Civil Dispensary to King George Hospital: A rough and winding journey

The district head quarter’s civil hospital at Visakhapatnam constructed in 1923 was named “King George Hospital” in the same year. In 2023 it completes its first century as KGH. But it had its humble beginning as a Civil Dispensary in 1845. During its journey from Dispensary to being a civil hospital, it had to overcome many obstacles and challenges through a rough and winding path, due to frequent policy and administrative changes brought in by the then Government, to become the renowned King George Hospital in 1923.

The Provincial Govt, at Madras, sanctioned dispensaries in the towns of present-day Tiruchirappalli, Madurai, Machilipatnam, Bellary and Cuddapa in December 1841, on an experimental basis and desired not to open any new dispensaries until they were satisfied with the results of those already sanctioned. Until this time the English East India Company government was of the opinion that the medical care of the natives was not their concern. They were concerned only about their European and Native army regiments and their Company officials for whom hospitals and dispensaries were established at Madras and Military stations.

Those were called Garrison Hospitals and were run by Army Doctors. In Visakhapatnam also there was a Garrison Hospital in the present old town area. Garrison surgeons were stationed here during those times. The dispensaries that were later established for natives were called Civil Dispensaries. The designation of Civil Surgeon was created to differentiate from Garrison Surgeon. But during the early days of civil dispensaries or hospitals, it was the Garrison Surgeons and the subordinate medical staff working in the Army that was drafted for civil service.

Around 1843 applications were sent from Salem, Calicut, Kurnool and Vizagapatam requesting the establishment of such Civil Dispensaries at these places. While examining these applications the Madras Medical Board passed the following remarks “ We did not expect that these institutions ( already established in 1841) would be duly appreciated until time overcome the prejudices of the native community by convincing them of the utility and humanity of such

establishments. The progress of the dispensaries at Madurai and Cuddapah has been checked by accidental circumstances, but it is encouraging to find that the Medical Officers in charge of those already established in the interior corner in opinion as to their ultimate success. We, therefore, sanction the formation of similar institutions at Salem, Calicut, Vizagapatam and Kurnool; but we cannot authorise you to institute dispensaries in other districts without our previous sanction”. The sanction was accorded on 18^th Feb 1845.

Accordingly, the Civil Dispensary in Visakhapatnam was established in August 1845. Initially, it was located in a rented building on the road leading from the present Turner’s Choultry to Dolphin Hotel. This was under the Provincial (State) Government of Madras and all the expenses were met by that government.

As can be seen from the statistical report of the dispensary it is evident that from the very beginning, apart from the outpatients, the in-patients were also treated at the dispensary. The number of people seeking medical relief was increasing year by year. In the year 1852, the Civil Assistant Surgeon in charge of the dispensary J.H.Blackwell reported that “the dispensary was situated in an out of the way corner of the city, away from the major thoroughfare, and that the building is not suitable for a dispensary to accommodate both sexes of the patients. If the dispensary is situated in a more central locality with a larger accommodation, more number of natives would seek medical relief

”. In another statistical statement of 1852, it was recorded that the in-patients remaining in the dispensary at the end of the year, as on 31^st Dec 1852 was 22. This implies that the bed strength was at least 22 in that year.

By the end of 1857, the dispensary was removed to a new building costing Rs. 17,200, of which a sum of Rs. 10,225 was by public subscription and Rs. 6,975 had been given by the Government. The public subscription was mostly contributed by the Rajas of Vizianagram and Bobbili and the members of the Gode family (a zamindary family in the city). This new building was located in the place where the present Physiology block of Andhra Medical College is located. (Same place where the dispensary is in the photograph given below) . The dimensions of the wards in this new dispensary were;

 

Ward	Length	Breadth	Height
Male ward	76 ft	21 ft	16 ft
Male ward for special cases	33 ft	11 ft	11ft
Female ward	48 ft	21 ft	16 ft
Female ward for special cases	21 ft	11 ft	11 ft

In 1861 the government changed its policy towards medical care and wanted the people to support their sick. The government decided that the local governments such as District or Taluka boards (present-day Zilla Parishads or Mandal Parishads) and Municipalities should provide the necessary funds. The Govt, also expected the wealthy natives to make some contributions to these institutions. The Govt, allowance for the diet of poor patients was restricted to Rs. 50 per month.

The Madras government issued a notification on 23^rd June 1863 informing the public that “The Govt considers that the time has now arrived when inhabitants of the Districts, where the Civil Dispensaries have hitherto entirely supported by the state, should be made to understand distinctly, that while the Government will continue to supply the Medical aid and Medicines, they expect the local public to provide the necessary funds for the food, clothing, and attendance required by their own sick poor: and that where this is not done, they will close the Dispensaries altogether. Civil Dispensaries are established solely for the benefit of the people: and if the inhabitants of a District desire to retain the advantages of an institution for medical relief amongst them, they must contribute to its support”.

At this crucial time, the Rajah of Vizianagaram came forward to make an endowment of Rs 20,000 to meet the diet charges for poor patients. The Rs. 20,000 was put in Govt securities and its interest was used for the patients. The Govt relinquished its management of the dispensary in 1864 and it became a private dispensary with a managing committee, consisting of the Collector as President, the District Surgeon as Secretary and the Executive Engineer as one of the members. Besides this Govt, officials perhaps the native donors to the dispensary were also included, as there were 7 members on that committee. The local district board and municipality provided funds. It may appear strange to call it a private dispensary with this system of management. But it is similar to that of the privately aided educational institutions of recent times. It continued to be a private institution till 1918.

Though it was called a dispensary, there was provision for in-patients. It is normally understood that in a dispensary, only out-patient treatment is provided, whereas in a hospital patients are admitted as in-patients for a longer period of treatment. The Govt during that time used the word dispensary loosely without making any distinction between dispensary and hospital. The dispensary at Visakhapatnam had admitted in-patients from the very early days. The number of patients that were treated in this dispensary/hospital from 1845 to 1873 is given in the table below:

Year	In Patients	Out Patients		Year	In Patients	Out Patients		Year	In Patients	Out Patients
1845	13	163		1855	211	5498		1865	467	11301
1846	56	244		1856	265	5016		1866	346	7950
1847	69	202		1857	205	4346		1867	218	6462
1848	95	481		1858	209	6026		1868	187	7797
1849	91	913		1859	….	….		1869	205	7718
1850	68	1796		1860	291	5530		1870	222	8321
1851	100	2325		1861	259	7268		1871	224	8398
1852	170	3610		1862	372	9934		1872	283	7452
1853	166	4269		1863	374	8943		1873	287	7126
1854	307	4541		1864	310	7194

In 1867 it was reported that when a representation was made to the Maharajah of Vizianagaram that the interest deriving from the endowment of Rs. 20,000 made by him in 1863 was not sufficient to provide a suitable diet and the clothing for the sick in the wards, he readily agreed to extend his charity by providing Rs. 150 per month. When further urged by the managing committee of the dispensary for the provision of iron cots and suitable bedding, the Maharajah further granted Rs. 550 for these and other necessary ward and consulting room furniture. Further, in 1874 Maharajah authorised the managing committee to apply to his Diwan if any further monetary assistance was required. The Govt then instructed the Collector to convey to Maharajah the high appreciation of the Govt for his very liberal support and valuable charity.

In course of time, separate wards for patients of different castes were made by the concerned castes within the hospital compound.

The hospital under private management had been running with the liberality of the Maharajah of Vizianagaram and the aid provided by the Municipality and the district board.

In January 1911 the Secretary of the hospital Committee proposed to the Govt for the demolition of the main building of the hospital and to convert it into a two-storeyed building using the same woodwork, doors, windows etc, as the existing building. It appears that the hospital Committee noticed the signs of decay in the building constructed in 1858 and also felt that the maintenance of the old building was expensive to be met from their available funds. The Surgeon General of the Madras Government after a personal inspection of the hospital reported to the Govt in June 1912 that “there was not sufficient room in the compound of the existing hospital to build it on the standard plan suggested and decided that it was best to follow the general arrangements of the existing building”. Based on the Surgeon General’s report the Govt of Madras issued a GO sanctioning the reconstruction of the Civil Hospital with Provincial Funds (state govt funds).

Subsequent to this sanction by the Govt, further correspondence went on between the hospital committee, Surgeon General, the PWD and the Govt Finally, a plan was made for the accommodation of 136 beds as against 86 in the then-existing hospital. In 1913, the Surgeon General of Madras while explaining the need to have a 136-bed hospital stated that “the existing hospital building was overcrowding and that the patients have had to be accommodated in the verandahs”. In April 1914 the plans were approved and a budget of Rs. 1,27,000 was sanctioned,

Before any work could be taken up against this sanction, the Executive Engineer had declared the surgical ward of the existing hospital building unsafe. In September 1914, the Superintending Engineer and Executive Engineer inspected the hospital building and advised the immediate evacuation of the patients from the ward and suggested shifting them to the Medical School building. On 14^th December 1914, the Surgeon General visited the hospital and made this report “Inspected the hospital this morning along with Major Illington., I.M.S.,…………………………………………………………………………………. The last

monsoon proved too much for the old building and the walls are falling out bringing with them the whole of the roof. Probably the next monsoon may bring down the rest of the buildings. It is necessary therefore to move the hospital into the school block at once and house the school elsewhere. I will address the Government at once on the subject, after having seen for myself the absolute necessity of moving the patients from this dangerous and overcrowded building. The attendance of both in-door and out-door patients continues rapidly to increase, and a new hospital is an urgent necessity not only for the reason given above but also for the sake of the teaching in the medical school attached to this hospital     ”

Perhaps this report had become a basis for the Govt to subsequently go for a bigger hospital at a new location. Meanwhile, it became an urgent necessity to shift the medical school and to convert the school building to temporarily accommodate the hospital. This temporary arrangement was contemplated because the medical school building was situated just beside the hospital as can be seen from the photograph given above.

Accordingly, the school was shifted from the medical school building to the upper floor of the Old Collector’s office, the present Queen Mary’s Girls High School building. The alterations to the school building were made to temporarily accommodate the hospital till such time that a new hospital building was built. The alterations were made keeping in view that the building would be used as a combined medical school and hostel after the hospital was shifted to a new building.

The bed strength of the dispensary/hospital from 1885 to 1937 obtained from available records is given below:

Year 1885	Male 20	Female 10	Total 30	Building Old civil hospital building
1899	38	8	46	“
1901	40	12	52	“
1902	65	12	77	“
1904	46	13	59	“
1912	64	21	85	“
1913	64	21	85	“
1914	64	20	84	“
1915	45	20	65	“
1917	101	36	137	Medical school building
1919	101	36	137	“
1923	…	…	192	KGH
1930	…	…	270	“
1937	…	…	348	“

The school building including the site was a gift of Maharani Sita Bai of Wadhwan (daughter of Maharajah Gode Narayana Gajapathi Row and stepdaughter of Maharani Gode Chitti Janakamma Gajapathi Row) made to the Govt through a registered deed. Under this deed, if at any time, the medical school buildings are not used for a medical school or college, the donor has the right to take back or reassign the building without any claim by the Govt, in respect of any additions or improvements made by them. Given the above, the Govt took the necessary consent from the Maharani to temporarily convert the school building into a hospital in the unavoidable urgent necessity.

In 1916-17, the Consulting Architect to the Government prepared drawings and specifications for the New Hospital at Vizagapatam. The construction of the civil hospital started in 1917-18. Almost during the same time, the State Govt, of Madras decided to take over all the district headquarters’ hospitals under their management, which hitherto were under private, municipal or local boards’ management, with the purpose to maintain them in a greater state of efficiency than before under the different managements. As per this decision the civil hospital at Vizagapatam, which was under private management from 1864, was taken over by the govt with effect from 1^st July 1918.

The new hospital buildings were occupied in April 1923. By that time, the total expenditure incurred on the construction was Rs. 6.09 lakhs. Some more individual blocks were still in progress. It appears that the civil hospital was renamed in the same year as “King George Hospital”. The total expenditure on the KGH at the end of 1927 was Rs 7.94 lakhs as against an estimate of Rs 11.12 lakhs. The works that were still in progress were the maternity ward, matron’s and nurses’ quarters and quarters for servants, engine drivers and other employees. The construction of buildings for the sanctioned civil hospital went on up until 1933.

The notable feature in the construction of the new headquarters hospital was that a powerhouse was built for the generation and supply of electricity to the hospital. There was no electric supply to the city until 1934 when Visakhapatnam Port constructed a powerhouse and agreed to supply to the town through Vizagapatam Electric Supply Company. One Mr B Borooah donated Rs. 35,000 to the King George Hospital in 1922 for installing electricity.

To sum up the narration, this institution has a history of 178 years up to this year (2023). From a small dispensary in 1845 to a district headquarters hospital, named King George Hospital in 1923 it has a history of 78 years. It was started as a dispensary fully owned and maintained by the State Govt of Madras in 1845 in a rented building a little away from the central locality. With the help of a local charity a new building was constructed at a suitable place and the dispensary was shifted into it in 1858. The state Govt of Madras relinquished its responsibility of the dispensary in 1864. The dispensary was placed under private management from then on. Till 1918, it was maintained by the liberality of the Maharajah of Vizianagaram and with aid provided by the local board and municipality. When the old hospital building was crumbling and some wards were declared unsafe and ordered for immediate evacuation, the Maharani of Wadhwan was kind enough to permit the govt to make alterations to the medical school building donated by her maternal family and to temporarily house the hospital till the new hospital building was occupied in April 1923. The history of this institution as King George Hospital started from then and is completing 100 years in this year 2023 along with Andhra Medical College in Visakhapatnam.

In this centenary year of AMC also in 2023, more information from the old students and professors is expected about the college and KGH as well.

Compiled by Vijjeswarapu Edward Paul Mobile: +91 94401 73695

Email: edwardpaulv@gmail.com

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