Medical Mobility Across Empire: Medical-Based Migration Between Nepal and British Ceylon (Sri Lanka), C. 1850-1947

This study examines the medical-based migration between Nepal and the British colony of Ceylon in the late 19th and early 20th centuries. It stands out as an underexplored case in an important area of British imperial influence. Most research on colonial medicine has concentrated on India, largely neglecting other South Asian regional medical contacts, such as those with Ceylon and Nepal. This omission matters because, as two trans-regional countries, they were integrated into the British Empire's military, labor, missionary, and medical infrastructure in various ways. This study redefines migration as a medically mediated process that affected institutions, disease control, and healthcare systems, highlighting medicine as a central driver of exchange. It reveals significant aspects that extend beyond the economic or military spheres typically discussed. This study's primary research question is how medical migrations occurred between Nepal and Sri Lanka during the British era and how they influenced regional healing practices and social hierarchies. This study focuses on three main themes: first, the migration of medical personnel for quarantine, surveillance, and colonial health services; second, opportunities for medical employment and training; and third, the need to treat and control epidemics. This research has allowed us to revisit several historically important areas. First, because studies of colonial medicine have focused mainly on Africa and India, it is essential to study Sri Lanka and Nepal. Second, medical influence has often been centered on colonial hospitals, missionary movements, or military health; however, research on medical migration is limited. Third, little research has explored how local practitioners, medical assistants, and unofficial healers promote interregional collaboration and therapeutic exchange. Finally, in South Asian contexts, the ethical issues surrounding medical migration, such as body assessment, coercive treatment practices, and access to public care, remain underexplored. Preliminary research indicates several instances of medically based migration, such as Nepalese soldiers and their families gaining access to British medical systems through Gurkha military service, which enabled them to join colonial hospitals in Ceylon. They worked in missionary hospitals, plantation dispensaries, and Ceylonese medical centers, and occasionally interacted with patients and staff passing through Indian ports, such as Madras and Calcutta. Medical journals and administrative letters further confirm that the imperial shipping network and port-health regulations provided the infrastructure for exchanging medicines, medical knowledge, and sanitary practices along these routes. This historical study employed an interdisciplinary, multi-archival approach. Primary sources, including the Ceylon Blue Books, Sanitary and Medical Administration Records, Hospital and Dispensary Records, Regimental Medical Records, Missionary Hospital Records, Port-Health and Quarantine Records, Medical Gazettes, and the Ceylon Medical Journal, served as the main sources. The results not only validate the migration of Western medicine to Nepal and Sri Lanka for medical treatment but also establish hybrid medical environments in which Western medicine coexisted with indigenous medical practices in these regions. Migration did not solely represent a colonial expansion of Western medicine but a function of negotiation, accommodation, and selective appropriation. Furthermore, this study confirms how the colonial medical system perpetuated colonial medical imperatives with a prioritized focus on providing racially, class-, and institutionally advantaged access to medical treatment in favor of military servicemen, colonial administrative functionaries, and indigenous elites, in contrast to informal medical practitioners and patients. By examining medical migration in South Asia, this research paper highlights the new significance of colonial medical history in understanding Western medicine in Nepal and Sri Lanka, not merely as colonies, but as a regional medical hub.