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Our nearly forgotten pandemic
"Influenza pandemic" is a household term in Indonesia, yet, all too often, the problem seems foreign to us because when we talk about flu pandemics we usually refer to incidents that happened on the other side of the world
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"Influenza pandemic" is a household term in Indonesia, yet, all too often, the problem seems foreign to us because when we talk about flu pandemics we usually refer to incidents that happened on the other side of the world.
One of the most widely cited examples is the 1918 flu pandemic, which is considered the worst plague in world history because of its massive death toll and extensive spread. Around 30 million people were killed in the pandemic - also known as the Spanish Flu - mostly in America, Europe and Africa.
Little do we know that our great-great grandparents fought in the same battle.
Alex Crosby (America's Forgotten Pandemic), John M. Barry (The Great Influenza) and Gina Kolata (Flu) along with scores of scientific papers on the 1918 pandemic have detailed how the epidemic struck, killed more people than World War I and disrupted health services.
But none of these works mention what happened here in Indonesia. Thus, psychologically, it is hard to relate to, as we get the impression that pandemic-prevention talks are simply fear mongering, a far-flung threat to our comfort. Historical records of the Dutch colonial administration show that our ancestors did not escape the havoc of the 1918 flu.
In the 1980s, Collin Brown, an Australian historian, published a paper titled The Influenza Pandemic of 1918 in Indonesia, which gives us an idea of what happened during the period. Around 1.5 million people died in Dutch East Indies, which was then home to just some 30 million people.
The first case was reported on the east coast of Sumatra. By July 1918, it had spread to Java and Kalimantan before reaching Bali and Sulawesi. It then reached the eastern part of the archipelago in Maluku and Timor.
It seemed to die down for several weeks, but soon reemerged.
The second wave came in October 1918 and was more widespread. Like the pandemic in the US and Europe, the second wave brought the most deaths. These deaths were recorded in the Dutch Kolonial Verslaag (Colonial Journal).
Some of Brown's reports show the horror of the pandemic situation. In Southeast Sulawesi, a Catholic missionary was quoted as saying that "deaths are everywhere". According to the report, in one Sulawesi village, 177 of its 900 people died in a period of just three weeks.
In Tana Toraja, 10 percent of the population reportedly died from the flu. Meanwhile, according to the Dutch regional administration, 36,000 people in Lombok, or 5.9 percent of the island's population, died.
Statistics are scarce and it is hard to gain a sense of what truly happened. Brown's research shows that most fatalities occurred in people aged between their mid-teens and mid-fifties, the same age bracket that has been most affected by the bird flu in Indonesia.
A medical journal by a Dutch physician, P.B. Van Steenies, however, reported that 46 percent the 777 flu related deaths recorded in Magelang, Central Java, between Oct. 1 and Dec. 31, 1918, were children aged 10 years or younger. Another 14 percent were people of aged 60 or more.
The Dutch Colonial government issued an Influenza Ordinance to ensure that any future outbreaks in the archipelago could be rapidly detected and contained. It also set up a commission to investigate the cause of the pandemic.
The commission's report, according to Brown, is heavily technical, devoting much attention to the clinical and biological element of the epidemic. It failed to reveal the mystery of the deadly flu.
The mystery lingers to this day. What would happen if a pandemic breaks loose - heaven forbid - again, in this more globalized world, with fast moving air traffic, a larger population and more enclosed environments like office buildings and shopping malls, where people are in close contact?
Without trying to scare people, the murky history of the pandemic should be unearthed, studied and made public so that with an entirely different setting of better infrastructure and human resource capacities, the country - the hardest hit by the H5N1 strain of the avian influenza virus - can learn lessons for our greater good.
For that part, historians could play a role to face the present challenge and prove that history does not only belong to the past, it makes us what we are today.
That an estimated 60 million people, or one fourth of Indonesia's population, could be infected by the virus once it gains the ability to transmit from human to human, we put too much at stake if we don't take the matter seriously. As popular wisdom says, history tends to repeat itself if we don't learn form it.
Emmy Fitri is a staff writer with The Jakarta Post. Arie Rukmantara is a consultant for a UN agency in Indonesia and the article reflects his personal views.
