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Smallpox in Kenya, 1880–1920
II. DISEASE AND SOCIAL CHANGE SMALLPOX
IN KENYA,
1880-1920
MARCH. DAWSON Department
of Hlstory.
Umverslty
of Wlsconsm.
Madison
Abstract-Inthe
late nineteenth century smallpox epldemlcs usually occurred during or at the end of fammes. Many hlstorlans have noted the relationship of smallpox and fammes. They believed malnutrltlon lowered resistance lo the disease. and hence brought on the epidemic. Nutrition. however, affects only the mortality rate of smallpox victims. and not the morbidity rate The helghtened morbtdity resulted rather from the famine responses of the starving populations. Increased population movements. trade. crowding mto areas with food. and the like. were the reasons for the epidemics, not malnutrltlon The earl) colonial period saw African societies undergo social and economic changes similar to the famine responses above. Trade expanded greatly with the mtroductlon of cash crops: labor mlgratlon caused larger and more frequent population movements; and urbamzation created larger and denser populations The introduction of vaccmation did help mitigate the adverse epldemiologlcal effects of these changes. but the British vaccmatlon campaigns were beset with many problems of their own. The result was that smallpox appeared in frequent local outbreaks with low mortality. and only occasronally In widespread eplde&cs
Although smallpox has a long history of endemicity in Kenya. the epidemiology of the disease has changed through time. The social and economic changes of the colonial period had significant effects on the way in which smallpox was spread. In the late nineteenth century, the disease maintained a very low level of endemdty. and at times of ecological stress flared mto devastating epidemics. The early colonial period saw the disease appear more frequently in small local outbreaks with sizeable epidemics being uncommon. Below. I will present some preliminary findmgs which help explain this change in epidemiology of smallpox ‘in Kenya; but some of the conclusions must be regarded as tentative since field work is still being conducted [ 11. In order to ?udy the impact of early colonial changes, It is essential to understand the epidemiology of smallpox in the late nineteenth century. As stated above. the major periods for the spread of smallpox m the late nineteenth century were during and Immediately followmg major famines [2]. This relationship between fammes ahd disease. particularly smallpox. has been noted by several historians [3-51. Many historians assume that sudden starvation weakened the population’s resigtance to disease thus causing the endemic form of smallpox to become epidemic. This assumption. however superficially reasonable. is not true. Malnutrition and many diseases do interact, usually synergistically, to the detriment of the victim. Nutritional status is also an Important determinant of the immune response of the host: however, in regard to smallpox. an indtvidual’s immunity to the disease is determined solely either by a previous contractlon of the disease or artificially through vaccination or variolation. Therefore, m the case of smallpox, malnutrition undoubtedly determined the fate of many smallpox sufferers. but could not act as the cause of a widespread epldemlc [6]. Rather. the most Important cause of the epidemics was the social reactlons to famme. This point is. demonstrated by the events which occurred durmg the 1897-1900 famine in central Kenya. 245
By June 1898 over most of -central and eastern Kenya, the long rainy season had failed and famine was imminent. The food shortages were compounded by vast losses of cattle by the Maasai. Kamba and Kikuyu in a pleuro-pneumonia eplzootic in the Fall of 1897 and an outbreak of rinderpest in March 1898 [7]. Hordes of locusts had already destroyed crops and vegetation in Kiambu and were movmg into Ukambani and Taveta [S-IO]. This was the beginnmg of the most devastating famine m the last 100 years in which an estimated one-tenth to one-half of the Afrlcan population died of starvation, dysentery. or smallpox in the next 2 years. Famine set m quickly in Ukambani. Many Kamba turned to huntmg for food, but game was rapidly depleted through a combination of disease. lack of forage, and hunting [ 1I-133. The Kamba sent caravans to the Kikuyu and Mbeere to trade for food. Special famine markets were arranged to deal with the increased volume of trade. By October 1898 famine was widespread in central Kenya [7. p. 29; 14. IS]. In early 1899 hundreds of Kamba were migrating to the Mount Kenya area in search of food; while many others went to Taita. Taveta, towards the coast, and the Mount Kilimanjaro area. Other Kamba resorted to raiding, particularly the Mbeere, for food [l6]. In many areas, including Ukambani, smallpox erupted probably in early 1899. The disease spread rapidly, particularly among the young. The Kikuyu. who were sheltering many Kamba. began to kill the Kamba entering their country in an attempt to keep the disease from their villages [ 15. p. 4; 17, 183. The effort was in vain and the areas involved heavily m trade suffered greatly from smallpox. By June 1899 an American missionary described Ukambam as practically depopulated with everyone either dead or gone m search of food [ 18. 19). The descriptions of Uicambam became even grimmer after September 1899. The followmg quotation is but one example: Along the jungle paths throughout the country. wherever we went dlsmai and harrowing spectacles were ever pre-
246
MARCH. DAWSON
sented to vtew. Sometimes we had actually to thread our way among naked and partrally devoured corpses [13. p 3591. The Kamba were in desperate straits and were roamtng over large areas of Kenya searching for food.
Many were suffering from smallpox and inadvertently helping to spread it [13, p. 357-8; 20.213. Railroad camps and caravans were raided and stealing was rampant [22]. In mid-1899, the British set up famine relief camps for Africans, but the food received there was often too late and many died there [17,22]. In late 1900 at the end of the famine, the estimates of Kamba mortality ranged from one-quarter to onehalf of the population [23]. The Kikuyu also suffered heavy population losses in this period. The rains failed in June 1898 in the areas of lower elevation of Kikuyuland, particularly in the south and east. The southern Kikuyu food reserves had already been depleted by heavy trading with Europeans and others. Epizootics had reduced Kikuyu cattle herds as they had those of the Kamba and Maasai. Thus, many southern Kikuyu began trading for food with their northern relations in the Aberdares and around Mt Kenya who had received abundant rainfall [8, pp. 112-3.392, 727-8. 746, 865; 24. 251. The famine spread northwards and westwards, due to the extensive food trading. The northern Kikuyu were supplying food not only for their kinsmen of the lower plains, but also for Ndia, Kamba, and Mbeere, who came in great numbers. As the drought continued, many southern Kikuyu abandoned their farms and went to the highlands in search of food and shelter with kinsmen and others. The journeys were long and many, especially the young and old, died en route, according to some accounts lining the paths with corpses. The refugees had to face raids by thieves, and there were several reports of “chiefs” robbing and murdering their own subjects for goats [S, p. 747 ; 24, p. 248 ; 25, pp. 94-51. There were also reports of cannibalism being practiced on travelers [8, p. 596; 24, pp. 243-41. Smallpox erupted extensively in the south, e.g. Kiambu, where thousands suffered. The disease was brought to the north in late 1899, and many deaths resulted from smallpox there, but none from starvation [8, pp. 697, 727; 24, pp. 243-4). Entire villages were wiped out by the disease with the worst destruction being in southern and eastern Kikuyuland [18, pp. 59, 245-j. Numerous observers estimated the population losses in the south to be between 60 and 95”;. The estimates for the Kikuyu as a whole ranged from 10 to 70”/;, of the population [26]. The actual number of deaths is difficult to determine, since many people left their homes to live with their kinsmen in non-famine areas, and did not return immediately, if at all. Nevertheless, the famine and epidemic had been so severe that as late as 1903 the Kiambu area appeared to be largely uninhabited [27]. From the above descrtption several types of famine relief measures are evident, raiding, trading, and population movements to non-famine areas. These activities were the causes of the massive epidemics. not malnutrition. The relief methods were departures from daily routines and altered usual inter-personal
contacts, and hence provided an opportunity for endemic disease to become epidemic. Endemic smallpox did become epidemic during fammes. Many historians, however. have not understood the actual dynamics. The pastoral population was too sparse to maintain smallpox endemically. The surrounding agricultural populations were dense enough to support the disease. When in 1892 an epizootic wiped out all the cattle, the pastoralists were forced to get food from the agriculturalists. When the lesser immune pastoral population came into extended and intensive contact with the agriculturalists an epidemic inevitably resulted due to the increased number of non-immune people, both pastoral and agricultural, in the infected agricultural villages. In Kenya, the same epidemic process occurred among the Maasai in both 1884 and 1892 after cattle epizootics, when the Maasai came into extensive contact with Kikuyu [28]. The Kamba and Kikuyu both had sufficiently large and dense populations to keep smallpox endemically, and both had local markets which permitted the disease to circulate [29]. Let us examine the way famine periods produced epidemic smallpox in these societies. Famine periods were characterized by raiding. In the 1898 famine raids occurred on caravans, European railway camps, other people (e.g. Kamba raids on the Mbeere), and even on one’s own people [30]. Raiding provided very limited opportunities for passing an infection between raiders and victims. but the sources do show one example. A European missionary related that once while travelling on the Athi plains he came upon a “heap of human bones”, and was informed that they were the remains of Maasai who had built camps there. During a smallpox epidemic among these Maasai, they were raided by Kamba from Kangundo, who captured their cattle (and probably some women), but also caught smallpox and spread the disease upon returning to Ukambani [S, p. 770; 311. Another effect of the increased raiding was the gathering together of warriors in compounds for either defensive or offensive purposes [ZS, pp. 122-33. This age-group (15-25 years old) suffers a greater mortality from smallpox. Thus when the disease was introduced among the warriors, the mortality was great. In fact, many sources specifically state that the mortality was greatest among the young [32,33]. Also, many families probably banded together for protection; thus increasing the size and population density of villages, and hence their vulnerability to epidemic disease. As has been seen above, trading was a very important means of obtaining food during famine periods. Food was a normal trading commodity, but famines saw a substantial increase in the volume of the trade. A Cuka informant told a researcher: People exchanged goods all the ttme, but the period of famines saw the mtenstficatron of the exchange and even the creation of more meeting places for exchange [14. p. 2381.
The increase was both in internal and external ing. Merritt found that Taita traditions state that ing a famine in the mid-1880s. men travelled village to village trading their valuables for food In 1898 in Taveta. as food became scarcer the
traddurfrom [34]. men
Smallpox III Kenya. 1880-1920
were forced to travel farther and wider to find food; as were the Kamba and Kikuyu [35]. External trade mcreased dramatically in famine periods also. creating the need for new special markets. All the people tn the region knew where these famrne markets were held and large numbers of people came to trade. The necessity of food even overrode political differences at times, and Mwaniki’s Embu informants claimed that hostilities were ceased in order to begin trade relations [14. pp. 12-3. 58, 101. 139, 2733. Kikuyu and Kamba traded heavily in 189%1900+ even though Kamba slaving activities had seriously strained their relations [36]. The increased population densities m non-famine areas were the result of two famine relief practices, pawning and migration. The pawning of families entailed a man placmg himself and his family, or only his family. in a servile position with someone tn a non-famine area. In return the patron provided them with food and protection, while they provided free labor for the patron. The family could redeem itself by payment of a fee by the returning husband or by workmg the fee off in labor for the patron. The Maasai and Kamba in 1892 and 1898 sent many women to the Kikuyu under such a relationship [S, p. 1677. Migration of individuals, families, or larger social units were usually directed to areas where kinsmen or blood partners lived. These migrants were permitted to settle for the duration of the famine or stay permanently. as did many. Lastly, there were mechanisms through which famine victims seeking refuge could be adopted by the non-famine peoples. This action was a frequent option used by the Embu and Kikuyu 114. pp. 12-3. 139, 304; 373. Usually small groups were the units of migration to the non-famine areas, but the total number of people moving to these areas was considerable. The Kamba seeking shelter with the Mbeere became numerous enough to militarily overwhelm their hosts [14, p. 217; 383. The sources describe large numbers of Kamba leaving their homes for Kikuyuland, and the numbers of Kikuyu going to the highlands were numbered in the thousands [8, p. 733; 25, p. 106; 39.403. Another reason for the massive smallpox epidemics was the breakdown durmg famines of the traditional means of deahng with the endemic form of the disease, and the practice of inoculating during epidemics. Both the Kikuyu and Taita practiced isolation of smallpox victims. During famines, the maintenance of such isolation was impossible. People travelled anywhere at any risk to obtain food. Thus, numerous reports can be found of many smallpox victims roaming around searching for food and spreading disease [2l. 34. pp. 122-3; 41,421. Inoculation (variolation) was reportedly practiced by the Kavirondo, who contmued the practice into the colonial period [43]. A person who is inoculated usually gets an attenuated form of the disease, and the risks of dying are fairly low. Although. if the inoculator penetrates too deep or the pus came from a person who was not past the critical stage of the disease, the risks were great. The major problem with inoculation as a public health measure is that inoculated people can infect other people with full-blown smallpox. Hence, a man can protect his family through inoculation, but unless they are all isolated they can
247
infect the rest of the commumty with the disease. During famines the amount of population movements made such isolation almost impossible [32. pp. IO& IO]. Famines clearly altered usual social and economic patterns, thus presenting the opportunity for endemic smallpox to become epidemic. Increased trade, larger and more frequent population movements, and greater population densities could have little other effect on the disease. The early colonial period saw African socteties undergo similar types of social and economic changes. but without famines. Trade expanded greatly with the introduction of cash crops; labor migration caused larger and more frequent population movementsi and urbanization created larger and denser populations. The mtroduction of vaccination did help mitigate the adverse epidemiological effects of those changes, but the British vaccination campaigns were beset with problems of their own. The result was that smallpox appeared in frequent local outbreaks. with very occasional widespread epidemics. After the 1897-1900 famine, smallpox did not appear in rural central Kenya on an area-wide scale until 1916. Between 1900 and 1912, most district and medical reports refer to smatlpox occurrences as “sporadic cases”, or appearing in a “mild form” C44.45). In 1913 the incidence of smallpox increased with serious outbreaks reported in Nyeri and Meru. and many scattered cases around Fort Hall [46-81. Again in 1914 and 1915 smallpox was quiescent, appearing in isolated cases or small local outbreaks. In 1916 with many African soldiers and carriers returning from the war, smallpox broke out again on a large scale with 100 outbreaks in Kenia Provmce alone 1493. The disease died down agam in 1917. but when the 1917-18 famine began the incidence increased, particularly around Nairobi [SO, 511. Again the disease appeared in rural areas in sporadic local outbreaks through 1920. Nairobi’s experience with the disease was somewhat different. The city with its denser population had frequent large outbreaks. The disease struck on a significant scale in 1909, 1913. and 1915-18 [S-4]. The occurrences in Nairobi were usually several months long and the reported cases numbered well over 100. Before 1920, Nyanza Province suffered more hea‘vily from smallpox than central Kenya. The area had been devastated in 1899-1900 by famine and smallpox. After that, the disease appeared sporadically m the area until 1909-10 when an epidemic struck every district m the Province [55J. As in central Kenya the disease was quiescent from 1910 through 1915. From I915 to 1918 smallpox was a serious problem in Nyanza. In 1915 and 1916 the disease swept through the entire Province and Kisumu District alone reported 3000 deaths due to the disease [56,57]. The disease remained at epidemic levels until 1919. when the number of cases finally dropped to low levels
IPI. Increased population mobility was the principal factor responsible for the increased frequency of smallpox. This is not to say that in the precolonial era there was not any trade or movement of people to different areas. Some of the precolonial Kikuyu mar-
248
MARCH. DAWWN
kets were attended by over a thousand people. some of whom travelled great distances to attend. Interethnrc trade, i.e. Kikuyt-Maasai. Kikuyu-Kamba are all well demonstrated [59]. Rather, the number of people mvotved m colonial labor movements was far greater than precolonial times, and the distances travelled were much longer. As early as 1905 the Kisumu Provinctal Commissioner reported “Kavrrondo” coming to work in Kisumu m substantial numbers, and by the outbreak of the First World War, over 20,000 registered laborers passed through Kisumu [6O, 61). In central Kenya m 1901, a British official on safari reported difficulty in obtaining food near Murang’a as all surplus crops had been taken to sell in Nairobi [62]. The food trade grew and by 1912 A. C. Hollis estimated that 10.000 Kikuyu per month left Fort *Hall to bring their produce to Nairobi [63]. In addition to the thousands involved in the produce trade, thousands of Kikuyu, Embu, and Meru were heading for Nairobi and Mombasa in search of work [64]. With the improved road network, railways, and active labor recruitment. the number of laborers and traders moving between their homes and work had reached the tens of thousands by the outbreak of the First World War. The labor mj~atton and increased trade had two effects on the epidemiology of smallpox; first, on the laborers themselves, and secondly, on the populatton m the Reserves. The men leaving the Reserves and traveiting to Nairobi, the coast. etc. exposed themsetves to infection in a new environment. Several witnesses before the 1912-1913 Native Labour Commission testified that returning laborers had contracted diseases while working away from home, and smallpox was often mentioned [46, p. 17; 63, p. 2041. Travel conditions were usually conducive to the spread of disease -with men crowded into rest camps or locked into railroad cars [65]. Once at the job, Iivmg conditions were not any better. Men were forced to live in cramped and crowded accommodations. Hobiey found on inspecting one estate that 50 Kikuyu were housed in seven huts, none of which were large enough to stand in [63. p. I ; 66]. On some plantations men were forced to remain Iivmg in huts with people suffering from leprosy or smallpox. and medical attention was usually non-existent [63. p. 102; 671. Hence. many laborers were stricken with the disease. The returning infected laborers or traders represented a threat to the populations in the Reserve. Numerous cases can be found of local epidemtcs origmatmg from a returned traveller. A typical example was a smallpox outbreak which raged for three months in Mukokonl (Ukamba Province) in October 1918. The original case was a man who had gone to Nairobi to sell his fowls; while there he stayed m a house where a Kikuyu had smallpox. Ten days after returning home, he let1 ii1 and infected 16 of the 20 people in his homestead [68]. The disease spread from there to five other homesteads [69]. The most clear-cut example of this threat to public health was the havoc wrought by the returning survivors of the Carrier Corps in 1916. The men were stmpiy returned to their home districts and released regardless of their suspected medical conditions [70]. The result in
Kema Province was 100 different outbreaks of smallpox, and several other diseases [71]. This example was repeated m many other areas of Kenya. ‘The creation of a city like Nairobi. which m 12 years grew from a group of tents to a city of 19.900 had a stgnificant impact on the epidemiology of smallpox [72]. The large and dense population of the city. bemg a business and transport center, and a constant attraction to labor, provided an environment where the disease could be constantly present. .4nd as a commercial and transportation center, Nairobi. also, functioned as a disseminator of the disease to the surrounding countrystde. The medical records give numerous exampies of rural outbreaks of smallpox starting from a person just returned from Nairobi. In fact, migrant Kikuyu workers regularly travelled back and forth between their rural homes and Nairobi on a weekly basis [73]. The area m Natrobi most frequently lived in by migrant Kikuyu workers was the Indian Bazaar, one of the most populated areas of the city. In fact, m 1912 one house there was found to have 75 people residing in it [74]. The Bazaar was visited by returning labor migrants from the coast and other areas on the railway to buy goods before returning home [75]. Consequently, every smallpox epidemic in Nairobi either was discovered in the Bazaar or quickly spread there. due to the presence of a large number of non-immune rurai people [76]. These people, when Infected. spread the disease after returnmg to their rural home areas [77]. As was stated above. the introduction of vaccmation by British medical authorities did help mitigate the adverse effects of the changes dtscussed above. The efficacy of the British vaccination campaign was hampered by several problems. The first problem was lack of funds. The fundmg of medical care for Africans was not a high priority in the coloniaf budget prior to 1920. Health officials were always plagued by shortages of lymph for vaccmatron at critical times. The director of Nairobi’s BacteriologIcal Laboratory claimed his staff and facilities were insufficIent to keep up with the demand for lymph. and more funding was needed desperately [78]. The small medical budget also restricted the number of vaccmators who could be employed. The second problem was the lymph itself. The vaccination returns from any area findicating number vaccmated. etc.) for the perrod under discussion were anything but complete. In most areas. the doctor or vaccinator followed up less than one quarter of the people he vaccmated [79]. Thus. for the great majority of vaccinations performed they could not tell whether the vaccmation took or not. Many times it probably did not take due to poor techmque, but also due to the loss of potency of the lymph itsetf. The lymph was easily ruined through the poor transportation and storage conditions at the rural outstations [80]. In 1916, colonial medical authorities discovered that the strain of smallpox used for lymph production at the Nairobi Laboratory was completely ineffective [SO]. This fact oniy came to light when numerous reports of vaccmated Africans contracting smallpox were received in Nairobi. The last problem was African resistance to the vaccination campaigns. Many Africans refused to be vaccinated for fear of being poisoned by the European doctor or African vaccinator [Sl]. In 1916 when smallpox was spread
Smallpox
m Kenya
widely by the returmng veterans of the Carrier Corps and the lymph was discovered to be ineffective. those “vaccinated” Africans who contracted smallpox were convinced that the British vaccmation campaign was responsible for the spread of the disease [82]. These two problems combined with the definitely large and sometimes septic sores led to opposition of the campaigns in some areas. On the whole. however. the vaccination campaigns in some areas. particularly among the Kikuyu. seem to have been particularly effective in helping control the disease. The epidemiology of smallpox n-r Kenya underwent a srgmficant change as the result of new economic and demographic patterns during the colonial period. The disease in the precolonial period was characterized in its endemrc state by very sporadic cases, but it erupted into widespread epidemics durmg famines. As mtercommunication increased with the growth of trade. population movements, and urban centers the incidence of smallpox increased giving rise to many local outbreaks. With the more frequent outbreaks of smallpox in the colonial period. the level of immunity m the population as a whole would rise, and when combined with a fairly effective vaccination campaign, the disease would tend to appear in a milder form. In central Kenya, the disease in the early colonial period was usually of a mild non-fatal variety, except for the very major upsets in I9 I6 and I9 I7 due to the Carrier Corps. In Nyanza Province, however, the disease did not appear to have responded to vaccination campaigns. In fact. most complaints about the efficacy of the vaccine were from that area. Instead. smallpox, despite more frequent endemic occurrences, seems to have followed its seven year epidemic pattern with major epidemics havmg occurred m 1899-1900. 1909-10, and 1916-17. In sum, m much of colonial Kenya. smallpox appears to have become a more frequent but less fatal disease, due to the rising level of immunity in the population.
18RO-1920
9. Taveta Chronicle 14, 144, 1898. 10. Hearing and Doing 4. 7. 1899 1I. Tavrra Chronicle 12. 110. 1898. 12. Hvarmy and Dorng 3. 8. 1898. 13 Watt R. S. In the Heart of Sasogedom. pp. 35@ 5. Marshall Brothers, London, 1912 14. Mwanikr H. S. Emhu Hlstorrcal Texts. p 273 East Afrrcan Lnerature Bureau. Nairobr. 1974. 15. Heurinq and Dorng 3. 7. 1898. 16. Hearrng and Dorng 4. 7. 1899 17. Munro J F Colomal Rule and Changes in the Kenya HIghlands
18.
19. 20.
21.
Dawson 1890-1918. American
M.H Paper
Fammes delivered
Assbciarion
for
and
epidemrcs
the
History
of the c$ M”edicine.
Madrson. Wrsconsm, 13 May 1977 Ford J. and Hall R. de 2. The history of Karagwe (Bukoba Drstrict). Tanaanvika Notes Rec. 24. 21. 1947. Ford J The role of tlx- tr~panosomrases rn A&can ecology. p 140. Clarendon Press. Oxford. 1971. Katoke 1. A H~sfory of Karagwe. East Africa Publishmg House. Nairobi. 1975. For a techmca) treatment of the relationships between nutrttron and mfectron. see Schrimshaw N. S.. Taylor C. E. and Gordon J. E. interactrons of Nurrrtion and Infection. W.H.O. Monograph Series No. 57. Geneva, 1968. 7. Great Brrtain. Parliament. Parliamentary Papers (Commons) 1899. c.9125. Report by Sir A.~Hardinge on the British East Afnca Protectorate for the Year 1897-98, pp. 1, 8. Kenya Land Commis8. Kenya Colony and Protectorate. slon Notes and Endence. Vol. 1, p. 706.
47 Oxford Universrty Press, Oxford. 1975 Arkell-Hardwick A. An Ivory Trader m Norrh Kellru. pp. 3545. Longmans. London. 1903. Hearing and Doing 3. 6. 1899. See all issues of Hearmg and Domy ror 1899 for descrrptrons of the famine. Tarera Chron. 17, 169. 1899 on the Kamba and smallpox.
as the authors. For a summarv of the most Important estrmates and sources see Mu&o [ 173. p. 48. note 1. 24. Boyes J. A White Kmg in East Africa. p. 247. N.p.. New York, 1912 25. Murrukl G. A Htstory of the Kiku.yu /.VJcJ-/Yfjo. p. 101 Oxford Umversny Press, Oxford. 1974 Murnrkl suggests that the Kikuyu also traded large food reserves to the Kamba. and thus depleted then own supplies used here were those grven by -wrtnesses 26. Estimates before the Kenya Land Commrulon. Vol I [8] See testtmony of Wilson indicatmg one tenth to one
quarter of all Kikuyu (p. 596): Tart (p 596). one Quarter of all Kikuvu: Boedecker (0. 696). 75”, of the populatton of Ktambu; Father Bernhard (p. 723). 75”,, of the southern Kikuyu; Patterson (p. 746). one half of the Kikuyu; Boyes (p. 726). 959/, of all southern Kikuyu; and Knapp (p. 769). one third of all K~kuyu. See file. 27. Barlow Papers, Umversrty of Narrobr Library Kikuvu Land Tenure, and enclosure. Memorandum Presenred
36.
31
In Kenya
to the 50th Meermc
Soc~rul
p
Hearmg and Dorng 4. I. 1900. 23. The estrmates are as numerous
29.
I. I would like to thank the Socra) Science Research Council and Fulbrrght-Hayes Doctoral Dissertation Awards Program for makmg funds available to conduct thus research; however, the vrews expressed m thus paper are those of the author only. 2 Some of the findmgs below were orrgmally presented in
the Kamhu IXXY-IYZY.
22
28. REFERENCES
249
32. 33. 34
35 36
37
38.
ro
rhe
Ken_va
Land
Enqurrr
Commrvsron.
December, 1932. p 3. A pomt evident m the Kenya Land Commission reports [S]. pp. 167. 244-5. 858, 865. Also both areas were mvolved m long-distance and regional trade networks which helped keep the disease in crrculation. Boyes [24] states that the Kariara Kikuyu were raidmg the people from Kabete who were coming m search of food [24. p. 2481. When the incrdent referred to occurred IS not clear from the testtmony. Dixon C. W. Smullpox. Churchrll, Essex. 1962. J. St. Austin’s Catholic Miss. 1. 8. October 14. 1899. Holy Ghost Father Archives. Pam Merrrtt E H. A History of the Tarta of Kenya to 1900. pp. 101. 103. 127. Ph.D Drssertatron, Indiana Umversity, 1975 Tarera Chron 16, 158. 1899. The Kikuyu also traded heavrly wrth the Maasar both in 1892 and 1898. There were several reports of special markets of the Kikuyu for the Maasai. Saberwal S. The Traditional System of the Emhu of Central Kenya, p. 44. Makerere Instttute of Social Research. East African Studies No. 35. np. East Afrrcan Pubhshmg House, Nairobi. 1970. Although Embu informants claimed that most of the Mbeere had already left for Kikuyuland m search of
rood. 39. Taveta Chronicle 18, 182, 1900. 40. Tare H. R. Notes on the Kikuyu and Kamba of Britrsh East Africa. JI R. anthrop. Insr. 34. 135. 1904.
250 31
42
43.
44. I5 46. 47 48 49. 50. 51. 52. 53 54. 55 56. 51. 58. 59 60. 61 67
MARC H. DAWSON
Leaksy L. S. B. Tltr Sourhrrn Rikuyu hr/ore IYO3,Vol. II. pp. 889-90. Academic Press. New York. 1978. The Tur,etu Cilrun. of October. 1899 [‘I] stated: “The trouble [smallpox] IS aggravated by homeless. and famme stricken Wakamba. who are met with everywhere wandermg about m search of the necessities of hfe. many of whom are stricken with the disease. and are carrying it from place to place. Owen W. E. The Kavirondo practice of inoculation with smallpox. Kenya Med. J. 1, 333-5, 1925. Leakey has claimed that the Kikuyu practiced maculation. He states that during an epidemic certam men. who were already immune to the disease. were appointed as Inoculators. These men would go around to the isolatlon huts and collect pus from the pustules of recovering smallpox victims. Then they would visit other homesteads and maculate those who desired it [41, pp. SS(rl]. I have interviewed two men who were themselves Leakey’s “inocu1ator.s” dunng the 1897-1900 famine-epidhmic. They have repeatedly stated that their Job was only to pierce people’s pustules with thorns, but that they never would touch anyone who did not have the disease. Mukuhi wa Karari, 9/27/78. 9/28/78. and Nduati wa Kaguamba. 10/3/78. 1014178. See. for example. Fort Hall District PolitIcal Record Book. pp. 5. 9. PCICP 11’711.1909-20. East A&a Protectorate. Annual Me&al Report, p. 24, 1912 (Hereafter cited EAP. Med. Rep.). Meru Distract Annual Report. P. II. MRUII. 1913114 (hereafter D.A.R.). _ . Nveri DA.R. NYIII. 1912-13 Ei.P. Med. Rep.. p. 41. 1913. E.A.P Med. Rep., p. 16. 1916. Ukamba Province Annual Report, p. 32. PC/CP 4/2/Z. 1918.‘19(hereafter P.A.R.). E.A.P. Med. Rep.. p. 16-17. 1918. Ukamba P.A.R.. p. 32. KBU/lO. 1916117. Ukamba P.A.R.. p. 18. PC/CP 41211, 1909-10. E.A.P Med. Rep, pp. 33. 35. 1915. Nyanza P.A.R. 1909110. Nyanza P.A.R.. p. 22. 1915116 Klsumu D.A.R.. p. 14, CNII. 1916~17. E A.P. Med. Rep.. 1919 Leakey L. S. B The Southern K~krcyubefore /~03. Vol. I. pp 19. 44 Academic Press. New York. 1978 Klsumu P.A.R.. p. 3. 1905/06. Nyanza P.A.R.. p 24. 1914115. Great Britain. Foreign Office. Confidential Prmts. Africa F.O. 403. vol. 318, Enclosure m No I2. Reporr
Brrwetw Nu~rohr. Mhrrrl. und K~rw. By Dickinson B. p. Il. 1901. 1917- I3 Testimony 63. E.A.P. Ntrr~re L&our Commr.~s~o~~. of Hollis A. C.. p. 3 64. E.A.P. Annual Report 1908/09. C.O. 544. 65. Kenya National Archives. TC246 MH I ‘17344,Letter from Ross P. H to P.M.O.. 6124116. for 66. Coast Province Arctuves. M P/78 I9 I3-L&w Mrwupa E,srures. Letter from Hobley to Lagett. 3/15,‘13 67 Orde-Brown G. St. J. Tile VLlnrshinyTrrhes of K;rtlylr. p. 182 Negro Umversltles Press. Westport (CT). 1970 (1925). 68. The other four had already had the disease. 69. Kenva National Archives. TC27l MD87,/1916. Letter fro& Hospital Compounder. Native CIVII Hospital to S.M.O. Ukamba Province 10/20/18. 70. Patterson W. J. Some Medical Aspects of the East Afrocan Campaign. M.D. Thesis, University of Edinburgh. 1919. 71. Kenya P.A.R.. p. 13, 1916-17. 72. East Africa Protectorate. Narrohi Sunrrary Conrmisslon 1913. Report. Evidence. etc. Appendix 1. Evidence. p. 56. 73. Ukamba P.A.R. PC/CP 4/2,‘l. 1914115. 74. E.A.P. San. Comm.. I91 3. ADD. . . I. .D 9 and Part 1. Report, p. I I. 75. Kenya Natlonal Archives TC27l MD76/I916. no. 137 Letter from PInIp H. R. A. I l/l l/16. 16. The 1909 epidemic broke out m the vdlage on the Nairobi River which had a rough population density of 6000 people per square mile. and then spread to the Bazaar [53]. The 1916 epldetmc or&mated In the Bazaar area and rapIdly spread to River Road. See Kenya National Archives TC259 MHl/ 18244. Notice from Dr Radford. Prmcipal Sanitation Officer, 2/23/16 71. The fact that Nairobi acted as a dlssemmator of dlsease to the rural areas cannot be doubted, but whether Nairobi was being Infected from other rural areas and then passmg the disease on is still a question up for examination. 78. For example, E.A.P. Nairohr Lab. Rep. 5. 5. 1914. 79. For example, see vaccmation returns m Nyanza P.A.R., p. ‘2, 1915116. 80. Nairobi Lab. Rep. 8, 221, 1917. 81 Cagnolo C. The Akikuyu. Their Customs. Tradwns. and Folklore. p. 254. Mission Prmting School. Nyeri. Kenya. 1933. 82. E.A P Med. Rep.. p. 31. 1916 on Country
IN KENYA,
1880-1920
MARCH. DAWSON Department
of Hlstory.
Umverslty
of Wlsconsm.
Madison
Abstract-Inthe
late nineteenth century smallpox epldemlcs usually occurred during or at the end of fammes. Many hlstorlans have noted the relationship of smallpox and fammes. They believed malnutrltlon lowered resistance lo the disease. and hence brought on the epidemic. Nutrition. however, affects only the mortality rate of smallpox victims. and not the morbidity rate The helghtened morbtdity resulted rather from the famine responses of the starving populations. Increased population movements. trade. crowding mto areas with food. and the like. were the reasons for the epidemics, not malnutrltlon The earl) colonial period saw African societies undergo social and economic changes similar to the famine responses above. Trade expanded greatly with the mtroductlon of cash crops: labor mlgratlon caused larger and more frequent population movements; and urbamzation created larger and denser populations The introduction of vaccmation did help mitigate the adverse epldemiologlcal effects of these changes. but the British vaccmatlon campaigns were beset with many problems of their own. The result was that smallpox appeared in frequent local outbreaks with low mortality. and only occasronally In widespread eplde&cs
Although smallpox has a long history of endemicity in Kenya. the epidemiology of the disease has changed through time. The social and economic changes of the colonial period had significant effects on the way in which smallpox was spread. In the late nineteenth century, the disease maintained a very low level of endemdty. and at times of ecological stress flared mto devastating epidemics. The early colonial period saw the disease appear more frequently in small local outbreaks with sizeable epidemics being uncommon. Below. I will present some preliminary findmgs which help explain this change in epidemiology of smallpox ‘in Kenya; but some of the conclusions must be regarded as tentative since field work is still being conducted [ 11. In order to ?udy the impact of early colonial changes, It is essential to understand the epidemiology of smallpox in the late nineteenth century. As stated above. the major periods for the spread of smallpox m the late nineteenth century were during and Immediately followmg major famines [2]. This relationship between fammes ahd disease. particularly smallpox. has been noted by several historians [3-51. Many historians assume that sudden starvation weakened the population’s resigtance to disease thus causing the endemic form of smallpox to become epidemic. This assumption. however superficially reasonable. is not true. Malnutrition and many diseases do interact, usually synergistically, to the detriment of the victim. Nutritional status is also an Important determinant of the immune response of the host: however, in regard to smallpox. an indtvidual’s immunity to the disease is determined solely either by a previous contractlon of the disease or artificially through vaccination or variolation. Therefore, m the case of smallpox, malnutrition undoubtedly determined the fate of many smallpox sufferers. but could not act as the cause of a widespread epldemlc [6]. Rather. the most Important cause of the epidemics was the social reactlons to famme. This point is. demonstrated by the events which occurred durmg the 1897-1900 famine in central Kenya. 245
By June 1898 over most of -central and eastern Kenya, the long rainy season had failed and famine was imminent. The food shortages were compounded by vast losses of cattle by the Maasai. Kamba and Kikuyu in a pleuro-pneumonia eplzootic in the Fall of 1897 and an outbreak of rinderpest in March 1898 [7]. Hordes of locusts had already destroyed crops and vegetation in Kiambu and were movmg into Ukambani and Taveta [S-IO]. This was the beginnmg of the most devastating famine m the last 100 years in which an estimated one-tenth to one-half of the Afrlcan population died of starvation, dysentery. or smallpox in the next 2 years. Famine set m quickly in Ukambani. Many Kamba turned to huntmg for food, but game was rapidly depleted through a combination of disease. lack of forage, and hunting [ 1I-133. The Kamba sent caravans to the Kikuyu and Mbeere to trade for food. Special famine markets were arranged to deal with the increased volume of trade. By October 1898 famine was widespread in central Kenya [7. p. 29; 14. IS]. In early 1899 hundreds of Kamba were migrating to the Mount Kenya area in search of food; while many others went to Taita. Taveta, towards the coast, and the Mount Kilimanjaro area. Other Kamba resorted to raiding, particularly the Mbeere, for food [l6]. In many areas, including Ukambani, smallpox erupted probably in early 1899. The disease spread rapidly, particularly among the young. The Kikuyu. who were sheltering many Kamba. began to kill the Kamba entering their country in an attempt to keep the disease from their villages [ 15. p. 4; 17, 183. The effort was in vain and the areas involved heavily m trade suffered greatly from smallpox. By June 1899 an American missionary described Ukambam as practically depopulated with everyone either dead or gone m search of food [ 18. 19). The descriptions of Uicambam became even grimmer after September 1899. The followmg quotation is but one example: Along the jungle paths throughout the country. wherever we went dlsmai and harrowing spectacles were ever pre-
246
MARCH. DAWSON
sented to vtew. Sometimes we had actually to thread our way among naked and partrally devoured corpses [13. p 3591. The Kamba were in desperate straits and were roamtng over large areas of Kenya searching for food.
Many were suffering from smallpox and inadvertently helping to spread it [13, p. 357-8; 20.213. Railroad camps and caravans were raided and stealing was rampant [22]. In mid-1899, the British set up famine relief camps for Africans, but the food received there was often too late and many died there [17,22]. In late 1900 at the end of the famine, the estimates of Kamba mortality ranged from one-quarter to onehalf of the population [23]. The Kikuyu also suffered heavy population losses in this period. The rains failed in June 1898 in the areas of lower elevation of Kikuyuland, particularly in the south and east. The southern Kikuyu food reserves had already been depleted by heavy trading with Europeans and others. Epizootics had reduced Kikuyu cattle herds as they had those of the Kamba and Maasai. Thus, many southern Kikuyu began trading for food with their northern relations in the Aberdares and around Mt Kenya who had received abundant rainfall [8, pp. 112-3.392, 727-8. 746, 865; 24. 251. The famine spread northwards and westwards, due to the extensive food trading. The northern Kikuyu were supplying food not only for their kinsmen of the lower plains, but also for Ndia, Kamba, and Mbeere, who came in great numbers. As the drought continued, many southern Kikuyu abandoned their farms and went to the highlands in search of food and shelter with kinsmen and others. The journeys were long and many, especially the young and old, died en route, according to some accounts lining the paths with corpses. The refugees had to face raids by thieves, and there were several reports of “chiefs” robbing and murdering their own subjects for goats [S, p. 747 ; 24, p. 248 ; 25, pp. 94-51. There were also reports of cannibalism being practiced on travelers [8, p. 596; 24, pp. 243-41. Smallpox erupted extensively in the south, e.g. Kiambu, where thousands suffered. The disease was brought to the north in late 1899, and many deaths resulted from smallpox there, but none from starvation [8, pp. 697, 727; 24, pp. 243-4). Entire villages were wiped out by the disease with the worst destruction being in southern and eastern Kikuyuland [18, pp. 59, 245-j. Numerous observers estimated the population losses in the south to be between 60 and 95”;. The estimates for the Kikuyu as a whole ranged from 10 to 70”/;, of the population [26]. The actual number of deaths is difficult to determine, since many people left their homes to live with their kinsmen in non-famine areas, and did not return immediately, if at all. Nevertheless, the famine and epidemic had been so severe that as late as 1903 the Kiambu area appeared to be largely uninhabited [27]. From the above descrtption several types of famine relief measures are evident, raiding, trading, and population movements to non-famine areas. These activities were the causes of the massive epidemics. not malnutrition. The relief methods were departures from daily routines and altered usual inter-personal
contacts, and hence provided an opportunity for endemic disease to become epidemic. Endemic smallpox did become epidemic during fammes. Many historians, however. have not understood the actual dynamics. The pastoral population was too sparse to maintain smallpox endemically. The surrounding agricultural populations were dense enough to support the disease. When in 1892 an epizootic wiped out all the cattle, the pastoralists were forced to get food from the agriculturalists. When the lesser immune pastoral population came into extended and intensive contact with the agriculturalists an epidemic inevitably resulted due to the increased number of non-immune people, both pastoral and agricultural, in the infected agricultural villages. In Kenya, the same epidemic process occurred among the Maasai in both 1884 and 1892 after cattle epizootics, when the Maasai came into extensive contact with Kikuyu [28]. The Kamba and Kikuyu both had sufficiently large and dense populations to keep smallpox endemically, and both had local markets which permitted the disease to circulate [29]. Let us examine the way famine periods produced epidemic smallpox in these societies. Famine periods were characterized by raiding. In the 1898 famine raids occurred on caravans, European railway camps, other people (e.g. Kamba raids on the Mbeere), and even on one’s own people [30]. Raiding provided very limited opportunities for passing an infection between raiders and victims. but the sources do show one example. A European missionary related that once while travelling on the Athi plains he came upon a “heap of human bones”, and was informed that they were the remains of Maasai who had built camps there. During a smallpox epidemic among these Maasai, they were raided by Kamba from Kangundo, who captured their cattle (and probably some women), but also caught smallpox and spread the disease upon returning to Ukambani [S, p. 770; 311. Another effect of the increased raiding was the gathering together of warriors in compounds for either defensive or offensive purposes [ZS, pp. 122-33. This age-group (15-25 years old) suffers a greater mortality from smallpox. Thus when the disease was introduced among the warriors, the mortality was great. In fact, many sources specifically state that the mortality was greatest among the young [32,33]. Also, many families probably banded together for protection; thus increasing the size and population density of villages, and hence their vulnerability to epidemic disease. As has been seen above, trading was a very important means of obtaining food during famine periods. Food was a normal trading commodity, but famines saw a substantial increase in the volume of the trade. A Cuka informant told a researcher: People exchanged goods all the ttme, but the period of famines saw the mtenstficatron of the exchange and even the creation of more meeting places for exchange [14. p. 2381.
The increase was both in internal and external ing. Merritt found that Taita traditions state that ing a famine in the mid-1880s. men travelled village to village trading their valuables for food In 1898 in Taveta. as food became scarcer the
traddurfrom [34]. men
Smallpox III Kenya. 1880-1920
were forced to travel farther and wider to find food; as were the Kamba and Kikuyu [35]. External trade mcreased dramatically in famine periods also. creating the need for new special markets. All the people tn the region knew where these famrne markets were held and large numbers of people came to trade. The necessity of food even overrode political differences at times, and Mwaniki’s Embu informants claimed that hostilities were ceased in order to begin trade relations [14. pp. 12-3. 58, 101. 139, 2733. Kikuyu and Kamba traded heavily in 189%1900+ even though Kamba slaving activities had seriously strained their relations [36]. The increased population densities m non-famine areas were the result of two famine relief practices, pawning and migration. The pawning of families entailed a man placmg himself and his family, or only his family. in a servile position with someone tn a non-famine area. In return the patron provided them with food and protection, while they provided free labor for the patron. The family could redeem itself by payment of a fee by the returning husband or by workmg the fee off in labor for the patron. The Maasai and Kamba in 1892 and 1898 sent many women to the Kikuyu under such a relationship [S, p. 1677. Migration of individuals, families, or larger social units were usually directed to areas where kinsmen or blood partners lived. These migrants were permitted to settle for the duration of the famine or stay permanently. as did many. Lastly, there were mechanisms through which famine victims seeking refuge could be adopted by the non-famine peoples. This action was a frequent option used by the Embu and Kikuyu 114. pp. 12-3. 139, 304; 373. Usually small groups were the units of migration to the non-famine areas, but the total number of people moving to these areas was considerable. The Kamba seeking shelter with the Mbeere became numerous enough to militarily overwhelm their hosts [14, p. 217; 383. The sources describe large numbers of Kamba leaving their homes for Kikuyuland, and the numbers of Kikuyu going to the highlands were numbered in the thousands [8, p. 733; 25, p. 106; 39.403. Another reason for the massive smallpox epidemics was the breakdown durmg famines of the traditional means of deahng with the endemic form of the disease, and the practice of inoculating during epidemics. Both the Kikuyu and Taita practiced isolation of smallpox victims. During famines, the maintenance of such isolation was impossible. People travelled anywhere at any risk to obtain food. Thus, numerous reports can be found of many smallpox victims roaming around searching for food and spreading disease [2l. 34. pp. 122-3; 41,421. Inoculation (variolation) was reportedly practiced by the Kavirondo, who contmued the practice into the colonial period [43]. A person who is inoculated usually gets an attenuated form of the disease, and the risks of dying are fairly low. Although. if the inoculator penetrates too deep or the pus came from a person who was not past the critical stage of the disease, the risks were great. The major problem with inoculation as a public health measure is that inoculated people can infect other people with full-blown smallpox. Hence, a man can protect his family through inoculation, but unless they are all isolated they can
247
infect the rest of the commumty with the disease. During famines the amount of population movements made such isolation almost impossible [32. pp. IO& IO]. Famines clearly altered usual social and economic patterns, thus presenting the opportunity for endemic smallpox to become epidemic. Increased trade, larger and more frequent population movements, and greater population densities could have little other effect on the disease. The early colonial period saw African socteties undergo similar types of social and economic changes. but without famines. Trade expanded greatly with the introduction of cash crops; labor migration caused larger and more frequent population movementsi and urbanization created larger and denser populations. The mtroduction of vaccination did help mitigate the adverse epidemiological effects of those changes, but the British vaccination campaigns were beset with problems of their own. The result was that smallpox appeared in frequent local outbreaks. with very occasional widespread epidemics. After the 1897-1900 famine, smallpox did not appear in rural central Kenya on an area-wide scale until 1916. Between 1900 and 1912, most district and medical reports refer to smatlpox occurrences as “sporadic cases”, or appearing in a “mild form” C44.45). In 1913 the incidence of smallpox increased with serious outbreaks reported in Nyeri and Meru. and many scattered cases around Fort Hall [46-81. Again in 1914 and 1915 smallpox was quiescent, appearing in isolated cases or small local outbreaks. In 1916 with many African soldiers and carriers returning from the war, smallpox broke out again on a large scale with 100 outbreaks in Kenia Provmce alone 1493. The disease died down agam in 1917. but when the 1917-18 famine began the incidence increased, particularly around Nairobi [SO, 511. Again the disease appeared in rural areas in sporadic local outbreaks through 1920. Nairobi’s experience with the disease was somewhat different. The city with its denser population had frequent large outbreaks. The disease struck on a significant scale in 1909, 1913. and 1915-18 [S-4]. The occurrences in Nairobi were usually several months long and the reported cases numbered well over 100. Before 1920, Nyanza Province suffered more hea‘vily from smallpox than central Kenya. The area had been devastated in 1899-1900 by famine and smallpox. After that, the disease appeared sporadically m the area until 1909-10 when an epidemic struck every district m the Province [55J. As in central Kenya the disease was quiescent from 1910 through 1915. From I915 to 1918 smallpox was a serious problem in Nyanza. In 1915 and 1916 the disease swept through the entire Province and Kisumu District alone reported 3000 deaths due to the disease [56,57]. The disease remained at epidemic levels until 1919. when the number of cases finally dropped to low levels
IPI. Increased population mobility was the principal factor responsible for the increased frequency of smallpox. This is not to say that in the precolonial era there was not any trade or movement of people to different areas. Some of the precolonial Kikuyu mar-
248
MARCH. DAWWN
kets were attended by over a thousand people. some of whom travelled great distances to attend. Interethnrc trade, i.e. Kikuyt-Maasai. Kikuyu-Kamba are all well demonstrated [59]. Rather, the number of people mvotved m colonial labor movements was far greater than precolonial times, and the distances travelled were much longer. As early as 1905 the Kisumu Provinctal Commissioner reported “Kavrrondo” coming to work in Kisumu m substantial numbers, and by the outbreak of the First World War, over 20,000 registered laborers passed through Kisumu [6O, 61). In central Kenya m 1901, a British official on safari reported difficulty in obtaining food near Murang’a as all surplus crops had been taken to sell in Nairobi [62]. The food trade grew and by 1912 A. C. Hollis estimated that 10.000 Kikuyu per month left Fort *Hall to bring their produce to Nairobi [63]. In addition to the thousands involved in the produce trade, thousands of Kikuyu, Embu, and Meru were heading for Nairobi and Mombasa in search of work [64]. With the improved road network, railways, and active labor recruitment. the number of laborers and traders moving between their homes and work had reached the tens of thousands by the outbreak of the First World War. The labor mj~atton and increased trade had two effects on the epidemiology of smallpox; first, on the laborers themselves, and secondly, on the populatton m the Reserves. The men leaving the Reserves and traveiting to Nairobi, the coast. etc. exposed themsetves to infection in a new environment. Several witnesses before the 1912-1913 Native Labour Commission testified that returning laborers had contracted diseases while working away from home, and smallpox was often mentioned [46, p. 17; 63, p. 2041. Travel conditions were usually conducive to the spread of disease -with men crowded into rest camps or locked into railroad cars [65]. Once at the job, Iivmg conditions were not any better. Men were forced to live in cramped and crowded accommodations. Hobiey found on inspecting one estate that 50 Kikuyu were housed in seven huts, none of which were large enough to stand in [63. p. I ; 66]. On some plantations men were forced to remain Iivmg in huts with people suffering from leprosy or smallpox. and medical attention was usually non-existent [63. p. 102; 671. Hence. many laborers were stricken with the disease. The returning infected laborers or traders represented a threat to the populations in the Reserve. Numerous cases can be found of local epidemtcs origmatmg from a returned traveller. A typical example was a smallpox outbreak which raged for three months in Mukokonl (Ukamba Province) in October 1918. The original case was a man who had gone to Nairobi to sell his fowls; while there he stayed m a house where a Kikuyu had smallpox. Ten days after returning home, he let1 ii1 and infected 16 of the 20 people in his homestead [68]. The disease spread from there to five other homesteads [69]. The most clear-cut example of this threat to public health was the havoc wrought by the returning survivors of the Carrier Corps in 1916. The men were stmpiy returned to their home districts and released regardless of their suspected medical conditions [70]. The result in
Kema Province was 100 different outbreaks of smallpox, and several other diseases [71]. This example was repeated m many other areas of Kenya. ‘The creation of a city like Nairobi. which m 12 years grew from a group of tents to a city of 19.900 had a stgnificant impact on the epidemiology of smallpox [72]. The large and dense population of the city. bemg a business and transport center, and a constant attraction to labor, provided an environment where the disease could be constantly present. .4nd as a commercial and transportation center, Nairobi. also, functioned as a disseminator of the disease to the surrounding countrystde. The medical records give numerous exampies of rural outbreaks of smallpox starting from a person just returned from Nairobi. In fact, migrant Kikuyu workers regularly travelled back and forth between their rural homes and Nairobi on a weekly basis [73]. The area m Natrobi most frequently lived in by migrant Kikuyu workers was the Indian Bazaar, one of the most populated areas of the city. In fact, m 1912 one house there was found to have 75 people residing in it [74]. The Bazaar was visited by returning labor migrants from the coast and other areas on the railway to buy goods before returning home [75]. Consequently, every smallpox epidemic in Nairobi either was discovered in the Bazaar or quickly spread there. due to the presence of a large number of non-immune rurai people [76]. These people, when Infected. spread the disease after returnmg to their rural home areas [77]. As was stated above. the introduction of vaccmation by British medical authorities did help mitigate the adverse effects of the changes dtscussed above. The efficacy of the British vaccination campaign was hampered by several problems. The first problem was lack of funds. The fundmg of medical care for Africans was not a high priority in the coloniaf budget prior to 1920. Health officials were always plagued by shortages of lymph for vaccmatron at critical times. The director of Nairobi’s BacteriologIcal Laboratory claimed his staff and facilities were insufficIent to keep up with the demand for lymph. and more funding was needed desperately [78]. The small medical budget also restricted the number of vaccmators who could be employed. The second problem was the lymph itself. The vaccination returns from any area findicating number vaccmated. etc.) for the perrod under discussion were anything but complete. In most areas. the doctor or vaccinator followed up less than one quarter of the people he vaccmated [79]. Thus. for the great majority of vaccinations performed they could not tell whether the vaccmation took or not. Many times it probably did not take due to poor techmque, but also due to the loss of potency of the lymph itsetf. The lymph was easily ruined through the poor transportation and storage conditions at the rural outstations [80]. In 1916, colonial medical authorities discovered that the strain of smallpox used for lymph production at the Nairobi Laboratory was completely ineffective [SO]. This fact oniy came to light when numerous reports of vaccmated Africans contracting smallpox were received in Nairobi. The last problem was African resistance to the vaccination campaigns. Many Africans refused to be vaccinated for fear of being poisoned by the European doctor or African vaccinator [Sl]. In 1916 when smallpox was spread
Smallpox
m Kenya
widely by the returmng veterans of the Carrier Corps and the lymph was discovered to be ineffective. those “vaccinated” Africans who contracted smallpox were convinced that the British vaccmation campaign was responsible for the spread of the disease [82]. These two problems combined with the definitely large and sometimes septic sores led to opposition of the campaigns in some areas. On the whole. however. the vaccination campaigns in some areas. particularly among the Kikuyu. seem to have been particularly effective in helping control the disease. The epidemiology of smallpox n-r Kenya underwent a srgmficant change as the result of new economic and demographic patterns during the colonial period. The disease in the precolonial period was characterized in its endemrc state by very sporadic cases, but it erupted into widespread epidemics durmg famines. As mtercommunication increased with the growth of trade. population movements, and urban centers the incidence of smallpox increased giving rise to many local outbreaks. With the more frequent outbreaks of smallpox in the colonial period. the level of immunity m the population as a whole would rise, and when combined with a fairly effective vaccination campaign, the disease would tend to appear in a milder form. In central Kenya, the disease in the early colonial period was usually of a mild non-fatal variety, except for the very major upsets in I9 I6 and I9 I7 due to the Carrier Corps. In Nyanza Province, however, the disease did not appear to have responded to vaccination campaigns. In fact. most complaints about the efficacy of the vaccine were from that area. Instead. smallpox, despite more frequent endemic occurrences, seems to have followed its seven year epidemic pattern with major epidemics havmg occurred m 1899-1900. 1909-10, and 1916-17. In sum, m much of colonial Kenya. smallpox appears to have become a more frequent but less fatal disease, due to the rising level of immunity in the population.
18RO-1920
9. Taveta Chronicle 14, 144, 1898. 10. Hearing and Doing 4. 7. 1899 1I. Tavrra Chronicle 12. 110. 1898. 12. Hvarmy and Dorng 3. 8. 1898. 13 Watt R. S. In the Heart of Sasogedom. pp. 35@ 5. Marshall Brothers, London, 1912 14. Mwanikr H. S. Emhu Hlstorrcal Texts. p 273 East Afrrcan Lnerature Bureau. Nairobr. 1974. 15. Heurinq and Dorng 3. 7. 1898. 16. Hearrng and Dorng 4. 7. 1899 17. Munro J F Colomal Rule and Changes in the Kenya HIghlands
18.
19. 20.
21.
Dawson 1890-1918. American
M.H Paper
Fammes delivered
Assbciarion
for
and
epidemrcs
the
History
of the c$ M”edicine.
Madrson. Wrsconsm, 13 May 1977 Ford J. and Hall R. de 2. The history of Karagwe (Bukoba Drstrict). Tanaanvika Notes Rec. 24. 21. 1947. Ford J The role of tlx- tr~panosomrases rn A&can ecology. p 140. Clarendon Press. Oxford. 1971. Katoke 1. A H~sfory of Karagwe. East Africa Publishmg House. Nairobi. 1975. For a techmca) treatment of the relationships between nutrttron and mfectron. see Schrimshaw N. S.. Taylor C. E. and Gordon J. E. interactrons of Nurrrtion and Infection. W.H.O. Monograph Series No. 57. Geneva, 1968. 7. Great Brrtain. Parliament. Parliamentary Papers (Commons) 1899. c.9125. Report by Sir A.~Hardinge on the British East Afnca Protectorate for the Year 1897-98, pp. 1, 8. Kenya Land Commis8. Kenya Colony and Protectorate. slon Notes and Endence. Vol. 1, p. 706.
47 Oxford Universrty Press, Oxford. 1975 Arkell-Hardwick A. An Ivory Trader m Norrh Kellru. pp. 3545. Longmans. London. 1903. Hearing and Doing 3. 6. 1899. See all issues of Hearmg and Domy ror 1899 for descrrptrons of the famine. Tarera Chron. 17, 169. 1899 on the Kamba and smallpox.
as the authors. For a summarv of the most Important estrmates and sources see Mu&o [ 173. p. 48. note 1. 24. Boyes J. A White Kmg in East Africa. p. 247. N.p.. New York, 1912 25. Murrukl G. A Htstory of the Kiku.yu /.VJcJ-/Yfjo. p. 101 Oxford Umversny Press, Oxford. 1974 Murnrkl suggests that the Kikuyu also traded large food reserves to the Kamba. and thus depleted then own supplies used here were those grven by -wrtnesses 26. Estimates before the Kenya Land Commrulon. Vol I [8] See testtmony of Wilson indicatmg one tenth to one
quarter of all Kikuyu (p. 596): Tart (p 596). one Quarter of all Kikuvu: Boedecker (0. 696). 75”, of the populatton of Ktambu; Father Bernhard (p. 723). 75”,, of the southern Kikuyu; Patterson (p. 746). one half of the Kikuyu; Boyes (p. 726). 959/, of all southern Kikuyu; and Knapp (p. 769). one third of all K~kuyu. See file. 27. Barlow Papers, Umversrty of Narrobr Library Kikuvu Land Tenure, and enclosure. Memorandum Presenred
36.
31
In Kenya
to the 50th Meermc
Soc~rul
p
Hearmg and Dorng 4. I. 1900. 23. The estrmates are as numerous
29.
I. I would like to thank the Socra) Science Research Council and Fulbrrght-Hayes Doctoral Dissertation Awards Program for makmg funds available to conduct thus research; however, the vrews expressed m thus paper are those of the author only. 2 Some of the findmgs below were orrgmally presented in
the Kamhu IXXY-IYZY.
22
28. REFERENCES
249
32. 33. 34
35 36
37
38.
ro
rhe
Ken_va
Land
Enqurrr
Commrvsron.
December, 1932. p 3. A pomt evident m the Kenya Land Commission reports [S]. pp. 167. 244-5. 858, 865. Also both areas were mvolved m long-distance and regional trade networks which helped keep the disease in crrculation. Boyes [24] states that the Kariara Kikuyu were raidmg the people from Kabete who were coming m search of food [24. p. 2481. When the incrdent referred to occurred IS not clear from the testtmony. Dixon C. W. Smullpox. Churchrll, Essex. 1962. J. St. Austin’s Catholic Miss. 1. 8. October 14. 1899. Holy Ghost Father Archives. Pam Merrrtt E H. A History of the Tarta of Kenya to 1900. pp. 101. 103. 127. Ph.D Drssertatron, Indiana Umversity, 1975 Tarera Chron 16, 158. 1899. The Kikuyu also traded heavrly wrth the Maasar both in 1892 and 1898. There were several reports of special markets of the Kikuyu for the Maasai. Saberwal S. The Traditional System of the Emhu of Central Kenya, p. 44. Makerere Instttute of Social Research. East African Studies No. 35. np. East Afrrcan Pubhshmg House, Nairobi. 1970. Although Embu informants claimed that most of the Mbeere had already left for Kikuyuland m search of
rood. 39. Taveta Chronicle 18, 182, 1900. 40. Tare H. R. Notes on the Kikuyu and Kamba of Britrsh East Africa. JI R. anthrop. Insr. 34. 135. 1904.
250 31
42
43.
44. I5 46. 47 48 49. 50. 51. 52. 53 54. 55 56. 51. 58. 59 60. 61 67
MARC H. DAWSON
Leaksy L. S. B. Tltr Sourhrrn Rikuyu hr/ore IYO3,Vol. II. pp. 889-90. Academic Press. New York. 1978. The Tur,etu Cilrun. of October. 1899 [‘I] stated: “The trouble [smallpox] IS aggravated by homeless. and famme stricken Wakamba. who are met with everywhere wandermg about m search of the necessities of hfe. many of whom are stricken with the disease. and are carrying it from place to place. Owen W. E. The Kavirondo practice of inoculation with smallpox. Kenya Med. J. 1, 333-5, 1925. Leakey has claimed that the Kikuyu practiced maculation. He states that during an epidemic certam men. who were already immune to the disease. were appointed as Inoculators. These men would go around to the isolatlon huts and collect pus from the pustules of recovering smallpox victims. Then they would visit other homesteads and maculate those who desired it [41, pp. SS(rl]. I have interviewed two men who were themselves Leakey’s “inocu1ator.s” dunng the 1897-1900 famine-epidhmic. They have repeatedly stated that their Job was only to pierce people’s pustules with thorns, but that they never would touch anyone who did not have the disease. Mukuhi wa Karari, 9/27/78. 9/28/78. and Nduati wa Kaguamba. 10/3/78. 1014178. See. for example. Fort Hall District PolitIcal Record Book. pp. 5. 9. PCICP 11’711.1909-20. East A&a Protectorate. Annual Me&al Report, p. 24, 1912 (Hereafter cited EAP. Med. Rep.). Meru Distract Annual Report. P. II. MRUII. 1913114 (hereafter D.A.R.). _ . Nveri DA.R. NYIII. 1912-13 Ei.P. Med. Rep.. p. 41. 1913. E.A.P Med. Rep., p. 16. 1916. Ukamba Province Annual Report, p. 32. PC/CP 4/2/Z. 1918.‘19(hereafter P.A.R.). E.A.P. Med. Rep.. p. 16-17. 1918. Ukamba P.A.R.. p. 32. KBU/lO. 1916117. Ukamba P.A.R.. p. 18. PC/CP 41211, 1909-10. E.A.P Med. Rep, pp. 33. 35. 1915. Nyanza P.A.R. 1909110. Nyanza P.A.R.. p. 22. 1915116 Klsumu D.A.R.. p. 14, CNII. 1916~17. E A.P. Med. Rep.. 1919 Leakey L. S. B The Southern K~krcyubefore /~03. Vol. I. pp 19. 44 Academic Press. New York. 1978 Klsumu P.A.R.. p. 3. 1905/06. Nyanza P.A.R.. p 24. 1914115. Great Britain. Foreign Office. Confidential Prmts. Africa F.O. 403. vol. 318, Enclosure m No I2. Reporr
Brrwetw Nu~rohr. Mhrrrl. und K~rw. By Dickinson B. p. Il. 1901. 1917- I3 Testimony 63. E.A.P. Ntrr~re L&our Commr.~s~o~~. of Hollis A. C.. p. 3 64. E.A.P. Annual Report 1908/09. C.O. 544. 65. Kenya National Archives. TC246 MH I ‘17344,Letter from Ross P. H to P.M.O.. 6124116. for 66. Coast Province Arctuves. M P/78 I9 I3-L&w Mrwupa E,srures. Letter from Hobley to Lagett. 3/15,‘13 67 Orde-Brown G. St. J. Tile VLlnrshinyTrrhes of K;rtlylr. p. 182 Negro Umversltles Press. Westport (CT). 1970 (1925). 68. The other four had already had the disease. 69. Kenva National Archives. TC27l MD87,/1916. Letter fro& Hospital Compounder. Native CIVII Hospital to S.M.O. Ukamba Province 10/20/18. 70. Patterson W. J. Some Medical Aspects of the East Afrocan Campaign. M.D. Thesis, University of Edinburgh. 1919. 71. Kenya P.A.R.. p. 13, 1916-17. 72. East Africa Protectorate. Narrohi Sunrrary Conrmisslon 1913. Report. Evidence. etc. Appendix 1. Evidence. p. 56. 73. Ukamba P.A.R. PC/CP 4/2,‘l. 1914115. 74. E.A.P. San. Comm.. I91 3. ADD. . . I. .D 9 and Part 1. Report, p. I I. 75. Kenya Natlonal Archives TC27l MD76/I916. no. 137 Letter from PInIp H. R. A. I l/l l/16. 16. The 1909 epidemic broke out m the vdlage on the Nairobi River which had a rough population density of 6000 people per square mile. and then spread to the Bazaar [53]. The 1916 epldetmc or&mated In the Bazaar area and rapIdly spread to River Road. See Kenya National Archives TC259 MHl/ 18244. Notice from Dr Radford. Prmcipal Sanitation Officer, 2/23/16 71. The fact that Nairobi acted as a dlssemmator of dlsease to the rural areas cannot be doubted, but whether Nairobi was being Infected from other rural areas and then passmg the disease on is still a question up for examination. 78. For example, E.A.P. Nairohr Lab. Rep. 5. 5. 1914. 79. For example, see vaccmation returns m Nyanza P.A.R., p. ‘2, 1915116. 80. Nairobi Lab. Rep. 8, 221, 1917. 81 Cagnolo C. The Akikuyu. Their Customs. Tradwns. and Folklore. p. 254. Mission Prmting School. Nyeri. Kenya. 1933. 82. E.A P Med. Rep.. p. 31. 1916 on Country