Battling with the "Flu" - 1919
By Katherine Woods
Precautions Taken in Seattle, WA, During the Spanish Influenza Epidemic Would Not Permit Anyone to Ride on the Street Cars Without Wearing a Mask. 260,000 of These Were Made by the Seattle Chapter of the Red Cross Which Consisted of 120 Workers, in Three Days. Photograph by American Red Cross circa 1918-1919. Library of Congress # 2017668638. The Red Cross Magazine, January 1919. GGA Image ID # 1501b5575d
On one of the dark days of last September, when Spanish influenza and its resultant diseases were spreading their devastation through New England, Eugene Shadbolt came from Red Cloud, Nebraska, to see his brother, who was dying at Camp Devens of pneumonia.
He found lodgings in the town of Aver. And there, thirty-six hours after his long journey had come to an end, he fell ill, alone in his strange boarding house, of his brother's disease.
He was only one of hundreds of men and women who had come to see their sick boys in camp; but when, under circumstances that made proper attention in the town almost impossible, he became ill, there was someone to care for him at once.
From the Red Cross headquarters at Camp Devens, an immediate request was sent to the commandant of the military hospital that Eugene Shadbolt be admitted to the emergency ward established by the army authorities in the Red Cross house.
Permission was given without delay; and there in the Red Cross house the man who had travelled so far from home was cared for until, on the first of October, twelve days after he fell sick and six days after his brother's death, he died.
There was nothing that could have been done for Eugene Shadbolt, as for his brother in the cantonment, which was not done, quickly, kindly, and as a matter of course.
And when, a civilian visitor to a military camp, he died, the Red Cross workers at Camp Devens took charge of all the arrangements over, which the Army had, of course, no authority and sent his body home.
That was one of the saddest of all the many sad things that happened at the New England cantonment during the weeks of the epidemic.
It was one of many incidents that illustrate the flexibility of the Red Cross organization and the inclusiveness of the Red Cross work. A great machine built up for the needs of war and the horror of battle, the American Red Cross was suddenly summoned to meet, without diminution or pause in its ordinary war work, the emergency of a terrible epidemic that for six weeks assumed the proportions of a country-wide disaster.
The Red Cross took care of Eugene Shadbolt, as it took care of hundreds of soldiers' relatives, far from home, frantic with anxiety, in piteous grief; it gave the help that made it possible for the military hospital at Camp Devens, which had been equipped for 1,200 patients, to care for as many as 6,700 at one time.
It undertook the responsibility for the children of the thirty-five young housewives who died in a New Hampshire town of 3,000 inhabitants; in the village of Maybrook, New York, which was without hospital, doctor, or nurse, and where one fourth of the population had influenza, it turned a moving picture theatre into a properly equipped hospital, with adequate personnel, within twelve hours.
With the cooperation of other agencies it sent pharmacists to a little town in Alabama, doctors to a settlement in the mountains of Colorado, social workers to cope with unsanitary living conditions in mining towns on the lakes; and it sent its nurses everywhere. Its field directors in cantonments worked for days without taking off their clothes.
Policement in Seattle, Washington, Wearing Masks Made by the Seattle Chapter of the Red Cross, During the Influenza Epidemic, circa December 1918. Photograph Courtesy of the American Red Cross. National Archives and Records Administration RG 165-WW-269B-25. NARA ID # 45499339. The Red Cross Magazine, January 1919. GGA Image ID # 150c85e92a
Its volunteer helpers scrubbed floors in Philadelphia tenements; its women motor drivers grappled with the problems of homeless war workers in Washington; its chief representative at Camp McClellan saw to it that the germ laden roads around the hospital were oiled within a few hours after the dust had been analyzed.
In city and village all over the country it provided what was needed for the sick, and for sick women's families food and household care; and in all the military camps and naval stations where the call came it bought supplies, furnished nurses, and looked after the needs—sometimes so tragic— of visitors.
It is attending now to after-care, both physical and social, for the victims of the epidemic and their families. And everywhere it has worked in constant cooperation with the existing agencies of relief, with the Army, the Navy, the public health service, the local authorities, and with the individual and—until the epidemic came and the Red Cross stepped in to meet the emergency—unorganized generosity of the community.
Even to glance at the history of those six weeks in the United States is to sense at once two things: One is the pooling everywhere of the resources of the community; the other is best summed up in the words of a Red Cross worker in one of the Western cantonments: "It is really funny, serious as the situation is, to see how people run straight to the Red Cross for help of every kind!"
And these things are not the opposites they may seem. In cooperation and concentrated effort alike, they make plain and very poignant the flexibility of the Red Cross in fulfilling its broad purpose—to give help where there is suffering, and to answer the call of emergency and disaster as well as of war.
With the need for organized action the National Red Cross took several immediate steps. A National Committee on Influenza was formed, with W. Frank Persons, Director-General of Civilian Relief, at its head, and arrangements were made at once for complete cooperation with the Surgeons - General of the Army, the Navy, and the Public Health Service.
On October first Surgeon-General Rupert Blue, of the United States Public Health Service, sent to the Red Cross War Council a request for specific, thorough-going aid.
He was at once assured that the Red Cross would give all the assistance asked, and that his suggestion of an appropriation of $575,000 for nurses' salaries and emergency hospital supplies had been met immediately.
And, on the same day a telegram was sent to each division manager, telling them all what steps had been taken in Washington and directing them to telegraph at once the information to the chairmen of all the larger chapters.
Within the space of one day the Red Cross all over the country was organized in readiness for emergency needs. At the same time the division managers were in structed to reprint and distribute a pamphlet on the prevention and cure of influenza which had been prepared by Surgeon-General Blue.
What the Red Cross thus undertook to do was, briefly, to supply "all the needed nursing personnel" for fighting the epidemic, paying the nurses' salaries and other expenses, and to furnish' emergency hospital equipment where the local authorities were unable to do so in a sufficiently short time.
The Red Cross was also to aid in the distribution of educational printed matter, and wherever necessary it was to finance traveling medical units. In working out the detail of complete cooperation, to prevent duplications or delays, it was arranged that in each state there should be working together a Federal Health officer, a State Health officer, and a Red Cross liaison agent, while in each community local resources were to be organized and used as far as they held out.
Emergency Hospital at Shelton, PA, Established by the State Board of Health, is All Under Canvas Tents. The Red Cross Magazine, January 1919. GGA Image ID # 150fc68f41
Inside View of One of the Tents at Shelton, PA, Showing the Method of Separating the Cots. Red Cross Nurses and Aids have Worked in Similar Tents All Over the State. The Red Cross Magazine, January 1919. GGA Image ID # 150ff3551a
To a great extent this was planned in advance of the epidemic. To quote Willoughby Walling, later in Mr. Persons' absence acting chairman of the influenza committee: "When the epidemic struck the seaboard, we organized the country." This organization that extended from Washington to every Red Cross chapter in the United States was the beginning of the national offensive against influenza.
It goes without saying that out of these broad plans for the meeting of a far-reaching disaster grew widely varied and strangely exacting details. The work of the Red Cross for civilian relief in the influenza epidemic is still going on and will continue for a long time to come.
But before it became necessary to organize the country for the succor of civilians, Red Cross camp service workers were already helping the Army and Navy to fight the plague among "the boys."
The work of the Red Cross representatives in the cantonments and naval stations came under three heads: supplies, nurses, visitors. Their part was simple enough; they must just go ahead in double-quick time and do whatever there was to be done.
They were there to meet emergencies; here was an emergency of a vastness undreamed of. As for what they did—here, for example, are some items from Camp McClellan: When influenza became prevalent in the camp, the Red Cross Field Director tendered the services of the organization—without qualification as to the size, the kind, or the cost of the work that might be assigned to it—to the Commander of the Camp, the Camp Surgeon, and the Commanding Officer of the Base Hospital.
The first request was for nurses, and in response to telegrams to various chapters in the division, forty nurses were supplied; this was many more than were first thought to be needed, but all were gladly used.
Meanwhile constant calls came over the telephone for supplies. Medicines, pajamas, masks, soap, screens, hot-water bottles—supplies that ranged from morphine to fly papers and from wallboard to socks were provided by the Red Cross in cantonments all over the country.
A typical note from Camp McClellan records the request for a motor truck for base hospital use; one had been ordered three weeks earlier but had not yet arrived. Now the need had become imperative; could the Red Cross possibly help? That was at four o'clock in the afternoon; by seven a fully equipped truck was delivered.
Then there was a call for four typewriters—and though typewriters were scarce, the Red Cross delivered the machines within twenty-four hours. There were many incidents of that sort—"supplies" by no means medical, urgently needed of a sudden, "found" immediately by the Red Cross.
Then there was the matter of the roads: the dust was analyzed, and influenza germs were discovered; the Red Cross offered to oil the roads, and the roads were oiled at once; the Quartermaster's Department chanced to be on its last gallon of oil, but the Red Cross got sixteen barrels for immediate use.
On the suggestion of the Red Cross the Chamber of Commerce of the town of Anniston undertook at once to have the dust laid on the main road between town and camp.
Within two days, the Red Cross thoroughly equipped its big warehouse as an emergency ward. Then it fitted the new army garage, three times as big, with plumbing for the same purpose. It equipped three 100-bed wards, from beds to thermometers.
With the cooperation of local factories, it got mattresses, sheets, gauze for masks on "hurry orders" that necessitated the working of machines in holiday hours and the waiving of formal "requisitions" that would have taken a little more time.
Later it met a call for colored nurses. One day it took complete charge of one of the hospital wards when there was a temporary shortage of attendants. It held itself in readiness to fit up a laundry if this equipment should be needed in the emergency.
When the field director turned in his first report to Washington, he added that these were "only a few" of the things that had been done. But they are typical things.
A major remarked to the Field Director at Camp McClellan that he was " indeed fortunate in having a large organization," and the Red Cross man, who knew that his small staff had worked day and night to "get things done," asked the officer why he said that.
"I've seen the work the Red Cross is doing in the camp!" the major replied, and added that all the praise he had heard of Red Cross efficiency had been proved true. But the Field Director made a little note of the army man's remark and smiled.
Cleaning Up the Grounds of the Emergency Red Cross Hospital Established in the Civic Centre of San Francisco. The Red Cross Magazine, January 1919. GGA Image ID # 1510901cf1
When influenza suddenly swept over Camp Dodge, Major Burch, in command of the base hospital, called in the Red Cross Field Director at once. " I am going to ask the Red Cross for assistance—probably much assistance," he said, " I must lean heavily upon the Red Cross, and I am afraid the demands in this matter will tax your resources and endurance.
Eventually the War Department will meet the requirements, but the emergency must be met by you." The Field Director replied that the Red Cross was there to serve, and to meet emergencies; but when the Commanding Officer gave him the preliminary list of supplies needed at once, he was startled.
It was a long list, to begin with, and as the day advanced, and he bought and bought and bought, the list grew longer. The Army representative explained that it was a matter of time—and men were then pouring into the hospital by hundreds.
The maximum capacity of the base hospital was about 2,200; in eight days there were nearly 8,000 patients, and of these nearly 6,000 were provided with equipment which had been furnished by the Red Cross.
The nursing force was trebled in two weeks and, as the Commanding Officer of the Hospital pointed out in the expression of its appreciation which the Army was quick to make, practically all of these were furnished by the Red Cross, and could have been assembled so quickly in no other known way.
The problem of nurses had its own seriousness. The problem of supplies was tremendous. But where the epidemic raged among men in the service, the Red Cross added to these duties work of a very different kind. It was the Red Cross in whose hands lay the responsibility for the care of the sick boys' relatives.
Line of Citizens in Seattle Waiting for Influenza Epidemic Masks at the Red Cross Headquarters. At One Time Durint the First Day, the Line was Two Blocks Long. The Red Cross Magazine, January 1919. GGA Image ID # 150facf013
It was often necessary, for instance, to supply money to men and women who had come suddenly a long distance, unprepared. In the case of the Chelsea Naval Hospital, where seven volunteer medical social workers handled an immense amount of night work, the Red Cross representatives found the visitors sleeping quarters in a city nearby.
In Camp Dodge a motor service was established in addition to a hotel registry, to carry the sick boys' mothers to them quickly when the call came—and it may be mentioned that in Camp Dodge an emergency telegraph office was installed in the Visitors' House.
There was far too much of it, and it was too varied, to describe—or even to catalogue—in a short article. And this, which is obviously true of the "military relief," is true to a yet greater extent in the fight against influenza among the Civilian population.
One could glimpse the whole, by observing a few typical achievements or happenings. And one must bear in mind always that here was a "pooling of resources," that the Red Cross was working hand in hand with other agencies, public and private, and with individuals, that one of its biggest pieces of work was often the "organization of the community."
In New York City, for example, on instructions from the Department of Nursing of the National Red Cross, the Bureau of Nurses of the Atlantic Division undertook the organization of the Nurses' Emergency Council, assembled with the cooperation by various agencies, to form a general nurses' recruiting office.
In a mountain town in Colorado that was absolutely without physicians, the Red Cross, acting in conjunction with the health authorities, had enough doctors sent to care for the sick, and shouldered all the expense involved.
In New Orleans the Red Cross was able to stop the sale of milk and soft drinks from street stands, as well as to have the saloons closed, through the aid of the State Food Administrator.
In Westerly, Rhode Island, where the epidemic suddenly assumed alarming proportions in the Italian section of the town, the local chapter of the Red Cross called upon the community's sanitary corps to meet the situation.
From the Superintendent of the Pennsylvania Board of Health came the statement that he had directed the eighteen district nursing supervisors to call upon the Red Cross membership in every county, town, and village and "had not found any one who failed to cooperate.'
He added: "They are furnishing supplies, helping with nursing, and doing the finest kind of cooperative work." In the instructions sent out by the National Committee on Influenza to all division managers, the details of cooperation with the Public Health Service and local health boards were made plain.
It was the great—and virtually unique—difficulty of this "epidemic that, after it had first appeared in New England, it spread throughout the rest of the country almost at once.
It was indeed, as it has been described, a "universal disaster." It could be alleviated, not by the general. moving of aid to one afflicted district, but by the organization of all the resources "on the spot." Yet what forces could be moved must be mobilized wisely.
At the end of October, when the tide of disease had receded from New England, nurses were sent from the Boston headquarters to the mining districts of Pennsylvania and West Virginia, where the ravages of the epidemic had not yet been stayed, and in some cases to the Pacific coast.
Meanwhile the National Committee was constantly receiving detailed reports of the situation and the resources in the different divisions. One day toward the end of October the Public Health Office of the City of Washington asked the Red Cross if it could supply, very quickly, 25,000 gauze masks; it was requested that, if it was a possible thing, the masks be furnished at the rate of no less than five or six hundred a day.
The report from New England had informed National Headquarters that there was a quantity of masks in Boston, available for use. The entire 25,000 were in Washington in twenty-four hours.
Quickly as the Red Cross recruited nurses and nurses' aides, there were of necessity rural districts, farms, tiny villages, which could not get personal attention.
For these Miss Jane A. Delano, Director of Nursing, wrote a series of articles giving, out of her own years of experience as a nurse, the fullest details of practical help, and these were published in newspapers that circulated through rural districts and isolated Western communities.
And in many a village where medicines were scarce, and in many a poverty-stricken home in city or country, the Red Cross met the individual need for medicines as it met the demand for hospital equipment.
In Washington, where the abnormalities of war time congestion brought peculiar difficulties, the National Red Cross established a 100-bed hospital in less than five days, and the city chapter added to its organization of kitchens and food delivery and its opening of a central recruiting station for nurses and all kinds of helpers, special aid for homeless women war workers in the form of a convalescent hospital and the service, day and night, of its motor ambulance corps.
There were women drivers and women stretcher-bearers, ready to carry sick girls, if need be, down three flights of stairs, and although the Government lent orderlies to help, the women ambulance workers found many a task to accomplish and problem to solve.
Throughout the Atlantic Division, hospitals were established and surveys, made wherever the need existed. A typical instance was that of Maybrook where, after opening the hospital within twelve hours, the Red Cross workers began a survey, making personal inquiries of 797 out of the town's population of about one thousand; the physicians sent to the relief of Maybrook made, outside their hospital work, daily calls ranging in number from two on the first day to 87 when the plague was at its height.
In Oswego, where a larger hospital had been equipped within two days, physicians motored through their allotted districts in cars on the front of which was the unescapable sign, "Doctor. No Charge," and people came out of their houses to call them in. The Division sent out 147 graduate nurses, 58 under-graduates and practical nurses, and 251 nurses' aides.
The Red Cross Motor Corps of San Francisco Rendered Valuable Emergency Service During the Epidemic. The Red Cross Magazine, January 1919. GGA Image ID # 150fa340a5
Much that has been mentioned is a matter of physical succor for the sick. But in Silverton, Colorado, for example, and Belen, New Mexico, where half the population was ill at once; in hundreds of towns where whole families were helpless at one time.
In thousands upon thousands of households where the mother's prostration left the children without food, it was obvious that relief could not be confined to those who were sick.
And so, everywhere, hot food was cooked and delivered, household workers were provided, nurseries were opened. In one little town in the Rocky Mountains every woman who was not sick volunteered at the first call for Red Cross aid.
And though "the worst is over" now, the work is not. In a small section of a small town in Massachusetts sixteen children were left motherless in a few weeks. In Washington—to quote just one instance—the parents of two little children died and left them absolutely alone in the world.
For all such children as these the Red Cross has assumed responsibility. Everywhere the serious pathological conditions that are the results of Spanish influenza are calling for the kind of attention that means not only watchfulness through convalescence, but the assurance that men with strained hearts shall not be obliged to climb four flights of tenement stairs at the end of a day's work, that women with weakened lungs shall have fresh air and good food and the possibility of rest.
The Red Cross is looking out for all these things. It is not actually doing the work itself unless no local agency can undertake it. But it stands ready to make sure that it will be done. It met the demands of the epidemic.
It is meeting them still.
Katherine Woods, "Battling With The 'Flu'," in The Red Cross Magazine: The Official Organ of the American National Red Cross, Garden City, NY: American National Red Cross, Vol. XIV, No. 1, January 1919, pp. 11-17.