By 1858, life on the Ballarat Goldfield was settled into a fairly steady if rough routine. Ballarat was a boozy, muddy, filthy, treeless site. Contagious diseases - cholera, typhoid, dysentery - were prevalent.
The most-feared disease was smallpox. Highly infectious, its symptoms were devastating: headaches and high fevers, acute nausea, followed in two to four days by the development of mouth ulcers, pus and fluid-filled lesions and blisters, with agonising abdominal pain and skin rupture. Death was usual in two varieties.
Dr Nicola Cousen has a PhD in history from Federation University. She's written extensively about medicine on the goldfields, with her doctoral research on Ballarat doctor and philanthropist Dr James Stewart, who amputated Peter Lalor's mutilated arm after Eureka, and was also Public Vaccinator.
She has examined the role of vaccination in Ballarat in the face of potential smallpox outbreaks in Victoria in 1858 and 1867, and how the populace reacted.
"The reactions and experience of people in the early stages of the COVID-19 pandemic was strikingly similar in some ways," Dr Cousen says.
"Human behaviour has changed little some 170 years on. We were originally protected from initial outbreaks because of distance the countries where there were outbreaks and quarantine. Suspected outbreaks of smallpox were contact traced to track the disease.
"Contact tracing smallpox-style involved a network of health officials from the Chief Medical Officer and Central Board of Health through to Local Boards of Health in each district, the Registrar of Births and Deaths of the district, the Public Vaccinator of the district through to local doctors and hospitals."
A case of smallpox was detected in Melbourne in 1858, but by 1854 the burgeoning colony of Victoria had already enacted legislation to combat the potential spread of a disease feared across the world.
The Act to make compulsory the Practice of Vaccination received royal assent in November 1854 - long before 'Big Pharma' was ever a conspiracy.
Children born after 1840 were to be vaccinated by mandate, and a certificate of vaccination was to be given to the child's parents or carers. Fines could be levied against those who failed to comply. It was hard to assess how widely the vaccines were administered, Dr Cousen says.
"This is difficult to measure because not all vaccination registers still exist," she says.
"Dr Stewart's registers from his Vaccination Hall in Armstrong Street no longer exist. He was the most prominent Public Vaccinator for the district, so there's a large hole in the data."
There were objectors and conspiracists, despite evidence the Chinese had practiced inoculation or variolation (giving a milder version of smallpox) for 900 years, using it widely for at least 300; and Edward Jenner's 1796 discovery that applying cowpox lesion fluid gave immunity to smallpox (called vaccination after the Latin vacca, or cow).
Almost as soon as the English parliament passed its compulsory vaccination law in 1853, social movements as the Anti-Vaccination League sprang up. Some argued vaccination was unsafe, others it infringed on their civil liberties and the rising mercantile belief in the principle of laissez faire ('let do', or 'let it rip') - that government intervention in public life was to be resisted.
In Ballarat, Dr Cousen writes, things were different.
"The influx of highly-educated middle-class immigrants during the gold rush, many of whom expeditiously established institutions, meant that Victoria developed differently to other Australian colonies. The relative modernity of Victorian public health is reflected in the speed at which the colony adopted medical advances and legislation following changes in the United Kingdom," Dr Cousen writes.
Ballarat and the colony generally adopted early both vaccination and the wider principles of public health, through the building of hospitals funded by public money and private subscription, an educated and informed public, and the use of vaccination laws.
"Ballarat was fortunate to have prominent doctors such as Dr James Stewart and Dr George Clendinning sitting on the councils of Ballarat West and Ballarat East," Dr Cousen says.
"Municipal councillors sat as the Local Board of Health at the end of council meetings, but health issues and correspondence from the central and local boards of health were also addressed during meetings."
That isn't to say disagreement over vaccination was non-existent.
"Like today, the Chief Health Officer received criticism from politicians, the press, the public and other medical practitioners about public health measures and how cases were handled," Dr Cousen says.
"The events, council meetings and Local Board of Health meetings were published in the newspapers.
"The community had reliable, trustworthy and experienced experts for correct information when some newspaper articles stirred up fear with misinformation."
Dr Cousen quotes the case of Ballarat eight-year-old Miss Lecki. Attended by Dr Allison and suspected of having chicken pox, then smallpox, and finally the less virulent cowpox, the Ballarat Star nevertheless:
"...misreported the case in an alarmist manner, suggested that Dr Allison was disgracefully derelict in his duty, and that he had placed the community at risk of the virulently infectious disease. A pitiable apology was given the following day...
"If the doctors, particularly the public vaccinator, had not been so well trusted by the public, the Star could have stirred up vigilantes to burn the family's tent and belongings, placing the sick child at risk.
"In terms of vaccination, vaccination rates would rise with the fear when there was news of outbreaks overseas and suspected outbreaks in the colony," Dr Cousen says.
"During the C19 alarm about suspected epidemics helped accelerate developments in public health. It is doing the same thing now with COVID-19."
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