House on Fire Read Free Page B

working in the smallpox eradication program, I visited many villages. In one house I might find a baby, face swollen, eyes closed, breathing hard, with exposed surfaces thick with raised, pus-filled blisters. In such cases I would have to admit that there was nothing to be done. The devastated parents were about to lose the child. The next house might reveal two children lying in the same bed. At first glance they might appear well nourished, though sick with smallpox. However, lifting the blanket would reveal that they were very thin and poorly nourished. Their swollen faces, for just a moment, concealed their starvation.
    In another house a young man might be wearing only a loincloth, because he didn’t want anything touching his face or limbs, which were covered with lesions. His legs were bloody. He was trying not to move, grimacing in pain when he did. Any touch caused the lesions to bleed. His face was contorted with pain; he wanted only to die.
    Each patient was part of a family and a community, yet others could do little to help. There was—and is—no cure for smallpox, and in this sense each patient faced the disease largely unaided. Shift your perspective to a larger scale of place and time, and these individuals become statistics—markers of suffering, but not the real thing. Shift your perspective again and the numbers become changes inflicted on whole cultures, dynasties, and nations, their place in history forever altered by this microscopic organism.
SMALLPOX IN HISTORY
    Until its eradication, smallpox accompanied humans and human cultures throughout recorded history. Lesions are apparent on Egyptian mummies dating from the second millennium B.C.E. In 1979, Dr. DonaldHopkins—instrumental in smallpox eradication in Sierra Leone and later in India
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was allowed to examine the upper half of the mummified remains of Ramses V, who died in 1157 B.C.E. of a disease characterized by a rash. 1 Hopkins concluded that the rash he observed was compatible with a diagnosis of smallpox, although attempts to identify a virus in detached pieces of skin were unsuccessful. 2
    Hopkins details how the virus propagated itself in human populations through the centuries following Ramses’ time, especially in Asia, Africa, and Europe. It came to the Americas with the European explorers, missionaries, and traders, who reported death rates exceeding 50 percent and as high as 90 percent among some indigenous peoples. In one of the saddest chapters in human history, proud, competent, and powerful groups were destroyed as settlers, carrying the smallpox virus and other diseases, moved into their ancestral homelands. From the Eastern seaboard, settlers carried smallpox with them as they moved westward in the 1830s and 1840s. Smallpox also traveled northward from what is now Mexico. The Blackfoot, once the most feared among Native American tribes, were decimated by smallpox. And the disease had, by 1837, reduced the population of the Mandan Indians to 150. 3
    Smallpox played a significant role at key moments in U.S. history as well. In the early battles of the Revolutionary War, American troops were placed at a disadvantage because they, unlike the British, had not been immunized by means of variolation, a prevaccination method then widely practiced in England that uses the smallpox virus itself to immunize. A risky procedure at best, variolation carried much greater risk in low-density populations, where smallpox was a sporadic disease and thus immunity levels in the population were low. The low immunity levels meant that variolation itself could cause widespread outbreaks. During the Battle of Quebec, on December 31, 1775, the Americans outnumbered the British, yet they were unable to sustain their attack because so many were weakened by smallpox. The English prevailed, and Canada remained with England rather than becoming part of the future United States. On February 5, 1777, after more than a year of