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Smallpox Inoculation (Variolation) in East Africa with Special Reference to the Practice Among the Boran and Gabra of Northern Kenya


Smallpox inoculation (variolation) was widely reported in sub-Sahara Africa before, during, and after the colonial era. The infective smallpox materials and techniques used, as well as the anatomical sites for inoculation, varied widely among different ethnic groups. The practice among the Boran and Gabra pastoralists of northern Kenya resembled that which was prevalent in a number of areas of Ethiopia. This is not surprising as the Boran also live in southern Ethiopia, and Gabra herdsmen frequently cross the border into this region. The Boran and Gabra technique for smallpox inoculation consisted of taking infective material from the vesicles or pustules of those with active smallpox, and scraping it into the skin on the dorsum of the lower forearm. Although the intent was to cause a local reaction and at most a mild form of smallpox, severe cases of the disease not infrequently resulted. Also, variolated individuals were capable of infecting others with smallpox, thereby augmenting outbreaks and sustaining them. The limited known reports of smallpox inoculation among the Boran and Gabra are presented in this communication. The expansion of vaccination with effective heat stable vaccines, the development of medical and public health infrastructures, and educational programs all contributed to the eventual disappearance of the practice among the Boran and Gabra.

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We wish to acknowledge the support and assistance of the following who have now passed on: the late Terence John Fredrick Gavaghan, the late Reverend Paolo Tablino, the late Monty Brown who was an expert on the history of northern Kenya, the late William Dixson, the late Cynthia and Sydney Downey, the late Frank Murray who possessed a profound knowledge of Luo culture, and the late Edward Rodwell whose knowledge of Kenya was all encompassing. We are very grateful to Mervyn and Elsie Maciel, who served for several years in northern Kenya, for all their help and support on this and other projects. We wish to thank Errol Trzebinski, a faithful friend and supporter, and a leading authority on early travelers and settlers in Kenya. Special thanks are extended to Sister Mary Reese, who lived and worked in the North Mara District of Tanzania for several decades, for her assistance, and to the Reverend Alexander Choka who provided access to the world of beliefs of the Luo people. Much appreciation is extended to Jay S. Friedman, the Reverend Pierre Huet of the Kimparana Mission of the Society of Missionaries of Africa, the late Mamadou Goundiam, and Zahn Sabake Traore for their participation in investigating the smallpox outbreak in the village of Tidjana, Mali. We wish to thank Lois A. Hahn for her careful preparation of the typescript, and Dorine Cooper for her assistance with the photographs.

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Correspondence to Pascal James Imperato.

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Imperato, P.J., Imperato, G.H. Smallpox Inoculation (Variolation) in East Africa with Special Reference to the Practice Among the Boran and Gabra of Northern Kenya. J Community Health 39, 1053–1062 (2014).

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  • Smallpox inoculation (variolation)
  • Variolation in East Africa
  • Luo variolation
  • Boran and Gabra variolation
  • Kenya
  • Tanzania