A Reluctant--But Necessary--Parody

 

Jeff–Saturday

 

I enjoy doing parodies of great poems. The exercise detaches my thoughts from reality, no matter how thorny the subject matter may be–a process some might argue, in my case, has proven irreversible.  Here’s my reworking of Reluctance a particular favorite of mine by Robert Frost. Its putative metaphor relates to the change of seasons, something soon to be upon us. My version addresses something already upon us.

 

Here’s my version of Reluctance:

Out through the streets and the hoods, Past folk living where I have traveled, I’ve witnessed the passing of those Among both the rich and the bedraggled, Left to face their fate all alone, As each life unraveled.   Many are gone now from the earth, Even more struggle to survive, Cursing as they battle An enemy well equipped to thrive On souls not believing that Jabs will keep them alive.   As the not-yet-dead lie lost and still, Their minds drifting to what might have been Had they listened to science– Not trusted the cursed false prophets’ din; Now in their fervent prayers to live, We join in as next-of-kin.   For let us never forget, That in this battle we’re related, By a single urgent truth: End Reluctance, be elated, True salvation lies for all In getting vaccinated.

 

And here’s the other guy’s original version.

 

Reluctance   Out through the fields and the woods And over the walls I have wended; I have climbed the hills of view And looked at the world, and descended; I have come by the highway home, And lo, it is ended.   The leaves are all dead on the ground, Save those that the oak is keeping To ravel them one by one And let them go scraping and creeping Out over the crusted snow, When others are sleeping.   And the dead leaves lie huddled and still, No longer blown hither and thither; The last lone aster is gone; The flowers of the witch hazel wither; The heart is still aching to seek, But the feet question "Whither?"   Ah, when to the heart of man Was it ever less than a treason To go with the drift of things, To yield with a grace to reason, And bow and accept the end Of a love or a season?   –Robert Frost

--Jeff

PS.  Just a subtle reminder that this month my tenth Chief Inspector Andreas Kaldis novel, THE MYKONOS MOB, is available across all e-book formats for $1.99 via this link.

LET THE TRAVELS BEGIN (AGAIN)

 Now fully vaccinated with the Moderna vaccine, I am once again ready to travel, and this season will be a busy one. Of course, it was impossible to do any travel during 2020 to travel to Ghana to research the third Emma Djan novel called LAST SEEN IN LAPAZ--that's Lapaz, Accra, not La Paz, Bolivia. However, having to stay home in 2020 facilitated my finishing Emma #2, SLEEP WELL, MY LADY in record time, as well as starting on LSIL, which I'm scheduled to turn in to the editor on or before July 1, 2021. The deadline looms large!

Now that I've passed the halfway point writing LSIL, I know which areas of research I need to focus on. In addition to the standard visit to Ghana, I need to travel to Nigeria and Niger, because substantial portions of the novel take place in these countries. You can get an idea of my itinerary from the map below, which is numbered in sequence according to the destinations during the trip.

So, for your reference, I will be in Lagos and Benin City, Nigeria, for ten days in July; Niamey and Agadez, Niger, for eight days; and Ghana for the remaining four weeks or so.

My destinations in West Africa (edited, original image Shutterstock / Porcupen)

I went to Nigeria as a small child but remember little to nothing about the trip, so Nigeria will be a new experience for me, as will Niger. The issue with these two countries is that neither scores high in the safety category. The US Department of State puts Nigeria at its Level 3 warning: reconsider travel; and Niger earns a Level 4: do not travel.

Then, why am I going to these two countries? I considered not doing it, but anyone can do Google and YouTube research. I believe I owe readers a lot more than that. Being "afraid" to travel somewhere is not going to cut it. On the other hand, I'm not throwing caution to the wind. I've secured a guide and escort to be with me at all times in both countries.

The unofficial jacket cover copy will help you understand what I'll be looking into during my travels.

When Nnamdi Ojukwu’s daughter Ngozi elopes with boyfriend Femi, Nnamdi appeals to Emma Djan and her detective agency boss to investigate Ngozi’s whereabouts. Weeks later, Femi is found murdered at his opulent residence in Accra, but Ngozi is still nowhere to be found. How is she connected, if at all, to Femi’s killing? As Emma digs further, she discovers Femi was part of a horrifying network of sex traffickers in Europe and several West African countries. Migrants from Ghana, Nigeria and other West African countries are duped into thinking they are on their way to success and riches in Italy. But once there, they are manipulated into prostitution with little chance of escape.

As successful as Femi has been, he has made a lot of enemies, all of whom have had possible motives to murder him. The question is, which one of them did it? Not only does Emma have to hunt the killer down, she’s in a race against time to find Ngozi—that is, if she’s still alive.

As you can see, LAST SEEN IN LAPAZ tackles the complex and uncomfortable subject of human and sex trafficking with scenes in Ghana, Nigeria, and Niger. The West Africans one sees on TV attempting to cross the Mediterranean, sometimes perishing in the process, depart mostly from the shores of Libya, but they originate primarily from Nigeria, and to a lesser extent from Ghana, Côte d'Ivoire, Burkina Faso, and Mali. Agadez, in Niger, is the legendary transit spot for migrants before they make the hellish trip to Libya across the brutal Sahara desert, which is fraught with danger from armed gangs, the intense heat, and the threat of dehydration. Needless to say, I'm not going to Libya.

Migrants crossing the Sahara packed into a pickup truck (Shutterstock/Torsten Pursche)    

Many migrants get stuck in Agadez or Libya because they find they don't have enough money to proceed. Sometimes, it takes months to gather the wherewithal to continue on. During that time, they may be subject to physical and sexual brutality, particularly in Libya. If and when they get to Italy--surprise, surprise. Contrary to the glowing picture painted of making tons of money working in a store or being a travel guide, migrant women discover they will be working as prostitutes for the "madam" who paid for much of their arduous journey. Now they owe her money--lots of it. The madam is often a woman who has been a prostitute herself. The blatant disregard for human life in this trafficking world is quite stunning.

Migratory routes from West Africa to Libya

Regardless of the present, this region of Africa holds a long and storied past--periods of epic achievements in culture and learning on the one hand, but strife on the other. Apart from researching for my novel, I'm hoping to make a connection with aspects of West Africa's history.

In addition, there'll be something new: I will be vlogging my journey, allowing for any slow or absent Internet connections I might encounter in different locales. My vlogs will be on YouTube. It's going to be quite an adventure.

The Man—and Woman—Who Beat Smallpox

Edward Jenner vaccinates James Phipps, 1798

Zoë Sharp

If you have a scientific bent, you have probably heard of Edward Jenner, an English surgeon and scientist who is credited with the discovery of vaccination against smallpox. Born in Gloucestershire in 1749, Jenner was the eighth of nine children of the local vicar and his wife. Jenner was apprenticed at fourteen to a surgeon and in 1770 he moved to London to complete his training.

 

Two years later, Jenner returned to Berkeley in Gloucestershire to become the local doctor and surgeon. One of his regular tasks was to help guard his patients against smallpox by a procedure called variolation. (And I’ll come back to this later.)

 

Smallpox got its name in 16^th Century Britain, to distinguish it from syphilis, which was known as the ‘great pox’. It is a highly infectious disease caused by the Variola major and Variola minor virus variants. Nobody knows exactly where it came from, but some of the earliest instances have been found in Egyptian mummies from the 3^rd Century BCE. During the last hundred years—up to the last known naturally-occurring case in 1977—smallpox is thought to have killed 500 million people, with approximately 300 million of those deaths taking place since 1900. The overall mortality rate was thirty percent, although some strains of the disease were noted to be almost invariably fatal.

 

In Edward Jenner’s time, outbreaks of smallpox across Europe accounted for one third of all cases of blindness, and 400,000 deaths a year. But, for some years Jenner had been intrigued by local country lore which claimed that dairymaids never got smallpox.

 

This was because they tended to catch cowpox, which appeared to offer them protection against smallpox. Cowpox is a mild viral infection in cows, causing a few similar symptoms, although to a far lesser degree and without apparent discomfort. Humans developed a few weeping pocks on their hands and felt unwell for a few days.

Edward Jenner

 

When Sarah Nelmes, a local dairymaid, came to see Jenner in 1796 with pocks on her hand, the doctor took the opportunity to gather some of the pus. He tested his theory on the eight-year-old son of his gardener, a boy called James Phipps, by making scratches on one of James’ arms and infecting these with some of the material from Sarah’s hand.

 

A few days later, James developed mild cowpox, but soon recovered. Six weeks later, Jenner inoculated the child with smallpox, which had no effect. Jenner concluded that James was now immune, and to prove his theory, inoculated the poor kid another twenty times. James never caught the disease, which might be considered reward enough, but Jenner later gave him a free lease on a cottage in Berkeley.

 

Jenner published an account of his vaccination of James Phipps in 1798, becoming the first person to do so, although he was not the first to carry out vaccination using cowpox. Most notably, Benjamin Jesty of Dorset in 1774, inoculated three members of his family, and Peter Plett from Kiel in what is now Germany in 1791, inoculated three children.

 

Up until the new method of vaccination with cowpox became the norm, the only protection against smallpox was variolation. (See, I promised I’d come back to that.) This practise developed in Asia, possibly as early as the 16^thCentury. It involved exposing someone to a very small dose of smallpox—taken either from a smallpox patient, or a recently variolated patient. The idea was that this person would contract a mild form of the disease, and would then be immune.

 

Usually, scabs from the smallpox pustules were dried and then blown up the nose of the person being inoculated, which sounds delightful. It wasn’t without risk, either—between one and two percent of those receiving variolation died as a result. Still better odds than catching full-blown smallpox, however.

 

By 1700, variolation had spread from Asia to Africa, India, and the Ottoman Empire. It was in Constantinople in Turkey that Lady Mary Wortley Montagu first learned about variolation. Lady Mary (1689-1762) was the wife of the British ambassador. She survived a bout of smallpox in 1715, but had suffered the subsequent scarring. Her brother had died of the disease two years earlier.

 

Lady Mary Wortley Montagu

Perhaps because of these events, she was keen to protect her own children. In 1718, while still in Turkey, she had her five-year-old son inoculated by a process of ‘engraftment’—inserting smallpox under the skin. This was carried out with the help of Charles Maitland, the surgeon at the Embassy. Her daughter was too young to undergo the procedure at the time. It was only after Lady Mary returned to England, and a smallpox epidemic broke out in 1721, that she had her daughter inoculated by this process of variolation, named after the smallpox virus itself. Again, Charles Maitland carried out the procedure—the first in Britain—which was much publicised.

 

Sadly, it was also greeted with much condemnation from the exclusively male scientific and medical communities. They were unimpressed by the fact that, in Turkey, variolation was usually carried out by elderly women with no education. Lady Mary was able to convince the Princess of Wales, Caroline of Ansbach, to take it seriously, however. In August of 1721, seven condemned prisoners awaiting execution at Newgate were offered variolation as an alternative. Not surprisingly, they accepted. All survived the experience, and were released.

 

In the East, inoculates knew that they must self-isolate after undergoing variolation, as live smallpox was used. In England this was not always understood or advised by medical practitioners. Nor was the dose of smallpox being administered always as tiny it was supposed to be, and some doctors bled and purged their patients unnecessarily. As a result, there were a number of deaths and complications. Politics and misinformation became involved, and Lady Mary’s reputation suffered as a result.

 

Nevertheless, having introduced smallpox inoculation to Western medicine, she continued to campaign for its widespread implementation. Edward Jenner built on the foundations of her work to come up with his vaccine. By doing so, on May 8^th 1980, the World Health Assembly announced that the world was free of smallpox.

 

This year, it is 300 years since Lady Mary’s three-year-old daughter, also Mary, became the first person in the West to be protected against a deadly virus. To celebrate, award-winning TV drama and comedy producer, Jo Willett has penned a new biography of Lady Mary, celebrating the remarkable life of this early feminist among the greatest politicians, writers, artists, and thinkers of her day. Sounds like a brilliant story.

 

THE PIONEERING LIFE OF MARY WORTLEY MONTAGU: SCIENTIST AND FEMINIST

 

This week’s Word of the Week is vaccination, created by Edward Jenner to describe his new treatment against smallpox. It comes from vacca, Latin for cow, from the cowpox virus Jenner used. (Although, Jenner experimented with horsepox virus as well, and when vials from 1902—which had contained the oldest known strains of smallpox vaccine—were subjected to DNA sequencing in 2017, scientists discovered it was more closely related to horsepox. So, perhaps that should be equusination?)

BACK TO NORMAL? ARE WE SURE?

Wednesday--Kwei

What's "normal?"

As Covid-19 vaccination slowly progresses in the US and worldwide, I keep hearing the question, "When will we return to normal?" But what's "normal," and are we sure that's what we want?

Meetings

It seems a long time ago, although it's only a year or so, since I last went to an in-person meeting. These took place in formal settings or over coffee, lunch, or dinner. All that was fine, but my main beef, especially in a place as sprawling and traffic-ridden as Los Angeles, was that a one-hour meeting didn't seem worth a round trip travel time of 2-3 hours on the freeway. Very often, the return trip lasts even longer than the inbound if you hit afternoon to evening rush hour, which is exactly when you're dying to get home.

Los Angeles traffic (Shutterstock/egd)

Studies indicate that when cars wait in traffic at an intersection, large amounts of particulate pollutants can enter the vehicle if the windows are open and/or the fan is drawing air in from the exterior. 

Apart from this, we're all aware how traffic jams can grate on one's nerves. I think it's generally agreed that it is not good for us mentally, and physically it's not the ideal either: sedentary hours sitting in one place takes a toll on the body. Take a look here at the bad list.

A social date is one thing, but for business meetings, I am quite comfortable on Zoom or any of the equivalent platforms. If you want to get me across town to meet up in person for a business meeting, there had better be a compelling reason.

Book discussions

I won't pretend virtual book clubs or bookstore signings are just as satisfying as in-person appearances. They lack the same kind of human warmth and interaction that a "live" event has. Additionally, the pleasure of physically signing books while meeting old and new readers at a book launch can never be duplicated on a Zoom, e.g. it's great to finally meet in the flesh people who have been following you or communicating with you online. 

On the other hand, let's face it, you can do two or more Zooms in a week without having to get in a car or on a plane or train or having to check into a hotel somewhere. In this way, I quite frankly saved a lot of money during 2020. One of my last in-person appearances before lockdown was on February 26, 2020, at the Ivy Bookshop in Baltimore, where I had a lovely book meeting hosted by the bookstore and our own Sujata. It was great fun, and no virtual event is ever quite as good.

A group of readers with Sujata and me, Feb 2020

Entertainment

Many years ago, I was a regular movie-goer. However, even pre-Covid,  I became squeamish about the state of cleanliness of the theater seats. Sometimes the theater smelled a little stale, and since it's half dark in there, there was no telling how clean the place really was. Do they wipe the seats down? If so, what do they use as a cleanser? Since Covid-19, that icky factor has grown 10-fold for me. I doubt I'll be returning to movie theaters for a while--certainly not in the manner I used to. So that's one "normal" I'm not really going to miss. I don't know about you, but when I look at this photo of a packed movie theater, I can't help automatically cringing somewhat. It's a learned reaction response. Where're all y'all's masks?

Movie theater in Thessaloniki, Greece, 2014 (Shutterstock/Ververidis Vasilis)

Travel

It's true that some cities have marvelous public transportation systems and that in many cases you don't even need a car the way one does in Los Angeles--I think of London, New York, Milan, Paris, Tokyo, Stockholm, etc--and in fact it's sometimes much cheaper and less of a hassle not to have a vehicle. 

I've long admired cities with excellent public transport. But in the future, will I be willing to get on one of those subway trains? It depends. This one looks fine:

Tokyo metro with distancing and masks (Shutterstock/Fiers)

This one, not so much. Maybe with a mask and full vaccination.

Crowded London Underground train December, 2020(Shutterstock/Yau Ming Low)

Restaurants, bars, etc.

I feel sorry for establishments that depended mostly or exclusively on eat-in dining and have had their businesses gutted by the pandemic. Many have adapted, while others have been unable to do so for one reason or another. I'm not much of a restaurant-goer, but I'll be more than happy to return to my few favorite restaurants if they have outdoor seating or indoor spacing with good ventilation. Some places have spent a fortune making these adjustments only to be shut down again with a new set of city or county rules. It's been tough for them.

Diehard fans of bars will likely return to "normal" because they never actually changed their behavior in the first place. Throughout the pandemic, a breed of hardcore party people, who would rather be killed than never party again, has failed to become extinct. Remember those wild Hollywood pandemic parties?

Handshakes and hugging

The handshake is one I will not miss. Why did people shake hands anyway? You can bow your head, nod, smile, wave, anything. But stop with the handshakes. Well, there's one handshake that's still fun: the 

Ghanaian one.

As for hugging--well, okay, I'm not the touchiest-feeliest kinda guy, but seriously, I think it was getting a bit much, don't you? Embrace your immediate family or bf/gf, but everyone else? They'll be fine. In general, lower your hug quota, i.e. you don't have a lot to go around, kinda like advance review copies.

Anything you will miss, or not, post-pandemic?

Disease Fighting Woman: Mary Montagu

Annmaria on Monday

Lady Mary Wortley Montagu did not invent inoculation.  She found out about the practice in the 18th century, from Turkish women.  Sad to say, history did not record the Turkish women's discovery, so we cannot laud them for their priceless contribution to disease prevention. But at least, today, I can set the MIE record straight on part of the contribution of women to this critical endeavor.

Last Wednesday, my colleague Kwei Quartey told us about early advances in immunization, beginning with the Scots physician Edward Jenner's fight against smallpox.  A brilliant contributor, no doubt, but Jenner was only thirteen years old when my entry into this pantheon. Lady Mary Wortley Montagu died.  She had already brought inoculation to England.

Lady Mary and Alexander Pope

I first learned about Lady Mary while studying 18th Century lit with my mentor and forever hero Sister Mary Catharine O'Connor PhD, PhD.  (Aside: This is not a typo.  This woman who had entered the convent at fourteen had two PhDs, both from Columbia University!) While teaching the works of Alexander Pope, SMC, as those who still love her called her, told us of Mary Montagu - her relationship with Pope and her many accomplishments.

Therefore, I already knew about Mary Montagu's medical exploits when Kwei told us, last week, about Onesimus, an African slave, who introduced the Bostonian Cotton Mather to the technique of inoculation.  Kwei quite rightly decried the fact Onesimus was left out of the history he had had read as a child.  Stan also quite rightly blamed Eurocentrism as the culprit.  I applaud anyone who corrects the historical record, especially when it comes to the almost total emphasis on the accomplishments of the white men.  Today I am here to correct the record on behalf of Lady Mary, a largely ignored woman when it comes to fighting disease.

Mary Pierrepont - born 15 May 1689 - aristocratic, beautiful, powerfully intellectual, owed her accomplishments entirely to herself.  Ignoring the "superstitious tales and false notions" that her governess tried to foist upon her, Mary, as a child and young woman, spent just about all her waking hours everyday in her father's extensive library, teaching herself Latin, mastering the classics in many subjects, and beginning extensive correspondences with a couple of Bishops who added to her self-education.

A celebrated beauty, even as a small child, she was on her way to being auctioned off to the highest bidder. Her father was putting the finishing touches on her marriage contract: an alliance with the most valuable possible suitor, a man with the absurd name of Clotworthy Skeffington.  But Mary was already in love with a friend's brother, Edward Wortley Montagu.  Just in the nick of time, the young couple eloped.

In the early 18th century, smallpox was a huge curse on humanity.  Intensely infectious and deadly - it killed twenty-five percent of the people who caught it.  Those who got out of it alive remained disfigured with scars.  Standard medical practices at the time included purging with emetics and bleeding, either through cuts in the flesh or the application of leeches.

Just a year after Lady Mary married, her favorite brother died of smallpox.  Two years later (1715), she herself contracted the dreaded ailment.  She survived, but her legendary beauty was spoiled.

 Meanwhile, her husband's career was going well.  He was named Ambassador to the Ottoman Empire.  She and their children went with him to Constantinople.  Her greatest claim to fame today comes for the letters she wrote while there.  As a woman, she was allowed to visit the women's quarters in Turkish court homes.  She wrote into the record vivid first-hand accounts of how those women lived.

She also learned how they prevented smallpox.  By taking live bacteria from the mildly infected and scratching it into the skin of well people.  Women practiced this technique.

Intent on protecting her own children, she talked over the issue with the British Embassy Surgeon, Charles Maitland.  Though he wasn't exactly keen on the idea, he did agree when she decided to have her nearly five-year-old son inoculated.  Young Edward Wortley Montagu was the the first English person ever to receive such a preventative treatment.  As was the ordinarily the case, the boy became mildly sick, recovered in a few weeks, and was safe from smallpox for the rest of his life.

Caroline, Princess of Wales

The family was back in England in 1721, when a major outbreak occurred.  Maitland, also then in London, agreed to inoculate Lady Mary's daughter - the first time such a treatment was used in Britain.  The medical profession was outraged.  But sisterhood took over.  Lady Mary convinced the the Princess of Wales, Caroline Ansbach to sponsor a test of the procedure.  Seven prisoners awaiting execution in Newgate Prison got an offer they couldn't refuse.  If they would agree to inoculation, they would earn their release.  They all survived and lived free.  The outcry against the procedure ramped up.  But the women involved stuck it out.  The Princess had Caroline and Amelia, her two daughters inoculated the following year.  In Russia, Catherine the Great herself and her son Paul, the future Tsar were inoculated later in the century.

In those early days, when the procedure was in its infancy, there were some dangers.  A small percentage of the people treated did develop serious cases.  But most lived on with immunity.

When Lady Mary died in 1762, Edward Jenner was still a child.  He did, as Kwei reported last week, develop a safer protection against smallpox using cowpox bacteria.  I maintain that these later improvements, while certainly great achievements, would not have been possible were not for the pioneering work done by the anonymous Turkish women and Lady Mary's insistence that the technique had merit.  They led the way.  The men who came along later built on the base of the women's idea.  And took the credit.

VACCINES--HOW A MILLENNIA-OLD LIFESAVER WAS, AND STILL IS, CONTROVERSIAL--Part 1

Wednesday--Kwei

In the era of Covid-19, we've heard a lot about vaccines and the international race to produce one. However, even if a successful vaccine emerges relatively quickly in the US, studies suggest that only 30-40% of Americans will accept the vaccine. In other words, hurry up and wait. The joint NIH-Moderna Phase 3 trial, which shows a lot of promise, has just hit a snag because they haven't enrolled enough African Americans and Latinx subjects. Because of a long and shocking history of unethical experimentation on black people by white doctors, e.g. the Tuskegee Syphilis Study of 1932-1972, black people's response to the suggestion of taking part in anything remotely experimental has been mostly, hell, no.

Terminology

Vaccination, inoculation and immunization are often used interchangeably, but there are distinctions:

• Inoculation is the introduction of an infectious agent or toxin designed to produce an immune response without overt illness.
• Vaccination is a specific type of inoculation named by Edward Jenner in reference to vaccinia, which is cowpox. Vacca is Latin for cow.
• Immunization is development of immunity by any means, whether artificial or natural.
• Variolation: the deliberate inoculation of an uninfected person with pustular matter containing the smallpox virus.

Famous Infection Fighters

When I was a nerdy teenager, I loved to read murder mysteries, but my other interests ranged from philosophy to science. I recall being riveted to a paperback that chronicled the history of how scientists discovered bacteria and viruses, and the luminaries who marked the milestones along a fascinating journey that included the development of vaccines. We're talking about Louis Pasteur, Robert Koch, Alexander Fleming, and so on.

My vivid imagination took me back to those bygone centuries when people ignored or misunderstood clues that science freely thrust under their noses. In May 1796, Edward Jenner, in an experiment that would have been deemed unethical in modern times, inoculated an 8-year-old boy, James Phipps, with fluid from a fresh cowpox lesion on the skin of a milkmaid. For years, Jenner had heard milkmaids say, “I shall never have smallpox for I have had cowpox. I shall never have an ugly pockmarked face.” Now Jenner wanted to see if that was true.

 

Edward Jenner vaccinating James Phipps, 1796 (Image: Everett Historical/Shutterstock

Over the next 2 weeks, Phipps had mild flu-like symptoms, but when exposed to the highly infectious smallpox, Phipps was protected from contracting the disease.  Jenner then did a little promotion of his vaccine, basing the word on vacca, Latin for "cow." The 30% lethality rate and horrendous optics of smallpox drove the urgency of finding a cure or prevention. If a person survives, smallpox leaves the most appalling scarring--enough to make one suicidal.

Child with active smallpox (Image:CDC/James Hicks)

Nothing Really New Under The Sun

However, Jenner wasn't the first person to use the inoculation technique against smallpox. Variolation, introducing a person to smallpox material from a patient in the hope that a mild, but protective, infection would result, was practiced in China and India as far back as 1000 or before.  

In 1648, there was a situation that will sound rather familiar to our modern ears: because of an outbreak of yellow fever in Barbados, Cuba, and the Yucatan, strict quarantine was imposed in Boston for all ships returning from the West Indies. Apparently, viruses weren't done with Boston, because in 1657, there was a measles outbreak. In 1694, Queen Mary II died of hemorrhagic smallpox (variola hemorrhagica).

The African Pioneer Very Few Know About

As a child in Ghana, I learned about Jenner, Pasteur, Koch et al., but no one told me nor did I read about a West African slave who brought the practice of inoculation to New England. In 1706, a prominent Puritan minister called Cotton Mather purchased an enslaved West African whom he named Onesimus (Greek for "useful") after the Biblical slave of the same name. This appears in the Epistle of Paul to Philemon, in which Paul says, "I beseech thee for my son Onesimus, whom I have begotten in my bonds: Which in time past was to thee unprofitable, but now profitable to thee and to me . . ."

Onesimus was one of about a thousand Africans in Massachusetts who were servant or slave. Mather hoped Onesimus would repent of "some Actions of a thievish aspect." Apparently the irony of Mather's slave ownership was lost on himself. Onesimus was clearly a smart cookie, because later on, he was able to buy his way out of bondage by paying Mather to purchase another youth, Obadiah, to serve in Onesimus's stead. Slick move, although I feel sorry for Obadiah.

Onesimus, who brought inoculation to Boston
(Photo: Face2faceAfrica.com) 

In 1721, yet another outbreak of smallpox ripped through Boston. At that time, Mather advocated  a technique of "ye Method of Inoculation," remarking that six years before, he had learned about it from "my Negro-Man Onesimus, who is a pretty Intelligent Fellow." Mather had informed the Royal Society of London that Onesimus "had undergone an Operation, which had given him something of ye Small-Pox, and would forever preserve him from it, adding, That it was often used among [Africans] and whoever had ye Courage to use it, was forever free from ye Fear of the Contagion. He described ye Operation to me, and showed me in his Arm ye Scar.” Accounts of smallpox variolation appear from scattered areas of ancient Africa, including Sudan, Ethiopia, and Southern Africa.

Hearing that this technique was also practiced in Turkey, Mather mounted a public campaign in favor of inoculation, but the large majority of white doctors in town were unwilling to try something suggested by an African, except for one physician by name of Zabdiel Boylston, who was the first American doctor to perform gallstone and breast removal surgery. In that same spirit, Boylston went ahead and performed variolation on 282 Boston inhabitants, keeping records on them and 5,759 non-inoculated residents who contracted smallpox. At the time, most people considered variolation ran counter to the will of God, and both Boylston and Mather met with strong opposition and even threats of violence. If this all sounds vaguely familiar, it's because it is. Anti-vaxxers existed in the 1700s just as they do now, and the irony is that 300 years later, the rhetoric is almost identical. Eventually, Boylston was arrested and released only on condition that he would not inoculate anyone else without government approval.

But Boylston was eventually triumphant. Of the 282 inoculated patients, only 2% died from smallpox. Of the nearly 6000 non-inoculated, 15% died. Boylston presented his findings in 1726 to the Royal Society chaired by the Royal Society.

Lessons & Summary

The history of vaccination and inoculation goes back millennia. Many people do not understand that large populations have given their lives through outbreaks of smallpox and other hideous and lethal diseases in order for us to reach modern times in which lifesaving vaccination is available. Smallpox has been largely eradicated in the world as a result, and countless deaths are prevented from diseases like rabies, meningococcus, polio, diphtheria, and yellow fever. Anti-vaxxers should carefully consider whether we really want to return to the 17th and 18th century.

The inoculation story has been largely told from the Eurocentric standpoint, but variolation, a procedure of the same principle, was practiced elsewhere, including in Africa, long before Jenner unveiled vaccination. Yet one would be hard pressed to cite Onesimus's contributions to a medical practice that has been a bedrock of public health and the eradication of disease.

For a detailed history of vaccines, I highly recommend you spend a few minutes looking at this timeline, and next post, I'll talk about the modern age of vaccines.