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Influenza Epidemic in Samoa

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Influenza Epidemic in Samoa Setting a Barricade against the East Wind: Western Polynesia and the 1918 Influenza Pandemic John Ryan McLane A thesis submitted for the degree of Doctor of Philosophy At the University of Otago, Dunedin, New Zealand June 2012 ii iii Abstract This dissertation is a comparative analysis of the experience of several western Polynesian states during the 1918-1920 influenza pandemic, and in particular an inquiry into how the response to the second wave of this pandemic determined the mortality for each island group. Historically, Pacific island states have faced challenges in controlling infectious disease. Distance, isolation, lack of resources, and the turbulent nature of local political authority have limited the ability of these states to mount an effective response to the transmission of introduced infections. The territories of Polynesia attempted a wide range of social measures for control of the 1918-1920 influenza pandemic. Their success or lack thereof depended more upon political and economic variables than indigenous cultural or health factors. The colonial entities of Fiji, Western Samoa, and Tonga were sequentially infected with the 1918 pandemic strain of influenza by the SS Talune that departed from Auckland in November 1918. Despite being infected by the same strain of the virus, at the same time of year, and the significant number of cultural commonalities between these states, their experience of the influenza was broadly divergent. This work seeks to understand the forces that drove the differential outcomes. Fiji had warning of the approach of influenza, yet the colonial medical staff discounted the risk and faced strong economic pressure to avoid quarantine measures. Fiji also had the largest and most ethnically diverse population, thus complicating education and outreach efforts, as well as strong recent memory of a devastating measles epidemic that destroyed indigenous confidence in the colonial medical system. Roughly five percent of the population of Fiji died. Western Samoa had a military garrison with little governing experience as well as a plantation economy that faced significant strain if isolation measures were put into place. Settlement patterns drove rapid spread of the disease and plantation agriculture led to famine across the group during the convalescent period. Western Samoa experienced the world’s highest known death rate from the 1918 outbreak with one quarter of the population succumbing. iv Tonga experienced a collapse of the political system in a state where tradition still played a large role. In the absence of the traditional political elite the populace were left to their own devices, and suffered accordingly. Somewhere between four and eight percent of Tongans were killed. Yet American Samoa, fifty kilometers from Western Samoa, was perhaps the only polity across the globe to experience no mortality from the influenza pandemic. A small, homogenous state under US Navy control, quarantine was successfully implemented and maintained for years, preventing the infection from reaching the island group in its most virulent form. This success was a factor in the maintenance of American Samoa as a colonial bastion while Western Samoa sought independence from New Zealand. A range of social, political, and economic factors determined outcomes as each of these states were exposed to influenza. The cultural, the political, and the medical are inextricably intertwined and it is these differences between the states, not their broad similarities, which define the experience of epidemic disease. v Preface and Acknowledgements This work began with my time as a Public Health Nurse in northwestern Alaska. One of the villages I was fortunate enough to be responsible for was Brevig Mission, whose residents were willing to allow Johan Hultin to exhume the bodies of those that had died in the influenza pandemic of 1918-1919. This work led directly to the re-creation of the viral genome of this particular influenza variant and a huge amount of subsequent research. Having been close to such momentous work, I began researching the impact of the 1918-1919 pandemic in the arctic. Unfortunately there were very few written records of the event. While searching for an area with similar issues of isolation and logistics, the Pacific island states were obvious candidates. Many people in Alaska supported and inspired my work, and they all have my thanks. The University of Otago and the government of New Zealand have been very generous both in financially supporting my research efforts and encouraging me along the way. The Department of History & Art History and the Division of Humanities have been willing to support my research travel and conference attendance, without which my research could not have progressed. The Norton Sound Economic Development Corporation and Norton Sound Health Corporation have provided additional funding, as has the New Zealand Nurses’ Association. To all these groups I offer my most heartfelt thanks. The greatest guidance and support I have received has come from my two wonderful supervisors. Barbara Brookes and Judy Bennett have been sources of endless information, contacts, and suggestions while gently nudging me to stay on track. Their patience and support have been boundless. I have been truly privileged to learn from the best. Thank you both, and I hope this makes you proud. My thanks as well to the Hocken Library in Dunedin; the Western Pacific High Commission Archives in Auckland; the National Archives and Turnbull Library in Wellington; and the National Archives of the United States, Great Britain, Australia, Fiji, Samoa, and Tonga. Their employees have met every request with vi cheerful assistance. No matter where I have traveled the open enthusiasm that I have been greeted with has amazed me. Additional assistance has come from many academics across several disciplines. In particular I would like to thank the following: Robert Glass at the American Samoan archives in San Bruno; Sandra Tarte and Ian Campbell for their assistance in Fiji and Vicki Luker for her advice in preparing for that trip; Phyllis Herda and the late Elizabeth Wood-Ellem for their insight into Tonga; Brij Lal, Anne Hattori, and Doug Munro for their broad knowledge of the Pacific as a whole; Gavin Maclean and Geoffrey Rice for their background concerning New Zealand, and Dennis Shanks for a view of the medical side of the pandemic. I am certain I have forgotten some that have helped me along my way. Please forgive any omission. To my officemates: Tomorrow is a myth, and my boots smell of donkeys. Marika; thank you for your patience, your support, and your unconditional love throughout this process. I love you with all of my being. Now it is your turn. This work is dedicated to my parents. They taught me the love of learning, and how to read a newspaper before I could walk properly. They have been unflagging in their encouragement, and have always helped me to chart a course that seemed right. Frequently the path taken was a course far from where their instincts would suggest. Thanks folks, I love you both more than I can say. vii Contents Abstract iii Preface and Acknowledgements v Contents vii List of Maps ix List of Figures x List of Abbreviations xii Glossary xiii Introduction 1 Chapter 1 Influenza 15 Chapter 2 Fiji 67 Fiji before the Epidemic 74 Trade and Economics 86 Medical History and Infrastructure 90 The Fijian Epidemic 106 Outside of Suva 128 Recovery and Consequences 136 viii Chapter 3 Western Samoa 151 Samoa before Partition 153 Western Samoa before the Epidemic 162 Health and History in Samoa 167 New Zealand and Occupation 170 The Epidemic in Western Samoa 180 Epidemic Impact and the Mau 199 Chapter 4 American Samoa 220 American Samoa: 1899-1918 223 Health and Medical Infrastructure 235 Quarantine: Epidemic Averted 248 Success and Consequences 260 Chapter 5 Tonga 269 Tonga before the Epidemic 272 Health History and Infrastructure 285 The Epidemic in Tonga 294 Aftermath and Accusations 310 Conclusion 317 Bibliography 327 ix List of Maps 1. Path of the Talune, October-November 1918 69 2. Islands of Fiji 75 3. Samoa 154 4. The Samoas 221 5. American Samoa 222 6. Tonga 270 7. x List of Figures 1. USSCo. Talune 68 2. Ratu Seru Epenisa Cakobau, date unknown 79 3. Crop rotation, Indian tenant farm, Vunisamaloa, ca. 1920s 82 4. People gathering at the wharf in Suva, 1900. 84 5. First graduating class of the Central Medical School of Fiji, 1888 103 6. Influenza information pamphlet issued by Fijian government, 12/11/18 116 7. Levuka, 1905 136 8. Nukulau Quarantine Station, Fiji 144 9. Samoan Times, front page 151 10. Raising the German flag at Mulinu’u, Samoa, 1900 164 11. Copra plantation, German Samoa 166 12. The raising of the British flag in Apia, 30 August, 1914 172 13. Colonel Robert Logan, 30 August, 1914 173 14. Sydney Daily Telegraph, article 197 15. The Samoa Times, obituary 200 16. A view of the governor’s mansion in Pago Pago from the Goat Island Quarantine Facility 224 17. Proposal for increasing capacity of Quarantine Station on Goat Island, Pago Pago Harbour, 1911 245 xi 18. A copy of Governor Poyer’s order announcing the quarantine against Western Samoa 252 19. Tongan population figures 271 20. King George Tupou II 280 21. Queen Salote Tupou, shortly before her ascension 292 22. The Royal Palace, Nuku’alofa 302 xii List of Abbreviations AUSN Australasian United Steam Navigation BWPT British Western Pacific Territories (forerunner of the WPHC) CMO Chief Medical Officer CSR Colonial Sugar Refining Company DPHG Deutsche Handels und Plantagen-Gesellschaft der Sudsee-Inseln zu Hamburg DMO District Medical Officer (Fiji) GBP Great Britain Pound LMS London Missionary Society OSC Oceanic Steamship Company PHO Port Health Officer PMO Principal Medical Officer (Samoa) RN Royal Navy SEC Samoan Epidemic Commission SMO Senior Medical Officer (Fiji) USN United States Navy USSCo Union Steamship Company WHO World Health Organization WPHC Western Pacific High Commission xiii Glossary Fomite: An inanimate object or substance, such as clothing, furniture, or soap, that is capable of transmitting infectious organisms from one individual to another.
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