When Rawalpindi became a British garrison in 1849, the decision was not just about military strategy. It was a blueprint for order, health, and control in a land the British sought to dominate. The 53rd Regiment of Foot of Queen Victoria’s Army established its headquarters there soon after annexation, and within two years, James Broun-Ramsay, the 1st Marquess of Dalhousie and Governor-General of India, laid out a permanent cantonment. By the mid-1850s, Rawalpindi had become the headquarters of the Northern Command of the British Indian Army. Its centerpiece was the Victoria Barracks, an imposing complex built in the Gothic “French Art” style with pointed arches, ribbed vaults, and flying buttresses. Nearly 175 years later, that very building still stands—now housing the Pakistan Army GHQ. The stone remains, but the philosophy that built it—the conviction that military strength was inseparable from public health—has long been abandoned.
The British left behind more than barracks and cantonments. They left a record of meticulous observation and planning. One of us, Engineer Arshad H Abbasi, while fighting to preserve the ancient Patriata Forest, discovered these documents in the British Library in London. That forest, originally conserved by the British, was not valued for aesthetics but for water security: Patriata’s pine cover helped regulate streams feeding Rawalpindi’s water supply. The British understood that an army cannot march on empty stomachs—or on contaminated water. For Rawalpindi, water was carefully sourced from the Kurang River and supplemented by the Soan. Managing rivers, forests, and sanitation was considered part of military infrastructure.
Yet even their foresight was tested. In 1872, Rawalpindi was struck by cholera, introduced by infected troops arriving from the plains. It was a sobering reminder that no garrison was immune. Instead of denial or political excuses, the British treated it as a turning point. Sanitation, disease surveillance, and preventive systems were strengthened. Cantonments became laboratories of military medicine. Every outbreak was documented in exhaustive reports, not buried under bureaucracy.
Only four years later, in 1876, another crisis unfolded. This time in Murree, then a sanitarium town where officers and soldiers sought escape from the deadly summer heat. The pine-covered slopes, thought to be a refuge of health, became the site of a devastating epidemic. Surgeon Charles Moore Jessop, an officer in the British Army Medical Service, confronted an outbreak of Asiatic cholera in Camp Gharial. His meticulous report, now preserved in London, reads like both a medical diary and a detective’s notebook—a record of suffering, mistakes, and innovation.
Murree was intended as a place of safety. Instead, a disastrous decision by military command turned it into a crucible of contagion. A cholera convalescent camp was sited on Topa Near Murree, directly upwind of Gharial. Jessop subscribed to the prevailing miasma theory, believing in “cholera air,” an invisible, poisoned atmosphere that carried disease. Though he was wrong about airborne transmission, his reasoning was sound: placing the sick upwind of the healthy was, in his words, a “hazardous experiment.”
What makes Jessop’s report remarkable is the detail it offers about sanitary measures. By 19th-century standards, the infrastructure was cutting-edge. Latrines with stone walls, mud roofs, and airtight receptacles. Macnamara’s filters to purify drinking water. Strict garbage disposal protocols. Camp police enforcing hygiene. The Raj treated sanitation as a defensive line, as essential as rifles or fortifications. And still, cholera struck. Science had not yet revealed the bacterium Vibrio cholerae, carried in contaminated water and food. Jessop, with half the evidence, could not find the true culprit.
His medical response, however, showed both ingenuity and compassion. He pioneered hypodermic injections of chloral hydrate to ease the excruciating cramps of the acrid stage of cholera. He insisted patients be propped up rather than kept flat, believing it improved circulation and breathing. These unorthodox treatments, though born of intuition, showed results. Jessop carefully logged survival rates and symptoms. His case notes reveal the human face of the epidemic: malnourished women from the 70th Regiment, children gasping for air in overcrowded tents, men poisoned by greasy “plum dough.” He concluded cholera struck “selectively,” preying on the already weak—those worn down by hunger, indigestion, and nervous exhaustion.
To strengthen his observations, Jessop compared Murree with Rawalpindi, which he used as a “control group.” There, troops maintained baseline health, unlike in Murree and Meerut where illnesses rose even before cholera struck. The contrast suggested to him that epidemics needed weakness to take hold.
Reading Jessop’s report today is like watching a detective solve a case with missing clues. He correctly identified risk factors: overcrowding, malnutrition, poor sanitation. He understood the need to isolate the sick. He innovated with treatments based on careful observation. Yet he missed the invisible killer—Vibrio cholerae. His “cholera air” was a metaphor for what he could not yet see.
The legacy of this system is layered. The British left behind hospitals, medical colleges, and sanitation systems. They also entrenched inequality: European troops and families received priority, while indigenous workers—cooks, cleaners, water carriers—were peripheral, their health noted only when it affected Europeans. Yet even this inequality carried a paradox. Jessop noted, with surprise, that many “natives” resisted the outbreak, perhaps because their bodies, hardened by harsher living conditions, were more resilient in the controlled camp environment.
What is undeniable is that the Raj recorded, investigated, and learned. They made mistakes, but they documented them so future generations would not repeat them. Prevention, observation, and institutional memory were pillars of their system.
Now, nearly 150 years later, Pakistan has inherited the buildings but not the mindset. The forest in Murree, once preserved for water security, is being destroyed. Water quality itself, once the centrepiece of military planning, is neglected. Rawal Dam, constructed in the 1960s to supply Rawalpindi and Islamabad, is today choked with untreated sewage, industrial effluents, and agricultural runoff. Once envisioned as a guarantee of clean water, it has become a source of contamination. Reports repeatedly warn of pathogens in Rawal Dam’s water, yet residents of the twin cities still drink from it, risking hepatitis, typhoid, and cholera. Unlike the British, who treated the 1872 outbreak as a turning point, Pakistan muddles through each crisis with temporary fixes and no institutional learning.
Meanwhile, outbreaks of hepatitis, typhoid, dengue, and even cholera continue to claim lives across Pakistan. But unlike Jessop, who logged every case in detail, Pakistan’s health institutions rarely publish transparent records. Outbreaks are downplayed, statistics manipulated, and once the crisis subsides, the memory fades until the next epidemic arrives.
The ghosts of Murree and Rawalpindi still speak. They remind us that epidemics are not only biological but social. They warn us of the dangers of inequality and neglect. They underscore a timeless truth Jessop stumbled upon: health is not simply the absence of disease. It is a state of vitality, rooted in nutrition, clean water, and a healthy environment. Where these are absent—whether in a colonial camp in 1876 or in Rawalpindi’s polluted reservoir in 2025—the stage is set for catastrophe.
Pakistan cannot afford to ignore these lessons. The British Raj, with limited science and technology, still understood that health was inseparable from strength. They preserved forests, secured water, and documented outbreaks relentlessly. Pakistan, with all the tools of modern medicine, has no excuse for allowing its people to drink unsafe water from Rawal Dam or breathe poisoned air in its cities. The ghosts of epidemics past are not just history—they are a warning. Ignore them, and they will return.
