Epidemics And Public Health In Early Colonial Somaliland

The First World War and the final campaign against the Sayyid in 1920, were instrumental in the outbreak of influenza and smallpox epidemics. The influenza pandemic affected the whole world (Crosby, 1976a,b; Hartesveldt, 1992). In Africa, the pandemic first hit Sierra Leone in 22 August 1918. In Somaliland, it hit Berbera in Early November (Patterson and Pyle, 1983, p. 1303 and Table 1, p. 1300). It was introduced into the town by ships from Aden and India (Patterson and Pyle, 1983, p. 1304). The spread of the disease was made possible by three factors. First wartime disruption and the movement of troops. Second the new systems of transportation, which made possible the spread of the disease quickly (Patterson and Pyle, 1983, pp. 1299±1302). Third the 1918 drought. In the case of Somaliland, there were no railroads as such. However the frequent stoppage of ships at Berbera, which carried soldiers, introduced the causative agent of the disease. Moreover, in early 1918, the country “suffered from an exceptional drought and owing to the shortage of foodstuffs, many tribes, which had hitherto maintained their destitute fellow tribesmen, found themselves no longer in a position to do so”. The report added, “There was consequently an influx of destitute into Berbera and in February it was found necessary to give relief to some 960 adults and 250 children” (British Parliamentary Papers, 1919). As already pointed out, famines played an important in the spread of diseases, such as smallpox, because famines forced people to congregate in limited and often unhealthy spaces. Although the influenza A virus does not need large populations to maintain itself, nonetheless, it gets transmitted from person to person by breath-borne droplets. In an epidemic form, the disease travels as `fast as its victims’ (Crosby, 1993a,b, p. 808). The movement of troops and paupers, hence, were instrumental in the spread of the disease in Somaliland. The disease reached Berbera in early November 1918 and quickly spread inland. 50% of the population was infected and about 5% died of the disease (General Staff, 1925). Another report stated that “the probability is that this estimate is low” (Kuczynski, 1949, p. 648). The unfamiliarity of the people to the disease, and the lack of immunity to it, made it a deadly disease. In certain parts of Africa, people referred to the disease as `white man’s disease’ (Crosby, 1993a,b, p. 809). The disease, however, had a deadly impact throughout the world, since the influenza A virus mutates so frequently that there was never any immunity to the disease anywhere in the world. At the least twenty million people died worldwide (Patterson, 1983, p. 485).

The pandemic was quickly followed in 1919 by a smallpox epidemic in Somaliland “which lasted to the middle of 1920”. The source of the infection was the mobilization of large imperial forces from India, Arabia and East Africa against the Sayyid Muhammad Abdulla Hassan. “From all the stations the total (number infected) for the last two years amounted to 1,056, the deaths numbering 354” (General Staff, 1925) and probably more people died in the interior, where there were no medical stations or doctors. The incidence of smallpox began to decline dramatically in the 1920s. The ending of the movement of armies and refugees across the imperial frontiers was the main reason for the decline of the incidence of smallpox in that period. The incidence of the disease in Protectorate, however, rose again in the 1930s.

As Table 1 shows, the incidence of the disease was most pronounced in 1935±1936. The rise in the incidence of the disease was due to the unsettled political conditions in Ethiopia. In 1935, Ethiopia was invaded, and conquered, by Italy. Ethiopian refugees of the Italian war of conquest moved into Somaliland and reintroduced the infection. The disease was most prevalent in centers that functioned as havens for refugees from Ethiopia, such as the refugee camp established at Manjaseh, 25 miles south of Berbera, which was run by the Bible Churchmen’s Missionary Society and directed by Dr. G.L.L. Gurney (Colonial Office Report, 1937). The disease also became prevalent in Berbera, Hargeysa, and Burao. Once the Italian conquest of Ethiopia was completed and the movement of armies and refugees ceased, the incidence of the disease in Somaliland came to a sudden end. Thus in 1937, as Table 1 shows, only one case of smallpox was reported in the whole Protectorate.

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