Geoffrey Rice – 1918 Influenza presentation

Thank you all for coming. This is a topical subject because it’s the
centenary this year, 100 years– in November, anyway– it’ll be 100 years since the worst
public health disaster ever to hit New Zealand. We were discussing just before– it’s very
funny. It doesn’t get listed as one of New Zealand’s
great disasters. We think of things like the earthquake in
Canterbury or the Airbus crash or things like that. But this was an act of nature. After all, viruses come out of the natural
world. And far more people died in this episode than
in any other disaster in New Zealand. Well, why should we remember it? There’s a rather urgent reason why we should
know about past pandemics because there is still a very high risk of another flu pandemic. No less an authority than Bill Gates has warned
that it’s still on the cards. There are new viruses– flu viruses– being
discovered regularly. We know– well, at least nine have appeared
since 2000. And mass jet travel has made the world a viral
village. Viruses travel around the globe very much
faster than they did 100 years ago. And we had near misses in 1997 with the bird
flu from Hong Kong and in 1997 with the H1N1 Mexican flu. So I think it’s a no-brainer that lessons
from the last big flu pandemic should help us make better decisions when we face another
one in the future. There’s an example of what I mean. I took that photo last year at Madrid Airport
on my way back from a conference, and there were– I mean, what you can’t see is the great
concourse over to the right. There must have been about 300 or 400 people
in that room all shuffling around slowly with ample opportunity to cough and sneeze at each
other. How many people died? Globally, a variety of estimates. The early estimates in the 1920s were of the
order of about 20 million. Johnson and Mueller, a very reliable estimate,
came out with about 50 million. Murray and Lopez raised the possibility of
60 million. If you read in websites or journal or news,
magazine articles, 100 million– I don’t buy that one. It’s just a bit too high. But we have reasonably good evidence for somewhere
in the region of 50 to 60 million people dying in 1918-19. To put it in perspective, that’s only about
2% or 3% of the world population back then. But it was extremely variable. Different places had it differently. Some places had it very badly indeed, like
Western Samoa and indeed, the Maori in New Zealand. Death rates vary from a very low Australian’s
2.6 per 1,000 to Western Samoa staggering 220 per 1,000. That’s 22%– a fifth of the population perished
from influenza. So there’s an 84-fold range of death rates. So don’t believe the 100 million ones. It’s been estimated if we had another pandemic
or disease disaster like that in New Zealand’s current population, we would be looking at
somewhere in the region of 30,000 to 35,000 deaths. To put it into perspective, though, the Black
Death of the 14th century is history’s worst recorded pandemic event. It killed at least a third of Europe’s population,
and good evidence shows that England over a period of about five years lost something
like a half of its population. Absolutely staggering impact, and we’re still
not quite sure whether it was just bubonic plague, or my bet is that it was also a pneumonic
plague because that would account for the rapid spread and the very high mortality rate. That’s the worst recorded pandemic. The latest global survey is a book by Laura
Spinney. I met her at the conference in Madrid. She’s a science journalist, a very good one,
and her book Pale Rider– it’s a very odd title. It’s a reference to the novel written by Katherine
Anne Porter. It’s one of the few novels about the 1918
flu. It was called Pale Horse, Pale Rider so she’s
picked up the second part of that. Laura argues that this was a protean event,
a most unusual event in world history, because it had so many diverse outcomes. As I said before, its impact was very diverse
in different places. And it’s intimately related to the First World
War. So we’re coming to the end of the WW100 celebrations–
sorry– commemorations this year. And it’s worth remembering that the it was
the war that made the pandemic worse than it might have been. And she argues that it affected the outcome
of the war. In the first place, the Germans’ Ludendorff
was planning a big spring offensive. America had joined the war. Huge numbers of American troops were arriving
in France. It’s been estimated that something like a
million American soldiers traveled the North Atlantic during 1918, and many of them were
carrying influenza virus from North America. Ludendorff blames the failure of his spring
offensive on the fact that most of his regiments, newly brought over from the Russian front,
had come down with influenza. And mind you, the British and the French were
also similarly effected. But they all kept very quiet about it. Being wartime, nobody wants to inform the
other of any sort of weakness. But Ludendorff specifically blamed the flu
for the failure of Germany’s spring offensive. That meant that the Allies actually won a
military victory at the end of 1918. And at the Paris Peace Talks in 1919, the
third mild wave of flu was still going around, and a lot of the representatives at the conference
had flu. President Hoover’s– sorry, Woodrow Wilson’s
aide, in fact, died of the flu Wilson himself had it very severely, and he
had been arguing for a tolerant, decent sort of peace. And because he was ill, Clemenceau, on the
French side, was able to get support for his extremely harsh punitive peace. So the whole nature of the Versailles Peace
Treaty might have been different if it hadn’t been for the flu, and we might have been spared
the rise of the Nazis in the Second World War. But that’s a big hypothetical. [LAUGHTER] Now, why is it called Spanish flu? Very simple answer. Spain was a neutral country in the First World
War. It had no censorship so it’s newspapers WERE
free to report anything. The King, Carlos XIII, got the flu, got over
it, but thereafter, journalists all around the world had a new label for influenza. If anybody had flu, oh, you’ve got the Spanish
flu. And Spanish are now extremely irritated about
this because it didn’t stop there. They had a very badly in Spain but not as
badly as in Italy. But they sort of get their name attached to
it. To put it into perspective, the First World
War killed an estimated 10 million soldiers, between 7 and 10 million civilians, but the
influenza killed at least twice that number, possibly three times that number. And then for many years, the world seemed
to forget about it. We were preoccupied with the Depression, the
Second World War. Not until the publication of Al Crosby’s book
Epidemic and Peace in 1976 thus sparked the wave of current scholarship, which is still
expanding. I’m pleased to say New Zealand was early in
the field. Next one. There we are, on the left. 1988, which is 30 years ago this year– good
god, that’s– hence my white hair. Published as a small textbook. And I took it into my head to find out who
died, where, under what condition, and the obvious source to me, as a naive, young historian,
was to go and look at the death certificates. So I spent about three years of my holidays
going out to Levin House in Lower Hutt and going through the death registers. Now remember, this was before the days of
laptops, digital cameras, all the paraphernalia you have today. It was old-fashioned historical research with
index cards all carefully written up. To analyze it all, I had to get the data converted
into numbers. Helpful friends in the sociology department
got the numbers converted onto punch cards, and we fed, with great trepidation, fed them
into the big Burroughs mainframe computer at the University of Canterbury, which rumbled
and roared and spat out reams and reams of crosstabs, which I couldn’t make head or tail
of. I had no idea. In fact, all I needed were percentages to
get rates, and a pocket calculator was quite enough for that. But anyway, this was one of Bridget Williams’s
first books when she was working for Allen & Unwin. And I’d done a lot of interviewing in Christchurch,
about 130 interviews in the old people’s homes I’d collected a lot of photographs, even some
cartoons in the New Zealand Observer. But she said, no, no, I just want just a cheap,
quick textbook. So it was published with all my tables and
graphs and so forth, but no photos in 1988. And then after I’d established a good working
relationship with Canterbury University Press– they’ve published about 11 of my books now–
Richard King suggested a second edition of Black November. And that came out in 2005, and I’m still delighted
with this book because it was the book I had in my mind’s eye back in the 1980s. It had a good text, all statistical information
analyzed, but also lots of eyewitness accounts, very human stories of people who’d lived through
and survived the thing, and the photographs and the cartoons. I’d updated to with three extra new chapters
on the relationship to the First World War, and the enormous surge in influenza research
and scholarship since that first book first published. Next one. Black November somewhat to my amazement remains
the only study in the world for a whole country based on the analysis of individual death
certificates. It’s only in the last 10 years or so that
the epidemiologists have got down to the level of individual records, and they’re now producing
some very, very interesting stuff on cities in North America and also some in South America
as well based on individual data. Going through the death registers at Levin
House, I found 6– just under 6,500 registered Pakeha deaths. Maori deaths were incomplete. I knew this from the start. I counted about 1600. But I did a lot of newspaper research. My young family at that stage was treated
to a summer holiday touring the North Island and calling in at the newspaper offices. Because, remember, this was years before papers
passed places like Otorohanga and Hawera. I remember taking notes, and the Hawera’s
archives were in a tin shed, a garage, on a corner. And I remember there were sheep trucks rumbling
past and making the whole place shake. But anyway, from the newspaper reports, I
found evidence of at least another 480 odd deaths that had not been registered. So over 2000 Maori, grand total 8,500. But I was well aware that in some parts of
the country, particularly the Waikato and North Island– in the Waikato, remember the
Kingitanga movement had boycotted the 1916 census and resisted conscription, and they
refused to have anything to do with Pakeha officialdom. Now I found newspaper reports and eyewitness
accounts of numerous deaths down the Waikato and scarcely any registered. So I thought there must have been deaths there
unrecorded. In Northland, there are monuments up there
which have names and in some cases only fewer than half of those names were registered. Jennifer Anne Summers, in her thesis on the
flu in the New Zealand military in 2013, found 258 more deaths overseas. I’d gone through the military register just
noting influenza and/or pneumonia. But she expanded on it widely. Basically, she assumed that any soldier who
died of sickness in the 1918 must have had the flu. So her figure might be a wee bit more than
it ought to be, but that brought the grand total up to 8,800. So allowing for those unrecorded Maori deaths,
in my latest little book, I’ve stuck my neck out and suggested that a good round figure
would be 9,000 deaths. Now compare that with the fact that New Zealand
lost 18,000 soldiers during the First World War over four years. But we lost 9,000– mostly civilians– in
the space of about six weeks. And some of them were doctors and nurses and
volunteers who’d gone out to help their communities and caught the flu and died. This is the latest book. Came out the end of last year, condensed for,
frankly, a juvenile readership. I aimed at high school kids because quite
a number of teachers use the 1918 flu as a good sort of case study or class exercise. A bit at the back about memorials and a bit
about new research, but a lot of the photographs. Hurray for Google Images. I found about a third of the new illustrations
are in color, updated quite a bit. Now, why did the bodies turn black? My grandmother called the black flu. That’s where I got the title of the second
book from. The cyanosis from pneumonia, where the lungs,
grossly inflamed– the alveoli often burst and released blood and fluid into the lung
cavity. And if this goes on long enough, your lungs
fill up with fluid, and you’re unable to get enough oxygen, and you die. But before you die, you start looking like
this. This was a watercolor by an artist called
[? Thornton ?] Shields for the British Ministry of Health. He sat at bedsides and recorded what patients
looked like. This is the last phase of cyanosis. And the sad, sad fact I found out only recently–
[? Thornton ?] Shields himself caught the flu and died not long after painting these
pictures. The skin turns a dusky purple, usually lips
and ears first. Other symptoms associated with this very unusual
influenza pandemic– epistaxis, massive nosebleeds. But interestingly, most of the people I interviewed
who’d had nose bleeds, that was what saved them. They believe that they turned the corner after
that. Women reported loss of hair– all of their
hair falling out. One woman in Christchurch I interviewed said
that she filled a shoe box with all her hair. It just fell out. And other people lost fingernails and toenails. How did it get to New Zealand? Well, let’s scotch a myth, first of all. The old view, still current among some old
people, is that Bill Massey brought it on the ship, the Niagara, in October returning
from an imperial war conference. They landed on the 12th of October. There had been some flu on board among the
stewards, one death. Very few of the passengers had it. Nobody had died among them. The ship’s captain had sent a wireless message
and said Spanish flu on board, which was a sort of trigger to severe stuff. But when the ship landed, it was– nobody
else was allowed on the wharf apart from the doctors, who went aboard and looked at these
flu cases. And they said, this is just mild ordinary
flu. Why, I’ve got cases on shore in Auckland much
worse than these ones. So the Minister of Health at the time said,
just ordinary flu, shipped may be cleared. So Massey was allowed ashore. It was actually the watersiders who put around
the rumor that he and Ward had avoided quarantine, pulled strings somehow to avoid it. And they had a reason for that, I think, because
not only do they have bitter memories of the 1913 Maritime Strike, which was pretty brutally
put down by Massey’s government, but they had already approached the government way
back in September suggesting a Maritime quarantine and the health department told them basically
to mind their own business. And yet it got in. I spend a chapter in Black November explaining
why the timing doesn’t fit in fiction from the Niagara. It was a couple of weeks too early in a way. But during that same week, three troopships
arrived in Auckland. There’s no mention of them in the newspapers
because of wartime censorship. But several thousand soldiers were disembarked
and went home, many of them in Auckland, others the length and breadth of the country. And they had come from camps in southern England
where the second severe wave of the flu had gone through about six weeks before. My money is on the soldiers. They are the ones who unwittingly brought
it back and carried it home all throughout New Zealand. Because this is the extraordinary thing. If it had come on the Niagara, you would have–
after an incubation period and circulation of perhaps two weeks, you would have expected
a really big, massive outbreak within two weeks. It didn’t happen. It was delayed. But what you do have in the first week of
November is virtually simultaneously right throughout the country outbreaks of severe
influenza. It was spread by the railway network and by
coastal shipping until they were held up. The health department in 1918 was very tiny,
only about a dozen staff in Wellington, and it was quite new– established in 1901. And all the senior medical men in the health
department had been attached to the Army for the duration of the war. So people like Dr. McGill were away Trentham,
Dr. [? Friendly ?] was up in Auckland, and Valentine, the Director General, was on leave. So the health department really caught on
the hop by this. But they adopted a kind of complacent, oh,
it’s not as bad as you think, which I would suggest to you is one of the first lessons
to learn from 1918. Don’t delay. You need to respond very promptly to influenza. It goes very fast. Influenza was declared a notifiable disease
on the 6th of November after the Minister of Health had gone up to Auckland on the train
to see for himself what was going on there. This gave medical Officers of Health in various
districts the powers to close schools, pubs, cinemas, dance halls, anywhere where people
might cluster together. Closing the schools an interesting move because
this flu affected young adults. It didn’t affect children and teenagers. They got off pretty much Scot free. In most towns, public meetings were held to
elect epidemic committees, and these were often the same people who’d been wartime patriotic
communities committees during the war, raising funds for the war effort. And they organized the towns. Hospitals were overwhelmed immediately, just
a sudden flood of pnuemonic influenza cases. So most cities– well, Auckland and Wellington
set up temporary influenza wards of hospitals in church halls and school halls. And in the lecture I gave last week to the
U3A in Wellington, comparing Christchurch and Wellington, I suggested that dispersal
of nursing effort was probably not a good idea Christchurch concentrated all severe
cases at the public hospital where experienced nurses could give them proper attention. Pneumonia needs very careful nursing. But all through the country, the middle months
of 19– of November 1918, shops, offices, factories all shut for lack of staff. One of the men I interviewed, Bert [? Engly,
?] said that he went out onto Lambton Quay, and he said you could have fired a gun that
way, turned around and fired a gun that way, and you didn’t hit anybody because there was
nobody about. It was like a ghost town. Public transport had stopped. There was nobody out and about apart from
the odd ambulance going past. Transport very disrupted, and Wellington had
severe shortages of flour and coal because of the flu. A couple of photographs. This is a much reproduced photograph of the
health department’s influenza center in Christchurch. It had actually been, as you can see in the
middle, the patriotic bazaar. It was the left luggage office for the Tramway,
but during the war, it was the place where you could bring and buy, a sort of white elephant
store, and the money went to the war effort And they just tacked a couple of signs– Public
Health Department Treatment of Influenza, Government Standard Influenza Medicine Depot. Now the official influenza remedy was basically
just a strong cough mixture with a little bit of alcohol. So it was very popular while the pubs were
shut. Next. The other official remedy or treatment for
the flu was a 2% zinc sulfate inhalation, atomized zinc sulfate. They tried this in the military camps in 1916,
and they thought it was reasonably successful. On the left, you see the first sprayer that
was used in Auckland in the health department’s office on Queen Street. On the right, you see Christchurch went one
better and set up a whole lot of sprayers in the bike sheds at the back of the government
building. And they went another step and used tramcars. They simply reconnected the compressed air–
the pipes from the compressed air breaking system to the sprayer and people could go
in one end and walk through breathing deeply and go out the other end without queueing
up and infecting everybody else. But the zinc sulfate inhalation was basically
just a very old fashioned disinfectant for bacteria. It had no effect on viruses whatsoever and
probably did more harm than good because some people overdid it, and it inflamed the respiratory
tracts. In Greymouth, they ran out of zinc sulfate
so they used formalin instead– [LAUGHTER] –with disastrous effects on people’s insides. Next one. This is the Wellingon– from st. Patrick’s
College in Wellington, the temporary ward, nice and peaceful. But the interviews I did and some of the letters
I had from survivors indicated that the conditions in these temporary hospitals was pretty desperate. The worst example from Wellington– I think
it was the Alexander Hall– where something like 100 very seriously ill pnuemonias, some
of whom were delirious and trying to get out of bed and escape in the night, being looked
after by just two volunteers who were not even trained nurses. So what hope did the rest of them have for
the proper nursing of pneumonia. One of the unexpected consequences of the
flu– another lesson to learn– is that with between a third and a half of the population
down with the flu, people weren’t out shopping, they weren’t able to cook for themselves,
and they needed feeding. And so most of the town set up soup kitchens. So the able-bodied were supplying vegetables
and meat to produce broth and soups and so forth. And because children and young folk were not
much affected, the Boy Scouts and the Girl Guides did most of the distribution, as you
recall from the cover of my book. The Boy Scouts were really important in that
job. OK. And convalescents took weeks to recover, very
seriously ill. They were several weeks before they go back
to work. It was certainly a very bizarre influenza
pandemic because the severe second wave in 1918 was simultaneous in both hemispheres. The peak of deaths in London, England occurred
in the same week as the peak of deaths in Auckland, New Zealand. Now that defies all normal epidemiological
principles. Influenza, as you know, is a seasonal disease. Normally, you get a new virus in the Northern
Hemisphere, six months later in the Southern. 1918, it was all around the globe within the
same couple of months. Really seriously bizarre. The other really key feature of 1918 is that
it– whereas influenza normally kills the vulnerable– the very young and the old–
this one often spared the elderly. In North American cities, quite often elderly
people were not much affected, but the secondary pneumonia killed lots of people in the age
range 25 to 45, young adults. Young parents– that was what got me interested
in the topic in the first place. And there are all sorts of other puzzles. In New Zealand, why was it that males died
at double the rate of females in the young adult age groups? Any thoughts please? Why would more men die? From the back? Because they’re out and about more. Out and about more, more likely to pick up
in fiction. Yep. What about getting back to work? Why would they want to get back to work in
a hurry? Married. With families. No unemployment benefit in those days. To put food on the table, they had to get
back to work. So my hypothesis is that a lot of men with
serious pneumonia got up to go back to work and had relapses and died. But that’s just my hypothesis. There are the graphs from Black November showing
the male deaths at the top there. See, the peaks in the age range 25 to 45 and
much lower bars on the graph for the females. Next one. There was a lot of diversity New Zealand. Some places had it bad. Some places got off lightly. Nelson, Timaru, Westport– very low death
rates. Some small places had very high death rates–
Inglewood, Taumarunui, Nightcaps. In these places, something like 90% of the
adult population came down with the flu, and the children often didn’t know what to do
to look after their parents. Taumarunui’s my hometown. What got me started on this was a chance conversation
with my father not long after my eldest daughter had been born. And as a family man, I was curious to know
about his family history. And I said, you know, your childhood in Taumarunui–
what’s the most vivid thing you can remember from your childhood? And he said, oh, black flu. And at that stage, I had a history degree. I hadn’t heard of it. And I said, oh, what was that all about? He said, oh, you’d remember it if you lived
through it. You wouldn’t forget that in a hurry. He said the whole town was flattened. His family, my grandparents, were among the
few that were still able-bodied, and they went door to door in the mornings to check
on their neighbors. And he had this lovely system for relighting
the coal fires in the mornings. But he said quite casually, oh, we had look
in the bedrooms to see if anyone died in the night. I thought I had him. They’d just look as though they were asleep,
wouldn’t you? But he said, no, no. In that flu, when they died, the bodies turned
black. Just imagine a 10-year-old boy seeing that. Anyway, Taumarunui was my first little case
study. Then I did an article on Christchurch, and
that methodology was copied by Linda Bryder in Auckland for her master’s thesis and Martin
[INAUDIBLE]. And that got me launched into doing a book. And I’ve already asked, why did Wellington
have nearly double the death rate of Christchurch? And why did Maori die at– well, at least
seven times, nearly eight times the rate of Pakeha? Next one. This is obviously not from the pandemic. It’s one of the few photographs in the Turnbull
Library of a Maori burial from this period. A child’s coffin, the man with the black armband. This is a sad but peaceful scene. The scenes in Maori communities, particularly
up in Northland, were anything but peaceful. People were dying so fast. Relief workers and nurses said that there
was a kind of fatalism. When a Maori caught the flu, they tended to
turn their face to the wall and wait to die. So there was very little incentive on the
part of individuals to help themselves or to help those around them. And that goes back and relates to all sorts
of deep-seated Maori beliefs about death. Next one. Recent research has suggested that the variation
in death rates may have had something to do with the immunity conferred by the mild first
wave of the flu, which went right round the world in the middle of 1918. And also preexisting medical conditions made
some individuals much more vulnerable to influenza than healthy people. It’s possible that, because the Maori population
in 1918 was 90% rural and some of them in very remote settlements that hardly ever saw
a Pakeha, they may have missed out on the mild wave that went through New Zealand in
1918. The Niagara arrived in the middle of that
mild wave. But poor standards of housing, traditional
sleeping houses where people slept together huddled together for warmth in the night,
poor nutrition, poor sanitation– typhoid was rife in most Maori settlements– made
them a very highly vulnerable population. And we know from Dr. [? Turbit’s ?] studies
in the 1920s that Maori had very high rates of tuberculosis right through male and female. And they also were very much into tobacco
smoking. Imagine, if you will, those old, gaudy portraits
of the old couriers with a pipe. My sister remembers from her childhood in
Taumarunui passing an old courier sitting on the steps of the post office, wrapped in
cloaks or blankets, puffing on their pipes. Maori women took up tobacco with as much keenness
as the males, and that probably gave them all lungs that were much more vulnerable to
a respiratory infection. It killed young adults. And here’s one prime example from Wellington. Doctor Matthew Holmes, married with two young
children, volunteered at the start of the war, went with the New Zealanders to Samoa
to capture from the Germans, then went to Gallipoli, survived Gallipoli, went to the
Western Front. He was invalided back after an illness, came
back in 1917, and then, when the pandemic hit Wellington, worked himself into the ground,
caught the flu, and died. He’s absolutely spot on, 42. Sorry, age 39. He’s a bit older than the 24-year-olds who
mostly died. But his grave is in the Karori Cemetery. One of the puzzles– the big one about the
young adults– has a new explanation which I can share with you. Shanks and Brundage– Dennis Shanks is probably
one of the leading Australasian researchers on this. He’s done a lot of work on the Pacific and
on influenza among the military– and also, working completely independently, a team led
by Alain Gagnon in Canada were getting into these individual death certificate city studies. And they noticed that for most cities in North
America, the peak age of mortality was 28 years. And that set them to thinking count back,
count back. They were born in 1890. What was happening in 1890? Well, you were in the middle of the previous
flu pandemic, the so-called Russian flu of 1889-92. That’s what made influenza endemic in New
Zealand an annual event thereafter. Now there was a completely different virus–
the H3N8. And they argued– both teams independently
came to the conclusion– that early life exposure to this flu virus may have damaged the T-cells
in the immune system or marked them in such a way that when they encountered a completely
different flu virus in 1918 as young adults it triggered their immune systems to overreact. You know, whoop. Red lights flashing. The immune system pours out chemokines and
other things. You could get a cytokine storm basically. And the reaction was worst in big, strong
men. That keyed in beautifully with a lot of the
eyewitness evidence that I’d collected. They said that it wasn’t your sort of thin,
weedy fellows who went down. It was big strong in the prime of life, and
they went down like nine pins. That was the sort of impression people had. That’s quite a satisfying solution. In 1918, New Zealand was at war, and I think
we coped with the flu pandemic better because we were at war. The whole country had been on a war footing. There were local committees raising funds. There were women’s circles knitting socks
and balaclavas for the troops, that sort of thing. And very often, it was the patriotic committee
that turned itself into the epidemic committee. But more importantly, the public had been
brainwashed for four years about duty and sacrifice. Our soldiers were over in France getting killed,
risking their lives for us. Here at home, why not risk your life to go
and help your neighbors? So neighbors often risked their lives, and
some of them caught the flu and died because of their neighborliness. But New Zealand society has changed a great
deal since 1918, and the question arises, would be cope as well today? Well, we have a lot of advantages. Communications are much better– you know,
texting, emails, Facebook, Twitter, all that sort of stuff. The first thing to remember is to let someone
know if you get sick so that you’re not left isolated and neglected. Next one. And one of my particular hobby horses– New
Zealand has hundreds of war memorials but no national memorial to the victims of the
1918 flu. 9,000 people died, and there’s no memorial to them. The public needs reminders to be educated
about past disasters. My good buddy Nick Wilson in the medical school,
he’s been researching and publishing on memorials to do with disease outbreaks as a means of
educating children, particularly school kids, to remind them of what has happened in the
past to be on their guard for the future. This is a statue of Dr. Margaret Cruickshank
who is was a GP in Waimate in South Canterbury. She was the first woman to enter general practice
in New Zealand. She took over Doctor Barclay’s practice when
he went off to the war. She died from the flu and exhaustion in November
1918. The community raised the funds, put up the
statue by William Trethewey, the Christchurch sculptor, and she’s still revered in the neighborhood. And I must lighten the mood of the meeting
by telling a funny little story about Dr. Cruickshank. She was doing the rounds one night, parked
her buggy outside this place, went into the old [? trap, ?] and then realized she’d left
her stethoscope in the buggy. She said, oh, never mind. I’ll do it the old fashioned way. I’ll put my ear against your chest and listen
to you. Now start counting, and I’ll tell you when
to stop. And of course, she was so exhausted, she just
fell asleep on his chest. She woke up to hear him counting– 364. [LAUGHTER] I picked up quite a number of little funnies
like that, but it was, on the whole, a very grim time. People realized that even if they hadn’t lost
people from their own family, there were others nearby who were dying of the flu. So two big lessons from 1918– self-reliance
and prompt response. Don’t wait. Don’t sit around waiting for somebody from
the health department or something to come knocking on the door. Be self-reliant and proactive. Be prepared. Organize your neighborhood, share supplies,
get volunteers, and when sickness strikes, look after your family first, then look after
your neighbors. And I think it’d be a good idea to revive
neighborhood watch groups and get to know your neighbors. You may not like them very much, but they
just might save your life in a future pandemic. Finally, here we are. Stay calm. Let’s hope it’s only flu because I think we’ve
got a fighting chance of coping with flu. If it’s SARS or Ebola, well, you might as
well take to the hills. Or it may be something else that we’ve not
heard of yet. And my personal advice– keep smiling however
rotten you feel. Be nice to those caring for you so they will
keep coming back to keep caring for you. Thank you very much for your attention. [APPLAUSE]

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