The last three years have seen the publication of several monographs on the twentieth-century history of Indians in East Africa. Anna Greenwood and Harshad Topiwala's Indian Doctors in Kenya, 1895–1940 is an important contribution to this growing literature. Moving away from narratives of politics and passports, it reveals the history of Indian medical practitioners in colonial Kenya. Greenwood and Topiwala rightly point out that histories of Kenya in general, and those of Western medicine in particular, have overwhelmingly focused on ‘old white triumphalist accounts’ and more recent studies of ‘black participation in empire’ (p. 2), as a result of which the history of Asian professionals in Kenya has been forgotten. Combing through colonial sources, local newspapers and personal memoirs, supplemented with oral interviews, they have put together archival fragments into a coherent history. The resulting book reveals the widespread presence of Indian medical professionals in colonial Kenya, numbering about 200 between 1895 and 1940 and amounting to half the number of European doctors practising in Kenya at the time (pp. 172–3).
The most significant revelation of this work is the new data Greenwood and Topiwala have painstakingly uncovered. They trace the very first Indian doctor in East Africa, Dr Nariman, to Zanzibar in 1883, where he was the Sultan's physician a decade before colonial rule. Colonial campaigns of conquest that included Indian soldiers heralded the arrival of larger numbers of Indian medical practitioners in the 1890s. When construction of the Uganda railways began, Indian medical staff also accompanied indentured labourers from India. While colonial authorities encouraged the recruitment of Indian doctors for Indian troops and labourers on the grounds of cultural and linguistic familiarity, Greenwood and Topiwala point out that Indians were an economical option too. European doctors and medical professionals received a higher wage than their Indian equivalents, and although Indians commanded higher salaries than Africans, they remained a cheaper option than Africans. Africanizing the medical services would have entailed setting up Western medical training institutions in East Africa (which began only in the 1930s), but most Indian doctors were recruited from Grants Medical College in Bombay, where they were trained as assistant surgeons (doctors), sub-assistant surgeons and hospital assistants without cost to the Kenyan government. While many Indian medical professionals returned to India, those who moved into private practice often became long-term residents in Kenya. Many of them became prominent leaders within the Indian diasporic community and in politics more generally. Highlighting the fragility and durability of race as a political and social category within the colonial state, Indian Doctors in Kenya tracks the rise and subordination of these professionals.
Greenwood and Topiwala highlight three important ways of thinking about colonialism and race in Kenya through ‘asymmetries of power’ (p. 5). While historians have argued that Western medicine was a tool of empire, the book asserts that, in Kenya, medical modernity arrived not from the metropole but ‘sideways’ from India. The encounter of Africans with medicine, as a tool of empire, was mediated by Indian colonial subjects. Yet medical hierarchies were racialized: while the Medical Officer and Primary Medical Officer were Europeans, Indian assistant surgeons and sub-assistant surgeons carried out the bulk of routine medical activities, and supervised Indian and African medical staff including dressers and compounders. Indian subordinates thus had a fair amount of autonomy when it came to mundane, everyday decisions in practising Western medicine on African colonial subjects. Finally, the presence of Indian private practitioners reflected the racialized medical hierarchy. Until the mid-1930s, Indians had no access to European hospitals and had to visit native (African) hospitals instead. Indian private doctors not only provided an important service but also donated their resources to building up the infrastructure of their own communities, for example by establishing the prominent Aga Khan and M. P. Shah hospitals in Nairobi.
From these trajectories, possible lines of future inquiry emerge. Greenwood and Topiwala convincingly show that Indian medical staff in subordinate positions carved out spaces of autonomy within the colonial medical services. Were their perspectives on African health and public policy different from the racializing colonial state? Furthermore, how did their practices and clientele intersect with practitioners of traditional medicine, Unani and Ayurveda? Also, the book notes that Indian doctors were stationed in Fort Hall and Kiambu in the early 1920s, a time when these reserves were hotbeds of African political activity where local chiefs and activists endorsed and challenged the racial policies of the colonial state and debated the presence of Indian traders in their midst. What might the presence of Indian doctors in African reserves tell us about the everyday encounter of race, medicine and colonialism from the non-European perspective? Finally, it might be worthwhile to move beyond Greenwood and Topiwala's focus on the growth and decline of the Indian medical community to explain the successes and limits placed on Indian doctors in Kenya. The authors argue that, from 1923 onwards, the colonial state prioritized African interests over those of Indians. But although the 1923 Devonshire Declaration ensured that African interests were paramount in theory, in practice the status quo of the racial pyramid in Kenya was maintained and Indians remained consistently economically and politically better off than Africans. A scholarly engagement with the antagonisms and complexities in the relationship between Indian doctors and other communities, especially Africans, would bring this important history of Indian doctors in keeping with recent new historiographical approaches to the study of race and colonialism in Kenya.
