remained below those at the urban hospitals. 8 s The GMS
adapted existing buildings and arranged with estate owners to use a dozen or so beds for
government patients at their private hospitals, such as the hospital at the St. Marie
estate. 86 The district hospitals were certainly not large or grand facilities, like the urban
hospitals, but they established a decentralised network of remedial care facilities within
the more densely populated communities throughout the island.

81 1885 LC #15, Surgeon-General AR, 4. The government traditionally did not challenge the
expenditures to incarcerate lunatics and lepers. However, the colony's financial predicament
caused the government to defer the costs of expanding the asylum this year.
82 The per capita daily cost to treat the GMS patients was .30¢ at the Port-of-Spain hospital
and .28¢ in district hospitals. Crane estimated that out-door relief would have cost .10¢. 1886 LC
#7, ReliefofPoor. 1886 LC #104, Surgeon-General ARfor 1885.
83 1885 LC #15, Surgeon-General AR, 4.
84 For instance, the hospital at Princes Town started with seven beds, but expanded to thirty
within a year. 1882 LC [unnumbered], Surgeon-General AR for 1881 (Half Year), 1.
8s 1882 LC [unnumbered], Surgeon-GeneralARfor 1881, 1.
86 Records on the GMS's use of the estate hospitals are minimal. In the early decade, GMS
used fifteen beds at the Caroni estate. GMS later used ten beds at St. Marie estate until 1887. 1882
LC [unnumbered], Surgeon-General AR for 1881, 1. 1888 LC #44, Surgeon-General AR, 5.

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 PhD Thesis - L. Jacklin. McMaster - History

Figure 5.2 - St. Marie Estate Hospital, 1March1916. The GMS used ten beds at this
hospital in the 188osfor public patients, before building the Cedros District Hospital.
Courtes o Rocke eller Archive Center. Re rinted with ermission. 8 7

P'igure 5.3 - Cedros District Hospital, 1March1916.

Courtesy ofRockefeller Archive Center. Reprinted with permission. 88

87 Rockefeller Archive Center, RF Photographs, 451, Box 117, 2294, P266I.

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 PhD Thesis - L. Jacklin. McMaster - History

While perhaps capitalising on a form of not-in-my-backyard sentiments, doctors

mobilised the tenets of preventive medicine and claimed that the hospitals helped
alleviate the congestion and high mortality rates in the urban hospitals. They called for
hospitals to be built in the districts sending large numbers of sufferers to the urban
centres and GMS dispensaries in communities that could not justify hospitals. 8 9 This
experimental phase meant that, in some instances, facilities opened and closed in short
order.9° Nonetheless, by the end of the decade, six district hospitals added significant
capacity to the network, treating 3,010 in-patients during the year.9 1 Innumerable other
sufferers received out-patient care. Crane described the district hospitals as "excellent
institutions," providing the sick poor with access to hospital therapeutics in their local
community.92 Trotman argued that the Legislative Council reacted negatively to
subsequent proposals to add more hospitals, claiming that the GMS services had a
"'pauperizing effect."' Legislators insisted that residents were now "'state aided from
cradle to grave,"' but Trotman doubted this assertion of the breadth of the socio-medical
safety net, showing instead that the continued inaccessibility of services sent many
people to Obeah practitioners.93

As the single reform for which Crane garnered support during the 1880s, the
important but relatively expensive program to create district hospitals proceeded apace,
despite encountering a major financial hurdle. The sugar depression focused London's
attention on the colony's troubled economy. Robinson forwarded the Legislative
Council's plan to build hospitals in St. Joseph, Couva, and Chaguanas to the Colonial
Office. (After resolving the tensions between Trinidad and London, these hospitals
increased the GMS system capacity by 100 beds.94) Robinson justified the expenditure
based on lower per patient costs and the potential to decrease mortality rates in the
districts, if sufferers could access medical care earlier.9s The system of district hospitals
was well-established in other colonies, such as Jamaica, which operated eighteen rural
facilities by this time.96 Whitehall rejected the proposal twice, demanding an explanation
of how Trinidad intended to raise the £3,300 to pay for the hospital construction. 97
Trinidad had just established the Legislative Council's new Finance Committee, which

88 Rockefeller Archive Center, RF Photographs, 451, Box 117, 2294, P266H.

89 1885 LC #15, Surgeon-General AR, 2-5. They called for hospitals in St. Josephs, Couva,

Chaguanas, and Princes Town, and dispensaries in Cedros, Oropouche, Toco, and Montserrat.

9o Reports mentioned the closure of small hospitals, but is unclear when they opened; some

came and went quickly. See, for instance, 1886 LC #97· Return showing the number ofCoolies in

the undermentioned Government Medical Institutions on the 20th Day ofNovember, 1886.

91 Hospitals were situated in St. Joseph, Tacarigua, Arima, Chaguanas, Couva, and Princes

Town. 1890 LC #35, Surgeon-General Report for 1889, 11.

92 1890 LC #35, Surgeon-General AR, 11.

93 Trotman, Crime in Trinidad, 227.

94 1888 LC #44, Surgeon-General AR, 5.

95 CO 295-311 (1886) #19497. Votes passed by Legislative Council.

96 James C. Riley, Poverty and Life Expectancy. The Jamaica Paradox (New York:
Cambridge Univ. Press), 51.
97 The minutes indicate the Colonial Office staffs annoyance with both Robinson's
deportment and the proposal. In declining to approve the plan, the staff did not dispute the
rationale, but pointed to the colony's poor financial position. CO 295-311 (1886) #19497. Votes
passed by Legislative Council.

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 PhD Thesis - L. Jacklin. McMaster - History

was now responsible for all colonial expenditures.9 8 Will argued that the local control
over the spending was a concession by the Colonial Office, rather than agreeing to
change the constitution of the colony, which the Council had been requesting. Whitehall
feared that giving more power to the Legislative Council would result in rule by a
"mischievous oligarchy," which was clearly pro-planter, and had little regard for the
lower classes.99 The despatches from London declining to approve the district hospitals
contained a clear warning to the governor and legislators. 100 The Colonial Office's
annoyance was multi-faceted.

Warring Factions and Imperial Interventions in 1886-87

In tandem with the Legislative Council's request for approval to establish the district
hospitals, a movement was afoot in Trinidad to silence the troublesome Surgeon-General
and end his crusade. At the same time that the legislators sought approval for their plan
to return the GMS to its former variant, where the Surgeon-General had no authority,
Crane appeared in person at Whitehall to challenge the government's decision. Although
Whitehall immediately pronounced the Legislative Council's actions to be contrary to the
interests of the people, the staff embarked on a lengthy process to discredit the proposal
submitted by the local legislature before Secretary of State Henry Holland invoked his
authority to veto the plan. The Colonial Office's action to disallow a proposal put forth by
Trinidad's governor and Legislative Council, but strongly opposed by another British
official, was a protracted process.

In March 1886, Robinson appointed a committee to streamline the GMS

administration. The terms of reference for the committee are unclear, but the ensuing
controversy suggests that the verdict to revert the GMS to the earlier variant had been
decided in advance. A shroud of secrecy enveloped the proceedings, as witnesses testified
in confidence. The government acted swiftly to repeal the 1875-76 ordinance, which
codified the GMS reforms, and reinstitute the 1870 law. 101 The Colonial Storekeeper
regained the responsibility to manage the institutions, while the Surgeon-General no
longer had paramount accountability for colonial medical matters. 102 Crane was also
relieved of his responsibility as the Medical Officer of Health. These changes were
portrayed as benevolent gestures to help the Surgeon-General reduce his personal
workload. 103 The government changed the ordinances in direct opposition to Crane's
protests. Robinson refused to allow Crane to read the documentation of the proceedings
and Council decisions, but sent it to London for official sanction. Both the despatch and
Crane travelled to London in October 1886. Crane immediately registered his complaint
at Whitehall about the proceedings. The Secretary of State gave the documents to Crane

98 Craig, The Legislative Council, 23-7.

99 Will, "Problems of Constitutional Reform," 706-13.

10
°
CO 295-311 (1886) #19497. Votes passed by Legislative Council.
101
1886 LC #79· Rules and Regulations. CO 295-311 (1886) #20601. Surgeon-General's
Dept. Encl. #2. Report of the Commission appointed to enquire into the working of the Surgeon­
General's Department.
102
CO 295-316 (1887) #4669. Report ofCommission. Crane to Secretary of State.
10
3 CO 295-311 (1886) #20601. Surgeon-General's Dept. Encl. #2. Commission Report. CO
295-316 (1887) #4669. Report ofCommission. Minutes.

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 PhD Thesis - L. Jacklin. McMaster - History

and declined to respond to Robinson until he received Crane's comments. 104

The Colonial Office reacted negatively to the contents of the despatch and the
events in Trinidad. The staff discussed, at length, that the existing colonial ordinances
codified the Surgeon-General's responsibility and authority to manage the medical
service and its institutional structures. They interpreted the Council's actions as a
challenge to the principle of appointing specialists to manage large government
departments. 10s In this case, the Surgeon-General's medical and professional acumen
were vitally important to the effective management of this tropical colony's public health
and medical infrastructure. Whitehall recognised that the Creole elite had attempted to
neutralise the functional head of a large department by abrogating the broad principle of
the Chief Medical Officer's accountability for financial, operational, and professional
management. The sympathetic comments of the Colonial Office staff acknowledged the
underlying struggles of Trinidad's tendency to arbitrary rule and the propensity of many
governors to align with the local influences during their sojourns. 106 The Colonial Office's
lead officer on the file, C. Alexander Harris, Secretary to the West Indies Committee,
counselled his colleagues to recognise that Robinson's actions were "mischievous," and
that they purposefully negated the important changes made by his reform-minded
predecessor, Governor Irving. 10 7

The Secretary of State and his staff unanimously agreed to disallow the ordinance
and to reprimand Robinson and the Council for two reasons. First, they believed that the
inquiry lacked any semblance of credibility. The proceedings involved the formality of
assembling commissioners, summoning witnesses to provide the necessary evidence,
and writing a lengthy report justifying the predetermined outcome. The staff discredited
the credentials of the members of Trinidad's committee and expressed their frustration
that Robinson had appointed officers of "obscure" standing to judge how Crane, who
they held in high esteem, managed the GMS. 108 Indeed, the committee members did not
hold influential positions in colonial governance. The Colonial Office may have been
concerned about setting the precedent of allowing secondary office holders, who
happened to be Creoles, judge the effectiveness of a trusted appointee.

The Colonial Office staff questioned the credibility and motives of the witnesses.
The committee had ignored Crane's copious submissions and relied on information
solicited from a select group of witnesses: the Colonial Storekeeper, GMS clerks, and
elite GMS doctors Pasley, Fabien, De Wolf, and Knaggs. Although the committee
certainly needed medically-informed evaluations about the care of institutionalised
patients, the Colonial Office staff questioned the impartiality of the doctors, who

10 4 CO 295-311 (1886) #20601. Surgeon-General's Dept. Secretary of State to Crane, 14 Dec.

1886. Secretary of State to Robinson, 14 Dec. 1886.

10 5 CO 295-316 (1887) #4669. Report ofCommission. Harris to Wingfield.

106 CO 295-316 (1887) #4669. Report ofCommission. Minutes.

10 ? CO 295-311 (1886) #20601. Surgeon-General's Dept. Minute, Harris to Wingfield, 27

Nov. 1886. Harris held the position of Secretary to the West Indies Finance Committee. The

Colonial Office List, 1914, 557.

108 The committee included David Horsford (Acting Auditor General), C.B. Hamilton
(Receiver-General), and D.L. O'Connor (Registrar in Bankruptcy). CO 295-311 (1886) #20601.
Surgeon-General's Dept.

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 PhD Thesis - L. Jacklin. McMaster - History

harboured "years ofjealousy" over Crane's control, 109 and would have benefited from the
recycled variant of the GMS.11° The doctors would not be dismissed from the medical
service, plausibly because the Colonial Office had difficulty recruiting doctors for
Trinidad, but Pasley and his colleagues would spend several years re-establishing their
credibility with London. 111

The second point of contention involved the committee's selective manipulation

of the data on the costs of treating patients. Trinidad's justification to revert the GMS to
its former structure revolved around the question of why the per capita daily costs of
treating institutional patients decreased during the decade following the 1875-76
reforms. This was a relatively obscure question, as the spending on institutional supplies
represented an insignificant portion of the annual budget to treat tens of thousands of
sufferers each year, pay hundreds of employees, and operate the institutions. Crane
quantified the reduction to be .15¢ per person daily, while increasing the food, clothing,
and medical comforts provided to patients. This was a significant saving when applied to
the 6,ooo hospital patients in 1885. 112 The quality and quantity of these items, vital to
patients during their recovery, had been substandard during the non-medical era of
hospital management, to the point where it caused great "alarm" for the doctors.113 The
GMS had also improved the patient and medical facilities in the institutions.114

The Trinidad committee relied on the testimony of Colonial Storekeeper

O'Donnell Fitzgerald, who insisted that the savings were due to decreases in the market
prices for supplies, rather than from the GMS reforms. 11s Harris rejected this allegation.
The number of patients had doubled between 1876 and 1885, while the expenditures on
consumable patient items increased by only 50%. 116 Secretary of State Holland overruled
the government's action to reinstate the Colonial Storekeeper as the managers of the
medical institutions and directed Council to abolish the department. 117

109 CO 295-316 (1887) #4669. Report ofCommission. Minute, Harris to Wingfield. Holland
to Robinson.
110 The case of C. Burgoyne Pasley is an example of the alliances. Pasley had been hired by
the Colonial Office. Creole society held Pasley in high regard, appointing him Acting Surgeon­
General during Crane's vacations. When the Colonial Office was discrediting the inquiry,
Robinson and Payne tried to retain their credibility by sending further despatches to substantiate
their claims of the inefficiency of GMS, which the Colonial Office staff discredited. CO 295-311
(1886) #22453. Surgeon-General's Dept. Pasley to Governor Robinson, 25 Nov. 1886.
111
After the failed attempt to discredit Crane, the Colonial Office staff observed that Pasley
switched allegiances and supported Crane. CO 295-313 (1887) #9405. Treatment ofMedical
Witnesses by Chief Justice. Minutes and Encl. #5, 30 April 1887.
112
CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General. 9
March 1886. CO 295-316 (1887) #4669. Report ofCommission. Harris to Wingfield.
11
3 1886 LC #104. Surgeon-General AR, 1-2. 1885 LC #15, Surgeon-General AR, 3.
11 4 CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General.
11
5 CO 295-311 (1886) #20601. Surgeon-General's Dept. Encl. #2. Commission Report.
116 O'Donnell Fitzgerald succeeded Samuel Fitzgerald as the Chief Storekeeper during the
1875-76 reforms. Crane pronounced the department "more obstructive than useful." In 1881,
several departments recommended disbanding the Colonial Storekeeper department, but Council
refused to close it. CO 295-311 (1886) #20601. Surgeon-General's Dept. Harris to Wingfield. Sub­
encl. #1. Surgeon-General. Encl. #2. Commission Report.
11
7 CO 295-316 (1887) #4669. Report ofCommission. Holland to Robinson, 17May1887.

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 PhD Thesis - L. Jacklin. McMaster - History

The committee's purposeful manipulation of evidence and statistics caught the

attention of officers in other colonies. At the same time that the Colonial Office was
negating the revival of the 1870 ordinance, Jamaica's Surgeon-General Dr. Masse took
up the cause of his embattled colleague in Trinidad. Masse informed the readers of his
annual report that Trinidad's Legislative Council was attempting to return its GMS
system to the pre-1875 variant, which had been "abolished on the grounds of excessive
cost and great inefficiency." 118 Masse compared the average daily costs to treat hospital
patients in the three major West Indian colonies.

Table 5.4 - Comparative GMS Expenditures, 1886-87. 11 9

Colony Total GMS annual Average daily

Population expenditure cost to treat
all_J>_atients
Trinidad 153,128 £ 24,425 lS 2 l/4 d
British Guiana 252,168 £ 33,619 1s3d
Jamaica 605,881 £ 45,057 lS 2 112 d

Mosse's statistics established that the three colonies spent about the same
amount per capita on patient treatments. Trinidad's total medico-social spending
differed from Jamaica and British Guiana, however, because they operated Poor Law
organisations, with their own equally large budgets, while Trinidad did not. As the
Colonial Office staff processed the various data, the government was meanwhile ignoring
Robinson's directive to create the system of Poor Relief, as introduced above. Crane
ensured that Harris and his colleagues recognised the need for the Poor Relief system. 120

Holland decreed that no changes would be made to the GMS. His despatch to
Robinson included a clear message that Robinson had aligned with the wrong side of
local politics: Crane's position would indeed "be upheld." The Colonial Office staff
criticised Robinson's deportment as the trustee: he had contravened the tenets of British
fair play and justice by withholding the report from Crane. 121 Although Crown Colony
rule allowed Whitehall to abrogate a colonial initiative to protect the subject peoples
from arbitrary rule, there were few late-century instances where it overruled the
recommendations put forth by the governor and Legislative Council. This now occurred
with a modicum of regularity when the controversies involved the GMS. The staff
decided that Robinson had become embroiled in local politics and could not control the
autocratic Legislative Council. Robinson subsequently threw his support behind Crane's
crusade for Poor Relief, while his former Creole allies refused to accept defeat.

118 Jamaica Sessional Papers 1886-87. Island Medical Department AR, 163, section 20.

119 Jamaica Sessional Papers 1886-87. Island Medical Department AR. Comparative

Statement of Expenditure, 163. These statistics appear to be preliminary 1886-87 numbers from

each colony.

12
°
CO 295-311 (1886) #20601. Surgeon-General's Dept. Sub-encl. #1. Surgeon-General.
121
CO 295-316 (1887) #4669. Report ofCommission. Minute, Harris to Wingfield. Holland
to Robinson.

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 PhD Thesis - L. Jacklin. McMaster - History

The Conflict Continues: Imperial Interventions in 1891-92

Conflicts continued to prevail in Trinidad. By 1891, the tensions between Trinidad's elite
and the crusading Gorrie and Crane escalated and necessitated further interventions
from the Colonial Office. By now, Trinidad's oligarchy had simply had enough of each
crusader and embarked on a program to rid the colony of these officials. On 11 May 1891,
the Creole elite formalised its new attack on the GMS when Robinson sent three
despatches to Secretary of State Henry Holland, Lord Knutsford. 122 As before, the
strategic objective of returning the GMS to its pre-1875 variant remained intact, although
the tactics changed to make this appear to be a prudent financial decision during the
difficult economic times. The justification revolved around two arguments. The first
concentrated on Trinidad's total annual expenditures on medical services, which were
deemed disproportionate to other colonies. The second argument positioned the cost of
employing GMS physicians as excessive and as governmental interference into the
operation of the free market. The legislators insisted that employing doctors in the civil
service "crushe[d] out all private enterprise," making it impossible for private
practitioners to earn a living. In the opinion of Trinidad's legislators, these problems
could be rectified by reducing the GMS budget by 50% to 75% and ceasing to employ
doctors in the civil establishment. 12 3 This plan therefore intended to reduce the medical
services provided by the government to the public.

Knutsford initiated a formal inquiry, but kept this investigation within his direct
control. He appointed a committee comprised of Dr. Crane, Trinidad Stipendiary Justice
Llewellyn Lewis, C. Alexander Harris, and Knutsford's Assistant Private Secretary, H.W.
Just. 124 Harris, it will be recalled, had been instrumental overturning the decisions of
Trinidad's 1886 committee on healthcare. Trinidadians had little opportunity to
influence the deliberations formally without representation on the committee, or even
informally, as the committee convened in London during October 1891. The
documentation regarding this inquiry did not state the terms of reference or define the
scope of the committee's authority, but Knutsford subsequently accepted its decision to
leave the GMS intact. Additionally, although the Legislative Council did not discuss Poor
Relief in the proposal to dismantle the GMS, the committee recommended that the
colony act on Crane's previously proposed system of out-door relief, and Knutsford
directed the governor to do so.125 Trinidad's legislators realised that the Secretary of
State had not only overturned their decisions, but he also mandated the Poor Relief
system that they had opposed.

The London committee set the stage for their recommendation to leave the GMS
system intact by amassing statistical proof to counter the assertions of excessive
spending. Council's charge hinged on a comparison of the annual GMS costs (£60,000)

122
The allegations were contained in Robinson's dispatches 164, 165, 166of11May189i.
1892 LC #12, Secretary ofState on Medical Establishment.
12
3 CO 295-335 (1891) #21907. Minutes ofCommittee. Knutsford to Broome. 1892 LC #12,
Secretary ofState on Medical Establishment.
12
4 The job functions for Harris, Just, and Lewis are stated in the 1914 Colonial Office List,
557, 575, 586.
12
5 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Knutsford to Broome. 22
December 189i. 1892 LC #12, Secretary ofState on Medical Establishment.

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 PhD Thesis - L. Jacklin. McMaster - History

with those of Barbados (£16,ooo) and Jamaica (£35,000). Robinson insisted that
Trinidad's costs should be on par with those colonies. 126 Knutsford's committee outlined
the "misleading" nature of comparing costs between colonies with fundamentally
different socio-medical infrastructures and population sizes. Council had again neglected
to account for each colony's substantial annual expenditures to relieve the poor; £39,080
in Jamaica, £13,233 in British Guiana, £17,660 in Barbados.127 Trinidad had not used
British Guiana as a comparison, although its population most closely resembled
Trinidad's, and both colonies were major sponsors of indentured immigration, incurring
similar statutory medical obligations to those workers. Likewise, the relatively sparse
distribution of rural residents minimised the potential for private physicians to set up
medical practices in outlying districts. British Guiana's total salaries for government
doctors exceeded Trinidad's costs. 12s

Trinidad's annual GMS expenditure of £60,000 was on par with the combined
medical and Poor Relief expenditures in other colonies. With its larger population,
Jamaica spent £74,080 on its socio-medical infrastructure of relief (£39,080) and the
GMS (£35,000). The much smaller colony of Barbados spent a total of £33,660 on the
two systems each year, without any indentured labourers. 129 British Guiana spent about
£66,ooo on the GMS and Poor Relief. 13° Trinidad's total expenditures remained in the
range of other West Indian colonies, although the lack of out-door relief and alternatives
for institutional care meant that the colony treated fewer people in a more expensive
way, when compared to the number of people who could have been assisted in a more
progressively structured system. 13 1

The proposal to reduce the GMS budget by 50% to 75% would have barely
allowed Trinidad to pay for statutory services (such as vaccination, DMOs for indentured
estate workers, and port health measures) and to provide a minimal level of service at
the asylums, gaols, and hospitals. London identified the repeated inaction on the plight
of the poor as the essential cause of the large institutional expenditures. 132 The
committee recommended that the Council should act on the relief proposals that had
been submitted during the past five years. Crane confidently predicted that the Poor
Relief system would allow the GMS to eliminate 500 beds from the network of hospitals
and consequently reduce its annual operating costs by £10,000. These costs of
maintaining the poor would shift to the municipalities, albeit at a lower per capita cost.
The local communities would then assist the poor, similar to other British colonies. 133

126
CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.
12
7 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions. Jamaica
Sessional Paper 1890-91, Report ofthe Board ofSupervision for the Relief ofthe Poor in
Jamaica,for the period ofEighteen Months ended 1st March. Appendix No. 19. Appendix No. 20.
128
CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.
12
9 Barbados spent £17,660 on relief and £16,000 on the GMS, as stated above.
1
3° In addition to the £13,233 expenditure on relief (as above), British Guiana spent £52,595
on its GMS, for a combined total of £65,828. BPP 1893-94 [c.6857-55] British Guiana Annual
Reportfor 1891, 5.
1 1
3 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions. 1892 LC
#113. Surgeon-General AR, 6.
13 2 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.
l33 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.

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 PhD Thesis - L. Jacklin. McMaster - History

Knutsford's committee then dealt with Trinidad's recommendation to cease

employing doctors as civil servants. The Legislative Council insisted that the GMS paid
excessive salaries to the doctors and that government doctors stifled the competition in
the medical marketplace. It wanted to decrease the number of GMS doctors and reduce
the salaries of those retaining their jobs. 134 The potential decrease in the number of
doctors and the desire to set the salary rate below the levels offered by other colonial
GMS organisations had serious implications for the colony's ability to attract doctors and
the ability for the poor to access healthcare services in the rural areas. Knutsford's
committee upheld the GMS's salary and career path structure, as originally modelled on
the Indian Medical Service. 13s This decision reflected their interest in ensuring
competitive wages and equity within the civil service. 136 The Colonial Office recruited
doctors for Trinidad and knew that careering physicians wanted to be compensated
according to the scale of salaries offered elsewhere.

The committee pointed to the health of the medical marketplace in Port-of-Spain,

where twenty-seven doctors practiced: thirteen private practitioners and fourteen GMS
employees. Only three GMS doctors exercised their privilege for private practice. 137
Council's complaint thus intimated that the part-time private practices of three GMS
doctors made the pay-patient market uncompetitive for thirteen independent physicians.
However, these private practitioners had always considered their practices more
lucrative than government work. 138 The committee also noted that independent doctors
would not set up rural practices because they could not earn sufficient income from the
impoverished residents without the government salary and associated fees. 1 39 A
reduction in the number of doctors and their salaries would have reduced the GMS's
compliment of human resources, implying that a greater number of residents would have
to find the means to pay private physicians.

The Creole's plan to dismantle the GMS did not stipulate the new structure that
they intended to subsequently put in place, but comments by Crane's nemesis, Dr. Louis
A. de Verteuil, reiterated their preference for the original system. Although he remained
a persistent critic of the GMS, de Verteuil continued to hold several lucrative GMS
contracts. The 1884 edition of his locally revered monograph on Trinidad's history and

1
34 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.
Knutsford to Broome, 22 Dec. 1891. 1892 LC # 12, Secretary ofState on Medical Establishment.
1
3s The number of GMS doctors did not change. The committee re-evaluated the allowances
paid to the doctors and made minor adjustments in the fees for various activities (such as issuing
Death Certificates), which nominally decreased costs. It also approved the doctors' request to
change the seniority reward from an increase of £100 per annum after ten years of service to £so
per annum after five years and then again at ten years of service. The initial salary for new doctors
was reduced from £300 per annum to £250, which was the amount that had been offered to new
doctors since 1884. 1892 LC #12, Secretary ofState on Medical Establishment, 2-3. CO 295-335
(1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.
1 6
3 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.
1
37 GMS employed thirteen doctors plus Crane in Port-of-Spain. Hospital surgeons were not
allowed private practice. 1892 LC # 133. Surgeon-General AR, 3-5.
1 8
3 Only one (unidentified) physician had expressed interest in government work, but then
decided that his private practice was more lucrative. CO 295-335 (1891) #21907. Minutes of
Committee. Encl. Minute of discussions.
1
39 CO 295-335 (1891) #21907. Minutes ofCommittee. Encl. Minute of discussions.

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 PhD Thesis - L. Jacklin. McMaster - History

future prospects criticised the organisation of the GMS and the career paths provided to
its doctors. He argued that the doctors should be accountable to private sector physicians
who had established themselves in society; elite Creole doctors would acquire
appointments as visiting physicians to the hospitals. 14° He was thus suggesting that his
elite colleagues could be enticed to relinquish part of their private practices to preside
over medical matters at the institutions. Assumedly their interest would be piqued
through lucrative financial contracts, as had been the norm in the GMS's early years.

Robinson and the Legislative Council had also remained silent on the fate of the
multitudes ofTrinidadians who would henceforth be restricted from accessing the GMS
services. However, Trotman provided information that suggests the Council's solution
for the African population, which was clearly portrayed as having regressed into
barbarism. In 1891, officials asserted that the "'African portion of the population can take
care of themselves when left alone in the woods."' Obeah practitioners would thus
benefit from the increased number of residents seeking their services, although Trotman
believed that they already conducted a brisk business in herbal therapeutics, to help
Afro-Trinidadians cope with their conditions of life. Many people continued to use the
herbalists, whether because of personal preference or, in Trotman's argument, the
"inadequate and chaotic state" of the GMS.141

In London, the committee concluded its investigation at the end of October.

Crane and Llewellyn Lewis returned to Trinidad. The Creole elite would have known
London's decisions before Knutsford's despatch of 22 December 1891. Knutsford
directed the new governor, Sir Frederick Napier Broome, to make no changes to the GMS
and to proceed at once with Crane's proposed system of out-door relief. Knutsford ended
his directives with an unequivocal demonstration of his support for Crane's "valuable
and hearty service which he has continually rendered to the Colonial Government." 14 2
Broome reprinted Knutford's letter for the Legislative Council.

While waiting for Knutsford's despatch, the Legislative Council launched its
attack on Sir John Gorrie. Brereton described their actions in late 1891, when the Creole
legislators voted to request a formal enquiry in Trinidad about the administration of
justice in the colony. 143 The failed attempt to marginalize Crane had taught the legislators
a valuable lesson of relevance to their campaign to return the justice system to its former
state: the Colonial Office would not remove a senior official at their behest. They realised
the need to organise the trustee's intervention in a manner that would allow them to
control the process by ensuring that the Imperial enquiry was conducted locally.
Brereton stated that Knutsford reluctantly agreed. Four British jurists and scholars
conducted the Judicial Enquiry Commission in Trinidad in the spring of 1892. Brereton
established that the white Creole oligarchy stacked the evidence in its favour to ensure
that this Commission had no alternative but to rule against the conduct of the "maverick"

1
4° LA.A. de Verteuil, Trinidad: Its Geography, Natural Resources, Administration, Present
Conditions and Prospects, 2nd ed. (London: Cassell and Company, 1884), 207-10.
1 1
4 Trotman, Crime in Trinidad, 223-7.
1 2
4 CO 295-335 (1891) #21907. Minutes ofCommittee. Knutsford to Broome. 22 December
1891. 1892 LC #12, Secretary ofState on Medical Establishment.
1
43 Brereton, Law, Justice and Empire, 300-2.

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 PhD Thesis - L. Jacklin. McMaster - History

judge, thus ending his tumultuous crusade. 144

Conclusions

The unremitting conflicts over the relationship between state obligations, poverty, and
the health of residents permeated the socio-medical landscape in Trinidad throughout
this decade. The ideologies of the Creole and British officials shaping the GMS remained
conflictive rather than cooperative and fostered a protracted struggle over the control of
financial and medical resources, until the escalating tensions necessitated imperial
intervention on at least two occasions. These actions from Whitehall were unusual
during a decade when many important initiatives created controversy in the colony.
When the Legislative Council overturned the recommendations of the Trade and Taxes
Commission and increased the duties on foodstuffs, heightening the struggles of the poor
during the economic depression, the Colonial Office did not take any steps to oppose the
powerful Creole elite. The Colonial Office's decision to intercede into the affairs of the
GMS may have resulted from it view of the importance of the medical services, or
perhaps because Crane kept arriving in person to plead the case of the Trinidadian
public. His stories of the suffering and dearth amongst the subject peoples undoubtedly
brought a personal dimension to the cause, which no amount of official correspondence
could have possibly conveyed.

The upper strata of Creole society held considerable suasion over many British
officials sent to administer the government and rule the colony. While Crown Colony
government had been organised to mitigate the actions of the Creole elites in plantation
colonies, in many instances in Trinidad it was difficult to ascertain who were the rulers
and who were the ruled. While the British officials needed to cooperate and collaborate
with the Creoles, Robinson's tenure represented a chaotic period. Although the governor
had distinct ideas on what needed to be done at times, his gubernatorial powers were
often impotent. This created many problems for the Surgeon-General. As with any public
health crusader in the nineteenth century, Crane certainly needed local executive
support for his reforms, which was not forthcoming to any extent. Gorrie faced the same
situation, although his position in the justice system gave him far more latitude for
action. As argued by Brereton, men like Gorrie periodically appeared within the Empire
and challenged the status quo: Surgeon-General Crane similarly personified the
principle of trusteeship. Both of these men had been influenced by their previous
sojourns in other parts of the imperial world, experiencing plantation society colonialism
from many different vantage points. These officials had a significant effect on their own
areas ofjurisdiction, even if only for a fleeting moment.

A significant portion of this study has investigated the attitudes and decisions
within the upper ranks of colonial society, due to the nature of the sources relevant to the
history of a state healthcare organisation. The records of colonialism infrequently
capture the voices of the public and the patients of the GMS system. Although the
individual patients may have been reduced to nameless statistics in the government
archives, these patients remained a vitally important driving force in the creolisation of
state healthcare in Trinidad. Sufferers played an important role by flocking to the towns
144 Brereton, Law, Justice and Empire, 300-14.

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 PhD Thesis - L. Jacklin. McMaster - History

and arriving on the doorsteps of the GMS doctors. The troubled economic times
unquestionably aggravated their difficult lives and strained the resources which they
could devote to health maintenance. With 47,000 of their numbers seeking assistance in
1891, a remarkable number by any measurement, Trinidadians were a force shaping the
struggle. While the elites argued over tax rates, Poor Relief, and the GMS, the patients
maintained the momentum to use their entitlements to the medical services, which may
have not been in such demand if the elite factions had resolved their differences and
taken action on the broader issues. As the only significant health reform during the
decade, the network of district hospitals remained important to the residents and the
GMS doctors, well beyond the period of this study. The hospitals helped to remove
several thousands of sufferers each year from the immediate gaze of the urban-dwelling
legislators in the colony's two major ports. The interconnected problems of poverty and
ill-health, however, did not go away. A system of Poor Relief would have reduced the
strains on the GMS organisation and assisted a larger number of people in a different
way, albeit merely shifting expenditures from one government department to another.
There is no way to anticipate how large the system would have become, but it may have
grown as large as the GMS, if not larger. The Legislative Council reflexively justified its
actions by proclaiming that the GMS services pauperised the residents, although the
GMS doctors asserted that the poverty created their large patient population. Such was
the nature of plantation society colonialism.

The government succeeded in its quest to avoid expanding the state welfare
services, although it lost the struggle to dismantle the GMS and return it to the limited
functions prior to the 1875-76 reforms. It did not act on Knutsford's directive to institute
the Poor Law system and the government would not reconsider its position for another
twenty-five years. The directives from the Colonial Office would imminently change, as
Joseph Chamberlain became the new Secretary of State. Chamberlain's philosophy of
constructive imperialism would allow the Creole elite to achieve its long-standing
objective of decreasing the size of the GMS organisation. Chapter 6 examines the
troubled times in Trinidad into the twentieth century, by considering the struggles of the
patients to gain and retain access to the GMS system.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

-Chapter6­
The Civilising Mission: GMS Policies and Patients, 1891-1916.

The 1803 Haitian revolution conditioned white Creoles and Britons throughout the
British West Indies to the possibility that their subjects could one day rise up. This fear
became a reality in Trinidad on 23 March 1903. Historians have interpreted the "Water
Riot" in Port-of-Spain as an important event in the emergence of a sense of black
consciousness and nationalism. 1 However, these studies overlook how many profound
struggles over the political economy of health brought the 5,500 ratepayers to
Government House on the ill-fated day. This study explores the complexities and
connections between the civilising mission, Water Riot, and state healthcare by
attempting to excavate the experiences of two of the most elusive groups in the records of
colonialism: ailing residents who were denied access to the GMS services and those who
became GMS patients. In the wake of the concurrent public health disasters and Water
Riot, the GMS became a focal point in the public and confidential reports by government
officials as they attempted to explain how and why the civilising mission had gone awry.

This study first establishes the profound changes to Trinidad's GMS and the
public health landscape, between the time when the new Secretary of State, Joseph
Chamberlain, introduced his strategy of constructive imperialism in 1895, and the Water
Riot in 1903. During this period, Surgeon-General Frances Lovell attempted to enhance
the image of the GMS system to attract elite patients, while paring the services for the
poor patients to the bone. Lovell's reforms were predicated on the colonial elites' unified
assertion that state healthcare services had not succeeded in advancing civilisation but,
instead, had pauperised the population. In brief, the subject peoples had become
shamelessly dependent on the state's benevolence. The analysis then examines, as best as
possible, how the poorest people in the colony interacted with the GMS system. Contrary
to the imperialist's view of a dependent pauper population, many impoverished people
could only obtain the state medical services, to which they were entitled by state policy,
by exerting significant effort and tenacity. Furthermore, many sufferers did not seek
assistance from the government until they had exhausted their meagre financial
resources and other therapeutics in the community. Thus, while the civil disobedience at
the Water Riot undoubtedly reflected an emergent sense of consciousness amongst the
lower orders, it was also a public expression of discontent about the colonial state's
public health and medical care system. Moreover, an important force in the creolisation
of the social policies on state healthcare - the subject peoples - had risen up en masse to
challenge the colonial elite.

The Prelude to the Riot: Refashioning the GMSfor Civilised Patients

Between 1870 and 1895, the Colonial Office had maintained a conservative position on
state healthcare, providing little directional guidance, but responding to the colonial

K.O. Laurence, "The Trinidad Water Riot of 1903: Reflections of an Eyewitness,"

Caribbean Quarterly, 15, 4 (1969), 5-22. Bonham C. Richardson, Igniting the Caribbean's Past.
Fire in British West Indian History (Chapel Hill: Univ. of North Carolina, 2004), 175-82.
Anthony Bogues, Caliban's Freedom. The Early Political Thought ofC.L.R. James (London:
Pluto, 1997), 11.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

officials when turmoil prevailed within the elite factions. This reactive deportment
changed noticeably in 1895, when Joseph Chamberlain took the reigns of control and
modified the strategy of the broader imperial project to constructive imperialism. The
new political climate allowed Trinidad's Legislative Council to alter its social policies and
the parameters of state healthcare services, aided by its new-found allies, Surgeon­
General Frances Lovell and Governor Hubert J erningham. Lovell proceeded to convert
the Port-of-Spain Hospital into a state-of-the-art surgical facility and locus of
therapeutics forthe upper orders of society, while significantly reducing the number of
lower class GMS patients throughout the system. These noteworthy reductions in the
services available to the public represented the local manifestation of the changing
metropolitan imperialist policies, which would ultimately contribute to the public's
dissatisfaction and stimulate their riotous actions.

Chamberlain displayed a keen interest in the potential for western medicine to

help the Empire become more productive: a modern, business-like approach would.
attempt to use British science and medicine to conquer microbes. In 1899, Chamberlain
established the London School of Tropical Medicine (LSTM), to train colonial doctors
and missionaries on the latest scientific methods and to conduct research on the tropical
diseases which had traditionally thwarted the progress of the Empire. 2 John Farley
argued that the Colonial Office staunchly supported tropical medicine to protect white
imperialists in the perilous tropics, while demonstrating a notable disinterest in the
health of the subject peoples.3 Chamberlain directed the governors of the West Indian
colonies to make significant reductions in their GMS expenditures. He reprimanded the
governments for being far too generous with the medical services provided to the public:
colonies could not afford those services and the "natives" did not need them.4

Surgeon-General Lovell lost no time jumping on the constructive imperialism

bandwagon. He re-conceptualised the GMS as an organisation providing services to a
substantially smaller number of "natives," while catering to the influential citizens who
were important to Chamberlain's strategy. In fact, the usual compliment of GMS patients
had been thwarting Lovell's plan to attract elite patients into the system. In the
metropole, a remarkable transformation had occurred in the public's perception of the
hospital during the late-Victorian period. William Bynum confirmed the change in
attitudes about the public hospital, which had accompanied the new medico-scientific
knowledge, diagnostics, and therapeutics. Patients from the upper and middle classes
used the hospitals more frequently.s This change did not manifest spontaneously in
Trinidad. Thus, in 1895, Lovell embarked on a campaign to refashion the urban hospitals
and make them more appealing to Trinidad's elite. Lovell built private wards at the Port­

2
BPP 1903 [cd.1598], Papers Relating to the Investigation ofMalaria and Other Tropical

Diseases and the Establishment ofSchools ofTropical Medicine, 3-13. Seamen's Hospital Society,

London School ofTropicalMedicine, Reportfor the Year 1899-1900 (1900), 2.

3 John Farley, Bilharzia. A History ofImperial Tropical Medicine (Cambridge: Cambridge

University Press, 1991), 4.

4 CO 295-391 (1899) #8041. Observations on Medical and Education Expenditures.

Confidential Jerningham to Chamberlain. Jerningham quoted Chamberlain's directive and use of

the term "natives."

s W.F. Bynum, "Ideology and Health Care in Britain: Chadwick to Beveridge," History Phil.

Life Sci., 10 (1988), 77-8.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

of-Spain Hospital for society's upper strata. Initially, wards inside the main building
were converted into private rooms, which then evolved into the detached private
structures, shown in Figure 6.1. Lovell introduced other amenities to the hospital,
building tennis courts and importing 200 rose bushes to adorn the grounds. 6

Figure 6.1 -Private Ward at the Port-of-Spain Colonial Hospitaf.7

Courtesy ofRockefeller Archive Center. Reprinted by permission.

State-of-the-art surgical procedures became a priority to attract the new clientele.

Patients who could afford to pay a token amount for hospital care, but who could not
afford private rooms, continued to be admitted to the public wards and treated alongside
the Poverty and Pauper Certificate patients, as shown in Figure 6.2.

6 1895 LC #94, Surgeon-General AR, 10. 1896 LC #129, Surgeon-General AR, 26.
7 Rockefeller Archive Center. RF Photographs, 451, Box 116, 2286, P6936, Port-of-Spain
Hospital. Front/Private Ward. This picture was probably taken between 1914 and 1916.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Figure 6.2 -Male Ward at Port-of-Spain Hospital [n.d. probably 1914-16). 8

Courtesy ofRockefeller Archive Center. Reprinted by permission.

The Legislative Council enacted new ordinances to establish the rules to allow
private patients to be admitted to the hospital. In 1895, Lovell confidently anticipated the
success of his initiative to attract a more desirable class of patients to the Port-of-Spain
Hospital. 9 Although poor Trinidadians had a long history of flocking to the urban
institutions, their social betters certainly did not flock to the renovated hospital. The
private facilities awaited the onslaught of wealthy patients, which never materialised.
Almost two decades later, in 1912-13, the statistics for the Port-of-Spain Hospital
indicate that a mere sixty-one paying patients used the private wards during the year:
this amounted to less than 1% of the people admitted to the hospital. 10 The therapeutics
remained a bargain at only 6/- per day, including major surgical procedures and
intensive nursing care. 11 However, the segregated wards and low-cost medical care failed
to transform the class of patients of the public hospitals, as had long-since occurred in
the metropole.

Elite Trinidadians who possessed the financial wherewithal to choose their locus

8 Rockefeller Archive Center. RF Photographs, 451G, Box 116, 2286, Port-of-Spain

Hospital, P6934 [n/d], Male Ward, 1st Floor, Main Building.
9 1896 LC # 129, Surgeon-General AR, 9. Ordinance 24 of 1895 revised the rules to allow
private patients to be admitted to the hospital.
10
The hospital admitted 6,761 patients in 1912-13. 1914 LC #91, Surgeon-General AR, 22-6.
11
The revenue from paying patients was £333. 1914 LC #91, Surgeon-General AR, 22, 26.

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 Ph.D. Thesis - L. Jacklin. McMaster- History

of healthcare continued to be treated either in their private residences or at institutions

in "at home" in the United Kingdom. Newspaper reports confirmed that influential
citizens often engaged multiple physicians when they were unwell, sometimes having
one or more doctors in continuous attendance for hours on end, providing unlimited
attention in their homes. 12 Many people from the upper ranks left the colony when they
needed hospital treatments. The media made it their business to report on the health of
society's influential, many of whom boarded the next ship to Britain when sick. Friends
and family turned out in force to bid them farewell during the continual departures of
officials, merchants, planters, and doctors. 13 The elite had confidence in the new
scientific hospital treatments in Britain, but continued to shy away from the GMS
facilities. Lovell failed to recognise that the hospital remained a space defined by race
and class. Trinidad's elite citizens may have been disinterested in allowing their white
bodies to be treated by the predominantly non-white nursing staff, or they may have
been deterred by the long-standing taint of the hospitals functioning as medicalised
almshouses. Although their motives are indeterminate in the historical records, it is clear
that they did not flock to the private facilities at the hospital.

Nonetheless, Lovell concentrated on reducing the number of poor patients in the

system. Chamberlain's 1899 directive to decrease medical spending provided an
opportunity to cut the GMS budget significantly. Governor Jerningham immediately
applauded the edict, telling Chamberlain that the GMS's high costs resulted from the
combination of "too soft hearted" governance, the high wages paid to labourers, and the
colony's history of allowing the subject peoples to rely on the government. In his opinion,
the state healthcare services had only succeeded in pandering to the Africans' "natural
laziness" and had pauperised the people. He thought that the industrious and frugal East
Indians represented a different sort of humanity; however, the GMS had encouraged
both subject races to idleness. 14 J erningham, Lovell, and the Legislative Council slashed
the GMS spending on out-patients and reduced the hospital beds in the system by at
least 30%. 15 These officials decided to curtail pauperism by forcing sufferers to provide
for their own medical needs. 16 Lovell continually claimed that the reductions did not
inflict hardships on the people: they were a necessary step to train the people about thrift
and industriousness. He counselled the doctors and officials that there could be "a little
suffering at first until the mass learnt [sic] that they must help themselves."17 To the
contrary, after Chamberlain left the Colonial Office, the officials who inherited this
legacy of constructive imperialism agreed that Lovell's measures had taken the GMS to
the "brink of a collapse" by the time of the Water Riot, in 1903. 18

12
For instance, Miss Annette Fernandez, a private elite citizen, had GMS Drs. Eakin and

Fabien "in constant attendance at all hours night and day." Obituary, The Mirror, 17 August 19oi.

1
3 See, for instance, "Items of news," Port-of-Spain Gazette, 6 Aug. 1905. "Death of Dr. F.B.

Archer," The Mirror, 5 Oct. 1901.

1
4 CO 295-391 (1899) #8041. Medical Expenditures. Jerningham to Chamberlain.

1
5 CO 295-391 (1899) #11877. Medical Retrenchment. Confidential Jerningham to

Chamberlain. 1896 LC #129, Surgeon-General AR, 9. This was codified by Ordinance 24 of 1895.

16
CO 295-391 (1899) #8041. Medical Expenditures. Jerningham to Chamberlain.

17
1895 LC #94, Surgeon-General AR, 22.

18
Governor Henry Jackson, the GMS doctors, and Surgeon-General James de Wolf agreed

that the GMS was on the verge of destruction by 1903. CO 295-432 (1905) #14856. Government

Medical Dept. Encl.: Despatch #106. Jackson to Colonial Secretary Lyttelton.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Lovell's zealous campaign to reduce the services for the lower classes reflected the
elite discourse on civilizing the "natives," rather than responding to their health needs.
The contradictions between the state policy and life in Trinidad imminently became clear
to some GMS doctors and the public. In 1896, the presiding surgeon at the Port-of-Spain
Hospital, Dr. E.A.G. Doyle, embraced Lovell's program of restricting admittance to
patients needing advanced medical treatments or state-of-the-art surgeries. He proudly
refused all "unsuitable cases," including the aged, chronically ill, and poor. However,
Doyle asked the government to exonerate him from any future blame,19 while claiming
that his actions did not inflict any suffering on the people who he ejected from the
hospital or turned away at the door. 20 Lovell remained dissatisfied. In 1899, he directed
the GMS doctors to be more vigilant turning away patients, insisting that it was vitally
important to educate the people to provide for themselves, and that this did not put
"excessive hardship on the sick poor." 21 Lovell's reforms seem rather disingenuous in
light of the conclusions by the 1897 West India Royal Commission. As introduced above
(in Chapter 5), the commission reported that the severe sugar industry recession, now in
its second decade, had put colonies on the verge ofbankmptcy, with little money in the
treasuries to relieve the widespread suffering amongst the lower classes. 22 While Lovell
and Doyle tried in vain to transform the hospital to a modern surgical facility, catering to
society's better classes, the lower orders were getting poorer and needed GMS assistance
even more than in the past.

By 1900, Doyle admitted that things had gone wrong at the hospital. He lamented
having discharged patients too early: "Hospital meant saving them from starvation." He
realised his error in turning away 1,080 people during 1899, who had arrived "only
suffering from want of food and some trifling ailments," but then returned "in a worse
state," or died before they could ask for help again. 2 3 The hospital refused admission to
2,885 people the following year, or one third of the people arriving at the door, denying
medical care to many "deserving" people; doctors now attended to only "urgent" cases. 24
The government's refusal to provide medical care had not taught the people to embrace
the values of civilised society. Rather, their untreated medical conditions became chronic
or terminal.

The public health problems increased with two epidemics in short succession.
The bubonic plague reached Trinidad in 1901. 25 Then, smallpox raged through the colony
in 1903, with 5,257 reported cases and twenty-eight deaths. 26 The new Surgeon-General,
long-serving GMS doctor James de Wolf, and the Medical Board forfeited all credibility
internationally by refusing to declare Trinidad an infected port, raising the ire of Atlantic
world partners, and generating attention in the international media and medical press. 2 7

1
9 1897 LC #50, Surgeon-General AR, 31-2.

20 1898 LC #105, Surgeon-General AR, 31-2.

21 1900 LC #58, Surgeon-General AR, 33.

22 BPP 1898 [c.8655], Report ofthe West India Royal Commission, 69. BPP 1898 [c.8657],

Report ofthe West India Royal Commission. Appendix C.

2
3 1900 LC #58, Surgeon-General AR, 30, 32.

2
4 1901 LC #44, Surgeon-General AR 35, 54, 56, 64.

2
s 1900 LC #137, Bubonic Plague.

26 1904 LC #75, Surgeon-General AR, 4.

2
7 "Reported Smallpox in Trinidad," The Times, 12 March 1903, 5. ''The Epidemic in the

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 Ph.D. Thesis - L. Jacklin. McMaster- History

The GMS doctors pronounced the epidemic to be eruptive fever and chicken pox: the
scientific spirit of medical discoveries had permeated the medical mind in Trinidad, as
they then proclaimed their discovery of a new strain of Varioloid Varicella. 28 Dissenting
private physician George Masson rallied the Governor of Barbados to the most unusual
intervention of sending his smallpox expert to conduct an inquiry in February 1903: Dr.
Bridger confirmed smallpox. 2 9 However, the Medical Board refused to accept Bridger's
conclusions. The Colonial Office's medical expert, Dr. Patrick Manson at the LSTM,
reprimanded the GMS doctors for overlooking that the virulence of smallpox varied from
epidemic to epidemic. Trinidad was not experiencing the most devastating form of
smallpox, but the disease was nonetheless serious and highly contagious.3°

Tensions heightened as the Atlantic community united against Trinidad. The

Barbados public charged the doctors with officially conspiring to hide the facts of the
epidemic.31 This debacle caused the West Indies colonies to create a uniform Sanitary
Convention.32 Many countries and colonies henceforth distrusted Trinidad's official
proclamations that the colony was free from notifiable infectious diseases. Ships would
often find that the next port refused to accept a clean bill of health issued in Port-of­
Spain.33 The problem lasted for several years. In 1911, The Lancet, Secretary of State
Lewis Harcourt, and Surgeon-General Henry L. Clare confirmed that the Atlantic
community continued to harbour a "general distrust" of the colony, since the Varioloid
Varicella fiasco eight years earlier. The members of the West Indian Sanitary Convention
doubted that Trinidad's medical officials and government upheld the obligations of the
Convention.34

The international community, Whitehall, and the Trinidad public recognised that
government officials and doctors masked the truth of the health conditions in the colony.

West Indies," British Medical Joumal, 23 May 1903, 1231. "The Trinidad Epidemic," The Lancet,

20 June 1903, 1750-1. "The Trinidad Epidemic/ The Lancet, 29 August 1903, 628-9. "Small-pox

in the West Indies," BritishMedicalJoumal, 26 Sept.1903, 779.

28 The Colonial Office's medical advisors, Dr. Patrick Manson and the Local Government

Board, immediately dismissed the Trinidad doctors' claim that they had 'discovered' a new form

of disease. CO 295-425 (1903) #14062. Epidemic in Trinidad. CO 295-417 (1903) #20491.

Eruptive Fever Experiments. CO 295-425 (1903) #30223. Epidemic in Trinidad.

2
9 CO 28-260 (1903) #3831. Chicken-pox in Trinidad. "The Trinidad Epidemic," The

Lancet, 15 August 1903, 496.

3° CO 295-425 (1903) #14712. Disease in Trinidad. CO 295-425 (1903) #19555· Epidemic in

Colony.

31 ''The Barbadoes Papers and Dr. Bridger's Report," The Mirror, 19 March 1903. CO 295­
417 (1903) #17127. Epidemic ofEruptive Fever. Encl. #3 in despatch of 22 April 1903. Minute by
Surgeon-General.
32 1904 LC #59, Quarantine System in the West Indies. Report of Delegates at Conference
in Barbados. "The Scurrilous Trinidad Newspapers," The Mirror, 16 September 1910.
33 For instance, in 1910 and 1911, plague and smallpox cases caused Jamaica, the United
States, and the Royal Mail Steam Company to refuse bills of health issued in Trinidad and to
quarantine ships from Trinidad. CO 295-458 (1910) #21244. USA Quarantine on Trinidad. CO
295-465 (1911) #16008. Jamaica Quarantine on Trinidad. Encl.: Chamber of Commerce to
Colonial Secretary.
34 "Medical Administration in Trinidad: The Vindication of Dr. H.L. Clare," The Lancet, 8
July 1911, 103-5. CO 295-472 (1911) #5152, Medical Enquily Commission. Dr. Clare to Under
Secretary of State. ·

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 Ph.D. Thesis - L. Jacklin. McMaster - History

In immediate weeks leading up to the riot, the deficient public health conditions and the
lack of disease containment measures allowed smallpox to ravage the population. The
new governor, Alfred Moloney, did not declare the presence of smallpox until 20 April,
four weeks after the riot, when an exasperated Colonial Office forced him to issue the
Smallpox Proclamation.35 On the morning of 23 March, the day of the Water Riot, the
media printed the last instalment of Dr. Bridger's report where he concluded that
Trinidad's doctors had deceived the public. He pointed out the facts, which would have
been painfully apparent to the residents: people were succumbing to the disease in
droves in the absence of preventive and isolation measures. Bridger had witnessed the
hospitals overflowing with patients and sufferers being discharged into the community
while still contagious.36 Residents must have been confused as all signs supported
Bridger's conclusion and contradicted what their government and the GMS doctors had
been telling them.

"Mournful Monday": 23March1903

By March 1903, the deteriorating health conditions heightened the tensions in Trinidad.
The GMS no longer afforded care to many sick people and especially those who had
exhausted their meagre resources during the course of their illnesses. Surgeon-General
de Wolf faced unprecedented demands for medical care as sufferers sought relief from
the dreaded smallpox and other maladies.37 Amidst these health disasters, the only
bright light on the horizon was the completion of the long-awaited waterworks system
for Port-of-Spain. Residents were infuriated because the government continually turned
off the water, or cut the pipes if officials suspected water wastage.38 Clean water would
provide relief for bathing, drinking, cooking, and cleaning away the tropical perils.39
Although officials tried to restrict the public's consumption of the water, residents
insisted they would use the water to clean their homes inside and out, to rid the town of
"disease-spreading matter."4° Residents believed these were good public health practices.

The Legislative Council alarmed the public by announcing that it intended to levy
taxes on water by introducing meters through the planned Waterworks Ordinance.
Tensions heightened with the further notice that the public would be restricted from
attending the Council's meeting on the second reading of the bill. Many members of the
public had clearly had enough and wanted their voices heard. The Ratepayer's
Association organised a mass meeting. This photograph of the protest meeting is

35 CO 295-417 (1903) #18788, Epidemic ofEruptive Fever.

36 "Dr. Bridger's Report on the Cases of Eruptive Fever," The Mirror, 23 March 1903.
37 1904 LC #75, Surgeon-General AR, 3.
38 EPP 1903 [cd.1662], Report ofthe Commission ofEnquiry into the Recent Disturbances
at Port ofSpain Trinidad, 15, 18, 21. "Cutting off the water," The Mirror, 18 Feb. 1903. ''The
Water Question," The Mirror, 28 Feb. 1903. "Again at work," The Mirror, 7 April 1903.
39 ''The Water Question," The Mirror, 7 April 1902. "Our Failing Water Supply," The
Mirror, 6 Feb. 1903. "Dangerous to Health," The Mirror, 18 March 1903. "Covered Drains," The
Mirror, 31 March 1903. "Important to the Burgesses," The Mirror, 13 Aug. 1903.
4° "Alleged Official Trickery," The Min·or, 23 March 1903. ''The Water Supply," The Mirror,
4 March 1903. "Disease in the Cup," The Mirror, 6 June 1903. "A Threatening Danger," The
Mirror, 13 June 1903. ''The Same Old StOI)' of 'No Water'," The Mirror, 16 Jan. 1903.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

instructive in sho\\ing the behaviours of these supposed "uncivilised" 2,000 residents.4 1

Figure 6.3 - Ratepayer's Association. Mass Meeting at Queen's Park, 21March1903.42

Reprinted with permission, British National Archives.

This photograph illustrates the orderly behaviour and civilised dress of the people
as they protested two issues. The tax-paying public objected to the introduction of water
meters, believing that water should be free, as it always had been, and that the charges
would be unduly high. The residents also resented being excluded from the government's
reading of the waterworks ordinance, scheduled for two days later on March 23rd.
Officials subsequently described these protesters as a "mob" of the "lowest class of
coloured people - thriftless and lazy," and "poor, excitable, and ignorant" people who
followed the (educated) black leaders into the riot.43 To the contrary, Bonham
Richardson argued that they were concerned and frustrated citizens.44 Arguably, these
pictures could have shown a meeting of Britain's better classes, were it not for the colour
of the faces in the crowd. The Legislative Council refused to listen to the resolutions from
the Ratepayer's Association meeting in Queen's Park.

On the day thereafter called "Mournful Monday," between 5,000 and 6,ooo
residents arrived at Government House for the Legislative Council meeting, an
astonishing gathering in a town with 6, 793 registered ratepayers. The thousands of

4' BPP 1903 [cd.1662], Water Riot Commission Report, 23.

42 British National Archives, CO 1069/392/130, Mass Meeting at Queen's Park.

43 BPP 1903 [cd.1662], Water Riot Commission Report, 13, 26, 29.

44 Richardson, Igniting the Caribbean's Past, 178.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

assembled residents waved flags and sang God Save the King and Rule Britannia for
several hours, hoping to drown out the government discussion inside the building.4s The
executives of the Ratepayer's .Association were refused entry to the Legislative Council
meeting at about the time this photograph was taken.

Figure 6.4 - Citizens assembled outside Government House, 23March1903.4 6

Reprinted with permission, British National Archives.

Though described by the Inspector General of Police as a "good-natured" crowd,

tensions rose after a few hours of patriotic singing, with no signs of any concession from
the Legislative Council. People started pelting the building with stones. Arsonists lit fires
at 2.30. The Light Infantry, regular police, and fire brigade refused to respond to the
government's call for help. Soldiers were summoned from the HMS warship Pallas in the
harbour.47 The white soldiers shot into the crowd, leaving forty-eight people wounded
arid sixteen ~ead, with three people bayoneted.4 8 Citizens wanted to discuss water and
taxes, but the day ended with a civilian massacre and Government House in ashes.

45 BPP 1903 [cd.1662], Water Riot Commission Report, 6-10.

46 British National Archives, CO 1069/392 (128), Crowd at Western Side ofRed House. 23rd
March 1903 between 12 & 1 pm (Looking down Abercrombie Street).
47 The detachment of white mounted Light Infantry insisted that its jurisdiction was
restricted to external threats. One detachment of armed officers appeared and left quickly when
the people threw stones at them. BPP 1903 [cd.1662], Water Riot Commission Report, 8-10, 31.
48 BPP 1903 [cd.1662], Water Riot Commission Report.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Figure 6.5- The Burning of Government House (the 'Red House'), 23March1903.49
Reprinted by permission, British National Archives.

Urgent telegraphs from the Chamber of Commerce's white doyens demanded

that Chamberlain recall Governor Moloney and the officials at once, and send a Royal
Commission of Enquiry.so Chamberlain appointed Sir Cecil Clementi Smith to chair the
commission, which spent six weeks in Trinidad taking testimony in April and May
1903.s1 On17 April 1903, the Barbados public applauded the appointment of the
commission, while suggesting that Whitehall should strike a similar commission to
investigate the officials who had allowed the smallpox epidemic to rage unchecked.s2

The turmoil over the supply of clean and potable water had complicated the
public health and medical fiascos during constructive imperialism. Chamberlain's
commitment to tropical medicine to protect the white imperialists, while reducing the
state healthcare services provided to the "natives," had the opposite effect than desired in
Trinidad: the white elites were fearful and the heightened ill-health had created unrest.

The Civilising Mission Gone Awry

After Sir Cecil Clementi submitted his report, the Colonial Office waited a suitable period
and recalled Moloney, despatching Governor Henry Jackson and Colonial Secretary
Hugh Clifford to subdue the tensions. A more fearful British and Creole elite now

49 British National Archives, CO 1069/392/138, Burning ofthe Red House. 23March1903.

5o BPP 1903 [cd.1661], Papers Relating to the Recent Disturbances at Port ofSpain

Trinidad. Encl. 4: Chamber of Commerce to Chamberlain.

51 BPP 1903 [cd.1662], Water Riot Commission Report, 3-12.

52 "Trinidad Royal Commission," The Mirror, 29 April 1903.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

claimed that they wanted to communicate with the people.53 While their public
expressions became more controlled, the disregard for health and well-being of the
public did not change. Pushed to the brink of collapse, concerns over the GMS would
feature prominently in the discussions amongst the new British officials, as they
contemplated why the civilising mission had gone awry.

As part of his official role quelling the racial controversies, Clifford wrote a
poignant report evaluating the failings of each subject "race": black- and coloured­
Trinidadians, East Indians, and the racially degenerating white French- and Spanish­
Creole elite. His assessment of Trinidad's 'Colour Question' stunned the Colonial Office.
Clifford stated the extent of racial strife in the colony:

... the Colour Question is the one, all-pervading, and immensely difficult question
that underlies, and affects, more or less vitally, every matter connected with the
administration of the Colony.... The Colour Question is all-pervading, and at any
time may, by an accidental circumstance, be rendered acute and dangerous. The
bulk of the political power is still vested in the whites who, however, have lost
their prestige, and are hated and suspected while they have ceased to command
admiration and are rapidly ceasing ... to command the respect which is born of
fear. The black and coloured people believe themselves to be the victims of gross
injustice, and claim, with some show of reason, that they are in many respect the
equals, and even the superiors of many of the whites.54

Clifford criticised the Water Riot report by his mentor, Sir Cecil Clementi Smith, for
failing to mention the pervasive racial tensions, although they were clearly central in the
riot and the other profound struggles in the colony.55

Clifford undoubtedly exemplified the racist British ideals of the era, which
troubled even his idolising biographer.56 This emissary, sent by the Colonial Office to
regain control over the colony, blamed the problems on the Africans' failure to progress
and embody the important moral and spiritual sensibilities of civilisation.57 Clifford's
evaluation remained confidential amongst the white British officials. However, in his
report in the public Blue Book, he barely concealed his distain for the non-white
residents as he explained the reasons why the GMS hosted so many patients .

... the average poverty is greater, though indigence in the tropics is robbed of
many of the terrors which it has in colder climates; and there is lacking to us that
strong, well-to-do middle class, which, both in France and in England, forms the
backbone of the nation .... the less wealthy have little to spare when the demands
made by the high cost ofliving have been satisfied; the poorer classes, from
whom the principal users of the Government Institutions are naturally drawn, are
averse from paying for what they there receive, even when they could do so, albeit

53 BPP 1905 [cd.2238-19], Trinidad and Tobago Report for 1903-04, 11-12 [Blue Book.]
54 CO 295-435 (1905) #17402, Colour Question in Trinidad, Hugh Clifford to C.P. Lucas,
"Memorandum on the Existing Condition of Race-Feeling in the Island of Trinidad."
55 CO 295-435 (1905) #17402, Colour Question in Trinidad.
56 Harry A. Gailey, Clifford: Imperial Proconsul (London: Collins, 1982), 52-3.
s7 CO 295-435 (1905) #17402, Colour Question in Trinidad.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

at the cost of some personal inconvenience.s8

Clifford stated that Africans resented the free medical care provided by the government
for the indentured Indians in the colony: Afro-Trinidadians decided that they, too, were
entitled to free medical care and had the right to use government resources, such as the
hospitals.s9 In Clifford's view, the lower orders had failed to embrace British values:
respectable Britons knew their taxes allowed charitable medical services to be delivered
to the poor. However, these residents had confused charity with entitlements.

Clifford had misconstrued the public's vocal complaint about the state healthcare
services provided by the GMS to indentured Indians. The non-elite majority had always
opposed being taxed to subsidise the sugar industry, and the tensions heightened when
the public was increasingly restricted from using the primary tier of GMS services. 60 The
people recognised that the GMS services were not governmental charity: the colony
levied taxes on imported products to pay for the system and it was the masses who
shouldered the burden of taxation. 61 Patrick Bryan's critique of the dichotomous nature
of Jamaica's GMS suggests the magnitude of the problem in Trinidad:

Medical facilities could not solve problems which were deeply rooted in a policy
of social exploitation which cynically and callously imposed taxes on the poor for
their own poor relief, or taxed imported protein foods used by the poor. 62

Residents drew a direct connection from their taxes to the GMS doctors and hospitals,
and thus considered, rationally, that they had paid for these resources. Conversely,
Trinidad's imperial trustees decided that the problems with the GMS had resulted from
the mistaken view of the uncivilised masses that they were entitled to free medical care.
Since 1895, the official discourse exonerated colonialism from any responsibility for
creating the poverty experienced by most residents. The GMS was acknowledged to be at
the brink of collapse, attenuating the insufficiency of the meagre coping mechanisms of
the people who needed to use the system.

Trinidad's lower classes were not passive recipients of the changing government
policies. This analysis now turns to the view of the patients and, in particular, the poorest
people in the colony, the GMS's Pauper and Poverty Certificate patients. As opposed to
being pauperised by the system, many people struggled to obtain their entitlements,
while using a variety of creolised therapeutic systems and western medicine as part of
their complex survival strategies.

58 BPP 1905 [cd.2238-19], Trinidad and Tobago Blue Book, 11.

59 BPP 1905 [cd.2238-19], Trinidad and Tobago Blue Book, 11-12.
60 "The Medical Service. Letter from 'A Sufferer'," The Mirror, 22 February 1904.
61 CO 295-395 (1899) #6998, Industries ofthe Colony. Encl. "Sugar Planters and Their
Opponents. West Indians and Members of Parliament. Facts for Mr. Chamberlain."
62 Patrick Bryan, The Jamaican People 1800-1902. Race, Class and Social Control
(Jamaica: Univ. of West Indies Press, 2000), 186.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Certifying Impoverishment:

GMS Pauper and Poverty Certificate Patients.

Poverty and Pauper Certificate patients represented the largest numbers of people in the
GMS system. In 1875-76, Governor Henry Irving had systematised the criteria by which
poor people qualified for services in The Regulations for Medical Attendance on the
Poor, 63 which remained in force during this study. In the absence of a system of Poor
Laws, and its mechanisms to authenticate poverty and medical need, the GMS deputised
officials and respectable citizens to ascertain the people's entitlement to use the system,
according to The Regulations. Before applying to the doctor, sufferers had to obtain their
certificates from officials or respectable ratepayers. 64 The screening process interjected
non-medical intermediaries into the patient-doctor relationship to ensure that poor
patients met the criteria of being poor enough for assisted or free services.

Poverty Certificates entitled sufferers to medical attention and medications

during a two-week period, for a few shillings for each visit to the doctor, after a burgess
or respectable local ratepayer signed the certificate. Pauper Certificates allowed patients
to receive treatments and medicines, free of charge, for four weeks. In contrast to the
Poverty Certificates issued by members of the community, sufferers needing the so­
called "pauper papers" had to apply to a government official, such as the local warden or
health inspector. 6s Table 6.6 summarises the number of certificates issued, between 1895
and 1915, where the data is available. More than 582,289 people used certificates during
the seventeen years tabulated in this graph, or an average of 34,000 people each year.

63 CO 295-276 (1876) #n95. Return ofmedical appointments under the new Scheme. Encl:
Regulations for Medical Attendance on the Poor. The regulations were reprinted in the annual
Almanacs. See, for instance, The Trinidad Official and Commercial Register and Almanack, 1882
(Port-of-Spain: J. Wulff, 1882), 50. [Hereafter, Trinidad Almanack, or Trinidad and Tobago
Yearbook (after 1898).]
64 Trinidad and Tobago Yearbook, 1898, 92-3.
65 The regulations, enacted on 1January1876, did not specify limits on the validity of the
pauper and poverty certificates. The published Regulations for Medical Attendance on the Poor
in the official almanacs to 1882 did not state time limits, but the two and four week limits were in
the 1886 and subsequent almanacs. It is unclear how long patients could use their certificates,
prior to 1886. CO 295-276 (1876) #1195, Return ofMedical Appointments Under the New
Scheme, Encl. in Trinidad despatch #5 of 6 Jan 1876. Trinidad Almanackfor 1886, 86-7. Sample
certificates are in CO 295-335 (1891) #21907, Minutes ofCommittee, Encl: Regulations for
Medical Attendance on the Poor, D. Wilson, Acting Colonial Secretary, 14 Sept. 1885. The
Regulations did not change, except for variations on the token fees and the introduction of the
expiry date. TrinidadAlmanackfor 1882, 50. Trinidad and Tobago Yearbookfor 1898, 92-3.
Trinidad and Tobago Yearbook for 1899, 185-6.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Table 6.6 - Poverty and Pauper Certificates Issued, 1895-1915.

Data Sources: Surgeon-General Annual Reports.

50,000
~
•
./
::J
tJ)

!!!. 40,000
tJ)
Q)
-ro
:e ~·· J •
(..)

30,000
(3
(fJ
~ 20,000
(.'.)
0
Q;
.0 10,000
E
::J
z
0
1895 1900 1905-06 1910-11
Year (Gm.emment Fiscal Year)
---­ -

__.._ Po1.erty Certificates - - ­ Pauper Certificates ----­ Total Certificates Issued

The statistics in Table 6.6 establish that the number of people who could afford to
pay the token sum associated with Poverty Certificates constituted the minority. The
larger group received Pauper Certificates, reflecting their claims to more destitute
circumstances. The largest increase in patients occurred amongst the recipients of
Pauper Certificates, who received medical care and medications free of charge, while the
number of Poverty Certificate patients settled into a rather constant range. The total
population and number of certificates issued increased substantially during this period.
However, the relative percentage of the public who used certificates remained constant,
averaging about 12-4% each year. 66 This trend suggests that the number of poor patients
reached equilibrium during these decades, with this disadvantaged stratum remaining
the same relative size, albeit large in absolute numbers.

The upward fluctuations in the number of certificate patients tended to reflect

cycles of prevailing poor health, epidemics, adverse climactic conditions, or general
economic distress. In some years, multiple factors caused more residents to seek
assistance from the government. The GMS doctors tended to the largest number of
certificate patients in 1903-04, when the small-pox epidemic and Water Riot caused an
extended period of civil unrest, economic dislocation, and the public health crisis. An
unprecedented 45,104 people, or 16.3% of the public, qualified for treatments as
certificate patients. 67 In other years, patient numbers fluctuated geographically in
response to local conditions. 68 For instance, Dr. Robert H.E. Knaggs attributed the

66 These annual averages are calculated using the mean annual population (from Appendix
2.2) and the number of certificates issued (from Table 6.6).
67 This is calculated for 45,104 certificate patients, in an annual mean population of 277,417
in the public at large (286,294 residents less the indentured East Indians, who did not qualify for
certificates and did not use the GMS primary tier).
68 For instance, in 1907-08 the Surgeon-General reported a decrease in patients in Port-of­
 Ph.D. Thesis - L. Jacklin. McMaster - History

increase in the number of paupers treated in 1897 to the "general hard times" faced by
the residents in his district, rather than any increase in morbidities. 6 9 In the St. Joseph
district, Dr. Henry Alston treated each of his 2,260 certificate out-patients an average of
five times that year.7° In other years, adverse economic conditions, drought, and
unhealthy public health or climatic conditions could take their toll and temporarily draw
more users into the system.

The sources do not confirm how many people tried to obtain certificates and
failed, or the number of people turned away without treatments. Dr. Doyle had refused
to treat one third of the people seeking admission to the Port-of-Spain Hospital in
1900,11 suggesting that a substantial number of people elsewhere may have been refused
certificates or treatments. Some doctors periodically considered the certificate
authorities too liberal in their evaluation of the circumstances of the applicants. In 1895,
Dr. R.C. Bennett waged a personal crusade to end what he believed was the "lavish and
improper issue of pauper certificates." He proudly reported his success in terminating all
medicalised out-door relief in his district: "The results have been magical. All the strong,
lusty, lazy loafers etc have vanished, like Shakespeare's Witches in Macbeth 'into thin
air'." Bennett believed that the poor in his district represented a purely "'artificial
construction"' and insisted that there was no need for these people to reappear at his
door.12 This pronouncement appears harsh in light of the difficult economic times in
Trinidad. If these so-called strong loafers truly required medical care, they plausibly
sought the services of a doctor in another district. On the other hand, Dr. Knaggs took
exception to Lovell's cutbacks and overrode the decisions of the certificate-issuing
officials, making a point that he often waived the minor fee required by the Poverty
Certificate.73 As a member of elite Creole society, Knaggs could assert his authority to
ignore the politically-motivated decisions. Hugh Clifford's insistence that the poor
Trinidadians found it a "personal inconvenience" to pay for medical care did not
acknowledge that doctors, such as Knaggs, recognised that many patients had very
limited resources.

Some doctors waged campaigns which failed miserably. The abject poverty of the
people startled Dr. J.F. Gibbon, the DMO in Tobago. In 1899, Gibbon described the
conditions throughout his district as "wretched in the extreme." He was dismayed to find
children huddled "on the floor in rags, sacking, and any refuse of clothing obtainable."
Nonetheless, Gibbon's comments reflected the civilising discourse of elite society. He
blamed the victims, insisting that the high morbidity and mortality rates would prevail
until the people achieved greater "enlightenment."74 Gibbon soon accepted the sights
which had once shocked him. He claimed that parents feigned pauperism to get free care
for their children and he decided to force the development of a "healthier consciousness

Spain and Princes Town, but an increase in San Fernando and six rural districts. 1908 LC #111,

Surgeon-General AR, 3. In the following year, patient numbers declined in Port-of-Spain and

nine districts, but increased in five other districts. 1909 LC #103, Surgeon-General AR, 8.

69 1898 LC #105, Surgeon-General AR, 21-2.

1° 1898 LC #105, Surgeon-General AR, 22.

1
1
1901 LC #44, Surgeon-General AR, 35, 54, 56, 64.
1
2
1896 LC #129, Surgeon-General AR, 24.
73 1896 LC #129, Surgeon-General AR, 19.
74 1900 LC #58, Surgeon-General AR, 38-9.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

of individual respectability" by making paupers pay one shilling, although The

Regulations entitled them to free care. Gibbon's crusade failed. One shilling may have
been a token sum to the doctor, but it was beyond the capabilities of many families. He
subsequently lamented that his actions resulted in a "considerable and much to be
regretted neglect of children."7s Most parents henceforth only made one ill-fated trip to
Gibbon when their child was in an "advanced Cachectic state," using the doctor to negate
the need for a post-mortem inquiry into the cause of death.76 No one held Gibbon
accountable for his failed attempt to civilise the people; similar to Dr. Doyle, individual
zealousness to civilise the people, by teaching them to provide for themselves, had only
succeeded in sacrificing the bodies of impoverished sufferers.

Commentators took pen in hand to criticise the obstacles placed in the way of
ailing people who attempted to obtain medical relief. For instance, in 1903, The Mirror
printed a letter from 'Truth,' who reminded readers of the conditions of life for the lower
orders. Sick people from Gran Couva's extended geographic district made their way to
town and camped out under the awning of the warden's office, waiting for his weekly
visit. The somatic conditions of these people wasting away on the street caused residents
to take matters into their own hands and make the four-mile journey to the warden's
main office in another town to procure certificates on behalf of the dislocated sufferers
languishing in the streets. 'Truth' summarised the inhumanity of forcing people into
public displays of suffering as "unpleasant and reprehensible," calling for the citizens to
be deputised to issue certificates to "deserving" paupers, so that the sufferers would not
be subjected to these extended periods of "human agony and distress."77 Gran Couva
residents displayed respectable behaviours by advocating on behalf of the paupers,
taking their complaint to the media when the warden and DMO did not share their sense
of urgency in ensuring that the people received the medical care paid for by their taxes.

The DMO's disinterest could become more pronounced as he progressed through

the GMS career paths designed to solidify his socio-economic position in the colony.
Junior physicians worked in the institutions, receiving promotions to progressively less
impoverished rural districts, perhaps finally meriting lucrative postings as urban DMOs
or managers of the large medical institutions.78 DMOs retained the right to private
practice and were encouraged to tend to paying patients to augment their low salaries.
Doctors could readily prioritise their private practices and the health needs of their elite
patients, who could engage the doctor as a private physician, rather than as a GMS
doctor. A doctor's tendency to neglect his governmental duties periodically became a
matter of public controversy. In 1901, The Mirror criticised the selective nature of the
medical practices of the DMOs in Port-of-Spain:

It is not likely that such a highly paid doctor is going to get out of his bed at night
to visit poor Quashie rolling with fever in a nasty, dark hovel on the banks of the
Dry River. His fee is not a certainty in that case. When Mr. Golden ... has an
attack of indigestion the case is somewhat different. 79

75 1907 LC #123, Surgeon-General AR, 15.

76 1908 LC #111, Surgeon-General AR, 13.

77 "The Poor Ye Have Always with You," Letter to the Editor, The Mirror, 22 April 1903.

78 CO 295-432 (1905) #14856. Medical Dept. Encl. #3, Surgeon-General, 23 February 1905.

79 "The Medical Service," The Mirror, 17 August 1901.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Editor R.R. Mole reminded readers that the GMS doctors received their salary to treat
poor fevered "Quashie" and other impoverished people in their districts. However, some
doctors wanted to direct their professional attention to "Mr. Golden" and other elite
patients outside the GMS system. The newspaper claimed that private practitioners
performed "most of the poorer and pratis work of the town," while the government
doctors continued to "compete with them for the patronage of the better classes." 80 The
records do not allow Mole's allegation to be confirmed or denied, but the media debate
over the duties of the doctors suggests that some sufferers had difficulties obtaining their
entitlements to state healthcare.

The majority of interactions among doctors, intermediaries, and the 30,000 to

40,000 certificate patients each year proceeded with a surprisingly minimal amount of
publicity. Contrary to the official view of the Africans and Indians as uncivilised, many
patients were hard-working community-oriented people. Residents refused to be
stigmatised, although Drs. Gibbon and Bennett, and Gran Couva's warden, tried to
impose shame on the patients. This presents a stark challenge to the official view that the
benevolent GMS services pauperised the population: the tenacity exercised by some
sufferers to receive their entitlement suggests the magnitude of medico-economic need.
The officials correctly identified that the people considered the GMS services as an
entitlement, but they misjudged ~he reasons why those people needed the help.

The Patient Experience

The government records rarely ever recorded the voice of the patient, which makes it
difficult to excavate the reasons why the people used the GMS services. Roy Porter
argued that the attempt to reconstruct the patterns of consciousness of the patients is
one of the major challenges to writing patient-centred histories from below. 81 Despite the
deficiencies in the sources, it is possible to ascertain two characteristics of the patients in
the system. Many people surmounted major difficulties to reach the GMS doctors.
However, the GMS was not necessarily a reflexive response: a large number of people
used many other forms of healing and medicine, but integrated the GMS services into
their regime late in the cycle of illness. One of the repetitive complaints the GMS doctors
voiced about their patients involved the large number of people who delayed seeking
their services. David Trotman argued that many people did not go to the hospital until
the last possible minute, because they distrusted the effectiveness of the GMS medical
care. 82 While many people may indeed have held this opinion, other laggard patients
considered it an alternative to their preferred form of healthcare, or they used the system
in a utilitarian way when their ailments created or amplified destitution.

Doctors continued to express great angst because so many patients did not seek

80 "The Medical Service," The Mirror, 17 August 1901. "The Medical Service," The Mirror,

27 Sept. 19oi.

81 Roy Porter, "The Patient's View. Doing Medical History from Below," Theory and Society,

14 (1985), 182, 185.

82 David Vincent Trotman, Crime in Trinidad. Conflict and.Control in a Plantation Society

1838-1900 (Knoxville: University of Tennessee Press, 1986), 148-9.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

GMS assistance until their conditions became far advanced. Their reports stated that
patients continually arrived in "pathetic" states, requiring months of intensive medical
and nursing care, while other sufferers had progressed beyond the point where medical
interventions could have a positive outcome. Physicians routinely criticized these
patients for their tendency to apply for medical relief only when "far gone in illness" and
in "hopeless condition."8 3 Patients had obviously suffered for some time, but sought the
GMS doctor only after their co-morbidities or destitution, or perhaps both, finally
rendered their conditions unmanageable. Doctors made a point of reporting the arrival
of new patients in extremely "low" or "collapsed" conditions and often recorded their
extreme states of malnourishment. 84 The physicians recognised that the impoverishment
complicated the patients' morbidities and "considerably diminished their chances of
survival. "8 s Doctors pointedly admonished caregivers for failing to be proactive in
summoning them. Dr. F.A. de Verteuil, for instance, insisted that he should have been
called to the homes of the majority of the people who died in his hospital, "but they are
brought down in hammocks and taken to the Hospital, when all chance of relief are
gone." 86 These types of complaints from the doctors became more acute during the
recurrent epidemics. Chief Surgeon Dr. E.A. Turpin identified the enormous strains on
the San Fernando Hospital when a local dysentery epidemic induced many long­
suffering residents to seek treatments. Their extant chronic illnesses, which happened to
be hookworm in many of these cases, had already rendered the patients' bodies too weak
to withstand an attack of dysentery. Turpin's staff had little success saving many of these
patients who finally sought admission to the hospital. 8 7

Countless patients presented themselves to doctors in weak and emaciated

conditions during the final throes of illness and then promptly expired. 88 As established
above (in Chapters 4 and 5), the GMS continually faced criticisms about the high
institutional mortality rates. Doctors reflexively responded to these critiques by
diligently recording and publishing statistics on the elapsed times between the admission
and death of hospital patients. These statistics confirm the doctors' complaints that
many people arrived in 'hopeless' conditions. For instance, in 1901-02, more than 87% of
hospital deaths occurred within one month of admission, and just over 12% of the newly
admitted patients who died did so within minutes or hours of arriving at the hospitals. 8 9
Similar mortality rates continued throughout this period. Doctors amassed these
statistics as a defensive action to exonerate their professional abilities. They attributed
many deaths to the long inactions by the deceased, insisting that many people arrived
"when their condition is practically beyond medical skill."9° Trinidad was not the only
plantation colony to experience this problem. Jamaica's GMS doctors continually voiced

83 1896 LC #129, Surgeon-General AR, 29. 1911 LC #130, Surgeon-General AR, 5. 1913 LC

#8, Surgeon-General AR, 21.

84 1896 LC #129, Surgeon-General AR, 29. 1897 LC #50, Surgeon-General AR, 34.

8s 1914 LC #91, Surgeon-General AR, 31.

86 1897 LC #50, Surgeon-General AR, 32.

87 1914 LC #91, Surgeon-General AR, 31.

88 1896 LC #129, Surgeon-General AR, 29. 1890 LC #35, Surgeon-General AR, 11. 1906 LC

#100,Surgeon-GeneralAR,25.

89 The death rates are calculated from the statistics in the annual reports. 1902 LC #57,
Surgeon-GeneralAR,35.

9o 1913 LC #8, Surgeon-General AR, 21.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

their frustrations over the spectacle of many terminally ill and "moribund" cases arriving
at their institutions.9 1 Similar to Trinidad, Bryan argued that many Jamaicans did not go
to the hospital until their diseases were terminal: sufferers meanwhile used other
therapeutic systems, with great success.92

Trinidad offered a multitude of different healing systems and remedies to the

public. Although we know little about the persistence of Inda-Caribbean practices, the
emerging literature of Afro-Caribbean healing confirms the perseverance of traditional
ideologies on health and healing, supported by an extensive array of practitioners and
resources in the community, through to today.93 The colony also supported a vibrant
pharmaceutical marketplace. Creole pharmacist L.0. Inniss confirmed the public's great
enthusiasm for 'Creole Remedies' and folk treatments. Inniss and his pharmacist
colleagues promoted a plethora of self-administered remedies.94 Trotman established
that Obeah practitioners and herbalist medicine retained vigorous followings in the
colony, especially due to the scarcity of the GMS resources in the rural areas:

... there were no doctors within ten to fifteen miles of rural areas like Moruga,
LaBrea, and Toco. There were no government health services in these areas, since
the health centers outside of Port-of-Spain tended to be located only in those
areas where there was a heavy concentration of indentured East Indian labor.95

Taken together, these forms of healthcare suggest that residents capitalized on many
different types of resources, and state healthcare services were simply one of the
solutions. Thus, although colonial officials inherently assumed that western medicine
was a superior system, many residents considered it as only one form of therapeutics.
The major attraction to the GMS for patients in "pathetic" states may have in fact been
the institutional facilities and medicalised relief, which helped address the problem of
destitution accompanying protracted illnesses.

As suggested by Trotman, the distance between patients and physicians was a

factor mitigating the potential for sufferers to use the GMS services. The problem of
lengthy and arduous journeys had featured prominently in the medical rationalisation of
the importance of constructing the network of district hospitals in the 1880s. Doctors
characterised these rural facilities as vitally important to "save those dangerously ill from
being subjected to long and rough journeys to Port-of-Spain or San Fernando," which

91 See, for instance, Jamaica Sessional Papers 1898-99. Report on the Public Hospital for
the year ended 31st March 1899, 1.
92 Bryan, The Jamaican People, 185-6.
93 As established in the literature review, above (in Chapter 1), there are no studies on
Trinidad, but the emergent literature for other British colonies suggests that many of these
traditions may have been in place in Trinidad. Michel Laguerre, Afro-Caribbean Folk Medicine
(Mass: Bergin and Garvey, 1987). Arvilla Payne-Jackson and Mervyn C. Alleyne, Jamaican Folk
Medicine (Jamaica: Univ. of West Indies Press, 2004), M.F. Olmos and L. Paravisini-Gerbert,
Healing Cultures. Art and Religion as Curative Practices in the Caribbean and Its Diaspora
(Hampshire: Palgrave, 2001).

94 L.O. Inniss, Trinidad and Trinidadians. A Collection ofPapers, Historical, Social and

Descriptive, about Trinidad and its People (Port-of-Spain: Mirror, 1910), 141-9.

95 Trotman, Crime in Trinidad, 226-7.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

had been the only location where residents could obtain hospital care until that time.9 6
The network of district hospitals helped to reduce the distances travelled by some
patients and doctors, but did not solve the problem for everyone. In 1905, Governor
Jackson acknowledged the need for patients to travel long distances to reach the GMS
facilities, at the same time that he had characterized the people as sadly lacking in
industriousness, as established above. Jackson admitted that sick people often found
themselves far away from medical care. Long journeys complicated their destitute
conditions, "so men whom a little earlier treatment would have saved from illness, and
who might even have been willing to pay a small sum for it, remain where they are until
they are so ill that it needs a lengthy stay in the hospital to set them up."97 Doctors
continued to complain about the length of the journeys faced by their patients,
complicated by the colony's primitive transportation infrastructure. The problem
heightened each year when the long tropical rainy season made the poor roads generally
inaccessible.98 Dr. A.P. Lange, for instance, bemoaned the fact that "disgraceful" road
conditions made it "almost impossible" for many to seek his services.99 Unhealthy bodies
lacked the physical wherewithal to make a difficult journey and could only hope that
their friends and family retained the s41.mina to get them where they needed to be.

The death of cocoa contractor Manson Mitchell ofTamana illustrates one such
example of patients who struggled with these obstacles. Mitchell died quickly after
succumbing to illness, in less than a day: the police inquired into his death. As with his
fellow independent peasants, Tamana residents had to travel about sixteen miles to
reach the doctor at Arima. The road conditions during the rainy season were so bad that
Mitchell could not get to the doctor. Death came swiftly. The rains continued to fall and
the doctor could not get to Tamana to certify the death before they buried Mitchell's
body. 100 Distance and road conditions remained an important impediment for many
sufferers other than Manson Mitchell. Arima's DMO, Dr. F.A. de Verteuil, confirmed the
magnitude of the problem. He attributed the rather high mortality of patients admitted
to his district hospital to the stresses of the journeys. Many patients fared poorly during
the trips and arrived "in a very deplorable condition." 101 Dr. F.A. de Verteuil was quick to
admonish caregivers for failing to summon him in a timely fashion, but had neglected to
account for the distance between himself and his patients.

Residents in this tropical climate often sought the services of a doctor as soon as
they succumbed to illnesses known to require immediate attention, but there was no
guarantee of finding the doctor at the end of an arduous journey. For instance, upon
suddenly becoming very sick, Tobago resident Richard Jones made the 13.5 mile journey
to the DMO. On finally arriving in Scarboro, Jones found that Dr. Gibbon was in
Trinidad. The police intervened, but Jones expired before reaching the town's hospital. 102
Similarly, the parents of five-year old Peua Dichong became extremely concerned over

96 CO 295-313 (1887) #9405. Medical witnesses. Encl. #5. Acting Surgeon-General B.

Pasley.
97 CO 295-432 (1905) #14856. Medical Dept. Encl.: Despatch #106. Jackson to Lyttelton.
98 1895 LC #94, Surgeon-General AR, 8. 1898 LC #105, Surgeon-General AR, 24-5.
99 1898 LC #105, Surgeon-General AR, 28-9.
100
"A Sudden Death at Tamana," The Mirror, 19 February 1902.
101
1896 LC #129, Surgeon-General AR, 30. 1897 LC #50, Surgeon-General AR, 32.
102
"Tobago. Sudden Death," The Mirror, 27 February 1902.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

their child's health amidst a fever epidemic and wanted medical attention at once. They
carried Peua from their distant village to Gran Couva two days in a row, but were unable
to engage the DMO. Little Peua died without seeing the doctor. 103

Residents more proximal to the urban hospitals did not necessarily fare better in
their quest. After travelling to the warden's office to get his certificate for admission to
the San Fernando hospital, Ramdeen continued on his journey, only to be found dead on
the road the next day. The post mortem inquiry revealed that Ramdeen died from acute
pleurisy and diseased kidneys, suggesting that he suffered immensely during his trek. 104
The media reported similar cases of dead bodies found along the routes to the
hospitals. 10s The experiences of these and innumerable other people confirmed the plight
of sufferers who attempted, but failed, to obtain medical assistance. Trinidadians needed
to possess inordinate tenacity at times to reach the medical services they desired.

Conclusions

Historians of medicine struggle to reconstruct the health experiences of sufferers in the

past, encountering all the challenges of history from below. Plantation society
colonialism added another level of complexity to the struggle to reveal the voice of the
patient, because of the enduring disinterest in the perspectives of the people who
managed the system. The most prevalent voices in the records of colonialism reflect the
views of the colonial elite and doctors who organised the system. They would have us
believe that Trinidad offered the potential of prosperity for industrious people, but that
their benevolent GMS services had instead allowed the subject peoples to develop a bad
habit of depending on charity.

When reading across the archival grain, many opposing realities of plantation
society come to light. Colonialism could make the people unhealthy and continually push
them towards poverty. Sufferers employed a variety of strategies to maintain or regain
their well-being, and the state's healthcare services represented one of those alternatives.
People who desired to engage with the GMS practitioners routinely encountered many
obstacles placed in their way, but exerted considerable tenacity to extract what they
desired from the system. The fact that tens of thousands of patients engaged with the
state's medical services organisation each year suggests that the GMS was indeed a vital
component of the colony's medico-social landscape, providing important services to
many patients who made conscious decisions to employ western medical therapeutics in
their quest for health. The discontinuity between constructive imperialism's version of
the civilising mission and the reality of life in Trinidad played out each day as the
broader tensions of colonialism continued to manifest in the struggles by the subject
peoples to access and utilise state medical services.

The events leading up to the ill-fated Water Riot confirmed that the public was
concerned about the politico-economy of health and well-being in their community.

10 3 "Death of a Child through Want of Medical Aid," The Mirror, 8 May 1902.

10 4 "Died on the Way," The Mirror, 8 February 1902.

10
s "Died on the Way," The Mirror, 7 Sept. 1901. "The post mortem," Port-of-Spain Gazette,

25 Oct. 1905.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Their demands for pure water to flush away the perils of the tropics and cleanse the
smallpox-infected town represented a civilised form of behaviour. When their orderly
protests were ignored, the actions of a few arsonists captured the attention of officials in
the metropole and necessitated a changing of the guard in the colony. Racial tensions
pervaded. However, as lamented and perpetrated by Hugh Clifford, the racial tensions
were never publicly mentioned in the report by the commissioners who investigated the
riot. Tense racial relations had always been at the root of the controversy over the GMS.
Thus, when tens of thousands of people continually sought the services of the GMS
doctors, even after the cutbacks, their power was derived from the aggregate of their
numbers. The Indo-and Afro-Trinidadian people continued to have a voice, albeit muted,
in the creolising of state healthcare, but only because they continued to be tenacious in
attempting to get the resources which they needed to deal with the effects of plantation
society colonialism.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

-Chapter 7­
Conclusions

Trinidad's Government Medical Services and its doctors experienced many challenges
during the period of this study, although many of the struggles were not unique to the
plantation society in this colony. The GMS doctors strove to keep up-to-date with the
constantly changing medical knowledge and attempted to keep their medical practices
and institutional facilities current. Similar to their colleagues in the metropole and other
colonies, the government doctors participated in the broad movement for medical
professionalization, while attempting to enhance their socio-economic standing. Patients
presented themselves with medical conditions and diseases which puzzled the doctors
and for which there were no therapeutic regimes to alleviate the suffering. In terms of
the institutional structure, the GMS was constantly criticised for being too costly, but it
never seemed to have quite enough resources. In these and countless other ways,
colonial medicine in Trinidad shared many challenges and characteristics with other
forms of organised medicine elsewhere in _the world.

The Colonial Office's edict for the colonial governments to assume the
responsibility for the medical care of the indentured East Indians was an anomalous
development during the imperial world's transition to free trade and amidst the rise of
laissez-faire government. The government's program to provide doctors and healthcare
resources to the sugar estates constituted a subsidy to private enterprises. Conversely,
the public health and medical responsibilities mandated for the employers by the Coolie
Immigration Ordinances were plausibly without precedent in any other part of the
imperial world, except for plantation colonies. These laws required private agricultural
companies to provide medical and health-related services to their employees, such as
hospital facilities and supplying their workers with daily rations of food. In effect,
Whitehall directed its plantation colony governments to intervene into free enterprise
while subsidising those same businesses to address the mortality and health problems
for an identified labourforce. In Trinidad, some planters rejected these forms of
governmental interference and attempted to circumvent their legal obligations.
However, the plantocracy never challenged the local decision to provide the government
doctors and medical services gratuitously to the indentured estate labourforce. The
planters derived a benefit from this secondary tier of the GMS services, paid for from the
public purse.

In Trinidad, the need for this governmental intervention was symptomatic of a

more fundamental problem, which remained the most prominent determinant of the
uniqueness of colonial medicine: the planters' disregard for the health and longevity of
the sojourning labouring East Indians. The legacies of slavery continued to permeate the
Creole elite's consciousness and attitudes about the African and East Indian subject
peoples. As argued throughout this study, the labouring bodies of the lower classes
continued to be commoditised and considered as expendable entities. This ideology
persistently shaped the contours of colonial medicine in Trinidad and periodically
incited the conflicts between the Creole and British officials.

The uniqueness of Trinidad's state healthcare and medical services involved its
status as a governmental entity in a post-emancipation plantation society. The broader

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 Ph.D. Thesis - L. Jacklin. McMaster - History

tensions of plantation society colonialism constantly shaped the contours of state

healthcare services. Trinidad was a racially troubled society where a tiny class of elite
white Creoles retained the economic, political, and social power, and wielded an
inordinate amount of authority over the lower orders of African and East Indian peoples.
This consolidation of power in the hands of a few allowed this elite to determine the fate
of many colonial residents, including their ability to live healthy and long lives. The
colony emerged from emancipation without the broadly based medico-social
infrastructure that had become so important to the British metropolitan model of the
mixed economies of social welfare and the medical marketplaces. The evolution of the
practice of modern medicine in the colony would be severely restricted by the lack of a
diversified system of public, private, charitable, and voluntary organisations. Plantation
societies were predicated on a structure of two socio-economic classes. The inordinately
large lower class mass of the colonial residents did not have the economic resources to
contribute to the creation of a diversified system. The upper strata of society did not
conceive of a personal obligation to institute philanthropic health-related programs, thus
forcing the responsibility to devolve to its members who governed the colony. As private
citizens and colonial rulers, Trinidad's white Creole elite retained a restricted view of its
obligation to become involved in the health and well-being of their subject peoples.

For the duration of this study, Trinidad's plantocracy maintained a purposeful

strategy to create a population of impoverished peoples, in an attempt to force the people
to labour in the gruelling and exploitative plantation economy. Many policies supported
this program, such as the restrictions on acquiring Crown Lands, the suppression of
wage rates, and the high taxation on basic foods and imported goods. The official
rhetoric constantly rationalised this strategy as an important part of the mission to
civilise the African and East Indian peoples, by transforming them into productive waged·
agricultural labourers and teaching the people the coveted British values of thrift and
industriousness. The plantocracy failed miserably as agents of civilisation within the
parameters of its own rather convoluted interpretation of the civilising mission.
However, Trinidad's Legislative Council was exceedingly successful in achieving its
objective of keeping the masses of the people impoverished. Extreme poverty
characterised this colony. At the end of this period, an educated black and coloured
middle class had started to emerge and would subsequently challenge the shackles of
colonialism which had kept so many people poor for so long. However, for the majority
of the century, very few people materialized to contest the status quo or advocate on
behalf of the poor. The powerful white Creole and British elites proceeded, generally
unchecked, to maintain the structure of plantation society in a form that cultivated and
sustained a culture of poverty.

The rampant poverty created many problems for the GMS doctors. The
government continually directed its GMS organisation to provide only the minimum
amount of remedial medical care services to the extraordinarily large number of sick and
ailing residents. The doctors were constantly attempting to treat the outcomes and
effects of a colonial environment that lacked many contemporary public health measures
and sanitary infrastructures: these had long-since become regarded as vitally necessary
for disease prevention in other colonies and countries. These deficiencies had a notable
effect on an impoverished population. The outcome of colonialism in Trinidad created an
environment that challenged the modernising practices of western medicine, which

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 Ph.D. Thesis - L. Jacklin. McMaster - History

increasingly focused on preventive measures and surgical interventions. Many doctors

would have preferred to eradicate the causes of so many problems, rather than
continuing to deal with their effects. From the medical perspective, the most enduring
problems faced by the GMS doctors resulted from the government's failure to come to
terms with the relationship between poor health, poverty, and sanitation in a manner
commensurate with the dominant medical ideals.

The post-Enlightenment reforming ethos fostered the rapid development of many

different factions, intent on improving the conditions of the poor and labouring classes.
In the metropole, the birth of the sanitary ideal and the public health movement in the
1840s had a major influence on the modernisation of medical science. ·British-trained
doctors and officials would henceforth carry many of these ideas and practices with them
as they travelled throughout the imperial world. However, Trinidad's plantocracy was
not necessarily interested in yet another set of reforming ideals from the metropolis. It
was erstwhile preoccupied with the economic and social dislocation caused by
emancipation and the introduction of free trade. In the 1840s, and again at various times
to 1916, Trinidad's economy was in dire straits and without the resources to finance the
newly emerging health and medical reforms, if they had been a priority, which they were
not. Certainly, many members of the Creole elite had discounted the importance of the
ameliorative measures during the last stage of slavery, when they owned the majority of
the Afro-Trinidadian people. It would be too much to expect that these former slave
owners, whose opposition to emancipation caused the Colonial Office to institute Crown
Colony rule, would transform themselves to an elite class which was concerned about the
health of the freed African peoples. India's intervention to terminate migration in 1838
and 1839, because of the high mortality rates amongst the indentured labourers,
confirmed that the plantocracy continued to view the non-white labouring bodies as
expendable commodities. In times of economic prosperity, the government modernised
the colony's sanitary infrastructure in very restricted areas, most notably in the two
major maritime ports and urban centres, where the white Creole elite tended to reside.
The majority of the population did not have the opportunity to benefit from any
widespread local implementation of the broader advancements in sanitary science and
public health.

The GMS doctors often criticised and agitated against the government's
reluctance to adopt more proactive policies and address the widespread poverty, which
they believed was causing the high incidence of disease and illness amongst their ever­
increasing numbers of patients. However, the notion of alleviating poverty or providing
economic relief to the lower classes contravened the fundamental tenets upon which this
plantation society continued to be structured. The Legislative Council repeatedly
declined or ignored the directives from the trustees of the imperialist project, including
some reforming governors and the Colonial Office, to institute any form of economic
relief. According to some doctors, a system of Poor Relief would have mitigated the
conditions which caused the high incidence of poor health and reduced the prevalence of
suffering amongst the poor. However, it is doubtful that an organised system of relief
would have reduced the colony's overall expenditures. Instead, it would have simply
shifted the expenditures from remedial treatments to preventive measures. The
Legislative Council therefore adhered to its long-standing tradition of dealing with the
outcomes of dirt and depravity, rather than adopting more current and medically­

-159 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

informed initiatives to eradicate the causes of the problems. The official ideologies about
the poor, who constituted the majority of the population, consistently rationalised the
poverty as the outcome of racial defectiveness and the failure of the people to absorb the
essence of British civilisation.

The colony continually demonstrated an affinity to institute western public health

and medical practices selectively, despite the increasing tendency of many other
governments to adopt the tenets of an increasingly uniform body of medical knowledge.
The advances in knowledge about the optimum way to contain contagious diseases, in
the 1860s and 1870s, transformed the nature of maritime quarantines and health
protections, stimulating regional sanitary conventions, which developed into
international initiatives and agreements by the end of the century. Medical officials and
doctors in Trinidad kept current with the rapidly changing body of knowledge. However,
and rather perplexingly, the local implementation of the relevant practices periodically
deviated from the generally accepted norms. In the instances of the 1871-72 and 1903
smallpox epidemics, Trinidad ignored the prevailing medical knowledge and practices on
isolating and containing contagious diseases, which allowed the epidemics to rage out of
control and imperil the health and lives of many residents. While the high infection and
mortality rates did not appear to cause great angst amongst the local authorities, the
imperative to control these contagious diseases became a concern of the international
community. Trinidad's Atlantic neighbours and imperial world partners exerted
significant pressure on the colony to conform with the contemporary public health and
disease containment measures. Although colonialism in Trinidad was predicated on the
elite retaining control of this plantation society, the increasing globalisation of the
medical knowledge on disease containment and eradication was a factor which it simply
could not control. Trinidad's legislators eventually, although not expediently, instituted
more commonly accepted measures for disease containment and protection. However,
the maritime Atlantic community continued to question and distrust Trinidad's claims
that the colony conformed to the prevailing procedures on disease prevention.

It is unfortunate that the records of colonialism left so little information about

the individual patients and their experiences within the GMS system. The official records
tended to reduce the sufferers into aggregate statistics on diseases, mortalities,
admissions, certificate holders, and many other categories, which were meaningful to a
medical bureaucracy with too few resources and tens of thousands of patients each year.
The continually increasing number of people who used the system entrenched the GMS
organisation and facilities within Trinidad's socio-medical landscape, while making its
costs a perpetual sore point amongst the ruling Creole elite. Despite all the
administrative anxiety about the number of patients flocking to the GMS doctors and
hospitals, the tremendous momentum by the peoples to use the system provided the
most formidable challenge to any governmental attempts to retract the services.
Historians of the British West Indian colonies are always on the alert for evidence of acts
of resistance by the subject peoples. Trinidadians certainly did not display any
discernable resistance to the imperatives of western medicine or reject the colonial
state's system of healthcare services. Instead, the people demanded their entitlements to
the services. Trinidadians realised that they bore the burden of excessive taxation to pay
for the system. When in need of the medical care, the people had no qualms about
demanding the services that they believed were due to them.

- 160 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

Trinidadians often had to work extremely hard to become a GMS patient.

Innumerable individuals traversed difficult terrains on lengthy journeys to seek medical
attention, sometimes in a personally incapacitated condition, or carrying a debilitated
friend or family member in a hammock or other conveyance. Some patients encountered
the purposeful stigmatisation in the system as they negotiated with certificate-issuing
authorities or interacted with moralising doctors. At times, the patients' maladies and
discomfort must have been acute to motivate them to persist through the various
obstacles. However, the GMS services were not the exclusive form of healthcare services
used by the sufferers and, perhaps, not their preferred alternative. Although very little is
yet known about the persistence of the African and Indian medical traditions, or the
community-based cultures of healing, this study confirms that they did indeed exist and
many Trinidadians relied on these resources before seeking assistance from the GMS
doctors. It is hoped that future studies will reveal the nature and breadth of these forms
of medical and healthcare solutions. They may have indeed been preferred by the
residents in their struggles to maintain their health and address their maladies when
ailing. Without detailed studies, it is difficult to ascertain where western medicine
ranked in the hierarchy of therapeutics employed by the Trinidadian people. It is clear,
however, that the colonial state's GMS healthcare services were one part of patients'
multi-faceted and complex strategies for survival.

- 161­
 Ph.D. Thesis - L. Jacklin. McMaster - History

Statistical Appendices - Population Vital Statistics

- 162 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

- Appendix 2 .1 ­
Quantifying Trinidad's Average Annual Net Migration

and Population Leakage

As discussed above (in Chapter 2), thousands of East Indians illegally left Trinidad each
year, in what was termed as the 'leakage' of the population. 1 Trinidad's Registrar­
Generals continually struggled with the governmental inability to count the number of
residents who departed from the colony each year. The consistent under-estimation of
the size of the population 'leakage', and concomitant over-estimation of the number of
residents during the inter-censual years, rendered many of the published statistics
inaccurate, including the figures on net migration, the total and mean population, and all
crude rates. However, in retrospect, the quantity of the population leakage each decade
can be quantified, which then allows the necessary calculations to produce more exact
statistics for the total population, and for the West Indian and East Indian sectors.

The following charts provide the detailed calculations of the 'leakage' of East
Indians during three decades, from 1891 and 1920. These statistics are then applied to
calculate the tables in Appendix 2.2 to 2-4.

The 'leakage' of East Indians involved only the people who illegally left the colony. The
problem in enumerating the departures from Trinidad did not apply to the government program
of East Indian immigration and the repatriation of East Indians back to India. The government
rigidly controlled the movement of East Indians between India and Trinidad (and vice versa)
aboard the ships they chartered, producing very accurate statistics of the net annual increase from
this legal form of migration.
 Ph.D. Thesis - L. Jacklin. McMaster - History

Leakage of East Indians:

1Janu~1891 to 31 December 1900 - Trinidad
-column 1­ -column 2­ -column 3­
1891 census is 5 April 1891 All residents West Indian East Indian
of Trinidad sub­ sub­
(columns population population
1901 census - 21 April 1901 2+3)
- less: adjustment fiscal year alignment 2 273,899 187,508 86,391
- less: adjustment for Tobago3 (3,186) (537) (2,649)
(18,676) (18,676) 0
1901 adjusted population: Trinidad
- less: 1891 census population 252,037 168,295 83,742
- equals: net growth in population (200,028) (129,786) (70,242)
- less: net natural increase 52,009 38,509 13,500.
- less: Trinidad-India migration (18,603) (13.494) (5,109)
- equals: net number of immigrants/ (13,81z) 0 (13,817)
(emigrants) during the 10 year period. 19,589 25,015 (5,426)
-Average annual net immigration/
(emigration), exclusive of Trinidad- 1,959 2,502 543
India migration. immwants immwants emwants

Between 1891 and 1900, the net total leakage of East Indians was 5,426 people, or
an average of 543 persons each year. West Indian net migration contributed, on average,
2,502 new persons to Trinidad each year.

2
The statistics for the census of 21April1901 require an adjustment to align the temporal
period with the government's fiscal year, which was the calendar year. The adjustments are as
follows for 1 January to 31 March: births (1,500 West Indians, 688 East Indians), deaths (963
West Indians, 485 East Indians), and East Indians arriving from India (2,446 persons).
3 Trinidad and Tobago were not enumerated as a united entity until 1901 and population
statistics for Tobago in 1891 are not available. Thus, Tobago's population in 1901 is subtracted for
this decade. Tobago's 1901 census population was 18,751, less the adjustment for natural increase
(January to March 31) of 75 people, for a net population of 18,676 people. There were no East
Indians in Tobago at the time of the 1901 census.
 Ph.D. Thesis - L. Jacklin. McMaster - History

Leakage of East Indians:

1Janu'!!:Y_1901 to 2 A_Q_ril 1911 ­ Trinidad and Tob~o
- column 1­ -column 2 ­ - column 3 ­
All residents: West Indian East Indian
T&T sub­ sub­
(columns population population
1911 census -Trinidad and Tobago 2+3)
- less: 1901 adjusted census 333,552 222,641 110,911
- equals: net growth in population (2zo,z13) (186,971) (83,z42)
- less: net natural increase 62,839 35,670 27,169
- less: Trinidad-India migration (34,219) (23,646) (10,573)
- equals: net number of immigrants/ (19,352) 0 (19,352)
(emigrants) during the 10 year period. 9,268 12,024 (2,756)
- Average annual net immigration/
(emigration), exclusive of Trinidad- 927 1,202 276
India migration. imm!grants imm~ants em!grants

Between 1901 and 1911, the net total leakage of East Indians was 2,756 persons.
West Indian net migration contributed an average of 1,202 new persons each year.

Leakage of East Indians

2 A_Q_ril 1911 to 31 December 1920 - Trinidad and Tob~o

- column 1­ - column 2 ­ - column 3­

All residents: West Indian East Indian
T&T sub­ sub­
(columns population population
1921 census population (adjusted)4 2+_.3_)
- less: 1911 census population 366,736 244,128 122,253
- equals: net growth in population (333,552) 222,641 110,911
- less: Net natural increase 33,184 21,847 11,694
- less: Trinidad-India migration 32,397 (19,524) (12,873)
- equals: net immigrants/(emigrants) 6,5oz 0 6,506
-Average annual net immigration/ 5,720 2,318 (8,037)
(emigration), exclusive oflndia-Trinidad 572 232 804
migration. emigrants immigrants emigrants

Between 1911and1921, the net total leakage of East Indians was 8,037 people,
while the total West Indian net migration was 2,318 people.

4 The 24 April 1921 census has been adjusted by subtracting the population increases
between January a 31 March: a natural increase of 378 West Indians, a natural decrease of 117
East Indians, and the repatriation of as 1081 East Indians to India.

- 165­
 Ph.D. Thesis - L. Jacklin. McMaster - History

- Appendix 2.2 ­
Vital Statistics for Trinidad (1891-1900) and the

United Colony of Trinidad and Tobago (1901-1920), based on Census data

and Registrar-General Annual reports, with the total population

adjusted for Population Leakage (from Appendix 2.1).

Statistics for the Total Population, including the West Indian and East Indian sectors.

Net Migration:

Net Imm~ants and (Em~rants)

Net West Net East Net East

Year Indian Indian Indian Total Population Total Mean
migration migration leakage Net at the end Population
(from to and from (from Migration of the year
appendix 2.1) India appendix
2.1)
1891
Trinidad 2,502 1,980 (543) 3,939 205,142 202,587
1892 2,502 2,566 (543) 4,525 211,558 208,352
1893 2,502 1,203 (543) 3,162 216,300 213,929
1894 2,502 1,812 (543) 3,771 222,086 219,193
1895 2,502 1,837 (543) 3,796 228,065 225,076
1896 2,502 2,374 (543) 4,333 234,140 231,103
1897 2,502 1,113 (543) 3,072 238,048 236,094
1898 2,502 546 (543) 2,505 241,760 239,904
1899 2,502 470 (543) 2,429 246,982 244,371
1900 2,502 (84) (543) 1,875 252,037 249,509
Total for
the decade 25,015 13,817 (5,426) 33,406
1891-1900

The united coloI!Y_of Trinidad and Tobag_o b~an reQ_ortin__g_combined statistics in 1901
1901
Trinidad
&Toba__g_o 1,202 3,378 (276) 4,305 277,639 274,176
1902 1,202 1,598 (276) 2,525 283,480 280,559
1903 1,202 1,808 (276) 2,735 289,108 286,294
1904 1,202 540 (276) 1,467 295,391 292,250
1905 1,202 2,894 (276) 3,821 302,520 298,956
1906 1,202 1,719 (276) 2,646 308,106 305,313
1907 1,202 1,108 (276) 2,035 312,646 310,376
1908 1,202 1,719 (276) 2,646 318,988 315,817
1909 1,202 1,923 (276) 2,850 325,838 322,413
1910 1,202 2,665 (276) 3,592 333,552 329,695
Total for
the decade 12,024 19,352 (2,756) 28,620
1901-1900

- 166 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

Net Migration:
Net Immigrants and (Em~ants)

Net West Net East Net East

Year Indian Indian Indian Total Population Total Mean
migration migration leakage Net at the end Population
(from to and from (from Migration of the year
appendix 2.1) India appendix
2.1)
1911
Trinidad
&Tobag_o 232 2,655 (804) 2,083
1912 232 1,779 (804) 1,207 342,062 340,751
1913 5 232 370 (804) (202) 345!.5_65 343,814
1914 232 443 (804) (129) 348,964 347,264
1915 232 44 (804) (528) 351,232 263,424
1916 232 1,170 (804) 598 356,221 353,727
1917 232 705 (804) 133 360,938 358,580
1918 232 0 (804) (572) 363,899 362,419
1919 232 233 (804) (339) 365,729 364,814
1920 232 (893) (804) (1,465) 366,733 366,231
Total for
the decade 2,319 6,506 (8,037) 788
1911-1920

s Detailed statistics on births and deaths are not available for 1913-14. These numbers have
been estimated, by averaging the number of births and deaths for the other nine years in the
decade.

- 167­
 Ph.D. Thesis - L. Jacklin. McMaster - History

Natural Increase for the Total Population (including West Indian and East Indian
sectors).

Births (from Deaths (from Net Natural

Registrar- Registrar-General Increase for the
Year General AR). Annual R<p_orts) Total P~ulation
1891 Trinidad 5,396 (4,217) 1,179
1892 7,251 (5,365) 1,886
1893 7,568 (5,987) 1,581
1894 7,608 (5,593) 2,015
1895 8,059 (5,876) 2,183
1896 8,175 (6,433) 1,742
1897 7,927 (7,091) 836
1898 7,962 (6,755) 1,207
1899 8,922 (6,129) 2,793
1900 10,021 (6,841) 3,180
Total natural increase
1891-1900 78,889 (60,287) 18,602
1901 Trinidad &
Tob~o 9,513 (6,892) 2,621
1902 10,068 (6,752) 3,316
1903 10,194 (7,300) 2,894
1904 11,304 (6,488) 4,816
1905 11,601 (8,293) 3,308
1906 10,877 (7,937) 2,940
1907 11,126 (8,621) 2,505
1908 11,638 (7,941) 3,6_9J
1909 11,662 (7,662) 4,000
1910 11,570 (7,448) 4,122
Total natural increase
1901-1900 109,553 (75,334) 34,219
1911 Trinidad &
Toba__g_o 11,674 (7,870) 3,804
1912 11,711 (10,295) 1,416
1913 6 11,828 (8,121) 3,707
1914 11,855 (8,327) 3,528
1915 8,591 (5,795) 2,796
1916 11,917 (7,526) 4,3_2_1
1917 12,566 (7,982) 4,584
1918 11,760 (8,228) 3,532
1919 11,567 (9,398) 2,169
1920 11,707 (9,238) 2,469
Total natural increase
1911-1920 111,176 (82,780) 32,396

6 Detailed births and deaths are not available for 1913-14. These numbers have been
estimated, by averaging the number of births and deaths for the other nine years in the decade.

-168 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

- Appendix 2.3 ­
Statistics for the West Indian Population.

Vital Statistics for Trinidad (1891-1900) and the

United Colony of Trinidad and Tobago (1901-1920), based on Census data

and Registrar-General Annual reports, with the total population

a d"L1usted f or P o_pu1atlon
. Lea k ag_e (from A~en d"IX 2.1 )
.
Births Deaths
(from Crude (from Crude Year End
Mean

Year Registrar Birth Registrar-

Death Population
Population

-General Rate 7 General

Rate 8 9

AR) AR)
1891 Trinidad 3,812
29.00
2,957
22-49
133,143
131,464

1892
4,779
35.39
3,497
2_.5:90
136,926
135,034

1893
5,218
37.60
4,032
29.06
140,614
138,770

1894
5,143
36.05
3,564
24.98
144,694
142,654

1895
5,361
36.56
4,002
27.29
148,555
146,624

1896
5,508
36.64
4,456
29.64
152,108
150,331

1897
5,418
35.23
4,528
29-44
155,500
153,804

1898
5,592
35.53
4,312
2:z.40 159,281
157,390

1899
6,069
37.57
4,087
25.30
163,765
161,523

1900
6,712
40-43
4,683
28.21
168,295
166,030

Total 1891-1900 53,612

40,118

Total 1891-1900
- average for the
decade 36.00
26.97

1901 Trinidad &

Toba_g_o 6,678 35-42 4,745 25.17 190,106 188,539
1902 6,953 36.24 4,621 24.08 193,641 191,874
1903
7,056
36.13
4,975
25-48
196,924
195,283

1904
7,906
39.68
4.437
22.27
201,596
199,260

1905
7,878
38.75
5,621
27.65
205,055
203,325

1906
7,406
35.84
5,470
26.47
208,193
206,624

1907-08
7,284
34.75
5,600
26.71
211,080
209,637

1908-09
7,781
36.53
5,116
24.02
214,947
213,014

1909
7,458
34-40
4,938
22.78
218,670
216,808

1910
7,519
34.08
4,750
21.53
222,641
220,655

73,919
50,273

Total 1901-1900
Total 1891-1900
- average for the
decade 36.18
24.61

7 The crude birth rate is the number of births divided by the mean population.
8 The crude death rate is the number of deaths divided by the mean population.
9 The mean population is the population at the start of the year, plus 50% of the births and
net immigration (from Appendix 2.2), less 50% of the deaths and emigration (from Appendix
2.2).

-169 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

Births Deaths
(from Crude (from Crude Year End Mean
Year Registrar Birth Registrar- Death Population Population
-General Rate General Rate
AR) AR)
1911 Trinidad &
Tob~o 7,592 33.88 4,933 22.01 225,532 224,086
1912 7,419 32.84 6,826 30.21 226,357 225,944
1913 7,563 33.21 5,023 22.06 229,129 227,743
1914 7,421 32.22 5,332 23.15 231,095 229,934
1915 5,308 30.34 3,731 21.33 232,904 174,678
1916 7,290 31.07 4,739 20.20 235,686 234,295
1917 7,581 31.93 5,038 21.22 238,461 237,074
1918 7,156 29.82 5,152 21.47 240,697 239,579
1919 7,172 29.64 5,508 22.76 242,593 241,645
1920 7,275 29.85 5,972 24.50 244,128 243,361

Total 1911-1920 71,778 52,254

Total 1911-1920 ­
average for the
decade 31.48 22.89

- 170 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

-Appendix 2.4 ­
Statistics for the East Indian Population.

Vital Statistics for Trinidad (1891-1900) and the

United Colony of Trinidad and Tobago (1901-1920), based on Census data

and Registrar-General Annual reports, with the total population

ad.!l_usted £or P0_2_U1atlon

. Leak~e (from A~en d.IX 2.1 )
.

Births Deaths Mean

Year (from Crude (from Crude Population Population
Registrar- Birth Registrar- Death at Year End 12

General Rate 10 General Rate 11

AR) AR)
1891 Trinidad 1,584 22.27 1,259 17.71 72,004 71,123
1892 2,473 33.72 1,868 25-48 74,632 73,318
1893 2,350 31.27 1,955 26.01 75,687 75,159
1894 2,465 32.21 2,029 26.51 77,392 76,540
1895 2,698 34.39 1,874 23.89 79,511 78,452
1896 2,667 33.02 1,977 24-48 82,032 80,771
1897 2,509 30-49 2,563 31.15 82,549 82,290
1898 2,370 28.72 2,443 29.61 82,479 82,514
1899 2,853 34-44 2,042 24.65 83,217 82,848
1900 3,309 39.64 2,158 25.85 83,742 83,480

Total for 1891­

1900 25,278 20,168
Total 1891 to
1900: average
for decade 32.02 25.53
1901 Trinidad
&Tobago 2,835 33.10 2,147 25.07 87,532 85,637
1902 3,115 35.12 2,131 24.03 89,839 88,686
1903 3,138 34-48 2,325 25.55 92,184 91,012
1904 3,398 36.54 2,051 22.06 93,796 92,990
1905 3,723 38.93 2,672 27.94 97,465 95,630
1906 3,471 35.17 2,467 25.00 99,912 98,689
1907 3,842 38.14 3,021 29.99 101,566 100,739
1908 3,857 37.52 2,825 27-48 104,041 102,804
1909 4,204 39.81 2,724 25.79 107,169 105,605
1910-11 4,051 37.15 2,698 24.74 110,911 109,040
Total for 1901­
1910 35,634 25,061
Total 1901­
1910: average
for the decade 36.60 25.76

10
The crude birth rate is the number of births divided by the mean population.
11
The crude death rate is the number of deaths divided by the mean population.
12
The mean population is the population at the start of the year, plus 50% of the births and
net immigration (from Appendix 2.2), less 50% of the deaths and emigration (from Appendix
2.2).

- 171­
 Ph.D. Thesis - L. Jacklin. McMaster - History

Births Deaths
Year (from Crude (from Crude Population Mean
Registrar- Birth Registrar- Death at Year End Population
General Rate General Rate
AR) AR)
1911 Trinidad &
Tobago 4,082 36.31 2,937 26.13 113,907 112,409
1912 4,292 37.38 3,469 30.22 115,706 114,806
1913 4,265 36.74 3,098 26.69 116,791 116,248
1914 4A34 37.90 2,995 25.60 117,517 116,978
1915 3,283 37.10 2,064 23.33 118,329 88,746
1916 4,627 38.86 2,787 23-40 120,535 119,432
1917 4,985 41.15 2,944 24.30 122,477 . 121,506
1918 4,604 37.59 3,076 25.11 123,201 122,839
1919 4,395 35.79 3,890 3i.67 123,136 123,169
1920 4,432 36.17 3,266 26.66 122,605 122,870

Total 1911-1920 43,399 30,526

Total 1911­
1920: average
for the decade 37.50 26.31

- 172 ­
 Ph.D. Thesis - L. Jacklin. McMaster - History

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The Lancet
The Medical Times and Gazette
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The Port-of-Spain Gazette
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CO 295-254 (1870) #8800. [Crane appointed Surgeon General.]

CO 295-259 (1871) #2696. [Bakewell and the Justice System].

CO 295-259 (1871) #6817. Medical Dept. ofPrivy Council to Secretary ofState.

CO 295-259 (1871) #8260. Letterfrom Royal College ofPhysicians to Secretary of

State.

CO 295-274 (1875) #8580. Scheme for Reorganizing the Medical Services.

CO 295-276 (1876) #1195. Return ofmedical appointments under the new Scheme.

CO 295-279 (1877) #13574. Statements against Dr. Crane and the mortality at the
Colonial Hospital.

CO 295-281 (1878) #13202. Disreputable and inefficient state ofColonial Civil Service.

CO 295-311 (1886) #19497. Votes passed by Legislative Council.

CO 295-311 (1886) #20601. Surgeon General's Dept.

CO 295-311 (1886) #22453. Surgeon General's Dept.

CO 295-313 (1887) #9405. Treatment ofMedical Witnesses by Chief Justice.

CO 295-316 (1887) #4669. Report ofCommission on Surgeon General Dept.

CO 295-316 (1887) #11453. Observations as to creation of new medical districts.

CO 295-335 (1891) #21907. Minutes ofCommittee to report thereon Medical

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Expenditures.

CO 295-342 (1892) #6356. Applicationfor Directorship ofSanitary Dept. Egypt.

CO 295-375 (1896) #23257. Coolies enlisted for labour in Columbia.

CO 295-375 (1896) #25430. Coolies enlisted for labour in Columbia.

CO 295-391 (1899) #4024. Tobago Medical Service.

CO 295-391 (1899) #8041. Observations on Medical and Education Expenditures.

CO 295-391 (1899) #11877. Medical Retrenchment. Confidential Jerningham to

Chamberlain.

CO 295-393 (1897) #8533. Return ofCoolies from Columbia.

CO 295-395 (1899) #6998. Industries ofthe Colony.

CO 295-407 (1901) #42210. Class ofEmigrants dispatched from Agency.

CO 295-417 (1903) #17127. Epidemic ofEruptive Fever.

CO 295-417 (1903) #18788. Epidemic ofEruptive Fever.

CO 295-417 (1903) #20491. Eruptive Fever Experiments.

CO 295-425 (1903) #14062. Epidemic in Trinidad.

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CO 295-425 (1903) #19555. Epidemic in Colony.

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CO 295-431 (1904) #25694. Medical Service.

CO 295-432 (1905) #14856. Government Medical Dept.

CO 295-435 (1905) #17402. Colour Question in Trinidad. Memorandum on the Existing

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CO 295-436 (1906) #20098. Indentured Coolie Labourers.

CO 295-452 (1909) #32738. Distressed British Subjects.

CO 295-455 (1909) #10150. Indentured Labourers.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

CO 295-458 (1910) #21244. USA Quarantine on Trinidad.

CO 295-465 (1911) #16008. Jamaica Quarantine on Trinidad.

CO 295-472 (1911) #5152. Medical Enquiry Commission.

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CO 885-5 (1889) #75· Hand Book for Surgeons Superintendent ofthe Coolie

Emigration Service by James M. Laing, MA. and L.R.C.S.E.

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CO 1069/392/15 [n.d.] Coolies onArrivalfrom India mustered at the Depot.

CO 1069/392/20 [n.d.] View ofSan Fernando.

CO 1069/355/41 [n.d.] Medical Examination ofNew Arrivals.

CO 1069/355/42 [n.d.] The Emigrants at their Meals.

CO 1069/355/46 [n.d.] The Depot Hospital. Accommodation for 94 patients.

CO 1069/392/128. Crowd at Western Side ofRed House. 23rd March 1903 between 12 &

1 pm (Looking down Abercrombie Street).

CO 1069/392/130. Mass Meeting at Queen's Park. 21March1903.

CO 1069/392/138. The Burning ofthe Red House. 23March1903.

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Books).

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 Ph.D. Thesis - L. Jacklin. McMaster - History

BPP 1839 #3, Report on the Affairs ofBritish North America from the Earl ofDurham,
Her Majesty's High Commission, &c. &c. &c., 11February1839.

BPP 1839 #3-11#, Appendix (A) to Report on the Affairs ofBritishNorthAmericafrom

the Earl ofDurham, Her Majesty's High Commission, &c. &c. &c..

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BPP 1854 #255, A Return ofthe Names, Stations, Dates ofAppointment, and Salaries of
the Emigration Officers in the United Kingdom; with a copy ofthe General
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BPP 1854 #349, Second Report from the Select Committee on Emigrant Ships.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

BPP 1854-55 #293, Return ofthe Number ofHer Majesty's Ships and Vessels now in
Commission on Home and Foreign Service; together with the number and
names ofthe Surgeons, Assistant Surgeons, and Dressers without Medical or
Surgical Diplomas, in every Ship or Vessel, and the Number and Names ofthose
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whose Names do not Appear in the Medical Register.

BPP 1876 #316, Ship Surgeons. Return ofNames, Ages, and Nationalities ofPersons
who have Served in the British Merchant Service as Surgeons whose Names do
not appear in the Medical Register; distinguishing those who have been
permitted so to service since the Date ofthe Board of Trade's Circular Letter of
September 1875 addressed to Marine Superintendents and Shipping Masters.

BPP 1881 [c.2995], Emigrant Accommodation on Board Atlantic Steam Ships. Reports
with Regard to the Accommodation and Treatment ofEmigrants on Board
Atlantic Steam Ships.

BPP 1898 [c.8655], Report ofthe West India Royal Commission.

BPP 1898 [c.8657], Report ofthe West India Royal Commission. Appendix C.

BPP 1903 [cd.1598], Papers Relating to the Investigation ofMalaria and Other Tropical
Diseases and the Establishment ofSchools of Tropical Medicine.

BPP 1903 [cd.1661], Papers Relating to the Recent Disturbances at Port ofSpain
Trinidad.

BPP 1903 [cd.1662], Report ofthe Commission ofEnquiry into the Recent Disturbances
at Port ofSpain Trinidad.

BPP 1904 [cd 1989], Coolie Immigration, Immigration Ordinances of Trinidad and
British Guiana.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

BPP 1906 #357, Coolie Labour.

BPP 1910 [cd 5192], Emigration from India to the Crown Colonies and Protectorates.
Report ofthe Committee on Emigrationfrom India to the Crown Colonies and
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BPP 1910 [cd.5193], Report ofthe Committee on Emigration from India to the Crown
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Colonies and Protectorates. Part III. Papers Laid before the Committee.

BPP 1922 [cmd.1679], Report by the Honourable E.F.L. Wood, MP (Parliamentary

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Census ofthe Colony of Trinidad and Tobago, 1901, Port-of-Spain: Gov. Printer, 1903.

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1887 LC #8. Report ofCommission on Trade and Taxes.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

1890 LC #83. Immigration. Correspondence relative to Immigration from the Azores

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 Ph.D. Thesis - L. Jacklin. McMaster - History

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 Ph.D. Thesis - L. Jacklin. McMaster - History

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 Ph.D. Thesis - L. Jacklin. McMaster - History

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Handler, Jerome S., and J. Jacoby, "Slave Medicine and Plant Use in Barbados," Journal
ofthe Barbados Museum and Historical Society, 41 (1993): 74-98.

Hardy, Anne, "Smallpox in London: Factors in the Decline of the Disease in the
Nineteenth Century," Medical History, 27 (1983): 111-38.

Harper, Marjory, "British Migration and the Peopling of the Empire," in Andrew Porter,
ed., The Oxford History ofthe British Empire. Vol. III. The Nineteenth Century,
New York: Oxford University Press, 1999: 75-87.

Harris, Bernard, "Charity and Poor Relief in England and Wales, Circa 1750-1914," in
Bernard Harris and Paul Bridgen, eds., Charity and Mutual Aid in Europe and
North America since 1800, New York: Routledge, 2007: 19-42.

--------"Introduction: The 'Mixed Economy of Welfare' and the Historiography of

Welfare Provision," in Bernard Harris and Paul Bridgen, eds., Charity and
Mutual Aid in Europe and North America since 1800, New York: Routledge,
2007: 1-18.

-------- The Origins ofthe British Welfare State. Social Welfare in England and Wales,
1800-1945, NewYork: Palgrave, 2004.

Harrison, Mark, Public Health in British India. Anglo-Indian Preventive Medicine 1859­
1914, Cambridge: Cambridge University Press, 1994.

Higman, B.W., "African and Creole Slave Family Patterns in Trinidad," Journal of
Family History, 3, 2 (1978): 163-180.

-------- "The British West Indies," in Robin W. Winks, ed., The Oxford History ofthe
British Empire. Vol. V. Historiography, Oxford: Oxford University Press, 1999:
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-------- Slave Population and Economy in Jamaica, 1807-1814, New York: Cambridge
University Press, 1976.

--------Slave Populations ofthe British Caribbean, 1807-1834, Jamaica: University of

West Indies Press, 1995.

-------- Writing West Indian Histories, London: Macmillan, 1999).

Hitchins, Fred H., The Colonial Land and Emigration Commission, London: Oxford
University Press, 1931.

Ho, C., "'Hold the Chow Mein, Gimme Soca': Creolization of the Chinese in Guyana,
Trinidad and Jamaica," Amerasia, 15, 2 (1989): 3-25.

Hoefte, Rosemarijn, In Place ofSlavery. A Social History ofBritish Indian and

Javanese Laborers in Suriname, Gainesville: University Press of Florida, 1998.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Holt, Thomas C., The Problem ofFreedom. Race, Labor, and Politics in Jamaica and
Britain, 1832-1938, Maryland: Johns Hopkins University Press, 1992.

Hurren, Elizabeth T., "Poor Law versus Public Health: Diphtheria, Sanitary Reform, and
the 'Crusade' against Outdoor Relief, 1870-1900," Social History ofMedicine, 18,
3 (2005), 399-418.

Inniss, Tara A., "'Any elderly, sensible, prudent woman.' The Practice and Practitioners
of Midwifery during Slavery in the British Caribbean," in Juanita De Barros,
Steven Palmer, and David Wright, eds., Health and Medicine in the circum­
Caribbean, 1800-1968, New York: Routledge, 2009: 40-52.

-------- "From Slavery to Freedom: Children's Health in Barbados, 1823-1838," Slavery

& Abolition, 27, 2 (2006): 251-60.

Jabour, Anya, "Slave Health and Health Care in the British Caribbean: Profits, Racism
and the Failure of Amelioration in Trinidad and British Guiana, 1824-1834,"
Journal ofCaribbean History, 28, 1(1994):1-26.

Jensen, Niklas Thode, "Safeguarding Slaves: Smallpox, Vaccination, and Governmental

Health Policies among the Enslaved Population in the Danish West Indies, 1803­
1848," Bulletin ofthe History ofMedicine, 83 (2009): 95-124.

John, A. Meredith, "Plantation Slave Mortality in Trinidad," Population Studies, 42, 2

(1988): 161-82.

-------- The Plantation Slaves of Trinidad, 1783-1816: A Mathematical and

Demographic Inquiry, New York: Cambridge University Press, 1988.

Johnson, Howard, "Introduction," in Howard Johnson and Karl Watson (eds.), The
White Minority in the Caribbean, New Jersey: Markus Wiener, 1998: ix-xvii.

--------The Bahamas from Slavery to Servitude, 1783-1933, Florida: University of

Florida Press, 1996.

Johnson, Stanley C., A History ofEmigration from the United Kingdom to North
America 1763-1912, London: Frank Cass & Company, 1966, reprint of 1913
edition.

Jones, Margaret, "Infant and Maternal Health Services in Ceylon, 1900-1948:

Imperialism or Welfare?" Social History ofMedicine, 15 (2002): 263-89.

Kale, Madhavi, "'Capital Spectacles in British Frames': Capital, Empire and Indian
Indentured Migration to the British Caribbean," International Review ofSocial
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Killingray, David, "The Influenza Pandemic of 1918-1919 in the British Caribbean,"

Social History ofMedicine 7, 1 (1994): 59-87.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Kiple, Kenneth, "Cholera and Race in the Caribbean," Journal ofLatin American
Studies, 17 (1985): 157-77.

-------- The Caribbean Slave: A Biological History, Cambridge: Cambridge University

Press, 1984.

Kiple, Kenneth, and Brian T. Higgins. "Cholera in Mid-nineteenth Century Jamaica,"

Jamaican Historical Review, 17 (1991): 31-47.

Kiple, Kenneth, and Virginia Kiple, "Deficiency Diseases in the Caribbean," Journal of
Interdisciplinary History, 11, 2 (1980): 197-215.

Klein, Herbert S., Stanley L. Engerman, Robin Haines, and Ralph Shlomowitz,
"Transoceanic Mortality: The Slave Trade in Comparative Perspective," William
and Mary Quarterly, LVIII, 1(January2001): 93-117.

Laguerre, Michel, Afro-Caribbean Folk Medicine, Massachusetts: Bergin and Garvey,

1987.

Lal, Brij, "Understanding the Indian Indenture Experience," Journal ofSouth Asian
Studies, 21, 1 (1998): 215-37.

Lambert, David, White Creole Culture, Politics and Identity during the Age ofAbolition,
New York: Cambridge University Press, 2005.

Lambert, David, and Alan Lester, "Imperial Spaces, Imperial Subjects," in David
Lambert and Alan Lester, eds., Colonial Lives across the British Empire:
Imperial Careering in the Long Nineteenth Century, Cambridge: Cambridge
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Laurence, K.0., ''.A Question ofLabour. Indentured Immigration into Trinidad and
British Guiana. 1875-1917," Jamaica: Ian Randle Publishers, 1994.

-------- "The Development of Medical Services in British Guiana and Trinidad 1841­
1873," Jamaican Historical Review 4 (1964): 59-67.

-------- "The Trinidad Water Riot of 1903: Reflections of an Eyewitness," Caribbean

Quarterly, 15, 4, (1969): 5-22.

Lees, Lynn Hollen, The Solidarities ofStrangers. The English Poor Laws and the
People, 1700-1948, New York: Cambridge University Press, 1998.

Li, Xiaoping, and Jo-Anne Lee, "Chinese in Canada," in C.R. Ember, M. Ember, and I.A.
Skoggard, eds., Encyclopedia ofdiasporas: immigrant and refugee cultures
around the World, Springer, 2004: 645-56.
 Ph.D. Thesis - L. Jacklin. McMaster - History

Look Lai, Walton, Indentured Labour, Caribbean Sugar. Chinese and Indian Migrants
to the British West Indies, 1838-1918, Baltimore: Johns Hopkins University Press
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Luke, Learie B., Identity and Secession in the Caribbean. Tobago versus Trinidad, 1889­
1980, Jamaica: University of West Indies Press, 2007.

MacDonagh, Oliver, A Pattern ofGovernment Growth 1800-1860. The Passengers' Acts

and their Enforcement, London: MacGibbon and Kee, 1961.

MacLeod, Roy, "Introduction," in Roy MacLeod and Milton Lewis, eds., Disease,
Medicine, and Empire. Perspectives on Western Medicine and the Experience of
European Expansion, London: Routledge, 1988: 1-20.

Mahabir, Noor K., Medicinal and Edible Plants used by East Indians of Trinidad and
Tobago, Trinidad: Chakra, 1991.

Mangru, Basdeo, Benevolent Neutrality. Indian Government Policy and Labour

Migration to British Guiana 1854-1884, London: Hansib, 1987.

Marks, Shula, "Presidential Address. What is Colonial about Colonial Medicine? And
what has Happened to Imperialism and Health?," Social History ofMedicine, 10,
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Marshall, Woodville K., "Peasant Development in the West Indies since 1838," in H.
Beckles and V. Shepherd (eds.) Caribbean Freedom: Economy and Society from
Emancipation to the Present, Princeton: Markus Wiener, 1993: 99-106.

Matthews, Gelien, "Trinidad: A Model Colony for British Slave Trade Abolition,"
Parliamentary History 26 (2007): 84-96

McCollin, Debbie, "World War II to Independence: Health, Services, and Women in

Trinidad and Tobago, 1939-1962," in Juanita De Barros, Steven Palmer, and
David Wright, eds., Health and Medicine in the circum-Caribbean, 1800-1968,
New York: Routledge, 2009: 227-48.

Mohammed, Patricia, "The 'Creolisation' of Indian Women in Trinidad," in Verene

Shepherd and G. Richards, eds., Questioning Creole. Creolisation Discourses in
Caribbean Culture (Kingston: Ian Randle, 2002): 130-47.

--------"Writing Gender into History: The Negotiation of Gender Relations among

Indian Men and Women in Post-indenture Trinidad Society, 1917-47," in Verne
Shepherd, Verene, Bridget Brereton, and Barbara Bailey (eds.), Engendering
History. Caribbean Women in Historical Perspective, New York: St. Martin's
Press, 1995: 20-47.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Mahapatra, Prabhu P., "'Restoring the Family': Wife Murders and the Making of a Sexual
Contract for Indian Immigrant Labour in the British Caribbean Colonies, 1860­
1920," Studies in History, 11 (1995): 227-60.

Mooney, Graham, "'A Tissue of the most Flagrant Anomalies': Smallpox Vaccination and
the Centralization of Sanitary Administration in Nineteenth-Century London,"
Medical History, 1997, 41 (3), 261-90.

Moore, Brian. Cultural Power, Resistance and Pluralism. Colonial Guyana, 1838-1900.
Montreal: McGill-Queen's University Press, 1995.

-------- "The Culture of the Colonial Elites of Nineteenth-Century Guyana," in Howard

Johnson and Karl Watson (eds.), The White Minority in the Caribbean, New
Jersey: Markus Wiener, 1998: 95-115.

-------- Race, Power and Social Segmentation in Colonial Society. Guyana after
Slavery, 1838-1891, New York: Gordon and Breach Science Publishers, 1987.

Moore, Brian, and Michele Johnson, Neither Led nor Driven. Contesting British
Cultural Imperialism in Jamaica, 1865-1920, Jamaica: University of West Indies
Press, 2004.

-------- 'Squalid Kingston' 1890-1920. How The Poor Lived, Moved And Had Their
Being, Jamaica: University of the West Indies Press, 2000.

Moore, Dennison, Origins and Development ofRacial Ideology in Trinidad. The Black
View ofthe East Indian, Canada: NYCAN, 1995.

Morgan, Jennifer L., Laboring Women: Reproduction and Gender in New World
Slavery, Philadelphia: University of Pennsylvania Press, 2004.

Northrup, David, Indentured Labor in theAge ofImperialism, New York: Cambridge

University Press, 1995.

Oxford Dictionary ofNational Biography (Oxford: Oxford University Press, 2004).

Paton, Diana, No Bond but the Law: Punishment, Race, and Gender in Jamaican State
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Payne-Jackson, Arvilla, and Mervyn C. Alleyne, Jamaican Folk Medicine. A Source of

Healing, Jamaica: University of West Indies Press, 2004.

Pelling, Margaret, Cholera, Fever and English Medicine 1825-1865, Oxford: Oxford
University Press, 1978.

Pemberton, Rita, "A Different Intervention: The International Health

Commission/Board, Health, Sanitation in the British Caribbean, 1914-1930,"
Special Issue of Caribbean Quarterly, 49, 4 (2003): 87-103.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

--------"Water and Related Issues in Nineteenth-Century Trinidad," Journal of

Caribbean History, 40, 2 (2006): 235-52.

Porter, Andrew, ed., The Oxford History ofthe British Empire, Volume 3, The
Nineteenth Century, Oxford: Oxford University Press, 1999.

Porter, Dorothy, and Roy Porter, "The Politics of Prevention: Anti-Vaccinationism and
Public Health in Nineteenth-Century England," Medical History, 32 (1988): 231­
52.

Porter, Roy, "The Patient's View. Doing Medical History from Below," Theory and
Society, 14 (1985): 175-98.

Reddock, Rhoda, "Contestations over Culture, Class, Gender and Identity in Trinidad
and Tobago. 'The Little Tradition.'" in Verene Shepherd and Glen Richards, eds.,
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Randle, 2002), 111-29.

--------"Indian Women and Indentureship in Trinidad and Tobago 1845-1917: Freedom

Denied," Caribbean Quarterly 32, 3/4 (1986): 27-49.

Richardson: Bonham C., Caribbean Migrants. Environment and Human Survival on St.
Kitts and Nevis, Knoxville: University of Tennessee Press, 1983.

--------Igniting the Caribbean's Past. Fire in British West Indian History, Chapel Hill:
University of North Carolina Press, 2004.

Riley, James C., Poverty and Life Expectancy. The Jamaica Paradox, New York:
Cambridge University Press, 2005.

Roberts, G.W., and J. Byrne, "Summary Statistics on Indentured and Associated

Migration Affecting the West Indies, 1843-1918," Population Studies 20.1 (1966):
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Ryan, Selwyn D., Race and Nationalism in Trinidad and Tobago: A Study of
Decolonization in a Multiracial Society, Toronto: University of Toronto Press,
1972.

Samaroo, Brinsley, "Cyrus Prudhomme David - A Case Study of the Emergence of the
Black Man in Trinidad Politics," Journal ofCaribbean History, 3 (1971): 73-89.

Seecharan, Clem, 'Tiger in the Stars.' The Anatomy ofIndian Achievement in British
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Women in Jamaica, 1845-1945," in H. Beckles and V. Shepherd (eds.) Caribbean
Freedom: Economy and Society from Emancipation to the Present, Princeton:
Markus Wiener, 1993: 245-50.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

-------- "Gender, Migration and Settlement: The Indentureship and Post-indentureship

Experience oflndian Females in Jamaica, 1845-1943," in Verne Shepherd,
Bridget Brereton, and Barbara Bailey (eds.), Engendering History. Caribbean
Women in Historical Perspective, New York: St. Martin's, 1995: 233-57.

-------- Maharani's Misery. Narratives ofa Passage from India to the Caribbean,
Jamaica: University of West Indies Press, 2002.

-------- "The 'Other Middle Passage?' Nineteenth-century bonded labour migration and
the legacy of the slavery debate in the British-colonised Caribbean," in Verne A.
Shepherd, ed. Working Slavery, Pricing Freedom. Perspectives from the
Caribbean, Africa and the African Diaspora, New York: Palgrave, 2001: 343-76.

Shepherd, Verene A., and Glen L. Richards, eds., Questioning Creole. Creolisation
Discourses in Caribbean Culture, Kingston: Ian Randle, 2002.

Sheridan, Richard B., Doctors and Slaves: A Medical and Demographic History of
Slavery in the British West Indies, Cambridge: Cambridge University Press,
1985.

-------- "From Chattel to Wage Slavery in Jamaica, 1740-1860," Slavery & Abolition, 14, 1
(1993): 13-40

Shlomowitz, Ralph, and John McDonald, "Mortality of Indian Labour on Ocean Voyages,
1843-1917," Studies in History, 6, 1 (1990): 35-65.

Singh, Kelvin, Race and Class Struggles in a Colonial State. Trinidad 1917-1945,
Jamaica: University of West Indies Press, 1994.

Smith, James Patterson, "Empire and Social Reform: British Liberals and the 'Civilizing
Mission' in the Sugar Colonies, 1868-1874," Albion, 27, 2 (1995): 253-77.

Michael Garfield Smith, The Plural Society in the British West Indies, Berkeley: Univ. of
California Press, 1965.

Steckel, Richard H., and Richard A. Jensen, "New Evidence of Slave and Crew Mortality
in the Atlantic Slave Trade," Journal ofEconomic History, XLIV (March 1986):
57-77.

Stoler, Ann Laura, and Frederick Cooper, "Between Metropole and Colony: Rethinkng a
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Empire. Colonial Cultures in a Bourgeois World, Berkeley: University of
California Press, 1997: 1-58.

Tinker, Hugh, A New System ofSlavery. The Export ofIndian Labour Overseas 1830­
1920, London: Oxford University Press, 1974.

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 Ph.D. Thesis - L. Jacklin. McMaster - History

Trotman, David Vincent, Crime in Trinidad. Conflict and Control in a Plantation

Society 1838-1900, Knoxville: University of Tennessee Press, 1986.

Walker, James W. St. G., "Race," Rights and the Law in the Supreme Court ofCanada.
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Watts, Susan, "Dracunculiasis in the Caribbean and South America: A Contribution to

the History of Dracunculiasis Eradication," Medical History 44, 2 (2000): 227­
50.

Ward, J.R., British West Indian Slavery, 1750-1834: The Process ofAmelioration, New
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Welch, Pedro, "Gendered Health Care: Legacies of Slavery in Health Care Provision in
Barbados over the period 1870-1920," Caribbean Quarterly, 49, 4 (2003): 104­
20.

Wilcox, Walter F., ed., International Migrations. Statistics. Vol. I and II, New York:
Gordon and Breach, 1969.

Wilkins, Nadine Joy, "Doctors and Ex-slaves in Jamaica 1834-1850," Jamaican

Historical Review 17 (1991): 19-30.

Will, H.A., "Problems of Constitutional Reform in Jamaica, Mauritius and Trinidad,

1880-1895," The English Historical Review, 81, 321 (1966): 693-716.

Williams, Naomi, "The implementation of compulsory health legislation: infant smallpox

vaccination in England and Wales, 1840-1890," Journal ofHistorical
Geography, 20 (1994): 396-412.

Wohl, Anthony S., Endangered Lives. Public Health in Victorian Britain,

Massachusetts: Harvard University Press, 1983.

Wood, Donald, Trinidad in Transition. The Years after Slavery, London: Oxford
University Press, 1968.

Worboys, Michael, "The Colonial World as Mission and Mandate: Leprosy and Empire,
1900-1940," Osiris, 15 (2001): 207-18.

Thesis (Unpublished)

Ramesar, M.D., Indian Immigration into Trinidad 1897-1917, Unpublished Master's

Thesis: University of West Indies, Trinidad, 1973.

Roopnarine, Lamarsh, Inda-Caribbean Indenture: Creating Opportunities out of

Adversity, unpublished Ph.d. dissertation, State University of New York at
Albany, 2002.

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