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Early records of inoculation and smallpox vaccination in Sarawak

If you are not familiar with inoculation or variolation (deliberately introducing the pathogen into an uninfected person), it is the method first used to immunize an individual against smallpox with material taken from a patient or a recently variolated individual, in the hopes that a mild, but protective infection would result.

The procedure was most commonly carried out by rubbing powdered smallpox scabs of fluid pustules (an inflamed blister containing pus) into superficial scratches made on the skin.

Then the patient would develop pustules identical to those caused by naturally occurring smallpox. This would lead them to develop a less severe disease than naturally acquired smallpox.

Slowly after two to four weeks, these symptoms would slow down indicating successful recovery and immunity.

According to historian Loh Chee Yin, vaccination against smallpox was introduced into Sarawak in the 1960s. However, inoculation was already practiced in the 1850s.

Drawing accompanying text in Book XII of the 16th-century Florentine Codex (compiled 1555–1576), showing Nahuas of conquest-era central Mexico with smallpox. Credit: Creative Common

Early records of smallpox inoculation in Sarawak

One of the early records of inoculation in Sarawak was recorded by Brooke Hugh Low in 1876. At that time, he was holding the post of Assistant Resident of Sibu. When he was travelling up the Baram river which was still under Brunei territory (Baram was ceded to Sarawak in June 1882).

He recorded about a smallpox epidemic which decimated the Kayan population in the area.

“I next proceeded up the Baram as far as Long Lusan, where Oyong Ngau now lives. He abandoned Batu Gadin on account of the smallpox which carried of 200 persons in his own house; 1,333 Kayans are estimated to have fallen victims to this epidemic, and 3000 Kenyahs. Although I did not ascend the river above this point I met several of the upriver chiefs, both Kayans and Kenyahs, and among the latter, Paran Libut’s brother, Tama Peng Wang, who assured me that his tribe had been decimated and that the Upper Baram, which before was populous, is now a mere waste. Houses which a year ago could boast of 100 fighting men can now scarcely muster 10. Fortunately for the Kayans there was a Selimbu Malay, one Haji Unus, at Batu Gadin who understood inoculation and inoculated some 3,600 persons of both sexes, and though many died, many also were saved.”

A record of Ibans practicing inoculation

Bishop Walter Chambers once wrote in 1857 about how inoculation saved a community of Ibans in Lingga.

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“The smallpox attacked six months ago (1856) the people up the main river, the Batang Lupar. In some of the Dyak houses it made frightful ravages, chiefly through the panic fear into which it threw the occupants, who in some cases, fled into the jungles, abandoning their sick friends and carrying the infection in their own bodies. It is said there are longhouses, whose occupants having thus rushed away, not one of them has since made his appearance.

The Dyaks regard the smallpox as an evil spirit, with the notion which induced our English peasantry to use the same caution to fairies- they never venture to name the smallpox, but designate it politely by the titles Rajah and Buah-kagu. I heard an old woman yesterday, telling how that, during the time she was nursing her grandson, she was continually begging, ‘Rajah have compassion on him, and on me, and spare his life- my only child.’

In the neighbourhood of Sakarran, the Malays inoculated with success both their own people and the Dyaks. By inoculation the disease was gradually drawing near to Lingga.

I wished the Dyaks not to inoculate until the appearance of the disease in the country, but they had an idea that the ‘Rajah’ was more mild to those who thus made submission to him. Out of hundreds who have been inoculated, only three have died under the operations.”

The Kayans’ knowledge of smallpox

Loh believed that the Kayans in those days were aware of the infectious nature of smallpox long before the introduction of inoculation and vaccination. They knew that immunity could be secured by complete isolation from affected villages.

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He cited an example from Charles Hose’s The Pagan Tribes of Borneo (1912). This is what Hose wrote:

“With this object the people of tributary stream will fell trees across its mouth or lower reaches so as to block it completely to the passage of boats, or a less drastic measure, will stretch a rope of rattan from a bank as a sign that no one may enter. Such a sign is generally respected by the inhabitants of other parts of the river basin. They are aware also of the risk of infection that attends the handling of a corpse of one who has died of epidemic disease, and they attempt to minimise it by throwing a rope aorund it and dragging it to the graveyard, and there burying it in a shallow grave in the earth, without touching it with the hands.”

As for the Ibans, it was a normal practice for the unaffected members of a longhouse to run away into the jungle to avoid smallpox infection.

Here is an example of how the Ibans who refused to be inoculated reacted to the epidemic according to Spenser St. John:

“When the smallpox was committing sad havoc among those Sea Dyak villagers who would not allow themselves to be inoculated, they ran into the jungle in every direction, caring for no one but themselves, leaving the house empty, and dwelling far away in the most silent spots, in parties of two and three, and sheltered only by a few leaves. When these calamities come upon them, they utterly lose all command over themselves, and become as almost timid children. Those seized with the complaint are abandoned; all they do is to take care that a bundle of firewood, a cooking pot, and some rice, are placed within their reach. On account of this practice, few recover, as in the delirium they roll on the ground and die.

When the fugitives become short of provisions, a few of the old men who have already had the complaint creep back to the houses at night and take a supply of rice. In the daytime, they do not dare to stir or to speak above a whisper for fear the spirits should see or hear them. They do not call the smallpox by its name, but are in the habit of saying, “Has he yet left you? At other times, they call it jungle leaves or fruits; and at other places the datu or the chief. Those tribes who inoculate suffer very little.”

Other records of inoculations and vaccination in Sarawak

In those days when a smallpox epidemic attacked Sarawak, the news was usually reported in the Sarawak Gazette.

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In 1868 for example, Sibu had a mild attack of smallpox. The gazette reported as the people failed to receive vaccine from Kuching, they were inoculating themselves.

On Apr 29, 1874, the gazette reported a smallpox epidemic was raging along the Batang Lupar and Rajang rivers.

The then principal medical officer-in-charge Dr. E. P. Houghton investigated the epidemic in person and found the disease to be measles and chickenpox.

Dr Houghton wrote in his report, “I vaccinated some children at Simanggang, which was successful and left a public vaccinator there to carry on the vaccination. I also started vaccination at Sibu in Rajang which was successful, and left two public vaccinators to vaccinate the people.”

Two years later in June 1876, Dr Houghton wrote this in the Sarawak Gazette; “Smallpox occasionally visits us but only in a sporadic form, and since vaccination has been so successfully carried on, there is every reason to hope this scourge will eventually be stamped out.”

Looking back at Sarawak history, smallpox epidemica appeared periodically affecting selected communities in the state.

These epidemics not only affected the Sarawak populations back in those days, it also caused the early migration of Sarawakians leading them to move from one place to another to flee from the disease.

If you’re freaking out about smallpox on top of your fears of the Covid-19 outbreak, don’t worry; smallpox was eradicated globally in 1980.

Patricia Hului
Patricia Hului is a Kayan who wants to live in a world where you can eat whatever you want and not gain weight. She grew up in Bintulu, Sarawak and graduated from the University Malaysia Sabah with a degree in Marine Science. She worked for The Borneo Post SEEDS, which is now defunct. When she's not writing, you can find her in a studio taking belly dance classes, hiking up a hill or browsing through Pinterest. Follow her on Instagram at @patriciahului, Facebook at Patricia Hului at Kajomag.com or Twitter at @patriciahului.

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