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Oswaldo Cruz

By: invivo

Oswaldo Gonçalves Cruz was born in 1872 in São Luís de Paraitinga, in the Brazilian state of São Paulo, the son of doctor Bento Gonçalves Cruz and Amália Bulhões Cruz.Still as a child, he moved to Rio de Janeiro. He began Medical school at the Medical School of Rio de Janeiro at 15 years of age and graduated in 1892 with a thesis entitled Microbial dissemination in water. Four years later, his dream came true: he specialized in bacteriology at the Pasteur Institute in Paris, which congregated the greatest names in science at the time.

Production of anti-plague serum

Production of anti-plague serum

When he returned from Europe, he found the port of Santos ravaged by a violent epidemic of Bubonic plague and soon engaged in tackling it. Due to the threat of the disease reaching the city of Rio de Janeiro, on May 25th, 1900, the Federal Serum Therapy Institute was created to produce anti-plague serum. The Institute’s Director-General was Baron Pedro Afonso, and our young bacteriologist was the technical director. In 1902, he became the Director-General of the new Institute, where he broadened the scope of its activities and expanded from the production of sera to basic and applied research and the training of human resources.

Sanitary campaigns

Campaign against yellow fever

Campaign against yellow fever


In the following year, Oswaldo Cruz was appointed Director-General of Public Health, the Minister of Health at the time. Using the Federal Serum Therapy Institute as a technical and scientific base, he launched his memorable sanitation campaigns. His first adversary was yellow fever, a disease which had dubbed Rio de Janeiro the reputation of foreigners’ grave, having killed four thousand immigrants between 1897 and 1906.

Oswaldo Cruz structured his campaign against yellow fever as a military operation, having split the city into 10 sanitary districts, each headed by a Health delegate. His first step was to end the ongoing duality regarding hygiene services. To do so, the federal and municipal governments joined efforts and the city’s medical and public waste handling authority was incorporated to the General Public Health Administration.

The sanitary police established harsh measures in fighting yellow fever, fining or summoning the owners of buildings with poor health conditions to demolish or renovate. The bug-trapping brigades crossed the city cleaning gutters and roofs, demanding that water tanks were closed, pouring petroleum into drains and manholes in order to kill larvae and mosquitoes.

In focus areas, they purged houses by burning sulfur and pyrethrum and isolated the sick or moved them to the São Sebastião Hospital.

Oswaldo Cruz based his strategy against yellow fever on the recent successes obtained by the Americans in Havana and on a few experiences carried out in Brazil which proved the theory developed by Carlos Finlay (a Cuban doctor) that it was a mosquito that transmitted the disease: the Aedes aegypti, which was known as Stegomyia fasciata or Culex aegypti.

At a time in which many still believed that most diseases were caused by “bad air”, the idea of “paying young fellows to hunt mosquitoes”, as a magazine stated back then, was laughable. The young researcher really tried to change people’s minds, having published a series of educational leaflets called Advices to the People, but he faced the antagonism of a great part of doctors, which did not believe Finlay’s theory.

Oswaldo wasn’t spared: cartoons mocking his measures were published in the press daily, songs with malicious lyrics were written, poems were made... However, laughter soon turned to hatred due to the strictness with which the sanitation actions were carried out - especially the hospitalization of the sick and the entry of sanitary agents (even unauthorized by the dweller) to perform purgings.

Oswaldo Cruz went on to fight bubonic plague. The campaign included the compulsory notification of cases, the isolation of patients and the administration of the serum produced at the Federal Serum Therapy Institute to the sick, vaccinations in problem zones (such as the docks), as well as the extermination of rats throughout the city. The link between rats and mosquitoes was unavoidable.

The decision of the Public Health authority to pay for captured rats - which gave rise to the rat buyers that wandered the city - only made matters worse. Even so, in a few months, the incidence of bubonic plague decreased with the extermination of rats, whose fleas carried the disease.

The Vaccine Revolt

In 1904, a smallpox epidemic struck the city. In the first five months alone, 1,800 people had been admitted with the disease to the São Sebastião Hospital. Although compulsory vaccination of children against the disease had been written into law since 1837, it had never been enforced. Therefore, on June 29th, 1904, the Government submitted a project reinstating the obligatory vaccination against smallpox.

The law included the vaccination of children below six months of age as well as that of the military, the revaccination every seven years and the requirement of a vaccination certificate for those applying for civil service positions, enrolling in a school, marrying or traveling. It also authorized the sanitary police to invite all dwellers in a focus area to vaccinate. Those who refused were submitted to observation in an adequate location, having to pay for their stay.

The law also determined punishments and fines for doctors who wrote fake vaccination and revaccination certificates, as well as forced school deans to comply with student immunization determinations and obliged all births to be notified.

Such draconian measures shocked the population and the antagonism to Oswaldo Cruz grew to its apex. Newspapers launched a violent campaign against the measure. Congressmen and unions protested and a League against Mandatory Vaccination was formed.

Riots during the revolt

Riots during the revolt

On November 13th, the Vaccine Revolt broke out. Clashes with the police, strikes, barricades, riots and shootings in the streets: the population rose against the government. On the 14th, the Military School at Praia Vermelha joined the rebellion, but after intense shootings, cadets were dismissed.

At the Rio de Janeiro neighborhood of Saúde, the city’s Port Arthur, the protest continued. Finally, the Government declared martial law and tumbled the insurrection on the 16th, but made vaccination no longer mandatory.

Oswaldo Cruz ended winning the battle. In 1907, yellow fever was eradicated on Rio de Janeiro. In 1908, an aggressive smallpox epidemic caused the population to go en masse to vaccination posts. Brazil finally recognized Oswaldo Cruz’s worth.

His reputation in the international scientific world was undisputed. In 1907, at the 14th International Congress of Hygiene and Demography, in Berlin, he received a gold medal for his sanitation work in Rio de Janeiro. He also reformed the sanitary law and restructured all health and hygiene agencies in the country.

Expeditions

In 1909, he left the General Public Health Administration and dedicated himself exclusively to the Institute, which had been renamed after him. He launched important scientific expeditions from the Institute, which allowed greater knowledge on the health conditions of the Brazilian rural areas to be obtained as well as contributed to the occupation of these regions. He also eradicated yellow fever from Pará and carried out a sanitation campaign in the Amazon that allowed the construction of the Madeira-Mamoré Railroad - which had been interrupted due to the great number of deaths among workers - to be finished.

“Yesterday, we visited the city of Santo Antonio. You cannot imagine what we saw. The most pessimistic description would fall short of their reality. It is enough to say that no one is native to the place. All children born infallibly die, and the few that are born are sick to such an extent that they soon perish,” said Oswaldo Cruz in a letter to his wife, Emília da Fonseca Cruz.

Cruz recommended a series of drastic measures for prompt implementation. Sanitary care would begin before workers reached the railroad, with the engagement of professionals in non-swampy areas, a minute medical examination and the supply of quinine during their stay. He also advocated for periodical examination of workers, the daily intake of quinine, a discount for the days in which the worker did not take the medication and a bonus for those who did not get malaria. Finally he suggested that shelters were built using nets, that boiled water was made available, that workers used shoes to work and that defecation be restricted to specific places.

In 1913, he became a member of the Brazilian Academy of Letters. In 1915, for health reasons, he left the Oswaldo Cruz Institute and moved to the city of Petrópolis. On August 18th, 1916, he took office as mayor of the city, having devised a vast urban development plan, which he would not live to see fulfilled. Suffering from renal insufficiency, he died in the morning of February 11th, 1917, at only 44 years of age.

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