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Anne Budgell won’t soon forget the handwritten letter in which missionary Albert Martin describes “the disposal of a hundred bodies through a hole in the ice.”

Martin was a Moravian missionary who served in Labrador for 34 years. He spent the last years in the Inuit community of Hebron and his letter describes the horror experienced decades ago as the 1918 Spanish influenza pandemic struck Labrador, decimating some of its communities.

His letter to the colonial secretary was among the material assembled for Budgell's new book We All Expected To Die: Spanish Influenza in Labrador, 1918-1919. Budgell crafted the history from letters, diaries, Hudson’s Bay Company journals, newspaper, government documents and the few elderly survivors interviewed for a film in the 1980s.

Theresa Tam, Canada’s current chief public health officer, writes in the foreword to the book that time has not erased “the health and social disparities” that Budgell chronicled in the Inuit communities decimated by the 1918 Spanish influenza pandemic. Tam says that in preparing today for the next pandemic, the disparities “are as important to address and plan for as are diagnostics, vaccines, and antiviral treatments.”

Budgell is scheduled to sign books at the Canadian Immunization Conference in Ottawa Dec. 4-6, where Tam and other medical experts are to commemorate the 100th anniversary of the devastating 1918 Spanish flu pandemic, demonstrate their commitment to Canada’s vaccination system and address pandemic readiness.

“At the end of World War I in 1918, after four years of unimaginable manmade destruction and millions of deaths, when people believed they could safely begin to rebuild their lives, a swiftly killing virus travelled the planet, affecting as many as one in three people,” her introduction begins.

“As many as 100 million perished in what is considered the most lethal pandemic in recorded history, the so-called “Spanish” influenza. The virus was exceptionally severe. A frightening aspect was that half the deaths were in young adults, aged between 20 and 40. Historian Alfred W. Crosby wrote: 'Nothing else—no infection, no war, no famine—has ever killed so many in as short a period.'"

Budgell writes that there were wide variations in the pandemic death rate from country to country, with two extreme examples often cited: Western Samoa, where between 20 and 30 per cent perished, and some villages of Alaska, where up to 60 per cent of people died. In Canada, about 50,000 people died. There was no place deadlier than in two tiny settlements located on the northeastern coast of North America, in northern Labrador: the isolated Inuit villages of Hebron and Okak where seven in ten people died.

'Let 'em die. It'll save us the trouble of feeding them'

A heartbreaking recollection from Joseph Obed excerpted from the book in the latest edition of Canadian Geographic magazine: “When my brother died, my sister-in-law tried to wake him up, but he was dead. She told me my brother just died, and since there was nothing I could do, I just said, 'Yes.' Then she said to me, 'I don’t want to die during the night ’cause you might be left alone.'"

"It could be just as much a nightmare for us in 2018 as it was 100 years ago." #health #Spanish #influenza #immunization #pandemic #flu #vaccination #Inuit #Labrador cc @CPHO_Canada @cic2018cci
Moravian missionary Bishop Albert Martin served in Labrador for 34 years. His last years were spent in the Inuit community of Hebron. Photo courtesy Hans Rollmann

The flu came to the communities on the Moravian missionary supply ship, the Harmony, along with "eagerly awaited" mail and cargo. Her unknowing crew returned the Harmony to Newfoundland to avoid being locked in by winter ice.

It was months before anybody knew Hebron and Okak had been nearly wiped out, but authorities in Newfoundland had already rejected an earlier plea for help from another part of Labrador. Budgell cites a newspaper story that reported one cabinet minister said, “Let ’em die, it’ll save us the trouble of feeding them.”

'You were taking your life in your hands to go outside without a rifle'

Based in St. John's, Nfld., Budgell began writing history after a 30-year career as a host, reporter and producer at CBC radio and television. Her previous book is Dear Everybody: A Woman's Journey from Park Avenue to a Labrador Trap Line.

National Observer spoke to Budgell about her new book.

Q. Some of the accounts of what happened to the people hit by Spanish influenza are heartbreaking. I know you’re a level-headed researcher, but it must have been difficult at times.

A. I think I was able to detach and distance myself somewhat because it’s so hard to imagine going through something like this that it seems a bit unreal.

When I met survivors and interviewed them years ago, I asked them how they could endure such hardship and loss. It was worse than just seeing your parents die. The dozens of sled dogs kept in the villages were rampaging around, tearing up the dead bodies. You were taking your life in your hands to go outside the house without a rifle. Imagine being five years old and witnessing that. But what the women said to me was that they had to survive, they had to carry on. What choice did they have?

Q. You wrote that the Spanish flu is not from Spain, but got its name because Spain was neutral during the First World War, and stories about the flu were appearing in Spain’s uncensored newspapers before the pandemic became a worldwide story. So, it’s “one of the biggest biomedical mysteries of the past century.”

A. One researcher has traced it to the United States, others say it came from China. Dr. Theresa Tam says it doesn’t really matter these days because the virus is present in waterfowl all over the world. It can mutate and the next thing you know, it’s in Hong Kong, or New Orleans, and because of how fast we travel now, it can be all over the world within days. The World Health Organization tries to keep track of flu viruses, as cases are reported, and then they have some chance of adjusting the vaccines to the ones they know are out there.

The government reaction was 'underwhelming and somewhat racist'

Q. You made a documentary film with Nigel Markham for the National Film Board of Canada about the devastation of the Spanish influenza in northern Labrador more than 30 years ago. The Last Days of Okak came out in 1985. What prompted you to make the film?

A. We knew the survivors were all elderly and if this story was going to be preserved in their words, we had to make haste. The youngest person we interviewed in 1979 was 66 years old and the oldest was nearly 80.

The 1985 National Film Board film by Anne Budgell and Nigel Markham tells the story of a Labrador Inuit community decimated by the Spanish influenza a century ago.

Q. Nearly 40 years later, you went back to the subject, dug deeper and wrote the book. Why?

A. I wrote an article about this a few years ago, looking at just one question. Did the missionaries really warn people that the flu was on the vessel Harmony? I found that the story of the warning did not emerge until months after the flu had killed more than 300 people.

Nothing the missionaries wrote at the time, in their many letters and reports, said anything about warning people. As I say in my book, they must have felt terribly guilty about their ship bringing the virus that killed so many people but weren't prepared to take the blame.

I also say in my book that since it was possible for people to appear well and carry the virus, they need not have been blamed. But they also did not need to blame the Inuit for “ignoring” warnings that were never given.

Just looking at that one thing made me realize there was much more to the story. I also dug into Newfoundland government documents to see what response there was to mass death in Labrador. And sadly, the matter was swept under the rug. I am describing the government's reaction as underwhelming and somewhat racist.

The hospital in the Labrador community of Okak and the Harmony supply ship at anchor in 1905. Detail from a photo by Dr. S.K. Hutton, Them Days archives

Q. How does what happened in Labrador differ from what happened elsewhere when the pandemic hit Canada?

Basically, poor communications and little medical help. Labrador people had no newspapers and after the summer cod fishery closed on the coast, only one telegraph station, at Battle Harbour. People travelled by water – and it took a week to get from St. John’s to Hebron if the ship didn’t stop along the way.

There was one doctor in all of Labrador, Harry Paddon in North West River, and he got the flu and was very sick. His wife, Mina Paddon and another nurse, Selma Carlson, probably saved many lives in North West River and the settlements around there.

But on the coast, at the two badly affected communities of Okak and Hebron, only one missionary had any medical training. Back then, all you could do for people was make sure they were kept warm and hydrated, and if everyone was sick, that didn’t happen. Many of the deaths attributed to flu were probably dehydration or hypothermia.

Journalist and author Anne Budgell poses for the cover of her new book We All Expected To Die: Spanish Influenza in Labrador, 1918-1919. Photo by Ned Pratt

'Pretty impatient' with people who haven't had their flu shot

Q. Theresa Tam, Chief Public Health Officer of Canada, has said publicly that the film inspired her medical career. And she wrote in the foreword of the book that the health and social disparities you chronicle are as important to address and to plan for as the diagnostics and drugs. What are some examples of the disparities?

A. There is an outbreak of tuberculosis right now in Nain, Labrador. It isn’t happening in St. John’s or Halifax or Toronto. Why is it only happening in the north? Or on reserves? There is a shortage of decent housing, overcrowding, poverty, poor health care. It’s a recipe for any number of poor health outcomes.

Q. You have noted that Innu communities are missing from the history. Why is that?

The Innu were nomadic hunters then and were not keeping written records of their whereabouts or the health of their people. It seems they were not in the vicinity of the places that experienced the flu in 1918. It was mentioned in some Hudson’s Bay Company journals, that Innu people were near places that had measles and smallpox outbreaks and certainly suffered deaths from that. I couldn’t find anything that said they had flu but someone else might find some proof yet.

Q. Medical experts seem to be sure that there will be another pandemic – it’s not whether there will be one, but when. A lot has changed in the century since the Spanish influenza. It’s still frightening though, isn’t it?

A. I agree it’s frightening, and I think we need to take whatever protection is offered to us, which right now is the annual flu shot. Dr.Theresa Tam and many other experts say we are way too complacent about influenza. She says an outbreak like the one in 1918 will have the emergency rooms of hospitals filled up in no time, and then hospital staff will get sick, nobody will be driving the ambulance, nobody will be caring for the sick in their homes. It could be just as much a nightmare for us in 2018 as it was a hundred years ago.

Q. Have you had your flu shot?

A. I’ve certainly had my flu shot and I am pretty impatient with people who tell me they haven’t had theirs.

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Human beings seem genetically disposed to a belief in their own invinceability - or conversely resigned to their own mortaltiy. Both attitudes are selfish - becuase they take no account of the effects of their mind-set on innocent others. Adults who don't bother to get flu shots may not get the flu themselves but might be the carrier that infects family and friends. This is the vector that spreads diseases of all kinds - and that might be prevented by the conscientious use of vaccines. Instead we have the vaccine "deniers" who are willing to be the cause of needless deaths and debillitating illness in others. Passive murderers by proxy.

Thanks for inserting the NFB film "The Last Days of Okak" it certainly jogged my memory. Names like Doris Saunders of Them Days magazine editor for instance. I remember visiting her in her shop in Goose Bay and chatting. My years in Labrador will remain special to me, even in the mid 90's it seemed remote and relatively untouched by the outside world, well somewhat relatively. The Innu and the Inuit were there long before the settlers came and stayed. I was a CFA that can't stay away, and I will certainly find Anne Budgell's book.