Dr A Ramachandra Rao
Dr Ayyagari Ramachandra Rao

Michael Ryan, Executive Director of the World Health Organisation recently said that India has tremendous capacity in eradicating the coronavirus pandemic. He cited the country’s success in handling polio and smallpox, both through targeted public intervention.

Of these, the smallpox story is directly connected to the history of Chennai, for it was here that the first decisive public intervention was done. And the man behind it was Dr Ayyagari Ramachandra Rao, the institution being the Communicable Diseases Hospital (CDH), Tondiarpet. I have written before about him, but a repeat is still worthwhile –

Summer may pack in a whole host of problems but we must be thankful that smallpox is no longer one of them. Right till the 1960s, despite rigorous vaccination campaigns, this deadly illness would repeatedly strike at Chennai’s populace during summer, killing several and leaving many others scarred or blinded for life.

Dr Rao, who was with the Health Department of the Corporation, had a long stint with the CDH, which, in his time, was known as the Infectious Diseases Hospital. In 1959, he became its first Superintendent, a post he held till 1964. By the time he rose to that post, he, according to his own account, had handled over 30,000 cases of smallpox. Under his guidance, a smallpox virus laboratory was set up at the CDH, which soon began attracting research scholars from across the world. Between 1952 and 1960, the lab and the CDH under Dr Rao, played an important role in assisting Dr Henry Kempe of the University of California in developing a more effective vaccine against smallpox. Dr Kempe was nominated for the Nobel Prize for this.

Back at the CDH, Dr Rao put the new serum to good use. By a study of the past records at the CDH, he arrived at the conclusion that smallpox occurred in three-year cycles, the first year being the most virulent. Having seen an outbreak in 1960, he prepared himself for 1963. His first step was simple – he insisted that any patient being admitted to the CDH, irrespective of the disease he or she was suffering from, had to be compulsorily vaccinated for smallpox. This prevented the infection spreading from smallpox patients to others in the campus.

The second step was revolutionary and controversial. World over, it was the considered opinion of experts that smallpox vaccine was ineffective in protecting infants. Dr Rao differed and insisted that any baby being delivered in a Government hospital in the city be vaccinated. Promoted as Assistant Health Officer and later Chief Health Officer of the Corporation, Dr Rao was able to carry on his campaign throughout the city. Children between the ages of one and three were also compulsorily vaccinated. The results were amazing. The number of cases of smallpox among infants in 1964 was practically non-existent. By one of those interesting coincidences, it was exactly 200 years after Dr Edward Jenner’s discovery of vaccination for smallpox. There were no epidemics thereafter in the city.

His work received international acclaim and Dr Rao became an advisor to the WHO, travelling extensively across the world to help fight smallpox. In 1972, he wrote a detailed account of his experiences. By 1979, thanks to people like him, the WHO declared smallpox an illness of the past.

Now for an aside – in 2013 I was researching the history of the Corporation of Chennai, at the request of the powers-that-then-were. One of my ‘discoveries’ was Dr Ayyagari Ramachandra Rao. I thought it will be good to have a photo of him in the book and searched high and low for it. Finally, the photographer Vinay Arvind located one moth-eaten picture high up in the wall of whoever was then the chief of the CDH. He begged for it and got it on the condition that the then chief also be photographed and included in the book. Just for the sake of the photo, I agreed and we managed to capture whatever was left of Dr Rao in that pic. Back at the designer’s, Malvika Mehra did whatever she could to reconstruct his face.

The book was aborted by the powers-that-were but I was left with many delicious stories, one of these being Dr Rao. I wrote about him in The Hindu in 2014 and a niece of his called up to express her delight. She had assisted him throughout the vaccination project. Before she rung off she told me that the photo did not look anything like her uncle – Malvika’s plastic surgery had been that thorough.

This is how we treat our heroes.

Next in this series – Madras handles Tuberculosis – watch out for it soon.