What began in June and July as an unusual flu epidemic (for that time) had, by early August, become a major health problem which put the whole population of Malaga on alert. The illness called 'Spanish flu', which arrived in Malaga in the summer of 1918, a century ago now, began at the end of the spring and lasted until the autumn. Between April and August 1918 and October 1918 and April the following year, the devastating epidemic took the lives of over 200,000 people in Spain and millions of others all over the world.
In Malaga, the figures in studies differ because detailed records were not kept at the time. It is said that there were 1,500 deaths but in reality there could been many more. At least ten times that number caught Spanish flu in this province, but the lack of reliable statistics makes it difficult to give an exact figure.
In the first period of the epidemic the health authorities reacted quite quickly, but in the second one, which started in the autumn of 1918 and lasted until the spring, the consequences were much more relevant and devastating, possibly because once the first epidemic was over, those in charge hadn't expected the Spanish flu to return.
An excellent piece of research on 'Illness and social crisis; the flu in Malaga (1918)' which was published by Malaga university in 1985, explains in detail what that pandemic in the province actually signified. It is the work of Juan L. Carrillo, Jesús Castellanos and María Dolores Ramos.
The illness known as Spanish flu (1918-19) was the worst pandemic in memory, and was even more virulent than the Black Death of 1349. The flu, which seems to have started in Kansas (USA), spread rapidly around the world and resulted in at least 50 million deaths. It arrived in Spain in the spring of 1918, left behind a long list of fatalities (between 150,000 and 300,000, according to researchers) and affected eight million other people.
The epidemic began in Malaga in the first week of June. A second one began in October and lasted until the spring of 1919. The first one was the most serious, and affected 3,000 people.
The illness became known as Spanish flu not because it started in this country, but because Spain published more information about it in the press than any other. As Spain was a neutral country in the First World War, the news about the epidemic was not censored. The nations involved in the war censored their press in order not to discourage their people any further, after so many lives had been lost during the fighting. The continual movement of troops from one place to another also favoured the transmission of the flu virus.
Where did it originate, exactly? Kansas, Peking? Nobody really knows, but if anything is certain about one of the most deadly pandemics in history, and despite the name it was given, 'Spanish flu' did not start in Spain.
The name "was due to rumours that the flu was caused by German agents who introduced pathogenic bacillus in Spanish tinned foods. This ignorance and the lack of real information during the fighting reinforced the fear," according to the French newspaper 'Libération' at the time. It did Spain no favours, especially as the country suffered the after-effects of the pandemic for a number of years.
In Malaga, the virus especially affected the poor people and most disadvantaged. Bad nutrition and lack of hygiene resulted in the infection causing more havoc. Most of the sick were treated at the Civil Hospital. The doctors there did their best to contain the contagion but couldn't stop the epidemic taking the life of about 1,500 people in Malaga.
The authorities reacted late to the second epidemic. It was only when the number of people infected rose sharply that they set a budget for dealing with the flu, printed a leaflet with information about how to prevent contagion, created a police force specifically for health matters and set up a register of those affected.
The Great War was not the direct cause of the 'Spanish flu', but it did have a lot to do with it starting and spreading, because the proximity between barracks, "the promiscuity of the soldiers and the massive movements of troops and civilians due to the conflict could have increased it," according to the aforementioned French newspaper 'Libération'.
On the same lines, some researchers link the profile of the victims with the incidence of the Spanish flu virus among soldiers fighting on the front, because they believe that their immune systems were weakened by the stress of combat, inadequate nutrition and lack of hygiene, which increased the probability of contracting the lethal virus.
As is always the case, some people benefited from the poverty and misery of Spanish flu, and in this case many, especially in the USA, who had brought the new life assurance policies suddenly found themselves among the wealthy.
The companies paid out around 100 million dollars - the equivalent of 20 billion in today's money - in compensation after the pandemic. One significant case is "the death from flu of a German immigrant in the USA", as described in the book. His widow and son received a sum of money which they invested in property, and today his grandson is said to be worth billions of dollars. That grandson is also one of the most powerful people on Earth: his name is Donald Trump.
A twist of fate back in the early 20th century contributed in its own way to the fact that now, in 2018, he has one of the most dazzling fortunes on the planet and enormous political power as well.
Professor Silvia García Barrios, who has studied the history of the Civil Hospital and that of Dr José Gálvez Ginachero, says that in the early 20th century there were hardly any hospitals in Malaga city or province. In the years between 1900 and 1915 the precarious sanitary infrastructure was the main cause of the high mortality rate, which was greater than the national average.
A very scarce water supply, deficient drainage, narrow streets, the lack of trees, overcrowded population, rubbish accumulating in the streets and economic crises meant that begging and destitution increased.
As a result, there were repeated epidemics, illnesses such as smallpox, typhus, malaria, Malta fever, tuberculosis, flu and and infectious illnesses in general. The continual movement of people from the countryside to the city aggravated the existing major housing problem, and the flu pandemic of 1918 and 1919 caused more than 1,500 deaths in Malaga.
To alleviate this difficult situation, Malaga had some important hospitals which still exist today, such as that of Santo Tomás, in the city centre, which was founded in 1507 and rebuilt between 1888 and 1891. It is now a protected building and due to be restored.
Others have disappeared now, such as the Hospital Real de San Lázaro, founded in 1492 to attend to people suffering from leprousy, which was demolished in the early 20th century and of which only the chapel remains; the Convalescents' Hospital, which was privately owned, in the square of the same name, founded in 1571 and demolished in 1848; and the Hospital de Santa Ana, in the Plaza de la Merced, founded in 1502 and demolished in 1913.
One of the oldest charitable institutions of the city, which still remains today, was known first of all as the Hospital Real de la Caridad; it was created by the Catholic Monarchs in 1487. It later became the Provincial Hospital of San Juan de Dios, and nowadays we know it as the Civil Hospital.
It was the most important in Malaga in the 19th century, and was the answer to the deficiencies at the old hospital of San Juan de Dios, in the city centre. It was run by the provincial government, and supported by members of the Malaga middle-class, including the Larios, Loring and Heredia families. At the time it received great praise, for example in an article published by La Tribuna in December 1918 which said: "The Provincial Hospital of Malaga can be said to be, without deviating from the truth in any way whatsoever, the best hospital in Spain after that of Bilbao".
Also very important for the city was the Noble Hospital, founded by the Noble family in 1870. At first it was run by a Board of Ladies, and it assisted people living in the area and sailors of all nationalities. This is where those injured in the incidents in Melilla (1893), those repatriated from Cuba and the Philippines (1898) and the victims of the shipwrecked frigate Gneisenau (1900) were treated.
At the time, these two were the only hospitals in the Malaga region and they played a vital role during the time of the epidemics.
Dr Gálvez Ginachero was a key figure in organising the fight against the Spanish flu epidemic in Malaga, together with a group of other local doctors. It should be remembered, however, that in 1918 José Gálvez Ginachero was not yet the director of the hospital; he was not appointed to that post until 1923.
The director of the Civil Hospital during the time of the Spanish flu was Alfonso Hurtado Janer, who had to deal with the epidemic a year after being appointed. Fernanco Ruiz de la Herranz took over from him, but resigned after two weeks and it was then, in February 1923, that Gálvez Ginachero became the director.