Lessons from the 1918 Spanish Flu


An important lesson India learned from the high-fatality 1918 Spanish influenza pandemic is that while the virus itself was fatal, starvation, hunger and malnutrition made matters worse.

Prime Minister Gareeb Kalyan Anna Yojana (PMGKAY) announced immediately after India’s first lockdown that poor segments of society would not face hunger during the Covid-19 pandemic.

A short article titled “The influenza pandemic in India in 1918”, published in The Lancet in December 1923, contained an account by Dr ES Phipson, responsible for Simla’s health. He mentioned the relatively low food supply, below-normal rainfall and high prices as the main reasons contributing to the genesis of the 1918 pandemic.

India has lost more than 12 million people to the Spanish flu, or 5% of the total population. The British government, at best, was not concerned with developing basic health care and humanitarian facilities for Indians living like its subjects. In the worst moments of the Spanish flu pandemic, the government shone with its blatant and shameful absence.

Since Mumbai, and later Bombay, was a key port of entry for India, especially for soldiers returning from WWII to Europe, the Bombay presidency was among the hardest hit. Another city that was hit the hardest by the pandemic was Karachi, which was a key transshipment port at the time like Mumbai.

Historian Mridula Ramanna gave a detailed speech on the experience of the Bombay presidency during this epidemic on YouTube in May 2020. She said: “For every 1,000 people living between the ages of 20 and 40, 62 men and 79 women are deceased. Mortality was estimated at 1,086,758 for the months of June to December 1918, an excess of total mortality compared to the average for the previous five years. The peak was reached in October ”.

These details were also discussed by Phillips Howard and David Killingray in their 2003 book, “The Spanish Influenza Epidemic of 1918-19: New Perspectives”. This book’s essays cover one of the lesser-known issues that made this pandemic deadly – the shortage of food grains.

During the war years, food grains produced in India were used for British troops on the ground in Europe. The export of food grains was common and this practice did not stop until late in the pandemic. Indian rulers raised this issue with the British government, and the export of wheat did not stop until 1918.

In wartime, there was also no possibility of importing food grains. Not that the UK government was working on such plans, but even if it was, supply chains around the world were twisted and put to service hundreds of global battlefields.

This situation was further complicated by famine in all provinces affected by the pandemic. The British Indian provinces of Bengal, Bombay, Central Provinces, Punjab, Rajputana and United Provinces have all experienced the impact of famine. This has exacerbated the low availability of food grains. Food inflation has skyrocketed across the country, depriving poor Indians of basic supplies, let alone nutrition.

Historians like Ramanna and others have identified this lack of access to food as a key problem during the Spanish flu. The poorest part of society has been hit much harder by the pandemic, as starving Indians succumbed en masse to the debilitating pandemic. Even without access to health care and medical facilities, millions of Indians could have survived if they slept on a full stomach.

Why is this important today? India has gone through difficult times in the current outbreak of the global Covid-19 pandemic. There have been several state capacity issues on the healthcare side, where India, like most other countries, has struggled to cope with the peak case load and peak death rate. . But one thing that has not received attention – because it has been well managed – is access to food supplies.

Prime Minister Gareeb Kalyan Anna Yojana (PMGKAY) was announced by the Modi government on March 26, 2020. This was immediately after the announcement of India’s first lockdown earlier in the week. The program was initially launched for three months, from April to June 2020, with a spending of Rs. 170,000 crore not only on food security, but on a range of other support measures. Later, the food support program was extended until November with an additional expenditure of Rs. 90,000 crore.

This program allowed each beneficiary to obtain 5 kg of wheat or rice and 1 kg of favorite pulses free of charge each month. The program covered all beneficiaries of the National Food Security Law, which covers nearly three-quarters of the entire rural population and half of the total urban population. Overall, around 800 million Indians are eligible beneficiaries under the National Food Safety Act, which is implemented through the public distribution system. The right to PMGKAY was in addition to the monthly right existing under the national law on food security.

This program ensured that migrant workers and other poor segments of society did not go hungry. When the second wave of the pandemic hit PMGKAY was reinstated for May and June 2021 for a total expenditure of Rs. 26,000 crore. The program has since been extended until November 2021, which would be the fourth phase of the initiative. The Ministry of Consumption, Food and Public Distribution is managing India’s food security during these difficult times.

An important lesson India learned from the devastating, high-fatality Spanish influenza pandemic of 1918 is that, although the virus itself was deadly, a combination of famine, drought, hunger and malnutrition took its toll. aggravated the situation. The weakened immunity of poor Indians has become a key factor in the impact of the virus on society.

This is one aspect of handling the Covid-19 pandemic, where India has praised historical experience.

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