By Shamara Wettimuny, Oxford University
Interest in the impact of epidemics and public health in Sri Lanka has naturally seen an increase since the dramatic spread of COVID-19 worldwide. Medical administration reports and newspapers available in the National Archives provide us with a longitudinal picture of Sri Lanka’s public health for the last 100 years, and the various epidemics Sri Lanka has confronted.
The report of the Principal Civil Medical Officer and Inspector-General of Hospitals provides a fascinating overview of multiple diseases plaguing Sri Lanka in the year 1918. The year 1918 is an interesting one – it saw the end of the First World War, and the onset of the Spanish Influenza. The Spanish Influenza devastated much of Europe. It also inflicted an enormous death toll in South Asia, particularly in India, but also in Sri Lanka.
According to this report, epidemic diseases were the most serious and widespread class of disease in Sri Lanka in 1918, followed by ‘ill-defined diseases’ and ‘diseases of the respiratory system’. The most notable cause of death was pneumonia, with 16,770 deaths. It would appear that much of these deaths by pneumonia occurred on estates, where health and sanitary conditions were appalling.
The years 1914 and 1915 had seen a rise in the number of plague cases. However, by 1918 it did not appear to be among the most notable causes of death by disease. Meanwhile, Sri Lanka was yet to face the worst killer in its history – the deadly malaria epidemic, which reached its peak in the mid-1930s. There were only 802 malaria deaths in 1918.
Between the mid-nineteenth and early twentieth century, Sri Lanka witnessed a disproportionate number of deaths due to ‘preventable diseases’, including those connected to poor sanitary conditions and sewage facilities. For example, in 1918, there were 12,264 deaths that were considered ‘preventable’. The reduction in such deaths over the last century is a testament to the vast improvements in Sri Lanka’s public health and sanitary systems.
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