Part one | The 1918 flu pandemic to remember

A century ago, so-called Spanish Flu was beginning a menacing march across South Africa. As we continue to endure the airborne coronavirus pandemic, what can we learn from the last one?

The weather had been odd that year. There were still no tarred roads on the outskirts of Johannesburg, so the autumn winds had whipped the city into a dust bowl. And by the time the morning of 1 October 1918 arrived, it was already shaping up to be a rainy summer.

William E Hill’s shift at the Farrar mineshaft in Driefontein had started at 10pm the previous night. Hill had been a winding engine driver for 10 years, and had driven the Farrar shaft engine for the past two. In spite of the weather, his shift had been as ordinary as any during the previous decade. Until he felt a queer sensation in his legs.

Hill was moving a cage carrying 38 mineworkers between stations when his legs went weak and he broke into a cold sweat. With the engine’s reversing lever in one hand and the brake lever in the other, he collapsed, unable to move. His vision was blurred and he could see a “multitude of lights and a number of reflections”.

Frozen, Hill could hear the warning bell ring – the engine was still running – then the bank bell, and then the collision. The cage careened into the shaft’s headgear at 20km/h before crashing back down. When it was eventually cut open, 19 injured men had to be untangled from 19 dead men, their necks broken.

Hill’s paralysis had been brought on by what at the time was commonly called Spanish Flu. And the workers who died as a result were among the first to be buried in the month that would come to be known as Black October.

Circa 1890-1923: Johannesburg mineworkers from the turn of the 20th century. The 1918 influenza epidemic would lay low tens of thousands of mineworkers. (Photograph by the Universal History Archive/ Universal Images Group via Getty Images)

The forgotten pandemic

We are living through the end of 100 years bookended by airborne pandemics. It is ending in the coronavirus, but it began with the highly infectious influenza epidemic unfairly labelled Spanish Flu. If we go by the number of deaths, and the relatively short space of time in which they occurred, this influenza was the worst pandemic in human history. Up to 100 million people died around the world in the space of a year and a half. There were more deaths then than there are Covid-19 infections now.

There was a time when those numbers would not have made much sense. But, from the malaise of our own pandemic, we can put them into a familiar context. As the end of the lockdown draws nearer, and we collectively release a breath that we have mistrusted for months, we are taking stock. Up to 50 000 people in South Africa are expected to die from Covid-19 in 2020.

It seems unimaginable that we might forget the ravages and lessons of this year. But it has happened before.

If we had suffered the same mortality rates that the country experienced during the flu of 1918-1919, 3.5 million people would have died in July and August this year. In 1918 South Africa, the flu killed 6% of the population in the space of six weeks – Black October. And still, it remains a largely forgotten pandemic.

Undated: South Africa, where the pandemic killed 6% of the population in a devastating six-week period, was the third worst-hit country as the highly infectious 1918 influenza swept the globe. (Excerpt from A Newspaper History of South Africa by Vic Alhadeff)

As the experience of the flu was forgotten, so were the important questions it raised. Chief among them the question of why societies are so fragile and unready for pandemics. One source that allows us to resurrect the questions of Black October, and remember a pandemic that should never be forgotten, are the pages of South Africa’s newspaper of record at the time, the Rand Daily Mail.

A ‘Spanish Flu’, from America

The Mail tracked the beginnings of the flu from a distance throughout the beginning of 1918.

If a globalised world provided the tracks on which the coronavirus became a runaway train, World War I was the principal vector for the flu pandemic. It even played an unlikely part in its name. The flu did not, as the name suggests, begin in Spain. Rather, it made its first appearance on an American army base in March 1918. But, as in all warring nations, information was tightly censored. A pandemic in the ranks was the last thing you wanted an enemy finding out about. Spain, on the other hand, was not involved in the war, so news of the flu was more readily available.

At this stage, the disease was not yet that deadly. It was, however, highly infectious, and spread quickly among American troops before travelling with them across the Atlantic.

In June, the Mail reported its spread from Spain to Belfast, where a munitions factory was shut down when the women working in it fell ill. In July, there were reports that 1 000 of the 3 000 prisoners of war being held in Hampshire, England, were infected. And in early September, there were whispers that the virus had arrived in Johannesburg when a certain Commandant James Richardson was unable to attend to his public duties for several days owing to “a sharp attack of influenza”.

But most early references in the Mail to the “Spanish Flu” were advertisements. Treatments such as Phospherine and Veno’s Lightning Cough Cure being sold at Dinwoodies pharmacies. Or “Dr Williams’ Pink Pills”, which claimed the best way to fight off influenza was to “build up the blood” after it had been thinned by the virus. Or Peps Lozenges: “Don’t Pooh Pooh That Cold!”

That was until 17 September.

May 1919: South African soldiers leave Tilbury Docks in England. The 1918 influenza was brought to South Africa on ships carrying soldiers returning from World War I. (Photograph by AR Coster/ Topical Press Agency/ Getty Images)
Circa 1914-1918: General Jan Smuts inspects South African Native Corp troops. Black soldiers returning from World War I were among those on the ships that brought the influenza from Europe. (Photograph by Universal History Archive/ Universal Images Group via Getty Images)

The second wave

The sun rose at 6.04am. Some families were celebrating. The McBrides announced the birth of their son, and Charles Hill and Gertie Holland their marriage. Others were mourning. The Langleys announced the death of their beloved brother, Alfred.

17 September was a fairly ordinary Tuesday in a rapidly growing Johannesburg, which at that time, according to medical historian Catherine Burns, resembled a disordered frontier town more than an organised city. Johannesburg was blissfully unaware of the invisible carnage that had crept into its midst. Theatres were still packed, some for the ominously titled production of The Price of a Good Time.

But a Mail article titled “Spanish influenza in South Africa” contained the beginnings of hints of a pandemic that would change the city forever. The Mail reported that a “few natives who recently returned from overseas” were carrying the virus. These were soldiers belonging to the South African Native Core, home from the war.

In truth, the tail end of the wave of the flu that had started in America had already arrived in Durban and made its way to the then Transvaal and parts of the northern Free State. What arrived with the soldiers on the Cape Town docks was a second, deadlier wave.

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In what University of Cape Town historian Howard Phillips calls “an absolutely tailor-made distribution of infected people”, the troops, who included white soldiers, took the virus with them along South Africa’s well-developed rail network.

A week later, the Mail reported that the virus had arrived in Johannesburg. It took three days for an outbreak that began among mineworkers to reach epidemic proportions. Of the 2 000 workers at the Village Main Mine, 110 were infected, along with 304 of the 2 000 workers at City and Suburban Mine. Symptoms included staggering and falling, as well as “a considerable amount of pain in the legs”.

But still, Johannesburg seemed largely unaware of the enemy within the gates.

The Empire Theatre was crammed to capacity for a Rand Soldiers Institute benefit that night. Traffic in Pretoria the following day was being redirected to accommodate the many Joburgers who had piled into trains to attend a big wedding. And over the coming days, the Mail would report that the “disease is far more inconvenient than dangerous”.

Undated: The General Hospital treated influenza cases in white and black women. The Twist Street Emergency Hospital saw white men. Black men were mostly treated at medical facilities on the gold mines. (Image supplied by Johannesburg: Images and Continuities, Peter Kallaway and Patrick Pearson)

Public health then and now

Having come through the peak of the coronavirus in South Africa, it is difficult to imagine anything other than a response coordinated through a centralised national health department. But this was not always the case.

It was through South Africa’s formidable extractive industries and migrant labour system that initial attempts to contain the flu in Johannesburg were organised. Workers were denied passes to leave the mine compounds “in order as far as possible to prevent spreading” of the virus. Workers laid low by the virus were often made to return to work the following day.

This response was in part down to the power of the mines, but also a reflection of South Africa’s scattered health system at the time. No provision for public health was made when the Union of South Africa was formed in 1910, and several attempts to unify public health since had “foundered on the rocks of vested interests”, according to Phillips, who has studied the flu outbreak since the 1970s. So, provincial and municipal authorities retained control over public health.

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On the same day that the Mail reported the flu’s arrival in Cape Town, a conference in Bloemfontein was debating the need for a central public health authority. The country’s readiness for the coming storm was exposed when, during a discussion on epidemics, it was suggested to “leave to government the more spectacular but less important duty of dealing with actual outbreaks”.

It was these fractures in public health that the flu would ultimately expose in deadly fashion.

South Africa’s national health department – the same one from which Minister of Health Zweli Mkhize has overseen the country’s coronavirus response – was created in 1919 as a direct response to the influenza outbreak. Even as public health became centralised, says Phillips, provinces were reluctant to cede their authority over hospitals, baking some of  the divisions and fragmentations into South Africa’s public healthcare system that we are still dealing with today.

The bottom line

By 30 September, a day before William E Hill’s collapse at the Farrar shaft in Driefontein killed 19 workers, there were more than 10 000 cases of the flu on Johannesburg’s mines. Practically every mine on the Reef was affected, but none had yet “found it necessary to discontinue operations even for a day”. At the Robinson Deep Mine, more than 1 500 cases were reported in the space of a day, but still operations continued.

The Chamber of Mines, with its eyes ever on the bottom line, released a statement assuring the public that the effect of the virus on operations was “not likely to be serious”.

In the following days, the virus spread into the municipal compounds and working-class shanties surrounding the mines, and on to the East Rand. It also began to make an appearance among the white residents of Johannesburg.

A week after William E Hill was laid low, hospitals started groaning under its weight. Beds were being made up on the floors of Johannesburg General Hospital. When the hospital in Germiston began to overflow, patients in the “African section” were “accommodated on the stoeps”.

The Mail, after more than 400 deaths among mineworkers, finally conceded that the outbreak was “on a scale that is causing some justifiable alarm”.

A day later, the paper declared the flu South Africa’s worst ever epidemic, “the plague being nothing to it”. In another sign of the mining companies’ near total control over black bodies and their life cycles, dying workers were not sent to government morgues but handled on the mines.

With daily burials at the Brixton Cemetery increasing eightfold, the Twist Street Primary School, in what is today Johannesburg’s city centre, was converted into a temporary hospital, largely through the efforts of women workers.

At the same time, the Mail raised for the first time what would become a central feature of Johannesburg’s influenza crisis: the slum-like living conditions of the city’s working classes. The paper’s editorial questioned “the extent to which the wretched housing accommodation found in the poorer parts of every big town in South Africa has been responsible for the size and severity of the present epidemic”.

In part two of this series, we trace the pandemic’s progress through the rest of the country and show how it changed our cities.

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