A strange disease arrived the shores of Lagos, capital of the colony and protectorate of Nigeria, on the 14th of September 1918.
It was a disease such as nobody had ever seen before.
It came through the sea, travelling on the Atlantic Ocean.
The first arrivals who showed the tell-tale signs and symptoms were crewmen from a merchant ship.
Influenza A, Virus subtype H1N1, nicknamed “Spanish Flu”, swept into town like an ill-wind, and very soon everybody was aware that there was an invisible enemy abroad. A great fear gripped the land.
The three sailors who were discovered to be sick, with fever, cough, weakness and signs of pneumonia were immediately conveyed by officials in charge of health and sanitation to a newly created Isolation Centre in Ikoyi.
The colonial authorities in Lagos had been warned about the deadly pandemic which had been raging for several months by that time, and which had recently landed in Sierra Leone, with devastating consequences on the local population. Because of this, and invoking the Public Health Ordnance of 1917, a protocol was instituted, requiring pre-landing boarding and screening of ships, passengers and crew, especially those arriving from Britain. People found to be ill were to be conveyed to the Isolation Centre. The ships themselves were to be quarantined offshore.
For these first arrivals, and a few other that came after them, the “Lagos protocol” was assiduously followed, limiting the danger to Lagosians.
And then a merchant ship, the SS Bida, sailing from the Gold Coast (Ghana) with two hundred and thirty-nine passengers, berthed at the Lagos quays. The ship’s captain knew Lagos well. Instead of pausing offshore and allowing his ship to be boarded by health and sanitary officials, he manoeuvred the ship directly inland to the Customs wharf, with local officials apparently turning a blind eye. Two hundred and thirty-nine passengers, many of them infected with the influenza virus, passed through Customs and dispersed, not just into Lagos, but farther afield, into the vast hinterland of Nigeria. It was, so to say, a failure of ‘Containment’ of the most epic proportions.
Stories of people falling ill and even dropping dead began to crop up with alarming frequency in the town. Some showed up in clinics run by private medical practitioners, infecting staff and other patients.
The Medical Officer of the Colony had earlier put out public notices about the impending epidemic through a government gazette and notices in the newspapers of the day, principally “The Nigerian Pioneer”, owned by Sir Kitoye Ajasa. On the 24th September, the Director of Medical and Sanitary Services, Dr Hood, convened a meeting of stakeholders to draw up strategies for slowing the spread of the disease. Public Awareness measures were to be taken to obtain the cooperation of the public in reducing public gatherings, while at the same time keeping open the economic lifelines of the city. Many of the ideas that had the most impact came from indigenous private medical doctors.
On the 7th October 1918, a public meeting was addressed by colonial health and sanitary officers, as well as Obasa, one of the local doctors. It was resolved that a house-to-house search be carried out to identify and evacuate sick persons who were a danger to the rest of the community. A volunteer force was raised for this exercise.
Unfortunately, work was hampered by the stigma and shame attached to the disease. People hid their ill relatives. Many, especially among the elite, feared they would forfeit their properties to the government if they allowed themselves to be taken away for isolation. Some ailing people “escaped” out of Lagos – travelling overland and on the railways, in the process spreading the virus all over the country.
It is estimated that half of the population of the colonial territory of Nigeria was exposed to infection. Five hundred thousand of them died.
There is more knowledge, capability and grit in Lagos 2020 than there was in Lagos 1918, and, despite a few hiccups here and there, the city, and the state, are poised to stare the virus down. The tragedy is that such knowledge, capability and grit are not evenly spread across Nigeria
The parallels, then and now
The parallels between the 1918 pandemic and the coronavirus pandemic of 2020 are remarkable.
There is more knowledge in 2020, though there is still no real treatment. There was no vaccine in 1918, and there is none yet in 2020.
The diseases are remarkable for their high toll on the lives of health workers. In 1918, so many in the sanitation gang employed to fumigate Lagos streets abandoned the job because of the high infection and death rates among their colleagues that a saying went round town “Owo re iku re, oyinbo pe e ko wa gba” (taking this job is throwing away your life).
The story of SS Bida, and how the virus ‘escaped’ into the community through the irresponsible behaviour of a few passengers and officials has a familiar ring in 2020.
“Stigma” and the shame of going into a public “isolation facility” led some “big” people in 1918, as in 2020, to “hide illness” or seek treatment in unsuitable places, thereby spreading the virus further in the community.
But there is more knowledge, capability and grit in Lagos 2020 than there was in Lagos 1918, and, despite a few hiccups here and there, the city, and the state, are poised to stare the virus down. The tragedy is that such knowledge, capability and grit are not evenly spread across Nigeria.
(Much of the historical detail in this story is derived from the excellent paper ‘Managing Epidemic: The British Approach to 1918-1919 Influenza in Lagos’ by Jimoh Mufutau Oluwasegun, published in the Journal of Asian and African Studies, June 2015)
P.S.
In the course of the last week, the sad news came of the death of three eminent medical practitioners in Lagos (of causes not necessarily related to the subject of this piece) – Professor Funmi Ajose (Dermatologist), Dr Tosin Ajayi (Medical Entrepreneur) and Dr Akinlemibola (Radiologist). This writer had cause to interact closely with each of them over the course of several years and is deeply grieved by their passing. May their souls rest in peace.
