1918-19 Influenza Epidemic: A Reminder Of A Common Humanity
By Uwem Jonah Akpan
The influenza epidemic of 1918-19 has been described as the one of the deadliest epidemic in human history. The pandemic swept the globe and in a matter of months, infected about 500 million people (about a quarter of the world’s population at the time). The death toll is estimated to have been between 17 million to 50 million, and possibly as high as 100 million. The number of deaths was thrice of those killed in military action in World War 1 (which lasted from the 29th of July 1914 to the 11th of November 1918). It is believed that the disaster overwhelmed whatever claims might have been made for the 6th century Plague of Justiniana or the Black Death of the 14th century in terms of its mortality. The influenza’s most peculiar and disturbing feature was the overwhelming preponderance of young adults’ mortality. It was totally impervious to the methods and practices of European – or any other – medicine. Its extreme infectivity, short incubation period, and the imperfect nature of vaccines hamper efforts to prevent or contain outbreaks even till now. In fact efforts at containing the 1918-19 pandemic were limited since the virus had not yet been identified.
Influenza is caused by a virus which is transmitted from person to person by the respiratory route. Many “flu” deaths were actually caused by pneumonia resulting from secondary bacterial infection of lungs weakened by influenza. Prior to the discovery of the viral etiology of the disease in 1933, several species of bacteria had been erroneously considered as being the causative agents. Medical sources claim that even till date, there is no chemotherapy for influenza, but antibiotics have always been available to control secondary infections since 1945.
Effective vaccines were not developed until the 1950s, and since the virus is genetically labile, new vaccines must be developed to cope with new strains. Some researchers also believed that the pandemic of 1918-19 was caused by the sudden creation, by mutation or perhaps by genetic recombination with a swine flu virus, of a particularly virulent strain against which people had no previous exposure, hence, no immunity.
Some of the Western scholars who have studied the influenza epidemic claim ignorance of the exact country it originated from. However, as noted, the epidemic had a global dimension. It occurred soon after World War 1 and the soldiers returning from the war fronts are said to have transmitted the disease. In West Africa, the disease was called ‘Spanish Influenza’, not only by the Africans but by the British colonial officers. Some scholars also hold the opinion that while one cannot say that the influenza was a British disease, there is no doubt that its introduction and spread in Nigeria were due to the activities of the British. For instance, it was clearly noted that the epidemic was introduced by passengers who travelled on board ocean liners, that the seaports were the primary focus of infection and that the disease spread along the easiest avenues and by the most expeditious means of transport, especially the railways and the overland routes.
In the middle of September 1918, the colonial medical authorities in the Southern Provinces of Nigeria issued urgent information to the effect that influenza had been declared an infectious disease. The colonial authorities also disclosed that three ships from Sierra Leone and Gold Coast (Ghana) had been isolated in Lagos, because the epidemic was causing havoc in Sierra Leone and Gold Coast (Ghana) from where the disease was believed to have been brought to Nigeria via Lagos by ocean liners.
It was also suspected that Calabar and Forcados were the other entry points of the virus into Nigeria. Two cases were identified on board of such ocean liners as S.S. Batanga, which was anchored at Calabar on the 28th September 1918. It was also reported that “isolated shores cases had appeared after the 7th of October 1918, among the Marine/Customs Departments and the shipping company’s employees. This scenario unambiguously pointed the outbreak of the infection to ocean ships.
While attention was being focused on Lagos, Forcados, Port Harcourt and Calabar as primary routes of the infection into the Southern Provinces, a new complication arose with the discovery that that the Northern Provinces constituted an unknown route of the epidemic into the Southern Provinces. The relevant colonial record found out that it was from the Northern Provinces that the epidemic was brought to Onitsha down the Niger River by a boat from Lokoja. It was however discovered that the disease had in fact reached the North from Lagos via the Western Railway. From the River Niger, the epidemic spread westward to Benin and some parts of Ika-Igbo of present-day Delta State. Also from the Niger, it spread eastward to some parts of Igbo land such as: Owerri, Okigwe, Enugu-Ngwo and Aba. From the Eastern Railway it spread further east to many parts of present-day Akwa Ibom and Cross River States. The areas included, Uyo, Ikot Ekpene, Abak, Opobo (Ikot Abasi), Calabar, Obubra, Afikpo, Abakiliki, Ogoja, Obubra and Ikom etc. Indeed, by December 1918, all parts of Nigeria had become affected.
The world-wide influenza certainly had disastrous effect throughout Southern Nigeria. Apart from the fact that colonial authorities were caught unprepared, the existing ignorance and superstitious background of Nigerians also created very damaging implications. Available colonial evidence states that in Ikot Ekpene District “it sparked off widespread campaign of resistance against twin mothers, which had been effectively discouraged by the missionaries”. The people thought the gods were angry that the twin mothers who hitherto were not considered as part of the human society had been accommodated among them.
Also, colonial sources reported that “wild rumors spread that the Germans shells had fallen on the tobacco stores and poisoned their stocks; that the white men were dying off; and that motor vehicles were breeding the sickness. Government officers hastened to hold meetings to quell the rumours. The wave of panic quickly subsided, but the pandemic itself continued to rage. Within Southern Nigeria as a whole, officials estimated that 3 per cent of the entire population had died as a result”.
Official records also state that the influenza epidemic caused an estimated 4,000 deaths in Opobo District and about 12,996 in Uyo and Abak Districts. The District Officer of Eket reported that “it was popularly believed that the influenza deaths were caused by the poison of ifot (witchcraft) “. In Ukanafun area, “bonfires of scented leaves were lit around family compounds to dispel the fumes. Idiong (diviners) told the public that the epidemic was the result of idiong spirit’s anger at the presence of the Qua Iboe Mission. Consequently, several church buildings were razed to the ground in 1918”. It is also reported that the near-total eclipse on the 29th May 1919 aggravated the fear of the people.
In other parts of the Southern Provinces, such as Benin Province about 15,000 died. In Ogoja Province 63,000 deaths were reported while in Owerri Province, more than 41,000 died. Another official report confirmed that “out of a population of nine million, at least a quarter of a million died from influenza in the Southern Provinces of Nigeria. In his contribution to the debate on the human mortality, a Nigerian historian, Ohadike, noted that these figures were underestimated “since they reflected only cases coming under immediate observation of medical officers”. This writer shares the above position. This is partly because his grandmother, who survived the deadly outbreak of the virus, used to tell him that the human mortality was so high in the entire Akwa Ibom area. According to her, because of the total ignorance of the people about the infectious nature of the virus, victims were not isolated at the initial stage and the death was accorded “decent burial” by the relations. This triggered the rate of infection of the living relations. When incident of death became more alarming, it was superstitiously believed that those that died as a result of the epidemic were not supposed to be buried in the grave. The respective communities had to resort to the unusual manner of standing from afar to rap the corpse on a mat and depositing same in a forest designated by respective communities for such purpose. According to her, the rate of mortality was so enormously high that it would be impossible to quantify.
In the Northern Provinces, the incidence was exceedingly heavy. More than one-third of the European community was attacked and 41 out of every 1,000 of those attacked died. It was also reported that 80 per cent of the indigenous population suffered sooner or later. In Ilorin, 55 per thousand Africans died.
As stated above, the influenza’s most peculiar and disturbing feature was the overwhelming preponderance of young adults’ mortality. Reports from all the Provinces of colonial Nigeria confirmed this. It was further revealed that there was a greater morality among pregnant women,” In short, it was the virile population who suffered most. The consequence of this was that the numbers of deaths comprised an unduly large proportion of the young and the vigorous. Such a loss of manpower had negative effect on the human capacity of the country in the later years.
Indeed, there was panic everywhere. The report of the Medical Officer in-charge of Benin area further confirms that “owing to the strong influence of juju and the superstitious nature of the people, a great many people did not avail themselves of hospital treatment and many of the population fled to their farms in the bush. Naturally, the dangerous and fatal disease was rendered doubly so by the indecent panic which prevailed”. There was mass withdrawal of labour from all productive arms of the economy and. In some parts of the country, the survivors had to run into the bush to isolate themselves.
The epidemic exceeded the experiences and resources of colonial Medical Department and the available methods were unsuccessful. It should be noted the colonial medical administration suffered from chronic underfunding and staffing shortages. The limited available funds were allocated to the enforcement of maritime inspection and quarantine; urban sanitation and the preservation of European life and health. At this time, fewer resources were being assigned to colonial medical administration owing to the demands of European warfare.
However, in spite of limitations, colonial administrators responded promptly to the epidemic. They established temporary dispensaries for the distribution of medicines. Handbills of advice were distributed; sanitary inspectors made house-to-house visitations to detect the disease and provide consultation; auxiliary hospital was opened in some places. Volunteers were recruited to participate in the relief effort. Government also resorted to the “locked down” method. Schools, churches, Native courts and markets were ordered to be closed and large public meetings prevented. Later, the epidemic reached such wide proportions that very few persons were seen on the roads.
This writer as a historian shares the opinion of Edward Hallet Carr who aptly posited that, “history begins with the handing down of tradition; and tradition means the carrying of the habits and lessons of the past into the future”. Put differently, the records of the past are kept for the future generations. It should be noted here that though historians are primarily concerned with the reconstruction of the past events, such work do serve as a guide to the future. Indeed, those that ignore such past are bound perpetually remain young and repeat the same mistake made the past.
The nexus of the brief historical narration with the current epidemic outbreak – Corona virus with the influenza epidemic, is that we are in a globalised world and share a common humanity of vulnerability. It is on the basis of globalization that a virus that did not originate in Nigeria now causes a near total “locked down” of the nation. It is now very obvious that despite mankind’s extreme exploits in science and technology, we are all humans and have the limitation to predict and design the future the way we may exactly want it to be. It is also clear that though the huge defence budgets by the so-call Superpowers may not be totally out of place, there are “some vital and more desirable” areas that deserve a “globalised” focus. The time has come for more resources to be deliberately diverted from armament to research. As a Nigerian journalist puts it, global focus should be shifted from “fighting terrorism to medical warfare. There is more to national strength than ballistic missiles. The capacity of a country to quickly conquer rampaging microbes and provide personal protection equipment to frontline health workers, and medicines and ventilators to citizens in sickbeds should be the focus of world leaders.”
It should never be forgotten that till date, no cure exists for the virus that caused the influenza that swallowed millions of human beings across all the continents of the world about a century ago. “Medical science could only counsel bed rest, symptomatic treatment then hopes for the best’. This is a lesson that the pandemic left with humanity about a century ago. This means that humanity still has a common enemy, and many more may be coming. The one that is here with us is equally devastating. Let the past experience serve as a compass on how to navigate the present storm on the basis of common humanity.
Dr. Uwem Akpan is a lecturer in the Department of History and International Studies, University of Uyo
©The Sensor Newspaper
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