Arguably the deadliest disease across human history was smallpox, a disease so old that 3000 year old Egyptian mummies bear its telltale scarring. Its worldwide eradication in 1980 took centuries of public health advances, which New Brunswick played an important role in.
Smallpox was a horrible disease. A victim would get small white dots appearing on their tongue, and within 24 hours all across their body their skin would erupt in giant red pimples oozing black pus. If they survived they would almost certainly be scarred for life. Many did not survive; 3 out of 10 who got smallpox would die.
Vaccines are commonly thought to have been invented in the 1700s in Europe. However, long before that, some of the general principles behind them were understood in China (since the 10th century), India since the (8th century), Turkey (since the 17th century), and Africa.
In China people would grind up dried up smallpox scabs and blow the powder up patients’ noses. In Turkey a small cut was made in a person and a little bit of pus from someone else’s smallpox pimple was rubbed in. These methods would give people smallpox, but, if all went well, it would be a milder version, which would prevent them from getting smallpox in the future.
The first mass-vaccination campaign was much later in Boston in 1721.
Smallpox outbreaks had decimated Indigenous populations across the Americas, with some estimates suggesting that up to 90% of the pre-contact population was wiped out, and regular outbreaks were common in New England.
Smallpox again arrived on a ship that year, immediately causing a mass outbreak. Within months hundreds of people were dying.
Puritan intellectual and Minister Cotton Mather had been interested in inoculation (the early word for vaccination) after being told about it by one of his slaves, Onesimus. He later recounted that Onesimus, who had been given to him as a “gift” by his congregation, had “told me, that he had undergone an Operation [as a child, in Africa] which had given him something of the Small-Pox, and would forever preserve him from it.”
Cotton Mather found that, following Onesimus’ instructions, if one used a needle to take pus out of an infected person, then graze the skin of an uninfected person with it, the patient would get sick but make a full recovery in a week, and not catch the disease ravaging New England.
He tested it on his own children, a testament to the desperation of parents: 80% of children who got smallpox died.
Cotton Mather began promoting mass-inoculation in Boston.
It was met with widespread, and violent opposition. The controversy took religious dimensions. Pastors like William Cooper, felt the pandemic was punishment from God and interfering might “provoke Him more.” However Pastors like Benjamin Colman argued that “God was to be discerned in nature as well as revelation” and that scientific advances like vaccines were sent from God.
Others, including doctors, worried about the potential for deadly side effects, both from the inoculation and from the very real possibility of infection, as this was before sterilization and proper hygiene.
In the end, doctors announced that of the un-inoculated who caught smallpox in Boston, 14% had died. Among those who were inoculated only 2% died.
For his efforts, Cotton Maher had a homemade bomb thrown through his window. The note attached to it read: “Cotton Mather, You Dog, Dam you. I’ll inoculate you with this, with a Pox to you.”
In 1796 British Doctor Edward Jenner discovered that if pus from the sore of someone with the vastly less deadly disease of cowpox was placed in a cut of a patient, they would get immunity to smallpox. This was a revolutionary advance in safety.
Responses to this varied widely. Many rushed to get their children vaccinated. However, as before, many remained fervently opposed.
Starting in 1853 Britain passed a series of laws requiring mandatory vaccines against smallpox. In the face of angry reactions and street protests, the laws were watered down to make it voluntary, and outbreaks would continue.
New Brunswick’s first smallpox vaccination may have been performed in 1848, when an outbreak ravaged the Mi’kmaq reserve Indian Island 28, in Kent County, and Dr. John Paddock went to help.
Dr. Paddock wrote a letter to Executive Council (Cabinet) describing that by the time he had arrived most people had fled, with only 25 people remaining. He inoculated 20 of them. Of the inoculated three became sick, but only with mild symptoms, and the spread of the disease stopped. Considering it a success, he begged the government to institute a mass vaccination program.
It doesn’t appear the government replied.
That same year a smallpox outbreak hit Saint John, and Dr. Paddock again launched efforts to vaccinate the people of that city.
New Brunswick mandated mandatory vaccines for schoolchildren in 1902, focusing on more common diseases with lower mortality like mumps rather than smallpox. If unvaccinated children attended school, teachers were fined.
In a 1903 exchange of letters between schoolteacher Mildred Foster and the Chief Superintendent of Education, the teacher inquired about what to do with an unnamed Indigenous little girl who showed up at her Albert Mines school with a doctor’s note saying her health was too fragile to be vaccinated. The Superintendent snapped back demanding to know what she was doing educating Indigenous children in the first place. It appears that after the intervention of a Dr. Marceu, it was agreed to allow the girl to go to school.
16 years later New Brunswick would make a giant leap forward in health, becoming a world leader, largely due to one person who later described his motivation:
“It was in 1917, when The Great War had revealed our weakness in the matter of physical and mental health that I came to the conclusion that the state of things as then existed with respect to Public Health in New Brunswick was unworthy of a province of the great British Empire, and that, if no one else stepped forward to step into the breach, I would, myself.”
Dr. William F. Roberts filled that breach by getting elected as MLA for Saint John and pushing through his idea to create the first ever Department of Health in the entire British Empire.
One of the compromises he made to pass the legislation was to agree to give up his own salary.
Only one month after Dr. Roberts’ Department of Health was created, the deadly Spanish Flu Epidemic reached New Brunswick. Dr. Roberts later recalled: “For nearly four months a literal hand to hand combat with death ensued, with makeshift staff, emergency hospitals, army surgeons, and any and all help that offered could be employed with even a prospect of usefulness.”
The efforts of the brand new Department led to New Brunswick having one of the lowest death rates in the country. Experts from all over North America came to study its successes, and duplicate them all over the continent.
Yet Dr. Roberts and the Department of Health didn’t rest. Almost immediately after the Epidemic subsided, they began mandatory mental and physical health inspections of schoolchildren, and ordered mass vaccinations.
“Before the year 1920 was out, 50,000 school children had been successfully vaccinated and we began to be able to look smallpox in the face,” Dr Roberts proudly told the Legislature.
As well as vaccination, Dr. Roberts’ Department of Health launched preventative health measures copied around the world, like free tests for sexual diseases, school nurses, clinics in rural communities, and free lunches in every school.
Dr. Roberts would be defeated in his reelection campaign by voters angry he had ordered milk to be pasteurized.
Smallpox was finally officially declared eradicated across the entire planet on May 8th, 1980.
