Public Health in Rio, 1918

From Pale Rider: The Spanish Flu of 1918 and How It Changed the World, by Laura Spinney (PublicAffairs, 2017), Kindle pp. 52-54:

At the time that Nava fell sick, Rio was the capital of a young republic. A military coup had brought the reign of Emperor Dom Pedro II to an end in 1889, and with the abolition of slavery the previous year, it had seen a massive influx of freed black and ‘mulatto’ slaves. The poorest moved into cortiços or slums in the city centre. The cortiços–the Portuguese word for ‘beehives’–often lacked running water, sewers and proper ventilation. Living conditions were better there than in the subúrbios, the shanty towns expanding on the outskirts of the city, but the cortiços were more visible. White, middle-class cariocas saw them as parasitising the city proper. Aluísio Azevedo conveyed the fear that they inspired in his novel O Cortiço:

For two years the slum grew from day to day, gaining strength and devouring newcomers. And next door, Miranda grew more and more alarmed and appalled by that brutal and exuberant world, that implacable jungle growing beneath his windows with roots thicker and more treacherous than serpents, undermining everything, threatening to break through the soil in his yard and shake his house to its very foundations.

When President Francisco de Paula Rodrigues Alves came to power in 1902, he launched an ambitious programme of urban renewal with the goal of turning Rio into a showcase of modern, republican civilisation. In his vision of the cidade maravilhosa, the marvellous city, there was no place for the cortiços, those nests of disease whose inhabitants, condemned by their biology, were ‘locked into a vicious cycle of malnutrition and infection’. They were razed and their inhabitants forced out. Six hundred homes were destroyed to make way for the magnificent Avenida Rio Branco, so that by the time the American travel writer Harriet Chalmers Adams described the city in 1920, she could write that ‘This portion of the city has been cooler ever since, as the breezes sweep through the wide avenue from waterfront to waterfront.’

But the easy mixing of the different classes that had once characterised Rio, their coming together in the seeking of pleasure–especially when it came to music and dancing–had gone. Now there was no area of carioca life in which rich and poor were not divided by an impenetrable gulf. The president also set out to rid the city of infectious diseases, and in this he was aided by a doctor, Oswaldo Cruz, who in 1904, as head of the General Board of Public Health, had ordered a campaign of compulsory vaccination against smallpox. At the time, the vast majority of Brazilians had no grasp of germ theory. For many it was their first experience of state intervention in public health, hence something extraordinary, and poor cariocas rioted. The ‘Vaccine Revolt’, as it was called, was about more than one perceived violation, however. It was an expression of a broader class struggle over whom the city should serve–the Brazilian masses, or the European elite.

A decade later, vaccination had been accepted by most Brazilians, but Cruz’s unpopularity survived his death in 1917, and it was this legacy that shaped cariocas’ response to the new disease threat in 1918. On 12 October, the day that the flu spread through the elegant guests at the Club dos Diàrios, the satirical magazine Careta (Grimace) expressed a fear that the authorities would exaggerate the danger posed by this mere limpa-velhos–killer of old people–to justify imposing a ‘scientific dictatorship’ and violating people’s civil rights. The press portrayed the director of public health, Carlos Seidl, as a dithering bureaucrat, and politicians rubbished his talk of microbes travelling through the air, insisting instead that ‘dust from Dakar could come this far’. The epidemic was even nicknamed ‘Seidl’s evil’. By the end of October, when half a million cariocas–more than half the population–were sick, there were still those among Rio’s opinion-makers who doubted the disease was flu.

By then, so many corpses lay unburied in the city that people began to fear they posed a sanitary risk. ‘On my street,’ recalled one carioca, ‘you could see an ocean of corpses from the window. People would prop the feet of the dead up on the window ledges so that public assistance agencies would come to take them away. But the service was slow, and there came a time when the air grew filthy; the bodies began to swell and rot. Many began throwing corpses out on the streets.’