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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.109 n.5 Pretoria May. 2019




In a Time of Plague: Memories of the 'Spanish' Flu Epidemic of 1918 in South Africa




By Howard Phillips, collected and edited. 2nd series. No. 50. Cape Town: Van Riebeeck Society, 2018. ISBN: 978-09947207-1-9

This is a timely, significant, moving and often absorbing compilation of testimonies, letters and memories of one of the most important events in South African (SA) history; yet, paradoxically, one that has been largelyforgotten: the 'great' or 'Spanish' influenza epidemic of 1918 - 1919. This virulent infectious disease visited the region in waves. The first - its impact relatively muted - via Durban, affected people in the then Natal h interland, followed by the Witwatersrand region in September 1918. A few weeks later, the second, far deadlier mutation of the v irus struck. Over 6 weeks it scythed through the Cape, the then Orange Free State, and the Ciskei and Transkei, and indeed across the country, as far north as Messina. A third, milder wave occurred in August 1919.

Many readers will know that the global pandemic resulted in ~50 million deaths (3 - 4% of the total population). Its lethal impact on SA is not as widely appreciated, with ~300 000 - 350 000 people perishing - most of them between 18 and 40 years of age - during 'black October'. Losing ~5% of its people, SA was probably the fourth worst-hit state in the world after Western Samoa (22%), India (6.2%) and Gambia (5.7%) The social and economic consequences for the country were profound.

After a succinct introduction, there are extracts from 127 letters and interviews from survivors and family members collated in the 1970s and 1980s. These are supported by a number of illustrations. The epidemic had a terrible toll, leaving behind 'a generation' of flu orphans, widows and widowers, as well as a legacy in national public health legislation whose implementation by no means benefited the majority.

Representing as broad a cross-section of South Africans, black and white, as it was possible to muster, this is a unique contribution to our history, giving glimpses into medical beliefs and practices of the time, and of the turns towards - and away from - religious healers and rituals in times of crisis. Evident too is the persistence of poverty and hunger in facilitating the work of pathogens in whichever age.

A sombre, yet deeply humane, testimony of the personal and social trauma of the epidemic and its impact in shaping 20th century SA, this book gives us much to think about as citizens of a globalised world where, it is widely predicted, a new, equally disastrous, plague of illness is likely to emerge within the foreseeable future.

Julie Parle

School of Social Sciences, University of KwaZulu-Natal, Durban, South Africa

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