The Spanish flu: a plague from across the sea

One hundred years ago, the death toll of World War 1 was overshadowed by the ravages of another terrible scourge

04 February 2018 - 00:00 By SHANTHINI NAIDOO

A hundred years ago nobody in the world could have foreseen that a significant portion of the population would be wiped out by a simple flu virus.
Spanish flu emerged around March 1918, a worldwide pandemic that swiftly killed between 50 million and 100 million people during World War 1.
The death toll will never be accurately known because the flu spread rapidly due to the war. The number of deaths was masked by warring nations not wanting to share their vulnerability and lower morale.
The "black death" arrived in South Africa six months later, in September 1918, and hit hard. Within a few weeks, up to 500,000 people were dead. The country was fifth hardest hit by the pandemic worldwide.
Its railway systems, ports and migrant labour networks allowed the spread of the virus to explode in nuclear proportions, an entire generation of young adults wiped out in a month.Survivor Joyce Kay recalled the morbid impact on Kimberley in the Northern Cape, where a 10th of the community died in a month. "Quite often they would find houses with everybody in it dead, nobody to save them. [They were alerted by] the stench, sometimes the blood trickling down under the door. They had to break open doors. And then, afterwards there wasn't even anybody to make coffins or there wasn't ... enough wood. They just rolled people in blankets ... whatever they could."
Emeritus Professor Howard Phillips of the University of Cape Town, a medical historian who has written extensively on Spanish flu in South Africa, says his interview with Kay was sobering. She was just 10 years old at the time. Her family was one of the few who were affected but miraculously survived.Phillips says the biggest impact of the flu was that it left behind a generation of orphans.
"For me, it was most significant that those who died in the largest numbers were young adults, 18- to 40-year-olds. These were, inevitably, young parents. It led to the creation of orphans on an unprecedented scale. I estimated about 900,000 orphans in South Africa.
"The emotional impact, lives shattered and social breakdown, is comparable only to HIV/Aids, but worse because it was a sharp, severely shortened time period."
The economic impact was a sobering after-effect.
"Families were reduced to poverty or had to look for other sources of income. I recall a story where a widow tried to find work diamond-digging in the North West in the hope of making a living for her and her child. The crisis was enormously intense."
Phillips says World War 1 contributed to the virus's rapid spread worldwide because soldiers were malnourished and battle-weary, and prone to infection. In South Africa, a relatively advanced transport system became a network of deadly vessels.
Phillips says the Spanish flu seems to have arrived on two ships, the Jaroslav and the Veronej, which docked in Cape Town on September 13 and 18 respectively, with members of the South African Native Labour Contingent on board.Both ships had travelled from France and docked at Sierra Leone, one of the places regarded as a central point of infection.
The spread in South Africa came in two waves, the first being via Durban, from where it spread to the rest of what was then Natal and the Witwatersrand. Within two weeks the epidemic spread to the rest of the population.
According to the South African History Archive, about 127,000 black people and 11,000 whites succumbed to the epidemic within three months.
This newspaper reported that the "Malay camp, Vrededorp, and other areas where coloured people and poor whites live showed that conditions are appalling there. Whole streets of the camp are under the pall of disease and death. The Indians in the Malay camp have been particularly hard hit."
In one home toddlers were found alive, while their parents died. In one house visited by a Sunday Times reporter, five people were dead. Four children, the family's only survivors, were crawling about the floor and over the bodies.
"The atmosphere of this place was so overpowering as to cause one to faint upon entering," the newspaper reported.
Phillips says there was some compassionate action from the citizens of a divided country."There was not really a full department of health then. From central government the response was limited and poor. The onus fell on local volunteers and authorities. People got involved in providing soup, nursing ... lots of people at the risk of contracting flu themselves went about and helped.
"There were some, not all, but some, who helped across racial boundaries in the South Africa of that time," he said.

"On a social-psychological level the flu epidemic led to increased levels of social anxiety among a population that had felt the impact of a world war. For both Afrikaners and Africans, the flu epidemic came after a number of crises impacting on both, resulting not only from the war, but from political and social dynamics within South African society.
"For Afrikaners, the epidemic followed a series of calamities that included the death of 26,000 women and children in the Anglo-Boer War, the failure of the 1914 Rebellion, and the growth of the 'poor white' problem," said Phillips.
The South African History Archive records a letter a reader wrote to what was then De Burger newspaper which reads, in translation: "Such suffering: war, drought, hunger, and plague; danger threatens us from all sides, while daily the Spanish flu decimates thousands in our midst."
Some suspect that many deaths during the 1918 flu epidemic could have been caused by aspirin poisoning. Doctors at the time recommended large doses of aspirin of up to 30g per day. Today, about 4g would be considered the maximum safe daily dose.
In the rural Transkei, the epidemic led to witch-hunts as people tried to find an explanation for the deaths of relatives. The commissioner of police of the Transkei stated in his annual report for 1918 that "the witch-doctor has been more active than in previous years".
This year, the "Australian flu" travelled to the UK and the US where it quickly became the worst in 20 years. About 100 people have died in the northern hemisphere winter and many more landed in intensive care. The virus is an evolved version of the Spanish flu, which was also an H1N1 strain.
• A book featuring 40 years of interviews by Phillips, 'In a Time of Plague', will be published later this year...

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