Relocating Heart Disease in the Tropics: Race, Risk, and Modernization in Post-Independence India

FAIN: RZ-51759-14

Columbia University (New York, NY 10027-7922)
Kavita Sivaramakrishnan (Project Director: January 2014 to December 2021)
David S. Jones (Co Project Director: September 2014 to December 2021)

Research culminating in the writing of a book and several articles examining the history of medical responses to heart disease in India. (36 months)

This project explores how heart disease came to be seen as a problem in India in the decades after its independence in 1947 by situating it within the politics of decolonization and the interactions between international and national experts as they shaped a new, global profession. It explores a unique paradox, of burgeoning interest in heart disease and cardiac technology in the 1940 and 1950s at a time when India's overwhelming epidemiological burden still stemmed from infectious diseases and malnutrition. Our research will reveal: (1) how and why cardiology and cardiac surgery first gained footholds at medical institutions in India; (2) how the two specialties were then taken up as an important component of India's national health agenda; (3) how international networks of medical training and exchange fostered these developments amid the complexity of Cold War politics; and (4) the consequences of this history for patients and physicians who grapple with heart disease in India.

Associated Products

50 Years Ago: India’s First Heart Transplant in the Time of Nehruvian Science (Database/Archive/Digital Edition)
Title: 50 Years Ago: India’s First Heart Transplant in the Time of Nehruvian Science
Author: Kiran Kumbhar
Abstract: Reports on research conducted by the two PI's
Year: 2018
Primary URL: https://thewire.in/the-sciences/50-years-ago-indias-first-heart-transplant-in-the-time-of-nehruvian-science
Primary URL Description: Article by Kumbhar entitled, 50 Years Ago: India’s First Heart Transplant in the Time of Nehruvian Science, in The Wire, an Indian online news outlet.
Access Model: Yes

“Making heart-lung machines work in India: Imports, indigenous innovation and the challenge of replicating cardiac surgery in Bombay, 1952-1962,” (Article)
Title: “Making heart-lung machines work in India: Imports, indigenous innovation and the challenge of replicating cardiac surgery in Bombay, 1952-1962,”
Author: Jones and Sivaramakrishnan
Abstract: In 1962, surgeons at two hospitals in Bombay used heart-lung machines to perform open-heart surgery. The devices that made this work possible had been developed in Minneapolis in 1955 and commercialized by 1957. However, restrictions on currency exchange and foreign imports made it difficult for surgeons in India to acquire this new technology. The two surgeons, Kersi Dastur and PK Sen, pursued different strategies to acquire the ideas, equipment, and tacit knowledge needed to make open-heart surgery work. While Dastur tapped Parsi networks that linked him to local manufacturing expertise, Sen took advantage of opportunities offered by the Rockefeller Foundation to access international training and medical device companies. Each experienced steep learning curves as they pursued the know-how needed to use the machines successfully in dogs and then patients. The establishment of open-heart surgery in India required the investment of substantial labor and resources. Specific local, national, and transnational interests motivated the efforts. Heart-lung machines, for instance, took on new meanings amid the nationalist politics of independent India: Even as surgeons sought imported machines, they and their allies assigned considerable value to ‘indigenous’ innovation. The confluence of the many interests that made Sen and Dastur’s work possible facilitated the uneasy co-existence of conflicting judgments about the success or failure of this medical innovation.
Year: 2018
Primary URL Description: https://journals-sagepub-com.ezproxy.cul.columbia.edu/doi/full/10.1177/0306312718794034?utm_source=summon&utm_medium=discovery-provider
Access Model: Subscription
Format: Journal
Periodical Title: Social Studies of Science, 8/2018, ISSN: 0306-3127, Volume 48, Issue 4, p. 507
Publisher: Sage Journals

Transplant Buccaneers:P.K. Sen and India's First Heart Transplant, February 1968 (Article)
Title: Transplant Buccaneers:P.K. Sen and India's First Heart Transplant, February 1968
Author: David S. Jones
Author: Kavita Sivaramakrishnan
Abstract: On 17 February 1968, Bombay surgeon Prafulla Kumar Sen transplanted a human heart, becoming the fourth surgeon in the world to attempt the feat. Even though the patient survived just three hours, the feat won Sen worldwide acclaim. The ability of Sen's team to join the ranks of the world's surgical pioneers raises interesting questions. How was Sen able to transplant so quickly? He had to train a team of collaborators, import or reverse engineer technologies and techniques that had been developed largely in the United States, and begin conversations with Indian political authorities about the contested concept of brain death. The effort that this required raises questions of why. Sen, who worked at a city hospital in Bombay that could not provide basic care for all its citizens, sought a technology that epitomized high-risk high-cost, health care. To accomplish his feat, Sen navigated Cold War tensions and opportunities, situating his interests into those of his hospital, municipal authorities, Indian nationalism, Soviet and American authorities, the Rockefeller Foundation, and others. The many contexts and interests that made Sen's work possible created opportunities for many different judgments about the success or failure of medical innovation.
Year: 2018
Primary URL: https://muse-jhu-edu.ezproxy.cul.columbia.edu/article/699247
Primary URL Description: Project Muse
Format: Journal
Periodical Title: Journal of the History of Medicine and Allied Sciences, 2018, ISSN: 0022-5045, Volume 73, Issue 3, p. 303
Publisher: Oxford University Press

"History of Cardiology in India," in Tandon's Textbook of Cardiology (Book Section)
Title: "History of Cardiology in India," in Tandon's Textbook of Cardiology
Author: Kavita Sivaramakrishnan
Author: David S. Jones
Editor: Dorairaj Prabhakaran, Raman Krishna Kumar, Nitish Naik, Upendra Kaul
Abstract: This chapter in this edited popular edited textbook of cardiology (well known and identified with its founder, Dr. Tandon) that is consulted by medical students and aims to trace a history of cardiology and cardiothoracic surgery in India that situates it in a colonial and post colonial history of medicine, science and technology. It also offers the reader (typically, a non-historian, medical student or instructor, informed reader)a historical narrative that also introduces a range of archives, data sources and voices to narrate a history that is not teleological but offers instead critical insights that aim to situate medicine in society, and its complex political, social and scientific exchanges
Year: 2019
Primary URL: https://www.amrita.edu/publication/tandons-textbook-cardiology
Publisher: Wolters Kluwer
Book Title: Tandon's Textbook of Cardiology
ISBN: 9789388696166

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