COVID-19: Echoes of the Spanish Flu Epidemic of 1918

Lindinxiwa Mahlasela researches history at Bayworld Museum in Port Elizabeth.

Corona virus reminds us of earlier pandemics such as the Spanish Flu of 1918 to 1920. Medical historian, Professor Howard Phillips observed that the Spanish Influenza was “the single most devastating episode in South Africa’s demographic history” (H. Phillips, 1984). He estimates that 500 000 South Africans died from the pandemic. This made the country the fifth hardest hit by the pandemic worldwide. 62% of the dead were from Cape Province, one of the four provinces that made up the Union of South Africa. The death rate was higher in rural areas, for example approximately 100 000 died in the then Transkei alone. This was largely due to the fact that medical practitioners and other health services were scarce and help was slow to arrive. Some districts didn’t even have a district surgeon. Similarly, Africans who lived in cities were seriously affected by the flu due to poor health services and poor standards of living.

The Spanish flu

Despite being known as the Spanish Flu, the virus started in Etaples, France where more than 100 000 men lived in close proximity with pigs and poultry.

The flu spread to the Kansas in the United States Kansas in March 1918 among troops who were awaiting shipment to Europe to fight the First World War. By June of that year about 43 000 US troops had died from the disease. US army officers deliberately misled their nation and pointed the origin of the flu to Spain because Spanish media was the first to report about the virus. Other European countries allegedly censored news about the virus as they would have disrupted the war efforts. As a result, the epidemic became known as the Spanish flu. The politics of naming a pandemic is again under scrutiny with US President Donald Trump has accused the Chinese government and the World Health Organization (WHO) of deliberately concealing the outbreak of the virus in Wuhan and allowed it to spread throughout the world. Thus, he has repeatedly called it the “Wuhan virus” (CNN, 2020).

Fever, as the Spanish Influenza was called in SA, made its first appearance in September 1918. The South African Army and the South African Native Labour Contingent (SANLC) were returning from the First World War. Two ships in particular, the Veronej and Jaroslav had individuals that had contracted the disease. Dr Wilmot in Cape Town determined that the infected individuals must have contracted the virus in Sierra Leone where the two ships first docked en route to Cape Town. However, due to lack or limited knowledge about the virus at that stage, the positive individuals were kept for examination (quarantine) for a few days and later released. From Cape Town, using the relatively extensive rail network, the returnees took trains to their respective destinations around the country.

In Port Elizabeth the virus came via a train from Cookhouse on the 4th October 1918. Within a period of three days 16 cases of the virus were authenticated by the Medical Officer of Health, Dr John Galloway. In his address he stated that “the source of the infection is clear, either they [the infected individuals] are people who have just arrived ill from the infected towns in the Union, or those who have been in contact with others who have travelled through the infected areas, who have themselves been suffering from the disease” (Eastern Province Herald, 1918). Moreover, he advised people to suspend travelling, avoid visits and public gatherings.

Dr Kay, Port Elizabeth district surgeon advised citizens to ensure that their servants “do not visit New Brighton”, a township that was started in 1903 and had a population of more than 5000 (Eastern Province Herald, 1918). Dr Galloway’s counterpart in Uitenhage, Dr Diermont, advised citizens to ensure that their servants remained on the premises at night. He went further and advised the council to disinfect the townships in order to ensure that they were “thoroughly cleaned” (Eastern Province Herald, 1918). His colleague in the council, Acting Mayor F.T. Couldridge concurred with his sentiments and further suggested that attempts must be made to “get the government to fumigate the railway carriages [because] they are the one of the worst places of infection” (Eastern Province Herald, 1918). The deputy mayor of Grahamstown was more emphatic in regards to avoiding contact between Africans and people of European descent. He observed that “it was easy to ascertain whether Europeans were suffering from the disease, but not the wondering natives. Natives’ movements should therefore be restricted in (Grocotts Mail, 1918).

There were similar comments elsewhere in the Union and they were a clear indication of “renewed sanitation syndrome fears by white residents that infection was spread by black inhabitants” (J.B. Gewald, 2007)  At this point I’m reminded of Zelda de Lange, former President Mandela’s personal assistant. In a Facebook post Zelda advised her friends to teach their helpers how to wash hands forgetting that cleaning has been their role long before the outbreak of COVID-19. Indeed, a video of a white elderly lady teaching black employees how to wash hands went viral on social media. The outcry that the video evoked response to the citizens in 1918: “why, whenever there is sickness of any kind a native has to suffer. We suffered during the rinderpest, bubonic plague, East Coast Fever, etc and now we have to suffer for somebody else’s neglect…when anyone falls into sin or commits an offense is it right to attribute it to the Prince of Darkness because he is the hated one? I think not” (J.B. Gewald, 2007).

As it is the case today, cities were the epicentres of the Spanish flu in 1918. This prompted migrants to run to the countryside. One young man from Cape Town went back home to Tsolo. Upon arrival he attended Intonjane (girl initiation). Unbeknown to him, he had the virus and passed it on to 27 others who were in attendance. All of them died. The hundreds of minibus taxis from the cities that were transferring migrants to the Eastern Cape to attend funerals and other ceremonies are a reminiscent of this story. As a result, 40 villagers in Port St Johns who attended a funeral are COVID-19 positive.

Mitigating Spanish Flu

Henry Forbes, mayor of Port Elizabeth in 1918 called upon citizens to volunteer their services and save the city’s citizens from the epidemic. Volunteers, some of whom were qualified health professionals worked in temporary hospitals that catered for white patients. Makeshift hospitals included, Old Provincial hospital in Richmond Hill, Lazaretto in Humewood, Feather Market Hall, Village Hall in Red House, New Provincial Hospital in Gabson Street, Seaman’s Institute South End, Russel Road Fire Station and North End Library. A depot was set up in New Brighton to dispense free medication.

Patients were given a whole lot of concoctions. E.W. Wells & Co Chemist in Makhanda offered “Well’s Influenza Mixture” (Grocotts Mail, 1918). Needham Chemist in Port Elizabeth had its own influenza mixture. The ever reliable umhlonyane, chamberlain, Epsom salts, quinine, BOSS, German cure, and Iyeza lefiva mixture from Mthatha chemist were some of the popular medications. Commando brandy was recommended in some quarters. Red House makeshift hospital in Port Elizabeth gave its patients champagne and did not record a single death!

Unfortunately, some volunteers contracted the virus and died from it. They included the wife of Port Elizabeth district surgeon, Dr Kay who himself was infected. In 1923 the Council honoured them by unveiling a plague that was designed by Mr Pickford Marriot.

Schooling, church services, theatres, and all activities that brought large groups of people together were suspended. Lockdown!

District surgeons advised people to ensure that they have enough fresh air in their houses. Additionally, they advised people to enjoy sunlight. Township dwellers were not able to practice some of the advices due to the structural issues in the township. For instance, New Brighton houses were made of zinc and extremely hot in summer. Inhabitants were unable to enjoy the fresh air just like social distancing is proving to be impossible in many townships today.

Although there was no vaccine, the Union government dispatched to the army to vaccinate people in rural areas of the Transkei. This was rejected in most parts on the basis that the government was actually injecting the people with the virus in order to wipe them out!  

What were the effects of the Spanish Flu?

  • The report of the influenza epidemic commission indicates the following:Just over 2000 citizens died in Port Elizabeth. The number of Africans is unknown. However, Eastern Province Herald on 8 October 1918 stated that “as was only to have been expected, its [Spanish flu] greatest ravages have been at New Brighton.” This indicates that the number of Africans was higher than those of European descent.
  • In Makhanda, Grocotts Mail reported a “rough estimate” of 1000 casualties at the height of the epidemic in October 1918
  • The Mayor of King Williamstown said that 7000 people died in his district.


The total number of South Africans who succumbed to the disease had since been a matter of interest to historians. The census of 1921 reported that the population was 500 000 less than expected from the last census in 1911. They attributed the shortage to the fever of 1918- 1920. Liberal historiography casts doubt on this figure.

The report of the commission of inquiry to investigate the effects of fever in 1919 would help to shed more light on the effects of the flu. Sadeck Kemal Casoojee, the man in charge of the retrieval of a lot of assistance during the writing of this article.

Memorializing Spanish Flu

Caluza composed a choral music song whose lines; “in the year of 1918 we were wiped out by a disease which they call influenza. It took friends which we loved, mothers, fathers, sisters and brothers” served to memorialize the destruction of 1918 (M. Vabaza, 2018).

Izithwalwandwe -President Mandela and Albertina[1] Sisulu- were born “ngonyaka wefever” (the year of the influenza) (N.M. Mahlasela, 2018). Amongst the AmaXhosa, years are marked by iziganeko (great events). We have Unyaka Weenkumbi (year of insects), Unyaka Wesimnyama (lunar eclipse) and many other events.

Names and nicknames were used to preserve historical events. For instance, an old man in my village was nicknamed “Ngowawufile” (M. Potelwa, 2018). His response would be “Ngo 1818 ENyubrayithi” (N. Siguba, 2018). I never got to interview the old man about this. However, I assume that “ENyubrayithi” is New Brighton and 1818 is 1918 a year which I assume was the year of his birth. It has since been confirmed that he had a connection with New Brighton. Similarly, the virus got many IsiXhosa names, umbathalala, ifiva, umalaleveva, etc.

The tradition of washing hands after the burial is said to have emerged during the Spanish Influenza epidemic. It is said that after the burial of the Influenza victim people were required to wash their hands to curb the spread of the virus because it was as contagious as the COVID-19.

Bayworld Museum lends its voice and calls upon South Africans to observe lockdown regulations.