05. The History of Epidemics in Ethiopia

Cholera: The Decline of the Killer Disease

We saw last week that cholera was one of the most serious epidemic diseases in Ethiopia’s historic past. Now read on:

A major epidemic of cholera, which appears to have originated in the East, reached the port of Massawa in October 1865. This outbreak was severely felt at the port, as described by the British envoy Henry Dr. Blanc: “All those who had been suffering from insufficient or inferior food supplies became easy prey; few, indeed, of those who contracted the disease rallied; almost all died.” The Pasha, or local ruler of the port, “was several times on the point of death, from great debility and complete loss of tone of the digestive organs.” Even the tiny European community suffered one casualty. The death toll at the port, according to Donin, a later French historian, reached no less than about 300 persons.

To Stop the Infection

Faced with this cholera outbreak at Massawa, the populace of the interior once more took immediate action to prevent the spread of infection. They cut off all communications with the coast, and refused to allow caravans to leave the highlands until the epidemic had ceased. Notwithstanding this precaution the disease soon advanced inland, first to Tegre, where, according to Blanc, it wreaked “havoc,” and then to other northern provinces. Shepherd, a later British observer, reported that it “raged with great violence in Antalo [i.e. Antalow] and the surrounding villages,” several of which were uninhabitated when he visited them a year or so later; while the Swiss adventurer Munzinger stated that the cholera also made “dreadful ravages” among the Danakil people.

Several cases of cholera were reported in May 1866 at Qorata on the south-eastern shore of Lake Tana. On hearing this news Tewodros, according to Blanc, “wisely decided” upon moving to the highlands of Begemder. Before doing so, however, he paid a brief visit to Qorata, to inquire as to the extent of the epidemic. His curiosity was, however, disastrous, for within a matter of days the disease broke out in his camp, and “hundreds were dying daily. In the hope of improving the sanitary conditions of his army, the Emperor moved his camp to some high ground a mile or so north of the town; but the epidemic continued to rage with great virulence both in the camp and in the town. The church was so completely choked up with dead bodies that no more could be admitted, and the adjoining streets offered the sad sight of countless corpses, surrounded by the sorrowful relatives, awaiting for days and nights the hallowed grave in the now crowded cemetery. Smallpox and typhus fever also made their appearance, and claimed the victims cholera had spared.”

Emperor Tewodros

Emperor Tewodros, fully conscious of the infectious character of the disease, decided on June 12 to leave for the higher and more healthy province of Bagemder. According to Waldmeier, a missionary witness, however, the march was “very difficult… We had to travel in the midst of a crowd of 100,000 soldiers, women and children. Some sick, dying and even dead, were carried in the crowd, and many others lay dead on the ground, the multitude passing over them, so that the smell became fearful, and the lamentation for the dead was heart-rendering.” By June 14 the soldiers were several thousand feet above the lake, but the cholera, smallpox, and typhus, according to the British envoy Henry Blanc,

“His Majesty Inquired…”

“His Majesty inquired what was usually done in our country under similar circumstances. We advised him to proceed at once to the higher plateau of Begemder, to leave his sick at some distance from Dabra Tabor, to break up as far as possible his army, and distribute it over the whole province, selecting a few healthy and isolated localities where every fresh case that broke out should be sent.”

Tewodros acted upon this advice, which accorded so closely with the custom of his own country. There was, however, no immediate respite. Waldemeier recalled that several of his own servants fell ill and died on the road, and that, upon arrival at Gafat, his wife was “seized with a violent attack of cholera, followed by typhus fever, which was so dangerous that she was brought to the very brink of the grave… the angel of death was daily claiming its victims.”

“Conditions So Serious”

Conditions were so serious that Blanc was released from detention by the Emperor, and, according to the chronicler, cured many cholera victims. The policy of flight was in due course successful, however, and Tewodros “before long had the satisfaction,” in Blanc’s words, “of seeing the several epidemics lose their virulence, and, before manyweeks, disappear entirely.” This is confirmed by Waldmeier who notes that “by degrees the cholera passed away.”

The magnitude of the epidemic was such that the medical historian Hirsch may well have been correct in declaring it a “point of departure” for the southward advance of cholera into the country of the Gallas [or Oromos in modern parlance], who, he believes, had previously been little affected by the disease.

It is interesting to note that the foreign origin of the outbreak was generally accepted. The oldest inhabitants of Tegre later told Dr. Parisis, a Greek physician in the service of Emperor Yohannes IV, that they remembered a cholera epidemic, presumably that of 1865-6, and categorically declared that it had been brought by Indian traders to Massawa, whence it had penetrated inland.

The Great Famine of 1888-1892

The last nineteenth-century cholera epidemic owed its intensity to the Great Famine of 1888-1892, which caused the debilitated population to become easy victims to infections of all kinds. The exact history of the outbreak is unclear. An Italian physician at Massawa, Dr. Filippo Rho, believed that the disease was brought to the port in July 1890 by Muslim pilgrims returning from Mecca. A French officer, Paul de Lauribar, on the other hand suggested that cholera had already broken out in the interior some months earlier, and was actually taken into Eritrea by destitute persons from the interior crossing the frontier in the hope of finding work, or relief.

The disease, according to de Lauribar, was rampant in the Italian colony from the end of 1889 to July 1890, and Italian carabinieric and “native troops” were continually going up and down the streets of the town burning corpses. Immigration across the border was prohibited, and many immigrants were forcibly deported. Despite the stringency of such measures, a further outbreak was reported along the Setit River in western Eritrea in 1891.

“It is Scarcely Possible to Realise”

Testimony to the extent of devastation is afforded by the British traveller Theodore Bent, who, after visiting the northern provinces in 1893, wrote:

“Civil war, famine and an epidemic of cholera have, within the last decade, played fearful havoc… villages are abandoned, the land is going out of cultivation…. It is scarcely possible to realize, without visiting the country, the abject misery and wretchedness which has fallen upon the Ethiopian empire during late years.”

The town of Dabarwa for example had, he says, been “decimated.” The result was that “a few piles of stones, an almost ruined church, and a few wretched hovels” were all that was left.

The Southern Provinces

The southern provinces of Ethiopia were also seriously affected, mainly in 1892, when cholera appeared at the Gulf of Aden ports, where numerous deaths were reported. A large number of the inhabitants of Bulhar, according to the British traveller Drake-Brockman, were wiped out. The rate of mortality is also graphically revealed in a British consular report for 1893. It lists the number of stricken and dead at the Somali ports as shown in the following table:

Incidence of Death among Cholera Victims at Somali Ports in 1893.

Many persons also died at the French port of Jibuti, among them two who attracted considerable official attention: the colonial administrator, Joseph Deloncle, and the good military physician, Dr. Aubry.

Spreading Inland

The epidemic rapidly spread inland. At the great Ethiopian religious centre of Sheik Hussein no less than four-fifths of the population was reported by Donaldson Smith to have perished. The Muslim walled city of Harar was also badly affected. Those infected, according to Menilek’s chronicler Gabra Sellase, included persons conveying cattle from Ogaden to the famine-stricken areas of the interior. Troops sent to guard the livestock also caught the disease, and many died. Their commander Azaj Walda Sadeq himself fell ill. Anxious to avoid the further spread of the epidemic, he ordered that the animals be kept in Adal, and that the roads be guarded to prevent the disease from advancing to Ankobar, where Emperor Menilek was then encamped. The chief then withdrew to the lowlands of Dibbi, south of Ankobar, where he had a tent erected in the forest and lived there in isolation, declaring: “If I die what matters so long as Menilek is master!”

The chronicler claimed that God heard the above words, and permitted the brave chief to recover, though few of those who caught the disease survived. One of the first of the epidemic’s many victims at Ankobar was Walda Gabriel, a priest renowned for his chanting. The French traveller Vanderheym described the population as “decimated.” The epidemic came to an end only after Menilek left the city, and made his way south to Entotto in September 1892. Addis Ababa, which Menilek had established as his capital a few years earlier, also suffered seriously: a British traveler, A.E. Pease, observed that the disease made “great ravages” there.

Cholera, according to De Coppet, the French editor of Menilek’s chronicle, at this time became known “ya nefas basheta”or “disease of the wind”. This was because it was popularly thought to have been spread by the wind which blew mainly from the north-east, that is to say, from the coast where it so often first appeared.

The Decline of the Disease in the Twentieth Century

Greater international controls, as well as the advance of medicine within Ethiopia itself, led to a substantial disminuation of cholera in the twentieth century. The last major epidemic, which occurred in the East around 1902, seems to have reached the country in 1906. but was reported only in Wallo.

The disease, in Ethiopia, was in fact never again to raise its ugly head as a major epidemic!