Skip to main content

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

Abstract

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.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. 1.

    Herbert, E. W. (1975). Smallpox inoculation in Africa. Journal of African History, 15(4), 539–559.

    Article  Google Scholar 

  2. 2.

    Miller, G. (1957). The adoption of inoculation for smallpox in England and France. Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  3. 3.

    Herbert. (1975). 541–542.

  4. 4.

    Herbert. (1975). 541.

  5. 5.

    Dixon, C. W. (1962). Smallpox (pp. 219–221). London: J&A Churchill Ltd.

    Google Scholar 

  6. 6.

    Dixon. (1962). 216.

  7. 7.

    Herbert. (1975). 546–549.

  8. 8.

    Pankhurst, R. (1965). The history and traditional treatment of smallpox in Ethiopia. Medical History, 9(4), 343–355.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  9. 9.

    Schneider, W. (2009). Smallpox in Africa during colonial rule. Medical History, 53(2), 193–227.

    PubMed Central  PubMed  Article  Google Scholar 

  10. 10.

    Seymour-Price, M., Cachia, C., & Fendall, N. R. E. (1960). Smallpox in Kenya. East African Medical Journal, 37(10), 670–675.

    CAS  PubMed  Google Scholar 

  11. 11.

    Dawson, M. H. (1979). Disease and social change: Smallpox in Kenya, 1880–1920. Social Science and Medicine, 13B(4), 245–250.

    CAS  PubMed  Google Scholar 

  12. 12.

    Conacher, D. G. (1957). Smallpox in Tanganyika 1918–1954. East African Medical Journal, 34(5), 157–181.

    CAS  PubMed  Google Scholar 

  13. 13.

    Maclean, G. (1950). Medical administration in the tropics. British Medical Journal, 1(4656), 756–761.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  14. 14.

    Owen, W. E. (1924–1925). The Kavirondo practice of inoculation with smallpox. Kenya Medical Journal, 1, 333–335.

  15. 15.

    Imperato, P. J. (1983). Early modern medical services at Moyale, Kenya. East African Medical Journal, 60(6), 367–373.

    CAS  PubMed  Google Scholar 

  16. 16.

    Imperato, P. J. (1981). Early modern medical services at Marsabit, Kenya. East African Medical Journal, 58(10), 769–775.

    Google Scholar 

  17. 17.

    Imperato, P. J. (1968). The practice of variolation among the Songhai of Mali. Transactions of the Royal Society of Tropical Medicine and Hygiene, 62(6), 868–873.

    CAS  PubMed  Article  Google Scholar 

  18. 18.

    Imperato, P. J. (1974). Observations on variolation practices in Mali. Tropical and Geographical Medicine, 26(4), 429–440.

    CAS  PubMed  Google Scholar 

  19. 19.

    Hopkins, D. R. (1983). The greatest killer: Smallpox in history (pp. 46–49). Chicago: The University of Chicago Press.

    Google Scholar 

  20. 20.

    Fenner, F., Henderson, D. A., Arita, I., Jezek, Z., & Ladnyi, L. D. (1988). Smallpox and its eradication (p. 270). Geneva: World Health Organization.

    Google Scholar 

  21. 21.

    Fenner et al. (1988). 283.

  22. 22.

    Imperato, P. J. (1967). Bwana doctor (p. 97). London: Jarrolds Publishers Ltd.

    Google Scholar 

  23. 23.

    Imperato, P. J. (1966). Witchcraft and traditional medicine among the Luo of Tanganyika. Tanzania Notes and Records, 66, 193–201.

    Google Scholar 

  24. 24.

    Owen. (1924–1925). 334.

  25. 25.

    Owen. (1924–1925). 335.

  26. 26.

    Herbert. (1975). 549–551.

  27. 27.

    Hopkins. (1983). 200–203.

  28. 28.

    Challenor, B. D. (1971). Cultural resistance to smallpox vaccination in West Africa. Journal of Tropical Medicine and Hygiene, 74(3), 57–59.

    CAS  PubMed  Google Scholar 

  29. 29.

    McNeil, D. G., Jr. (2014). CDC shuts labs after accidents with pathogens. Anthrax and flu sites. Shipments of specimens halt, complicating research. The New York Times, CLXII(56,560): A1, A11.

  30. 30.

    Fenner et al. (1988). 106–107.

  31. 31.

    Pankhurst. (1965). 347–348.

  32. 32.

    Mérab, E. (1912). Médecins et Médecine en Ethiopie: Généralités, Pathologie Médicale, Pathologie Chirurgicale et Accouchements, Médecins Etrangers en Ethiopie (pp. 110–111). Paris: Vigot.

    Google Scholar 

  33. 33.

    Pankhurst. (1965). 347.

  34. 34.

    Pankhurst. (1965). 350.

  35. 35.

    Schneider. (2009). 209–213.

  36. 36.

    Conacher. (1957). 173–174.

  37. 37.

    Maclean. (1950). 756.

  38. 38.

    Hopkins, D. R., Lane, J. M., Cummings, E. C., & Millar, J. D. (1971). Two funeral-associated smallpox outbreaks in Sierra Leone. American Journal of Epidemiology, 94(4), 341–347.

    CAS  PubMed  Google Scholar 

  39. 39.

    Baxter, P. T. W. (1954). Social organization of the Boran of Northern Kenya. Oxford: Lincoln College, University of Oxford.

    Google Scholar 

  40. 40.

    Tablino, P. (1999). The Gabra of Northern Kenya. Nairobi: Paulines Publications Africa.

    Google Scholar 

  41. 41.

    Fenner. (1988). 949.

  42. 42.

    Seymour-Price et al. (1960). 673.

  43. 43.

    Report of the International Commission for the Certification of Smallpox Eradication in Kenya. (1979). Geneva: World Health Organization.

  44. 44.

    Seymour-Price et al. (1960). 671–673.

  45. 45.

    Seymour-Price et al. (1960). 672.

  46. 46.

    Seymour-Price et al. (1960). 672.

  47. 47.

    Schneider. (2009). 206.

  48. 48.

    Seymour-Price et al. (1960). 672.

  49. 49.

    Annual medical report (pp. 11–12). (1934). Nairobi: Kenya Medical Department.

  50. 50.

    Annual medical report. (1934). 11–12.

  51. 51.

    Annual medical report. (1934). 11–12.

  52. 52.

    Low, M. W. (1934). Marsabit district annual report (pp. 18–19). Kenya National Archives AR/1705.

  53. 53.

    Low. (1934). 19.

  54. 54.

    Low. (1934). 19.

  55. 55.

    Low. (1934). 18–19.

  56. 56.

    Stott, H. (1945). Variola minor in Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene, 38(6), 445–460.

    CAS  PubMed  Article  Google Scholar 

  57. 57.

    Bullen, D. A. (1934). The annual medical report, Moyale and Mandera District, year ending 31 December 1934. Moyale District Annual Report. Kenya National Archives AR/1657, p. 11.

  58. 58.

    Howes, R. J. C. (1934). Moyale district annual report. Kenya National Archives AR/1657, p. 26.

  59. 59.

    White, L. (2011). Differences in medicine, differences in ethics: Or, when is it research and when is it kidnapping or is that even the right question? In P. Geissler & C. Molyneux (Eds.), Evidence, ethos and experiment: The anthropology and history of medical research in Africa (pp. 445–461). New York: Berghahn Books.

    Google Scholar 

  60. 60.

    Imperato. (1968). 871.

  61. 61.

    White. (2011). 449.

  62. 62.

    Frankenberg, R., & Leeson, J. (1976). Disease, illness and sickness: Social aspects of choice of healer in a Lusaka suburb. In J. B. Louden (Ed.), Social anthropology of medicine (pp. 223–257). London: Academic Press.

    Google Scholar 

  63. 63.

    Henderson, D. A. (2009). Smallpox: The death of a disease—The inside story of eradicating a worldwide killer (pp. 193–195). Amherst, NY: Prometheus Books.

    Google Scholar 

  64. 64.

    Fenner et al. (1988). 682–685.

  65. 65.

    Imperato, P. J. (1969). Personal diary. 21 March (p. 80).

  66. 66.

    Report. (1979). 6.

Download references

Acknowledgments

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.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Pascal James Imperato.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

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). https://doi.org/10.1007/s10900-014-9928-5

Download citation

Keywords

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