Balmis Expedition

Smallpox, a devastating disease, decimated the populations of the Americas after it had been brought over from Europe by the Spanish conquistadors in the 1500s,[1] but also threatened the slave trade with small pox epidemics on board of the ships carrying human cargo.[2]

Vaccination, that is inoculation with cowpox material, is a much safer way to prevent smallpox than older methods such as variolation, inoculation with smallpox material, which ran the risk of itself spreading smallpox. Vaccination had been pioneered in the West by the English physician Edward Jenner in 1798. At that time, about 400,000 Europeans died each year from the disease.[1] At the same time, Europe engaged in slave trade and the Haitian Revolution (1794-1804) occurred. Francisco Javier de Balmis was a military physician.[3]

Balmis balcony in the Domus museum in La Coruña (Spain), a tribute to the people of the expedition

Monument in A Coruña in honor of the orphan children who took part of the expedition.

Historical marker installed in the Philippines to commemorate the arrival of the expedition in the Philippine Islands.

In November 1794 the daughter of King Charles IV of Spain, Infanta Maria Teresa, had died from smallpox. He had heard of the vaccine discovery. Colombia and Ecuador experienced a smallpox epidemic and called on the king for supplies.[3]

On 30 November 1803, the expedition set off from A Coruña in northwest Spain sailing on Maria Pita. It carried 22 orphan boys (aged 3 to 10) to act as carriers of the cowpox virus. The boys were necessary because the vaccine consisted of infecting patients with cowpox, which is a virus closely related to smallpox but produces a much milder disease that confers immunity to both. However, only an active infection could be transferred to successive patients, so two boys were infected with cowpox at the beginning of the voyage, with two more infected at a time as it progressed across the Atlantic and beyond.[4] The medical staff and caretakers for the boys consisted of Balmis, a deputy surgeon, two assistants, two first-aid practitioners, three nurses, and Isabel Zendal Gómez, the rectoress of Casa de Expósitos, an A Coruña orphanage.[5]

The mission took the vaccine to the Canary Islands, Puerto Rico, Venezuela, Colombia, Ecuador, Peru, Mexico, the Philippines and China.[6] The ship carried also scientific instruments and translations of the Historical and Practical Treatise on the Vaccine by Moreau de Sarthe to be distributed to the local vaccine commissions to be founded.[7]

In Puerto Rico, the local population had already been inoculated from the Danish colony of Saint Thomas. In Venezuela, the expedition divided at La Guaira. Balmis went to Caracas and later to Havana.

At Balmis’ request Cuba sent three enslaved girls to Campeche, Mexico, as additional carriers of the vaccine; following Mexican independence and emancipation, Mexico continued to bring in slaves from Cuba as vaccine carriers.[3]

The Venezuelan poet Andrés Bello wrote an ode to Balmis. José Salvany, the deputy surgeon, went toward today's Colombia and the Viceroyalty of Peru (Ecuador, Peru, Chile, and Bolivia). They took seven years and the toils of the voyage brought death to Salvany (Cochabamba, 1810).In New Spain, Balmis took 25 orphans to maintain the infection during the crossing of the Pacific. In the Philippines, they received help from the Catholic church, which was initially reluctant until Governor-General Rafael Aguilar made an example by vaccinating his five children. Balmis sent most of the expedition back to New Spain while he went on to China, where he visited Macau and Canton.[8] On his way back to Spain in 1806, Balmis offered the vaccine to the British authorities in Saint Helena, despite the Anglo-Spanish War (1796–1808).[7]

Balmis expedition may be considered the first international healthcare expedition in history.[7][9] Jenner himself wrote, "I don't imagine the annals of history furnish an example of philanthropy so noble, so extensive as this."[1]

In 2006, Julia Alvarez wrote a fictional account of the expedition from the perspective of its only female member in Saving the World (2006).

• Mark, Catherine; Rigau-Perez, Jose G. (2009). "The World's First Immunization Campaign: The Spanish Smallpox Vaccine Expedition, 1803–1813". Bulletin of the History of Medicine. 83 (1): 63–94. ISSN 0007-5140.

• En el nombre de los Niños. Real expedición Filantrópica de la Vacuna 1803-1806. Spanish language PDF book by the Spanish Pediatry Association.