The Environmental History of Africa

Topic 7 - World Disease: Influenza 1918-19

  1. Disease is not a static environmental factor or one independent of human activity (such as climate).
    1. Placement in time, space, and social impact. Not an independent variable
    2. Can affect humans directly or through effects on crops or livestock (e.g. potato blight, hoof and mouth, rinderpest, wheat/maize rust.

  2. Influenza: The 1918-19 Pandemic: The Spanish Flu
    1. Probably worst outbreak of infectious disease in world history: 20 million died world-wide (2times WWI deaths).
    2. 11/2-2 million died in Africa.
    3. Called Spanish flu in Europe and the Americas, but also local names that reflect local responses to its effects (Ethiopia: YaHedar Besheta, lit. "disease of the wind").
    4. Spanish flu is well documented in Europe and North America, but poorly documented locally in Africa, but universal experience in virtually all world societies. Its local history offers valuable insight into local history, economics, and social institutions.

  3. Influenza Characteristics:
    1. Caused by air-borne virus though death usually came by secondary bacillic infection.
    2. No understanding of viral cause by medical specialists, no drugs until 1950s.
    3. 1918 version was mutation or genetic recombinate form of swine flu for which no immunity.
    4. Some African experience with flu but Western doctors local healers had no real experience in how to treat, stop, or cause.
    5. Sources unclear; in Ghana flu came from Freetown, probably on American ship SS Shonga. Infection then spread directly along lines of trade and communication.

  4. Best documented case in East Africa is Ethiopia
    1. Flu arrived first in AddisAbaba in spring; more virulent version came the following fall; later moved north; poorly diagnosed by doctors; local residents called it "Ya Nafas Bisheta (Disease of the Wind).
    2. Most descriptions are from foreign residents so hard to tell if affected foreigners more.
    3. Grizzly stories of shallow burials, shortage of grave diggers.
    4. Responses in Addis Ababa including a massive exodus from the city; The Orthodox Patriarch was among the first to leave; spread disease north with those fleeing.
    5. Young Haile Sellassie (then known as Regent Ras Tafari) taken ill early. When told the doctor needed to leave him to tend to sick in the city, he replied to the doctor "Stay with me; God will take care of the others." Many physicians died tending the sick.
    6. Second wave in fall came from coast.
    7. Deaths were quick and massive. Estimates of 10,000 deaths in capital. Death rate of almost 1 in 10 urban dwellers.
    8. Serious effect in rural areas where economic activity stopped during harvest time; creating great hunger later.

  5. What social and historical patterns are evident in influenza epidemic?
    1. Clear connection to world trade and lines of communication
    2. Perhaps intensity in cities
    3. Failure of colonial health services
    4. No particular advantage of social class and thus hygiene and diet
    5. See handout on Gold Coast infection data.