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The Story

Sisters on the double front: the war and Spanish flu

30 April 2021

 One hundred years ago the epidemic in the middle of world war I

In Sofia, the capital of Bulgaria, there is a small war cemetery dating back to the First World War. It contains the remains of 201 Italian soldiers, who had been transferred there far from the front as prisoners of the Austro-Hungarian army. When the Spanish flu epidemic arrived in 1918, the huts in the Orlandovtsi camp on the outskirts of the city became a deadly hotbed. Many died, and among them, there were three Italian nuns who had been posted with the troops and were serving in the camp infirmary. The tombstones are there still and recount that sacrifice, and save the memory from oblivion.

A century ago, a conflict and a pandemic converged implacably. The war itself helped the virus to spread, with millions of soldiers (and refugees) travelling from one continent to another, from one front to another, in a flurry of people and supplies. Historians say that the military health service was well aware of the danger of the spread of infectious diseases. Above all, they feared typhus, cholera and smallpox. Instead, an unprecedentedly virulent influenza arrived. To put the virus into context, whereas the war caused 37 million deaths, the epidemic killed at least 50 million, and they were almost all young people between the ages of 15 and 40. Moreover, it was mostly women who died, and probably because they were the ones caring for the sick and consequently infected en masse. However, the Spanish flu story has remained off the radar, and has been rediscovered now that we are confronted with a pandemic with which there is a resemblance. Since then, a century of scientific discoveries, increasingly futuristic technologies and medical advances has come into the world. A hundred years ago, however, when a disease that no one could understand revealed itself, and above all cure, people did what they could. One hundred years ago, like today, it was the doctors and nurses who were sent to the front line, and nuns were amongst them. Eugenia Tognotti, an essayist and lecturer in the History of Medicine at the University of Sassari says, “We must try to place ourselves in 1918”. At the end of the nineteenth century, there had been an enormous leap forward in bacteriology, and the names of the “microbe hunters” were venerated, above all Robert Koch and Louis Pasteur, but science had not yet discovered viruses. So they were groping in the dark about the disease, which brought coughs, high fever, nosebleeds, breathing difficulties, neurological effects, and in many cases proved fatal. How should it be treated? “Since the cause could not be found”, Professor Tognotti replies, “and since there was no really effective medicine available, many treatments were tried, but the only solution that worked was the so-called non-pharmaceutical treatments, referred to today by the acronym NPI. These included rest in a warm place, attention to nutrition, hydration, and hygiene. Since it was thought that the cause could be a bacillus lurking in the mouth, gargling was recommended. To combat the fever, wet cloths were applied to the face and chest. The nuns, and not only those who had been trained in hospitals, played a fundamental role. The Sisters Ministers of Charity of St Vincent de Paul were particularly active in caring for the sick, as it is one of the cornerstones of their congregation. It is impossible to put a figure on it, but it is certain that the Sisters’ presence slowed the spread of the virus and limited the number of deaths.  A similar scenario had already happened in the cholera epidemics that raged at the end of the 19th century. Sister Asuncion Riopedre, the Provincial of the Order of Hospitaller Sisters, a congregation founded in Madrid in 1881 at the instigation of the saintly Benedetto Menni, says, “Originally we looked after women suffering from mental illness, who had been ignored by everyone else. A few years later, however, a cholera epidemic broke out. The Sisters and Brothers were trained how to use the antidote and, with Father Menni’s coordination, they did not hesitate to take care of families in Ciempozuelos at the beginning, and thereafter in other places like Getafe or Chinchón”. The spread of Spanish flu was like an unstoppable windstorm. Health facilities were swept away. In Italy, like other European Countries at war, the combination of the pandemic and conflict prevented effective countermeasures. Even talking about the epidemic was impossible, at least in the early days. Imagine isolating outbreaks, imposing quarantines and mobilising assistance at that time. What the sisters did, therefore, was a spontaneous charitable action, and traces of that can be found scattered in memoirs. Snippets of stories that allow us to glimpse stories common to many throughout Italy, such as that of Sister Fausta Finco, of the Order of the Sisters of Charity of St Jeanne Antida Thouret. In a book dating back to that time, called Opera dell'Ospedale Congregazionale 1915-19, it is recalled that “during the war the Sisters of Charity served as nurses in almost all the hospitals and shelters in Modena and were in close contact with the hospitalized soldiers. Sister Fausta contracted Spanish flu and died in Modena on February 21, 1919. She died a victim of her sense of duty due to illness contracted while in service at the Campori hospital. This was during the flu epidemic; she died after having served for 14 consecutive months, without a single day's interruption. During this time she lavished endless care on soldiers from the front, to alleviate their suffering”.

In the United States, on the other hand, where the management there was firmer and more organised, the sisters’ contribution to the fight against the epidemic was more widely spoken about. In 1919, the Catholic Historical Society of Philadelphia, as The New York Times has recently recalled, published a book in memory of the sisters who had spent so much time bravely in that city. The title of the volume is The Work of the Sisters During the Flu Epidemic. In 1919, the authors wrote, “The nursing forces had been reduced by the war. There were serious shortages in many hospitals. And now it was a matter of life and death”.

Therefore, the Philadelphia Board of Health ordered the closure of schools, theatres, and even the suspension of church services. Yet, that was not enough. Archbishop Dennis Dougherty offered to house as many sick people as he could in the Curia buildings, and called on the forces to gather the priests, the nuns, and the Society of St Vincent de Paul. He asked everyone to look after the sick. He asked the nuns, in particular, to leave their convents. Although they were not very experienced, two thousand answered the call. Wearing white coats and gauze masks, they took care of a large section of the population, especially immigrants from Italy, Ukraine, Poland, China, black families, Jewish families and the poor. All those in need were helped. Religious sisters did not hesitate to enter filthy flats where parents lay dead in their beds and children cried in desperation and hunger.

The nuns in Philadelphia washed clothes, served hot soup, provided water, ice and blankets. “The call ‘Sister!’ could be heard every minute of every night”, said one. Another says, “At first I was afraid. I had never had direct contact with death. However, I realised that someone had to do it. I took my coat, mask, and started my service. The shifts lasted twelve hours. Many became ill. Several died”. A third, “Through this experience, I have come to appreciate my vocation to religious life as never before”.

In Louisville, Kentucky, a huge military camp had been set up and named after the twelfth president, Zachary Taylor. It housed 50,000 soldiers returning from the European front. The chaplain, Brother Regis Barrett, when faced with the catastrophe of one sick soldier in every four, begged the Dominican Sisters of the Holy Rosary to help him. In relentless shifts, each had the task of caring for at least one hundred infected soldiers, struggling with fever, dysentery and vomiting.

Something similar happened in Massachusetts, at Camp Devens, where there too the schools were closed for health reasons, and the teaching sisters devoted themselves to caring for the sick. The annals of the Dominican Sisters mention experiences in New Orleans, Pittsburgh and New York. The Sisters of Mercy were involved in at least a hundred other settings, including Mary’s Hospital in San Francisco. In Canada, the local Morrisburg Leader newspaper’s editorial, dated 1919, reads, “No one will forget the splendid work of the sisters who worked among us. No one knew their names then. All that was known was that help had been requested and that two Sisters of Charity came immediately by train from Prescott. Today, we can reveal that their names were Sister Mary Charles and Sister Mary Ursula”. Morrisburg is an emblematic little story. Eugenia Tognotti comments, “The Spanish flu epidemic was one of the most devastating failures of medical science. The discovery of bacteria had led us to believe that there would no longer be any unknown diseases and that there would be a cure for everything. The flu, however, caused by a virus that would not be isolated until 1933, shattered the optimism with which the 20th century had begun. And this also explains the oblivion that fell on the pandemic, and with it the mighty work of women to assist the sick, nuns included”.

By Francesco Grignetti
A journalist with La Stampa, an Italian national newspaper.