New Zealand’s worst disease-disaster: 100 years since the 1918 influenza pandemic

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University of Canterbury Emeritus history professor Geoffrey Rice is the author of Black Flu 1918: the Story of New Zealand’s Worst Public Health Disaster, Canterbury University Press, 2017. On the 100-year anniversary of the flu that wiped out thousands of Kiwis, he recounts the misery.

It took four years for the First World War to kill 18,000 New Zealand soldiers.

Yet in just six weeks, from early November to mid-December 1918, at least 9000 New Zealand civilians and soldiers died from influenza and pneumonia in the so-called ‘Spanish Flu’ pandemic.

This was New Zealand’s share of a global calamity. The most reliable estimates place the death toll  at between 50 and 60 million, or about 3 per cent of the global population at that time.

We know nothing about large parts of Africa and Asia, and may never know, for simple lack of evidence. Sixty million dead would be about three times the total death toll from the First World War, soldiers and civilians combined.

Many people thought the 1918 flu was a return of the bubonic plague because the cyanosis of severe influenza and pneumonia turned the victims’ bodies black.

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It was a seriously bizarre pandemic. Influenza normally kills only the vulnerable, the very young and the frail elderly, or those with lungs damaged by TB or other respiratory diseases. But this A/H1N1 virus (now commonly known as ‘Swine Flu’) killed mostly young adults aged 25 to 45.

Children and teenagers seemed virtually immune to the 1918 flu, as did the older middle-aged. The latest explanation posits that the cohort born during the previous flu pandemic, the so-called ‘Russian’ flu of 1889-93, suffered from compromised immune systems that over reacted when confronted by a different flu virus in 1918. This is a neat and plausible hypothesis, but it doesn’t explain all of the quirky and unusual features of the 1918 flu.

Laura Spinney’s recent book Pale Rider: the Spanish Flu of 1918 and How It Changed the World describes the 1918 flu as a ‘Protean’ event, massive and complex, affecting different places in different ways. Some countries got off lightly (most notably Australia, thanks to a strict maritime quarantine) while others such as India and Indonesia lost millions.

Indigenous peoples suffered worst of all. Western Samoa, then under New Zealand military control, lost 22 per cent of its people, while American Samoa, protected by maritime quarantine, had no flu cases at all. John Ryan McLane’s recent research has found an even bleaker picture in Western Samoa. The loss of adults and disruption to agriculture caused a famine in 1919, and the population dropped by a third between 1917 and 1920.

The most striking discovery was the great disparity between Pakeha and Maori death rates. New Zealanders of European descent died at a rate of about 6 per 1000, whereas Maori died at a rate of 42 per 1000, or seven times the Pakeha rate. While virtually all Pakeha deaths were registered in , only about two-thirds of Maori deaths were officially recorded.

Reports from relief parties visiting pa and kainga suggest many deaths were not recorded. Maori flu monuments in Northland and Hawke’s Bay support this view: fewer than half of the names can be found in the death registers.

Resistance to conscription and the boycott of the 1916 census by Waikato Maori further complicate the picture, but it seems likely that Maori mortality in the 1918 flu has been underestimated and was more like 2500. That would push their death rate up to 49 per 1000, or nearly five per cent, which is similar to the death rate among indigenous Fijians, and eight times the Pakeha death rate.

Why were Maori so much more at risk of death in the 1918 flu? There is no single simple answer. A combination of factors made for a perfect storm. The Maori population was still largely rural, and many remote settlements may have missed the immunity conferred by the mild first wave of the pandemic.

Land loss had impoverished many Maori communities, traditional food-gathering had been curtailed, and standards of nutrition and housing were generally low. A communal life style, with crowded sleeping whare, facilitated the spread of droplet infection. Many Maori had lungs damaged by widespread TB and tobacco smoking. Traditional herbal medicines were ineffective against pneumonia.

How did the flu get into New Zealand? At the time it was commonly believed that the passenger ship Niagara had brought the flu, along with Prime Minister Massey, returning from a war conference. His political enemies accused him of pulling strings to avoid quarantine.

But this has been shown to be a mistaken myth. Auckland was still in the grip of the mild first wave influenza, which lasted from mid-September to mid-October. The most likely sources of new infection in October 1918 were troopships returning with hundreds of sick and wounded soldiers from camps in southern England where the severe second wave of the pandemic had been raging. Many were now symptomless carriers of the virus. They scattered to their homes, all over New Zealand, and a fortnight later severe influenza burst out almost simultaneously up and down the country.

This coincided with the end of the war, and in many towns people gathering to celebrate the Armistice unwittingly spread the severe flu even more widely. Influenza was declared a notifiable disease on November 6 and schools, bars, billiard saloons and dance halls were closed. Very soon shops and offices and factories were also closing for lack of staff and customers.

The whole country seemed to shut down for a fortnight in the middle of November, and streets were deserted apart from hurrying ambulances or volunteers door-knocking to find the worst cases. Temporary influenza wards were set up in schools and church halls – even under racecourse grandstands in Hastings, Reefton and Gore – and soup kitchens were hastily arranged to feed the feeble convalescents. Boy Scouts and Girl Guides helped to distribute food and medicine to stricken households.

So many people were dying at the same time that undertakers could not cope, and councils stepped in to commandeer trucks and vans to take coffins to the cemeteries, where teams of men were digging graves. In Auckland special trains took coffins from the city to Waikumete Cemetery twice a day for a fortnight to clear the backlog. Some people think that the large open area of unmarked graves at Waikumete is a mass grave. Not so. All victims were buried individually in numbered plots with ministers of religion officiating. But these were mostly paupers’ graves, and no headstones were ever erected.

Auckland certainly had the first of the flu pandemic in New Zealand, but not the worst of it. The final count was 1128 Pakeha flu deaths in Auckland, a death rate of 7.6 per 1000. Wellington lost 773 residents, at a rate of 8 per 1000. Christchurch lost 458 at a rate of 4.9, and Dunedin even fewer, 273 at 3.9 per 1000.

The impact was extremely diverse and uneven. Some towns such as Cambridge, Tauranga, New Plymouth, Nelson, Westport and Timaru had low death rates, possibly because they had gained more immunity from the mild first wave, while others such as Hastings, Dannevirke, Hawera, Masterton, Amberley, Kaiapoi, Temuka, Oamaru, Winton and Invercargill had high death rates.

A few unlucky places had exceptionally high death rates: Huntly, Inglewood, Taumarunui, Taihape, Denniston, Owaka, Winton. The worst Pakeha death rate was at Nightcaps in Southland, where nearly all the adults were stricken and left without care: they suffered a Maori death rate, 25 per 1000.

Fortunately it is in the nature of influenza outbreaks that they peak rapidly and die away almost as quickly. Most places were clear of fresh flu cases by early December 1918, and the economic effects were negligible. But for thousands of families life would never be the same again. Over 6400 Pakeha children had lost a parent, and 135 had lost both parents.

New Zealand coped well with the 1918 flu. Neighbours helped neighbours, and communities organised themselves promptly to help the stricken. We must remember, however, that New Zealand had been brain-washed by four years of wartime propaganda to volunteer and ‘do your duty’.

How well would New Zealand cope with a similar crisis today? Though we have an excellent Pandemic Plan, mandating a ‘whole of government’ response and incorporating many of the lessons learned from 1918, New Zealand has changed and all sorts of things could go wrong.

The best advice is to be prepared and self-reliant, with stocks of face masks, aspirin and paracetamol, bedpans and spare sheets. And be nice to your neighbours. They just might save your life in a future pandemic.

Geoffrey Rice is the author of Black Flu 1918: the Story of New Zealand's Worst Public Health Disaster.

SUPPLIED

Geoffrey Rice is the author of Black Flu 1918: the Story of New Zealand’s Worst Public Health Disaster.

Extracts from Geoffrey Rice’s forthcoming book, That Terrible Time: New Zealand Eyewitnesses of the 1918 Influenza Pandemic

Maurice O’Callaghan, St John ambulance volunteer 

One house I went to was in Grey Lynn, where we found a man who had been dead three days. His body was in the bed, and his wife was lying in the same bed, not dead but driven out of her mind by the fact that she was lying in bed with a dead husband and could not get up. We had to get the husband buried and an order from the health authorities for the woman to be placed in Avondale Mental Hospital. 

Grace Stewart, from Papakura

My father, myself and my twin sisters caught the flu. Another sister who was delicate nursed the twins whilst my mother nursed father and me, and she never caught it. I was then about 17 years of age. Until then I was very healthy and robust, never even knew what a headache was.

For myself I never regained my usual health… I was in bed for six weeks. My fingers and fingernails went black. My tongue was covered in some sort of fungus half an inch thick, which I would scrape off and then rinse my mouth every morning. The pain in the whole of my body was unbearable. One of the twins had a very severe nose bleeding, and the doctor said that saved her life.

Grace Stewart.

G. W. Rice collection

Grace Stewart.

Jean Forrester, St John volunteer who helped at the temporary influenza hospital in the Seddon Memorial Technical College in Auckland

I was there when my eldest brother died at Kilbryde, another emergency hospital…I was assigned to the Art Room on the first floor, which was tiered like a lecture theatre. All day we went up and down those steps, bed-making, sponging the patients, working between the beds and doing whatever was required . . . [One man] was delirious and kept asking if it was four o’clock, as he was going to die then. Four o’clock came and went but he did not die then. He just couldn’t accept that he hadn’t died, and became so deranged in his ravings that he was removed to the mental hospital. 

Irma Pickett’s father worked for the Auckland Harbour Board

One day before I got sick I had been sent to the shops on a message. I was a very nosy child so I was interested on the way home to see a big furniture van stop in Wellington St and men were bringing out of houses what seemed to be rolled up rugs, and then I saw feet sticking out at one end.

Another time on my way home I was passing an old shop and saw a note in pencil stuck to the door which said ‘For God’s sake help us.’ I told my mother who rang the police. I heard later that a family of five were dead, some found on the floor. The house at the back of the shop had to be hosed out by the Fire Brigade

Another time I was told not to go near Victoria Park. Needless to say curiosity got the better of me, and I went to see why. There were bodies wrapped in canvas lying in the grandstand, waiting to be buried . . . My late husband lived in Greenlane near the Ellerslie racecourse and he told me that a hospital was set up under the big grandstand there and that bodies were put out on the grandstand seats, the same as at Victoria Park.

Bert Ingley and his inhalation certificate.

G. W. Rice collection

Bert Ingley and his inhalation certificate.

Bert Ingley was a cadet in the Customs Department in Wellington

I woke from a most disturbed sleep with some sort of irritation in my nose, and when I switched on the light I found that blood was beginning to pour from both nostrils. I tumbled out of bed to the wash stand, half filled the basin with water from the jug, placed the basin on the chair beside the bed, and got back under the blankets.

After a while the bleeding stopped, but by this time the basin appeared to be full of blood. You can imagine the horror of my landlady and her husband, who had heard the commotion and came in to see how I was. I believe the lady almost fainted…The only after-effect was the shedding of all my hair. I became quite bald for a time. I also became extremely hungry during my convalescence, and lived only for food and yet more food.

Edith Chapman, from Waimate, South Canterbury

You must have heard about Dr Cruickshank, she was a wonderful doctor in Waimate who died of the flu in 1918. Such a tragedy, to lose her own life after helping to save other people. I heard this funny story about her, that shows how hard she worked. She went to one place and found she’d left her stethoscope in the buggy, so she put her ear to this man’s chest and told him to count out loud while she listened to his lungs. So he started off, ‘One, two, three, four’ and so on. And she fell sound asleep! She woke up to hear him still going, ‘Nine hundred and ninety seven, nine hundred and ninety eight . . .’ I think he was one of the survivors. But there weren’t many funny stories like this one. That was a terrible time.

 

Zinc sulphate inhalation sprayer at the Health Department office, Queen Street, Auckland.

G. W. Rice collection

Zinc sulphate inhalation sprayer at the Health Department office, Queen Street, Auckland.

Source : https://www.stuff.co.nz/national/health/107298823/new-zealands-worst-diseasedisaster-100-years-since-the-1918-influenza-pandemic