An outlier in public health history in India: A.T.W. Simeons's scheme for rural medical relief, Kolhapur, 1943-47.

It is customary to date provision of health services in rural India to the Report of the Bhore Committee (1946) and its descendants. It is presumed that in pre-Bhore India (the last half-century of the British era) the rural public health scenario was devoid of discerning commentators and practical effort. The presumption is misleading. Historical material shows that attempts, official and non-official, to improve rural environments and attend to the health problems of villagers were not wanting. Such efforts followed two main, sometimes intersecting, streams, namely sanitation and medical relief. I examine a little-known, yet noteworthy effort in the latter category, connected with Bombay Province, which incorporated in fledgling form modern practice in rural healthcare delivery. The central character was a medical expatriate of German ancestry (but contested nationality), whose connection with Bombay spanned almost two decades including the period of the Second World War. Albert Theodore William Simeons (1900-70) was a specialist in tropical medicine whose intellectual interests and facile pen ranged wide. Providence and the paranoia of the war-time Government of British India saw him in 1943 as Director of Public Health in the princely state of Kolhapur. Here he set up and supervised a novel scheme for 'Rural Medical Relief' centred on trained villagers as first-line providers of medical treatment. The scheme endured after Simeons's departure from India, and worked well enough to be remembered post-1947 by senior medical personnel of the time and also (but without crediting him) in official publications. The Kolhapur experience also inspired a first-of-its kind fictional work by this multi-faceted personality. Archival material available in India relating to Simeons's years at Kolhapur is trifling. Other primary sources have therefore been utilized to rescue the history.