Looking Through Indonesia's History For Answers to Swine Flu

The Jakarta Globe, Emmy Fitri

Children orphaned by the 1918 flu pandemic.
(Photo courtesy of University of Indonesia’s School of History)

See Also: Vital Lessons to be Learned from 1918 Flu

“It seemed like there was a kind of toxin in the air. People fell sick so easily, went to bed and then never woke up,” an elder of South Sulawesi’s Toraja tribe said.

Another added: “Here we called it raaba biang [loosely translated as falling plants] because people got sick and died like falling bushes. Even those who buried them, they died shortly afterward. There are no official records but we were told it happened in 1918.”

The senior citizens, Tato Dena and Kun Masora didn’t experienced the raaba biang themselves, but the story of the deadly disease that swept through Toraja in 1918 has been passed on from generation to generation. Tato’s grandfather and Kun’s aunt died in the pandemic.

Tato and Kun were interviewed by Arie Rukmantara, a former bird flu communications consultant at the United Nations Children’s Fund. “There is a mass grave-like site in Sirope, Makale village, that most likely was the burial site for people who died of the flu,” Arie said. “Unless something extraordinary occurs, Torajans usually make a grave for each deceased person.”

The story of the raaba biang in Toraja was one of the findings presented by historians from the University of Indonesia last week that, the researchers said, confirmed two things: that the pandemic was not a hoax, as many skeptics have said, and that Indonesians battled the same plague that struck the Americas and Europe in 1918.

More than 500 million people worldwide were infected in the 1918 pandemic, caused by the H1N1 virus, or swine flu virus, and an estimated 50 million died, far more than those killed during World War I.

Swine flu is a respiratory disease caused by type A influenza. Symptoms resemble those of the common flu, including sore throat, coughing and fever.

For almost a year, the historians scoured through colonial government records for anything related to a pandemic. Fortunately for them, the Dutch kept good records of their administration.

In Indonesia, about 1.5 million of the archipelago’s 30 million inhabitants died in the pandemic.

“We have found records of sporadic flu cases in Ambon [Maluku Island] in 1852 and then in West Borneo in 1860, Blora [in Central Java] in 1875, and Muara Teweh, Padang Panjang in 1890,” chief researcher Kresno Bramantyo said. “Those were Dutch military bases and most cases reported were of military personnel. Some were contained in the army camps but some spread outside and infected civilians.”

Kresno, however, could not confirm if the outbreaks that occurred in the 1800s had any relation to the 1918 flu pandemic.

The pandemic is thought to have peaked here in 1920, when the colonial administration issued the Influenza Ordinance. The ordinance demonstrated the scale of the flu outbreak, as it called for all officials, not just those in the health sector, to take measures to curb the spread of the disease, including banning infected people from leaving their houses.

Increased security checks on ships from abroad were also ordered as officials suspected that the virus was brought to the country by ship passengers.

The administration also ordered people in affected areas to hoist yellow and red flags to indicate that there were cases of the flu in their neighborhoods.

Other measures included setting up a commission to investigate the cause of the flu, and distributing quinine to fight the disease because most cases presented symptoms similar to malaria.

Records also speak of the role that dalang , or puppet masters, played in spreading word about the disease. “We found a book written in Javanese called ‘Lelara Influenza’ [‘Influenza Disease’], which chronicles the flu, researcher Harto Yuwono said. “This book seems to have been authored by the puppet masters themselves because they used wayang similes to tell about the presence of a deadly disease.”

Experts said the 1918 pandemic pushed doctors and scientists to work harder to develop treatments and to find the cause of the disease. Some mysteries, however, like how the pandemic ended, remain unsolved to this day.

The historians could not find any documents or reports mentioning the end of the pandemic. Due to the magnitude of the outbreak and the sweeping response of the colonial government, they expected that there would be papers officially declaring the pandemic over.

Cases were reported in Indonesia as late as 1930. The United States and Britain had their last reported cases in the 1920s.

“Cases were also reported in Papua, but unfortunately we have scant details from Papua. But we heard a story about how Papuan tribesmen created a dance, still danced today, to ward off the flu,” Harto said.

With the world facing another flu pandemic, the historians said they wanted to contribute “lessons from the past” in a bid to curb the spread of the new H1N1 virus. As of Tuesday, 178 countries had reported a total of 414,945 infections and 4,999 deaths. Indonesia so far has 1,097 confirmed cases and 10 fatalities, according to the Health Ministry.

“It’s time to see the pandemic from multisectoral perspectives, because it’s not just the concern of the health sector,” said Memed Zulkarnain, chief of communications at the National Commission on Avian Influenza and Pandemic Preparedness.

Memed quoted a passage from John M Barry’s book “The Greatest Influenza,” widely billed as the authoritative work on the disease: “The story of the 1918 influenza virus is not simply one of havoc, death and desolation … It is also a story of science, of discovery, of how one thinks and how one changes the way one thinks.”

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