The 1918 Flu Pandemic
Devastation is the only way to describe what The Salvation Army faced in the days leading up to the 1918 flu pandemic and during it.
Imagine: the First World War breaks out and plummets entire countries into armed conflict, the deployment of troops to an array of battlefields exacerbates the spread of a deadly virus, and as a session of cadets at The Salvation Army training school in the USA Eastern Territory prepare to face these challenges, the school itself burns to the ground.
Undaunted, The Salvation Army reinvented itself in a way no other organization could. Even in the face of possible illness and death, its soldiers became laser–focused on their new mission to restore healthcare in communities. They also remained cognizant of their ultimate mission, which is to help save souls from sin and to demonstrate the love of Jesus Christ without discrimination.
General Evangeline Booth’s account of these perilous times was recorded in an article published by The Salvation Army in its War Cry magazine. She expressed the deep gratitude she felt toward her officers and soldiers and related a heartfelt thanks to them that was shared by many individuals, agencies, and organizations around the world.
Through telegrams and letters from as far away as India, Korea, China, and Japan, they recognized the significance and the courage of so many Salvationists who had responded to the scourge that claimed the lives of thousands of people in the United States and millions worldwide.
“The way our people braved the disease when visiting hospitals, nursing the sick, and burying the dead was inimitable, and in the patient and heroic discharge of their duties some lost their lives,” Booth wrote. “This epidemic wrought havoc with every department of our work. Especially was this so with those phases that have to do with our young people and with public meetings.
“There was also the severe and almost irreparable loss sustained through the death of 25 of our own officers. Some of these had given long years of faithful service, while others were called away in the prime of life. They loved not their lives to the death and were called away in the midst of their toil.”
“The life of whole cities was paralyzed by the frightful visitation and hospitals, doctors, and nurses were at times so few compared to the demand that thousands sickened and died without remedy.”
— General Evangeline Booth, the War Cry, (circa 1919)
Standing in the gap
After expressing her deep regret for the losses, Booth nonetheless confirmed, “We must press on, for every gap in the fighting front must be filled.”
As the disease spread, those gaps widened. City hospitals and clinics quickly reached capacity, pressing the Salvation Army’s citadels into service to house patients.
In John Merritt’s The History of the Salvation Army, he wrote, “Hospitals to care for influenza patients were established within corps buildings at Roxbury, Massachusetts and in Charleston, West Virginia in 1918 and were maintained with local physicians and community support.”
Red Cross volunteers made and passed out gauze face masks to be worn by doctors and nurses. Boy Scout troops pitched in, running medicine from pharmacies to patients. Early automobiles were volunteered to help transport patients and physicians.
With respect to public health, African Americans experienced systemic challenges. “When the 1918 influenza epidemic began, African American communities were already beset by many public health, medical, and social problems, including racist theories of black biological inferiority, racial barriers in medicine and public health, and poor health status,” wrote Vanessa Northington Gamble, MD, PhD, Professor of Medical Humanities at The George Washington University.
To address these problems, Gamble said they established separate hospitals and professional organizations and repudiated the theories. “It appears that the incidence of influenza was lower among them, but it still overwhelmed their medical and public health resources.”
Nursing leader Lillian Wald, director of the Henry Street Settlement and chair of the newly formed New York City Nurses’ Emergency Council, issued an urgent call for nurses to join the fight.
The Salvation Army responded to Wald’s call as well as the Bureau of Communicable Diseases; the Bureau of Child Welfare; the Red Cross; the Maternity Centers; the Association for the Aid of Crippled Children; the Milk Stations; the New York Diet Kitchen; the Social Service Department of Mt. Sinai, Presbyterian, and Beth Israel hospitals; the Catholic Nursing sisterhoods; the Teachers College Department of Nursing, and other social agencies.
Trained nurses, as well as untrained volunteers, constituted the front–line response. Skilled nursing was essential for influenza patients. There was minimal understanding of the disease, and no antiviral medications to inhibit its progression or antibiotics to treat the complicating pneumonia that often followed.
Aspirin, bed rest, sponge baths, whiskey, cough medicines, clean bedding, and hot soup were among the therapies most often prescribed. Local pharmacist frequently used advertisements to warn customers that the pandemic had cleared their stock of the much sought after Vick’s® Vapo Rub. Local markets also advertised that their meats, particularly pork, had been properly inspected for the virus.
In Ontario, Canada, nearly 70 percent of all victims were between 18 to 43 years of age. The Salvation Army opened its own hospital. New cases and more deaths continued to emerge in successive waves.
In San Bernardino, Calif., the Red Cross had an emergency hospital in the Redlands Salvation Army building. Mary L. Saunders, age 40, was the head nurse. As an experienced professional, she had also been superintendent of the Redlands Hospital in 1914.
Flattening the curve
By late October, the earliest locations of the influenza epidemic saw numbers of new cases decline. Newspapers reported that the epidemic was over at two U.S. Army bases in Syracuse, N.Y., but elsewhere the epidemic continued.
The New York State Public Health Department continued warning everyone to cover their mouths and noses when sneezing or coughing. Doctors also recommended washing hands and wearing masks. Fort Devens in Western Massachusetts reported they were using whiskey, eggs, and milk to fight flu and pneumonia.
Also in October, the superintendent of the St. Lawrence State Hospital in Ogdensburg, N.Y., reported that 300 patients and staff were ill. Physicians’ wives were assisting in the care of the sick. The Salvation Army also set up a hospital and 24 patients were admitted with influenza.
From January 1918 through 1920, an estimated 500 million people were infected with the disease worldwide. It reached every corner of the globe, decimating even the most isolated settlements in the Pacific and even in the Arctic. It’s estimated the virus contributed to the deaths of between 50 million and 100 million worldwide, representing between 3 percent and 5 percent of the world’s population.
The corps facility in Charleston, West Va., eventually became the Charleston Hospital, which evolved into a home and hospital for unwed mothers. It remained open and served the community with distinction until its closure in 1964.
“Big things almost invariably are accompanied by big difficulties, and it was so in this case, for we had no easy task to prepare for the exceptional demands,” wrote Booth.
“From the president down, in a personal sense, all seemed to highly esteem The Salvation Army for its work’s sake. They admired the objects of the movement and greatly esteemed its spirit.
Competent, confident, compassionate
“’Were we competent?’ was the all–important question, and because of the boundless confidence that filled our hearts, we were glad to submit to all the needed observation. You all know that recognition duly came, and it has been our constant privilege to so labor as to merit the flood of commendation that has poured in upon us from the highest official quarters. Nothing has been more gratifying unless it be the unbroken note of praise and gratitude that has come from the men with and for whom we toiled.”
General Booth also praised The Salvation Army for remembering its ultimate mission. “At all times, they lifted up the cross and preached Christ and Him crucified. The influence of their devoted and uplifting service has served to strike with admiring wonder the whole world.
“I question if any of us at this time can sufficiently measure or duly appreciate the far–reaching importance and benefits which this devotion, faithfulness, sacrifice, and service of our splendid men and women, who served with equal devotion and sacrifice at home, brought to the Army.”
Today, as the world battles yet another pandemic, the far–reaching importance of the Army’s contribution in 1918 can be clearly seen with 2020 hindsight. Hopefully, the lessons learned from that experience will inform the Salvation Army’s response going forward.
by Warren L. Maye