The Effects of the British on India, Bangladesh, and Pakistan

Researched by Rimsha Shamim

“The sun never sets on the British Empire.” This popular saying described the abundant land the British owned worldwide. It meant that though the sun had set in Britain, it would still be in one of the various territories due to time differences. One of these territories was called the British Raj. At its peak, it included the modern-day countries of India, Pakistan, and Bangladesh. It lasted from 1858 to 1947. In 1947, amid new protests and calls for independence, the British government in India decided to create a united Indian state. However, before the British, “Indians” did not have a national identity, nor did they call themselves “Indians.” In Hindi, the most spoken language in the country, the country is referred to as “Bharat,” a Sanskrit name. They separated themselves based on language, religion, or caste. These groups clashed consistently when this new “united” country was created. After months of bloodshed in the regions of Kolkata, Mumbai, Delhi, and more, the British made a move. It was decided to partition them, creating the Muslim-majority Pakistan and placing the Hindu and Sikh majority in India.

People rushed across borders, wanting to be where they seemed they belonged. People died in masses at the border due to unreliable and overwhelmed transportation. Territories near the border became the subject of mass dispute, the new countries trying to grab the most fertile and gem-rich lands. Pakistan celebrates its independence on August 14, 1947. India celebrated on August 15, 1947. Later, the creation of Bangladesh was due to cultural, economic, and political discrimination between West and East Bengal. For example, Urdu was declared Pakistan's official language, while most East Pakistanis spoke Bangla (the official language of Bangladesh today). East Pakistan fought for independence and became Bangladesh on December 16, 1971. This history is still relevant today, as shown by its effects on South Asia’s healthcare system.

The British introduced the standard of an official healthcare system in South Asia. They set up hospitals in popular trading ports such as Bombay (now Mumbai), Bengal (at the time still part of “India”), and Madras (now Chennai) and networks across the nations, as well as infrastructure for research on disease prevention and medical breakthroughs. The hospital ushered India into the new age of medicine, improving the medical practices compared to what they were at the time. “Colonialism and the Transformation of Traditional Medicine” explains this phenomenon: “In India, for instance, British colonialists promoted Western medicine through the establishment of medical colleges and hospitals, often sidelining traditional practices such as Ayurveda and Unani” ( Bi 3). “India” refers to the entire subcontinent at the time. These hospital systems were attuned to Western cultural practices, diseases, and medicines, often disregarding the practices popular in the native population. The indigenous people would also refuse to use these services as a form of rebellion or due to mistrust, causing these hospital networks not to affect or negatively affect South Asians. Reworking the medical standards for graduating and current students in the modern day should still be a conscious effort. “The Impact of Colonial-era Policies on Health Workforce Regulation in India: Lessons for Contemporary Reform” states,  “Such drastic changes have not yet taken shape in India, and even today, medical education struggles to shake of the metropolitan, urban orientation of curriculum and is failing to make graduating physicians more attuned to the needs and requirements of the local communities and primary health centers.’” (pg. 7). As the country grows, these outdated policies serve a complicated system that is neither efficient nor applicable to the needs of the local population. 

Recent photo of Pakistan citizens collecting free bread. Image credit to Getty Images

A tactic the British used to ensure the most profit from the indigenous population was starvation and famine. Depriving the more “expendable” native population of resources provided surplus for those in power. This applied to the more poverty-stricken parts of the population, as many South Asian lords and ladies were still extremely wealthy and allowed to be in power to encourage industry growth. For example, the 1943 West Bengal crisis killed around three million people, according to the National Library of Medicine. It occurred when World War 2 was in full swing. Cities that specialized in military production and military workers were often more affluent than other areas of the subcontinent due to the economic stimulation provided by the war. However, World War 2 also caused British legislation to neglect the parts of South Asia not actively contributing to the war, causing widespread poverty and starvation. Many strategic maneuvers were at the expense of the native population. The British, anticipating Japanese invasion on the coast of the highly successful military production city of Calcutta and the West Bengal region at large, implemented policies to halt Japanese advancement in case it happened. They wanted to deprive the Japanese of resources if they did conquer it, making the progress as useless as possible. Therefore, they removed excess rice from coastal districts and confiscated boats capable of carrying more than 10 passengers to aid in the war effort by sea. This led to severe food shortages and halted the growth of coastal industries, such as fishing.

Furthermore, the British would import most Indian goods to trade and barter, forcing Indians to buy back their goods. To survive food shortages, humans develop what is known as the “Thrifty Gene Hypothesis.” This biological phenomenon is seen when a population goes through starvation. This gene promotes fat storage and use during times of food shortage. These genes were passed on to kids who don’t suffer the same circumstances, instead making them more prone to type 2 diabetes, heart disease, and obesity. As a result of these widespread famines in the South Asian regions, they are six times more likely to develop diabetes than Europeans. However, these effects and studies on them have been repressed for years afterward due to the idea under the British government that it was due to other factors, such as “overpopulation” or solely due to “unpredictable weather.” A report by the National Library of Medicine states, “Churchill even claimed that the Indian population were the beastliest in the world after the Germans, the famine was created by themselves caused by overpopulation, and that Indians should pay the price for their negligence (Collingham, 2012).” Due to the marginalization of the native people, investigations or solutions weren’t put forth, instead allowing the South Asians to starve, and still today, there isn’t adequate research on the health side effects caused by the constant starvation. 

From the forced partition that led to widespread violence and displacement, to the starvation of millions during wartime, colonial decisions continue to shape the modern-day challenges faced by India, Pakistan, and Bangladesh. The healthcare infrastructure established under the British Raj promoted Western norms and sidelined traditional practices, resulting in broken systems struggling to meet the needs of the diverse population. Additionally, the biological consequences of the unfair policies contribute to health disparities today, making South Asians more susceptible to health problems. This paper illuminates how deep the roots of colonial trauma go in the South Asian subcontinent. 

Resources/References Used

Bi, Ziyue. “Colonialism and the Transformation of Traditional Medicine.” Research Archive of Rising Scholars, 5 Nov. 2024, pp. 1–10. https://doi.org/10.58445/rars.1938.

Mallik, Senjuti. “Colonial Biopolitics and the Great Bengal Famine of 1943.” GeoJournal, vol. 88, no. 3, 6 Dec. 2022, pp. 3205–3221. Springer Nature, https://doi.org/10.1007/s10708-022-10803-4. Accessed 19 Apr. 2025.

Sriram, Veena, Vikash R. Keshri, and Kiran Kumbhar. "The Impact of Colonial-Era Policies on Health Workforce Regulation in India: Lessons for Contemporary Reform." Human Resources for Health, vol. 19, no. 1, 18 Aug. 2021, https://doi.org/10.1186/s12960-021-00640-w.