Reforming Medicine: Dr. Krishnabai Kelavkar

In 1923, Dr Krishnabai Kelavkar – a social reformer and one of the earliest women physicians in India – established the eponymous Kelavkar Medical Centre at Kolhapur. Nearly a century later, the institution stands as a reminder of the early contributions of women physicians to the male dominated field of western medicine in colonial India. It is only in recent decades that the contributions of women physicians in colonial India like that of Dr Anandibai Joshee and Dr Rukhmabai Raut have been lauded. Krishnabai’s name too should be added to the list of trailblazers. Not only were these doctors key participants in the women’s health movement, but they also challenged established social norms to create a space for their knowledge and expertise, supported by reformist organizations, powerful reform-minded patrons, and their own families.

Krishnabai was born on 26 April 1879 in the Bombay Presidency, when Indian social reform movements were at their zenith. The latter half of the nineteenth century, the ‘Indian Renaissance’, witnessed the spread of reformist institutions like the Arya Samaj and Satyashodak Samaj. Social reformers moved the wheels of education for women and those belonging to ‘untouchable’ castes by establishing institutions that catered to these marginalised groups. Indian reformers also collaborated with the colonial government to pass legislation that safeguarded the interests of these groups, resulting efforts to improve the status of women and reduce caste-based discrimination. These socio-religious reform movements were involved in a complex intellectual undertaking of questioning and simultaneously adapting to the colonial constructs of Indian tradition.

While it is true that Krishnabai’s life cannot be detached from the milieu of her times. It is also important to recognize the inimitable qualities that make up the personality of an individual. In this case, the determination and courage that drove Krishnabai to act independently of social pressures, to go against the established social norms, and stand up for her ideals. Born into a Kshatriya family, Krishnabai grew up in Kolhapur, a princely state ruled by the philanthropic and reform minded Chhatrapati Shahu. Though she belonged to an upper caste family, their economic condition was precarious. Moreover, her father was diagnosed with pinta, a rare tropical infectious disease affecting the skin. Krishnabai’s mother, Rakhmabai, was an educated woman who took up teaching positions in Kolhapur, first at the Kolhapur Durbar and later at the Female Training Institute, to support her family through the economic crisis. The Female Training Institute was a result of Shahu’s efforts to improve the status of women and provision of education to all. Throughout the late nineteenth century and the early twentieth century, he was the leading voice in favour of social reform movements in Maharashtra and contributed to the discourse surrounding gender relations in Bombay Presidency.

During the period under consideration, philanthropy began to take the form of a social movement in colonial India. Social reformers from different professional backgrounds began to provide funds for education of women, which sequentially aided the social reform movement. They firmly believed that women’s education was crucial for their empowerment.  Krishnabai was a beneficiary of such financial aid from Shahu and Jamsetji Tata, a renowned nationalist industrialist from Bombay. Realizing  Krishnabai’s academic calibre, Shahu patronized and paid for her entire education. In 1902, Krishnabai sailed to Dublin, Ireland as a part of her professional training – to pursue a surgical course in Midwifery and Diseases of Women. This time, in addition to state funding, the J. N. Tata Endowment Fund supported Krishnabai and Freany K. Cama, a fellow graduate from Grant Medical College.  Launched in 1892, the Fund was Tata’s first venture into constructive philanthropy, and Tata himself had selected Krishnabai and Cama to receive the fund’s support. He had identified the need to support and train Indian women physicians to address the intertwined problems of rising infant mortality rates, the scarcity of female doctors, and the reluctance of Indian women to consult male doctors.

In 1893, Krishnabai had graduated from Female High School in Poona. The school had been established by the reformist women’s organisation Arya Mahila Samaj to promote women’s education. She enrolled in Fergusson College in Poona, where she studied English, Sanskrit and Mathematics, amongst other subjects. Krishnabai’s father, Krishnajee Kelavkar, was also a firm believer in women’s education, and supported her application to the College. Krishnabai was one of the first female students to be admitted to this institution for higher education, clearing a special entrance exam along with Ms. Godubai Deshpande.

At Fergusson, Krishnabai faced, and challenged, gender-based discrimination on the part of the institution’s management. Reflecting on this, Krishnabai wrote in her memoir:

“…we (girls) were given seats in a corner of the hall near the professor’s seat with chika curtains all around us. It was then I experienced what a purdah lady felt. A separate staircase was also kept for us. All these precautions, as it was found afterwards, were not at all necessary. We never had any occasion to complain about our fellow students’ behaviour towards us… That is one reason why these curtains disappeared in the next term”.

She firmly believed that these practices of segregation were unnecessary and unjust and saw no reason to suspect poor behaviour from her peers. Her father, Krishnajee, also appealed to the college authorities against such discriminatory systems.

The experiences at Fergusson played a pivotal role in shaping Krishnabai’s personality. In the years that followed, Krishnabai situated herself as a social reformer, challenging discrimination more widely while developing her medical career. Graduating in 1895 at the top of her class, Krishnabai was clear about both the professional as well as societal role she wished to embrace. She joined the Grant Medical College in Bombay, alongside becoming a permanent member of the Prarthana Samaj, a Hindu reform society focused on challenging the caste system, encouraging female education, and abolishing child marriage. On completing her medical training in 1901, the newly-minted Dr Krishnabai Kelavkar moved back to Kolhapur, where she started to practice medicine at the Albert Edward Memorial Hospital for Women and Children as Assistant Surgeon and Head of the women’s section. While the position had been intended for Dr Anandibai Joshee – the first Indian woman to obtain an M.D. in western medicine – Krishnabai replaced her following Joshee’s untimely death from tuberculosis. These were all unusual decisions for a Marathi-speaking woman.

Krishnabai played a decisive role in developing maternity care in Kolhapur. Under her leadership, maternal and infant welfare improved significantly between 1903 and 1923. Krishnabai worked to build public awareness about safe and hygienic birthing methods and infant care. She published articles on a wide range of issues, with titles like ‘Precautions to be taken by parents for the birth of a healthy baby’, ‘Illicit pregnancies’ and ‘Minimum age gap between successive children’. Her service drew appreciation from both the princely state of Kolhapur and beyond, and she was even awarded the Kaisar-i-Hind Medal (silver) by the British monarch for advancement of public service in India in 1908. An Anglo-Gujarati journal – Hindi Punch – wrote that “she heals the disease quite as well with her drug and her surgical knife as with her sweet smile and her gentle treatment of the patient”. Such recognition also made her an inspiration for a younger generation of women doctors in the Bombay Presidency.

Despite an illustrious career, Krishnabai voluntarily retired from public service in 1923 and moved into private practice. The 1922 death of Chhatrapati Shahu – the ruler of Kolhapur, whose support had helped her surmount the educational obstacles faced by women – influenced this decision. Krishnabai had faced a significant amount of criticism as a woman medical professional, and the lack of political support following Shahu’s death in a male dominated bureaucracy prompted her voluntary retirement. She went on to establish the Kelavkar Medical Centre and became one of the first women to set up an independent practice in colonial India which operated until her death in 1969.

Education in India in the early 19th century was largely distributed based on the caste system, and upper-caste women had greater access to opportunities for higher education. Dalit women faced a double discrimination in accessing educational facilities in colonial India, both as members of a lower caste community and because of their gender. Though Dalit women have greater access to higher education but the impetus for socio-cultural reform continues to be relevant in twenty-first century India, as gender and caste inequities persist, including within the medical community. In May 2019, Payal Tadvi – an aspiring gynaecologist from the underserved and underrepresented Bhil Muslim tribal community – committed suicide. Pursuing postgraduate study in medicine at the Nair Hospital in Mumbai, she faced abusive casteist slurs and harassment from upper caste female colleagues. Her professional achievements could not override endemic inequalities: all women are not equal in Indian society.

Remembering the remarkable lives of the early women physicians points to the potential promise of the unfinished project of social reform for the Indian medical profession and public health more widely, and the need for continued work to challenge intersecting inequities – caste alongside gender.