Beatrice a hundred year old mystery

My grandmother died aged 25 when my father was only 14 months old. One of the few photos we have is her sitting with him, a baby on her lap. She looks so lovely, but it feels strangely heartbreaking knowing that in a matter of months, she would be dead. What caused her death or even any details of her death seems still shrouded in mystery. It was 1925 and attitudes to death were different in those times. The general approach then could be summarised as ‘least said soonest mended’!

A friend, even in the 1960s, said her mother had died when she was just 13 and her sister 11. They were sent to school the day of their mother’s funeral and no one ever mentioned her mother again. Such a reaction was fairly common in those earlier years of the 1920s, and to be fair, there were so many deaths from diseases and other causes that perhaps not talking about such losses was a practical way of coping. What is there to say about the death toll of World War I when 40 million died between the years 1914 and 1918? My grandfather fought in that war. The Spanish flu which followed from 1918 to 1919, killed another 50 million. In the face of such a scale of loss, possibly people opted to just accept death as an ever-present feature of their lives. 

My grandfather was born in 1898 and entered the army aged only 16. It is hard to imagine him going through World War I as a teenager and facing the brutal horror of those days including the battle of the Somme. During that time he was shot in the upper arm and once recovered was sent right back into battle. By the time World War I was over he was in his early 20s. He returned to Northern Ireland fell in love with Beatrice Magee and married in 1923, aged 25. They had a baby boy but after just two years, his young wife suddenly died.

Because her death was seldom discussed my father knew little of his mother’s death. He was fortunate that his mother was one of many siblings and during his childhood, he had many loving aunts lavish attention on him. But that void where a mother should have been was ever-present. He had questions that were never answered. One gossipy villager whispered that she had been sent to an asylum and died there. In the absence of real knowledge, toxic gossip often takes its place. Also in today's world, not knowing your family’s health details leaves you uninformed about important things like any inherited diseases there may be. When a relative examined one side of our family tree, he was horrified at the number of male relatives who had died quite young from heart disease.

Last week, my brother found an old tray in the attic of our garage and brought it down for us to see.  It had been there for decades but we read its inscription as we examined it.  Given to Beatrice Magee on the occasion of her marriage in 1923.  My brother took it home and cleaned, polished and fixed the tray and my Mum placed it in the living room behind the photograph of Beatrice holding her baby.  It triggered renewed memories of this lady that none of us had ever met.  Several family members had failed to find Beatrice’s death certificate while carrying out their research and there seemed to be a mystery in its absence.  

This week I applied online and bought a copy of her death certificate using a different birth date than the one commonly used.  This morning the death certificate arrived and I felt that at last the mystery of almost a century would be solved.  However, the death certificate was written in such poor handwriting I could not make out the cause of death!  In frustration, I sent it to relatives, medical and otherwise hoping they could help decipher the words.  It took a day but the answer eventually came, she suffered from “mitral regurgitation 2 years cardiac failure certified”.  So there in back and white at last was the answer.  

In examining the names on her grave there are signs of the scale of loss of life in those days.  Of her 10 siblings a five-year-old Violet died of scarlet fever in 1914 (the scarlet fever epidemic would peak in 1914).  The Spanish flu in 1919 took two of her brothers 24-year-old William and 19-year-old Charles.  They had to carry out the coffin of one brother through the family front door in November and then the second brother in December.  The scale of such loss was repeated through homes throughout this country.  It hurts the heart to think of it all.  There are no words.  How that generation weathered so much in such a short time should remind us all of the preciousness of life that we too often take for granted.  War and disease rip families apart. Each loss leaves a void that lingers in the hearts of all those who loved them.  

PS The Spanish Flu originated in the US on March 11, 1918, at Fort Riley a military camp in Kansas.  When those soldiers went to fight in World War 1 they took the disease to Europe and the rest of the world. It feels odd that the war my grandfather fought resulted in a disease that killed his wife's two brothers. However, pestilence and warfare were often fellow bedfellows over the millennium and no doubt recent wars will continue to contribute to the re-emergence of infectious diseases.  Already diseases such as cholera, polio, measles, tuberculosis and malaria are rising in the conflict areas of Iraq, South Sudan, Syria, Afghanistan and Yemen. The sad truth is that adequate prevention and treatment of communicable diseases are often impossible in times of conflict. In fact, war itself provides perfect vectors for disease such as refuge camps, mass movements of populations, poor sanitation, and a lack of access to either proper medical assistance, water or a healthy diet.

war fuels disease and messes with our minds

It started by accident.  I got lost in Senglea in Malta.  

That triggered a hunt for news in the archives of the British papers on Senglea.  So great to have this resource with newspapers available from 200 years ago.  The two earliest mentions of Senglea in the British newspapers were interesting.  One, from the Manchester Courier June 26th 1847, concerned a lady from Senglea who was bitten by a cat and subsequently caught rabies and died of the condition.  

The second was an article entitled The Sickness at Malta, from The Dublin Evening Mail on Monday 30th October 1848.

This recounted a strange sickness affecting the British troops stationed in Malta.  This article talks of a prevailing disease amongst the military, but chiefly in the barracks at Fort St. Elmo.  The 1st battalion of the 44th, the 1st battalion of the 69th and the head-quarters of the Royal Artillery were stationed in this area.  The Lieutenant-General Ellice, in charge of these forces, ordered a change of quarters.  He unwisely moved the 69th from Senglea to St Elmo and sent another battalion to Floriana and other random movements of the troops in response to the outbreak.  This backfired in that the Senglea battalion, who had been previously free of disease suddenly started dying of the same complaint.  Those battalions moved to various other places continued to suffer from the disease in the same numbers as before.  The only result of this movement had been to spread the disease among a wider population. Dr Potelli, the chief surgeon of the civil hospital, was convinced that the disease was Asiatic Cholera but Dr Barry, the principal military medical officer, persisted in his claim, supported by other military doctors that it was no such thing.  

In one day on 11th October they had seven deaths and still the disease progressed in the midst of conflicting opinions.  There is a strange mention of a native, meaning a Maltese, being brought in, suffering from what appeared to be the same complaint.  His illness was dismissed as being brought on by unwholesome food or possible neglected disorders of the bowels!!  A curious twisting of facts making it the patient's own fault.  To allay the fears of the general population the presence of stagnant water within the Fort St Elmo was blamed for the outbreak of disease.  The fact that mostly military personnel were affected (they claimed) pointed to this being the case.

By 1850 despite their conviction to the contrary, Cholera was indeed found to be the culprit and yet the practice of responding to outbreaks had not improved.  When a company of the 44th Regiment, stationed at San Francesco de Paolo Barracks, lost a third of its men to the disease the military reacted by sending the entire company to Gozo.  Within ten days of their arrival no less that 26 men fell ill with 16 deaths.  Unsurprisingly, cholera then appeared in the village of Ghajnsielem, beside the Fort and spread throughout Gozo resulting in 105 attacks and 78 deaths among the civilian population.

All of this makes one think about how disease and war could be linked in more ways than we could possibly imagine.  Apart from the movement of troops which provide a perfect vector for the spread of disease throughout a population, war itself is a perfect breeding ground for disease.  

Take for example Syria.  The war there has resulted in millions of Syrians being displaced.  High percentages of its ambulances and hospitals have been damaged or destroyed.  Only 10% of its pharmaceutical need are now being met.  Vaccination coverage was 91% in 2010, now a mere 50% of children born since the war broke out have been vaccinated.  To put that in perspective, there were no cases of cutaneous leishmaniasis before 2008.  

cutaneous leishmaniasis

By 2012 there were 52,982 confirmed cases.  This is just the tip of the iceberg.  Poliomyelitis, measles, meningitis and scabes  are all spreading among the vulnerable population.  Could those parents who peddle anti-vaccine rhetoric please take note!  Leave emotions and gut instinct aside and look at the facts, so many lives depend the presence of effective vaccines.  Those living in refugee camps and in poverty do not have the luxury of your options.  Poor diet, lack of sanitation, stress, contagions from close quarters are not choices people make.  They are a result of external forces beyond their control and for those who have an excess of money, food and good healthcare to be so short-sighted is frankly inexplicable.

War and disease have a history together.  During the Napoleonic wars , eight times the number of British army soldiers died from disease than from battle wounds.  In the American Civil war two thirds of the 660 000 deaths of soldiers were caused by pneumonia, typhoid, dysentery and malaria.

The result of the so-called Spanish flu, following World war 1 in 1918, was a worldwide death toll of between 50 and 100 million worldwide. Recent investigative work by a British team led by virologist John Oxford of St Bartholomew's Hospital and the Royal London Hospital has suggested that the major troop staging and hospital camp in Étaples, France, has almost certainly being the centre of the 1918 flu pandemic. A significant precursor virus, harboured in birds, mutated to pigs that were kept near the front is proposed as the source. 

The Second World war had its own contributions.  One of which was that dengue increased in South-East Asia during the war and the immediate post-war period, due to the spread of mosquitos and different virus strains throughout the region.  This disease produces a spiking fever, searing muscle and joint pain, blood seeping through skin, shock and possibly death.  Today this disease threatens 2.4 million people worldwide.  With such tasks facing humanity it begs the question should we be wasting valuable resources on wars?

In order to really understand why war is so conducive to disease we need to understand the various changes that contribute to the spread of disease.

1. mass movement of populations
2. lack of access to clean water
3. poor sanitation
4. lack of shelter
5. poor nutritional status
6. collapse of public health infrastructure
7. lack of health services

More than 25 countries in Sub Saharan Africa are affected by conflict and 70% of all deaths in these countries are caused by infectious diseases.

When you have a displaced population they will have a 60 times higher mortality rate.  Today there are 40 million refugees and displaced people.  The figures are heart-breaking, almost too huge to take on board.

The Zaatari refugee camp in Jordan

The loss of life can be quick and huge.  When there was an outbreak of cholera and dysentery in Goma (formerly Zaire) in 1994, twelve thousand Rwandan refugees were killed in just 3 weeks.

In Afghanistan malaria was very well controlled before conflict began in 1979.  In the past twenty years there have been 2/3 million cases every year.

In the Democratic Republic of Congo, 1930 there were more than 33 000 cases of trypanosomiasis (sleeping disease).  With health care initiatives by 1959 this figure had dropped to less than a thousand cases.  The conflict that erupted in the 1960s meant that by 2001 the number of cases was estimated at 40 000.  It is hard not to hold your head in despair.

In focussing on physical complaints alone, of course we do not have the whole picture.  It is estimated that 10% of the World's population lives with mental illness.  In 2008, five years after Liberia's civil war had ended 40% of Liberians had symptoms of major depression.  Conflict leaves scars that we have yet to understand fully. For example, in Northern Ireland there has been a doubling of the suicide rate since the peace agreement in 1998.  Conflict, it seems leaves effects that linger and eat into the mental wellbeing of a population long after peace has been established.

What strikes one is that we cannot afford to have war.  We must learn the lessons of the past.  War is far too expensive in terms of human suffering, creation of disease and far too distracting from the vital tasks that lie ahead in this world of ours.

refugees in Europe   Photographs that speak to the heart

Getting ready for the New Year

In many ways this Christmas sticks in your mind when disasters are spoken off.  The Mayan calendar ending  spanned a huge range of doomsday scenarios and it was quite disturbing the number of elderly relatives who confessed to being quite content if the world ended.  They obviously felt life had gone on long enough and going out with a bang and lots of company held a certain appeal.  Unfortunately, these turbulent times are nothing new. 

Imagine living through the World wars or even the Spanish flu, which alone wiped out 40 million.  My great grandmother lost two sons in one week from that Flu.  I cannot begin to imagine what that was like to endure.  With World War I fresh in the mind there must have been a feeling that the horror would never cease.  The young and the strongest, the flowers of each family mowed down with breath taking speed.  The Spanish flu took out those with strong immune systems and so it must have seemed as if the blood let, in those trenches was not enough. If ever you walk, as I did with a cousin, through the war graves in France the scale of such losses hits you.

As far as the eye can see there are graves and as you crest one hill more stretch out in yet another vista of never ending crosses to mark lost lives.  The real consequences of war, its horror hit home and we were silenced by the horrendous loss before us.  

Years later, I had a similar feeling in Auschwitz when visiting the camp with a friend, Pari.  We entered a huge barn like room with shoes of those killed in the camp. 

It felt as if one’s heart was being squeezed in a vice, tightening with the absolute horror of it.  As the train pulled out of that place, Pari and I sat opposite each other in a carriage, in silence.  I found myself rubbing at my chest as if trying to ease the physical pain that knotted there.

Who can forget the more recent disasters such as the Tsunami on Boxing Day 2004 that wiped out 227,898 lives in terrifying unexpected swiftness.  If someone had predicted these disasters we would not have grasped even the possibility that such things could occur.  Our brains would have rightly denied the forthcoming horrors as impossible, intolerable and unendurable.  But our disbelief does not prevent such tragedies happening. 

Likewise, the fact that such tragedies do occur, does not necessarily mean we learn from our mistakes.  Wars still occur with depressing frequency; even natural catastrophes that afflict the world fail to unite us in response.  Instead, a strange lethargy keeps us continuing with business as usual.  As if daily routines will soothe things.  It strikes me that knowing the future might not help.  In fact spelling out such disasters would not be meet or seemly.  Our perversity in not awakening to such tragedies, adapting, learning and changing is however, distressing.  There are lessons to be learned and such losses of life should instil in all of us an urgency for change. 

If nations can endure such horror when we rise up to war, we must wage peace instead.  When humanity is facing such natural calamities and disasters, the need to be a world united in the race to save lives becomes achingly apparent.  These are lessons none of us can afford to forget.   

Millenium Goals - the good news

Just over ten years ago the world’s leaders established goals and targets to free humanity from extreme poverty, hunger and disease.  The Millennium declaration set global priorities and allowed the world to focus their efforts.  I tend to be a cynic and am generally a half glass empty rather than a half glass full type but credit where credit is due – progress has been made, even in this financially taxing time.

Another example of what we can do when we work together is how the world tackled Smallpox.  Existing since 10,000 BC this disease was a real killer - estimates vary but proably 500 million people paid with their lives.  So when the world decided to eradicate this disease from the face of the earth it was no small task it set itself.   But it was united, a rare thing indeed for the human race, and in 1979 it succeeded in wiping this dreadful scourge out.  Speaks volumes about what this world can achieve when it sets its mind to it and acts as one!