Osmania General Hospital: An Icon in Need of Intensive Care

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    The irony is hard to miss. Built in the aftermath of a massive flood and a plague epidemic, Hyderabad’s Osmania General Hospital (OGH) is likely to be consigned to rubble during another public health crisis, the Covid-19 pandemic.

    The iconic hospital, a forlorn reminder of a critical chapter in Hyderabad’s medical history, was built by Mir Osman Ali Khan, the seventh and last Nizam of Hyderabad State, in 1919. Today, it sits derelict on a sprawling campus, parts of which have turned into near-impenetrable jungle as a result of neglect.

    On the morning of July 27, the main door of the state-run hospital’s in-patient block was locked for the first time in over a century. Orders to vacate the building were issued after rainwater gushed into the building on July 15, flooding the general wards on the ground floor. Photos and videos of patients perched on beds and hospital staff wading in ankle-deep water went viral online.

    Patients were moved into newer buildings on campus. And, facing a backlash over the incident, the government announced that the iconic building would be demolished. In news reports on July 23, Telangana Health Minister Eatala Rajender was quoted as saying: “The government will raze the building and raise new towers.”

    Coming after decades of neglect and failure to act on successive heritage panel recommendations, this announcement has distressed activists and experts alike. Tearing down the OGH will erase a heritage gem and a rich history.

    A Tamarind Tree and Chloroform Trials

    On September 28, 1908, the Musi River flooded — in what would be labelled the most destructive flood in Hyderabad’s history — and wiped out large parts of Afzal Gunj, then a grain merchants’ hub. Hundreds died, and the toll would have been far higher if not for a tamarind tree that stood near a small local hospital, on what would later become the OGH campus. Over 150 people survived the rushing floodwaters by clinging to that tree. The hospital was ravaged by the flood, but even today, on September 28 each year, people gather under the tamarind tree, to remember the many saved, and the many lost.

    Incidentally, the Afzal Gunj hospital was an interesting historical landmark. It was there that the first international trials of chloroform were conducted, between 1888 and 1891, as it was one of the renowned hospitals in the region. The trials were taken up after the sixth Nizam, Mir Mahboob Ali Khan, sponsored the Hyderabad Chloroform Commission, on the advice of his personal physician Dr Edward Lawrie.

    The Scottish Dr Lawrie had been appointed Residency Surgeon in Hyderabad in 1885. He was also the resident surgeon of the hospital. Chloroform was already being used for surgical procedures at this time, but how to use it safely had still not been determined, and many patients were dying on the operating table as a result. Dr Lawrie played a key role in establishing its safe use as an anaesthetic – disproving claims by other prominent doctors from the West, who had believed the drug was causing deaths by damaging vital organs.

    Three years after the historic little hospital was flooded, in 1911, came the epidemic that would lead to the founding of Osmania General Hospital. Osman Ali Khan had just begun his reign as Nizam when the bubonic plague hit. Month after month, as scores were infected and died across his State, the Nizam set up the City Improvement Board in 1912 to oversee general improvement in living conditions. The OGH was part of his plan to modernise Hyderabad.

    An Architectural Gem

    The OGH campus covers over 26.5 acres on the banks of the Musi River. Along with the high court, constructed around the same time on the opposite bank, the OGH – with its massive domes that can be seen for miles – defines the skyline of Hyderabad’s Old City. Built at a cost of Rs 20 lakh, it was designed by the British architect Vincent Jerome Esch, who was also at the time assisting architect William Emerson in building the exquisite Victoria Memorial in Calcutta.

    In those days, the OGH was one of the largest and best-equipped hospitals in the region. Though the building’s plan followed Western architectural norms, its Indian identity was evident in the use of specific historical motifs, including domes, chajjas and merlons. It remains a fine example of the Osmanian style of Indo-Saracenic architecture.

    The iconic main building is an imposing three-storey structure constructed using granite laid in lime mortar. The windows are arranged in arches which are, at places, decorated with masonry lattice. Apart from the iconic main building, there were nurses’ quarters so personnel could stay on the premises and not spread infection out in the city. Another building took care of the hospital laundry. These were demolished after 1956, to make way for modern hospital blocks and create more parking space.

    Left to Crumble

    For over 60 years, the facility has been left to slide into decay, say activists. “The OGH is a morose picture of government apathy, with vast unused spaces engulfed in vegetation. Issues including water seepage, structural damage, and rats inhabiting the corridors are accelerating its deterioration. Many additions and alterations have been made in recent times, blocking ventilation and drainage,” says a local activist, requesting anonymity.

    Fearing for their safety, doctors have been demanding that the building be brought down. They have cited incidents of chunks of plaster crashing to the ground, and sometimes on to patients’ beds. In November 2018, junior doctors went on a 75-day strike, asking the government to declare the building unfit for use.

    “The issue with OGH is not the building, but its maintenance,” says a local heritage activist. “Roofs will leak and plaster will peel if a structure isn’t cared for. The OGH has become symbolic of the state’s neglect of its heritage sites.”


    The heritage building occupies just 1 acre of the 26.5-acre campus. Activists are urging the government to repair and preserve the main building, and build a new hospital around it. “There is so much vacant space behind the heritage building. If the government wants, it can utilise that space to build a world-class hospital,” says P Anuradha Reddy, Hyderabad convenor for the Indian National Trust for Art and Cultural Heritage (INTACH).

    The OGH is a Grade II-B heritage structure, earmarked by the Hyderabad Metropolitan Development Authority as a local landmark that contributes to the image and identity of the city. It is, accordingly, protected under the Authority’s heritage regulations.

    Amid the media frenzy that followed the flooding in July 2020, Dr M Iqbal Javeed, executive member of the Osmania Medical College Alumni Association, told the Deccan Chronicle that maintenance of the hospital had been neglected since 1985. Hinting at a possible government campaign to wipe out heritage sites to make way for new constructions, he added, “There is no doubt an ulterior motive and rainwater is only a ruse for a hidden agenda.”

    In 2015, INTACH had conducted a structural, stability and safety study on the hospital. Its report stated that the building was structurally safe and could be used after repairs and restoration work. “To reduce the load on the building after restoration, we had suggested that the building be used for the out-patient department and for administrative purposes,” says Reddy.

    INTACH conducted another survey in 2019. “We found that nothing we suggested in 2015 had been acted upon. In fact, certain portions of the building had deteriorated further. We suggested converting one section into a museum because the hospital is a reminder of our rich medical history,” Reddy says.

    None of the suggestions made has been implemented and as things stand, the situation is dire. Here’s an overview

    1. Shoddy road work to blame for water-logging?

    In a report in The Hindu, a civic official blamed the 300-year-old Asaf Jahi-era drainage system for the waterlogging inside the wards. The official said since there was no blueprint of the drainage system, located 20 ft below the ground, de-silting of the drains was impossible.

    Reddy says there could be another reason for water seeping into the wards. “Some time ago, to build a road on the premises, the authorities raised the ground level in a few areas behind the heritage building. While the road work was underway, an underground drain was also disturbed, obstructing the flow of water. The slope and obstruction combined to cause rainwater seepage,” she says.

    1. Booming land prices a burden

    Hyderabad’s population has boomed, even if you consider just the past decade. In the 2011 Census, it stood at 6.7 crores. Now, unofficial estimates put it at over 10 crores. This has made vacant land a priceless commodity for real-estate developers, putting ever-increasing pressure on this prime plot.

    1. ‘Citizens aren’t bothered’

    “There is so much demolition happening in the Old City. Hyderabadis are not bothered about their own heritage,” says a conservation architect. There has been no general outrage at the neglect of the OGH. “Citizens ought to be the primary custodians of heritage. Instead, even in the Old City, we hear owners of structures saying things like, ‘It’s an old building, it’s scary, dangerous and dilapidated. It doesn’t suit my family’s needs. I’ll build a new one in its place’. Instead of pushing for the government to help or act, that is the attitude of local people,” the architect adds.

    Petitions to Protect the OGH

    About a week after the flooding, a petition was launched on the website asking the Telangana government to protect the heritage structure and build a new hospital behind it. In days, nearly 10,000 people had signed. Sadly, while these campaigns generate discussion and possibly even awareness and sentiment among the public, they rarely cause policy changes.

    Another campaign launched by two local journalists will hopefully be more effective. It seeks the intervention of local elected representatives. The journalists have asked people to write to Hyderabad Member of Parliament Asaduddin Owaisi and the state Health, Medical and Family Welfare Departments, asking them all to intervene to save the heritage structure.

    Also at Risk

    Decades of neglect have already cost Hyderabad gardens, lakes, wells and other heritage gems. The Charminar, Golconda Fort, Hathi Bowli at Hayatnagar, Toli mosque and caravanserais in Shaikpet and Hayatnagar are all in urgent need of conservation.

    The Saifabad Palace was razed on July 7, 2020, to make Telangana Chief Minister K Chandrasekhar Rao’s Rs 400-crore, vaastu-compliant New Secretariat dream come true. The palace was one of the finest examples of Asaf Jahi-era architecture. “In 1956, my father, a Hyderabad civil services officer, had his office at the Saifabad Palace. As a child, I used to visit him there. There were wooden doors, beautifully etched glass panels and a grand staircase,” reminisces Reddy.

    “The government would prefer to sacrifice the city’s heritage to accommodate the real-estate industry. Apart from destroying streetscapes, demolition eliminates history,” says a local historian, on condition of anonymity. “Saifabad Palace is gone. Osmania General Hospital could be next. The government has the vision and deep pockets to build new structures. If only they had a similar vision to protect these monuments.”


    Aveek Bhowmik is an independent journalist with over 18 years of experience in the field. He is an avid traveller and a passionate storyteller who likes to write about heritage, lost traditions, local communities, sports and food.

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