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When the first cases of smallpox broke out among troops during the Civil War, military officials—on the Union and Confederate sides alike—immediately quarantined the infected in a tent or a makeshift hospital to prevent the transmission of the virus. But when smallpox began spreading among formerly enslaved people, officials either ignored it or argued that the virus spread viciously among black people because of racial inferiority and unsanitary habits.
The outbreak shouldn’t have happened. Medical authorities had long-established procedures to respond to epidemics, and smallpox was not a mystery. In the summer of 1721, at the height of a smallpox epidemic in Boston, an enslaved African named Onesimus explained the process of inoculation, which had been prominent for centuries in Asia and Africa, to the Puritan minister Cotton Mather. The process of injecting lymph, the colorless fluid that oozed from under a smallpox vesicle, into a healthy person created a mild version in its host, who thereby gained immunity. In 1796, Edward Jenner, an English physician, developed a vaccine for smallpox by using the lymph from infected cows. While many Civil War doctors doubted the efficacy of the vaccine or simply struggled to properly administer it, preventive protocols to protect the population did exist. Quarantine as a practice had originated in 14th-century Venice.
Yet federal and military authorities forced freedpeople—sick and well—into makeshift camps, placing them, in effect, under lockdown together, leading to the explosive spread of the virus throughout the African American community.
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In the months after President Lincoln had issued the Emancipation Proclamation in January of 1863, no infrastructure was in place to provide new freedpeople with basic necessities, let alone to combat a deadly virus. Mortality rates increased. In the face of a widespread epidemic, the people had to help themselves in order to survive. Harriet Jacobs, a formerly enslaved woman who had escaped to the North but returned to the South to help, wrote to charitable groups and asked them to immediately send clothing, blankets, and other resources. With the money Northern benevolent associations sent, Jacobs, with the eventual assistance of the military, constructed a makeshift hospital for freedpeople.
In Baltimore, Miss Downs, a black woman who operated a boardinghouse, used her small income to care for children orphaned by smallpox. C. E. McKay, a white reformer, wrote in a newsletter that part of Downs’s income had been “expended in medicines for one of the little orphans, who is dropsical, her head and neck swelled to an unnatural size, and her arms and legs slender as pipes.” Downs wasn’t the only person to open her home to the orphans. Black women in many communities took in children who lost their parents to smallpox. Evidence of how African Americans had to care for themselves during the epidemic, like McKay’s report, are buried in diaries and Northern benevolent associations’ newsletters, not in government records, as the health of their communities suffered well into the 20th century.