1832 cholera epidemic
The first report of cholera in Europe in 1817 heralded the four great pandemics which were to sweep the continent in the 19th century. The progress of the disease across the world has been described by Hirsch and mapped by May, while local outbreaks have also been described, usually by contemporaries. Some of the most outstanding are the descriptions of the outbreak of 1832 at Oxford, and Newcastle, and the London outbreak of 1849 described by Snow.
Many of these provided excellent accounts of the course of the epidemic and were illustrated with some of the earliest medico-geographical maps. Indeed, Snow's paper was the first to link the disease directly to infected water, largely as a result of his cartographic treatment of the incidence of cholera in Soho. However, most of these studies dealt only with urban conditions and though, because of this, accurate distribution maps can be produced, they provide little or no comparison with surrounding rural districts.
C S Hooper
Islands are geographical laboratories and C S Hooper's account of the cholera outbreak in Jersey in 1832 enables us to study the contrast between the spread of the disease in urban and rural areas, and also sheds some interesting light on the social geography of the island at the time.
Hooper, as medical officer for Jersey, was in an ideal position to study the development of the epidemic and his account was published less than a year after the outbreak. Though the description is not illustrated by a map, there is a detailed breakdown of cases and deaths giving, by parishes, the age and sex of the unfortunate victims. Further details of the progress of the epidemic are recorded in the local newspapers, where a column headed 'Cholera Morbus' was a depressing daily feature throughout the late summer and autumn of 1832.
The first indication of the outbreak, Hooper reflected, was an outbreak of bowel troubles in the island prior to the actual diagnosis and announcement of the presence of cholera. The direct source of the infection remained unknown - cholera was rife in both France and England at the time - but it seems most likely that the disease reached Jersey via St Malo or one of the other channel ports because of the relatively greater commerce between Jersey and France than between Jersey and England.
The outbreak had been preceded by a 53-day drought broken on 5 August. Hooper was unable to give a definite source of infection in the island but places poor drainage, especially in the older parts of St Helier, high on his list of contributing factors. He also includes poverty and hunger and adds drunkenness as an exacerbating feature:
- "it would be somewhat difficult to find a place where, in proportion to its magnitude, intemperance had more votaries, or where poverty, demoralization and squalid misery prevailed to a greater degree"
Most of this the result, he suggests, of the presence in Jersey of English and Irish labourers, coupled with the low price of spirits. It must be noted here that in times of depression and unemployment, neither of these groups was eligible for parish poor relief.
The problem of drainage in St Helier had been brought to the attention of the committee of the Board of Health in 1831. The main problem was the fact that the upper part of the town drained into the lower, flatter, and poorer quarter of the town near the quayside. The fall of the main drain was only 8 inches per 1000 feet. Plans for a new drain were under discussion but had not been completed by 1832.
One of the worst areas was Cabot's Yard in Sand Street. The Board of Health report had stated:
- "The drain of the yard runs down over the ground, between two rows of dirty, low houses ... this drain empties itself in a large hole at the end of the yard where it remains stagnant, there being no outlet to the sea ... the new line of Quays having left no drain for the said yard. Besides the neighbours and occupiers of the yard throw all their filth on the piece of gravel which is at the end of the yard, and causes a dreadful stench, which, if not removed by a drain into the sea, and a covered drain (put) in the yard, will certainly be the first quarter for Cholera."
The Board was entirely correct. One of the first three victims of the disease came from Cabot's Yard and, in the first five days of the epidemic, two thirds of the tenements had provided victims. The remaining tenants were then removed to the encampment on Gallow's Hill (West Hill), to the west of St Helier, and it is interesting to note that no case of cholera was reported in the camp throughout the epidemic.
Mont-au-Pretre was the last area of St Helier to suffer from the disease, on 28 August, and that only mildly with 3 deaths from 8 cases. The cholera had spread to Georgetown and Gorey by 24 August. By then the epidemic was beginning to decline in St Helier but newspaper reports of the 25th show that cases had been reported in St Clement (someone who had fled from Cabot's Yard), St Saviour, St Brelade, St Ouen and St Peter. At the same time a list of the doctors responsible for the 12 districts into which the parish of St Helier had been divided was published, with a detailed description of the areas covered.
Districts 1 and 2 comprised the two more rural vingtaines of Mont Cochon and Mont-a-l'Abbé, while Mont-au-Pretre was divided into a more rural and a more urban district - districts 3 and 4 respectively. The town itself was divided into eight districts. Districts 4, 5 (Rouge Bouillon), and 6 (including Charing Cross, York Place, and Rue de Hue) occupied the area west and north of the present harbour and were the worst hit districts. They provided half of the total number of recorded cases of the disease in the parish. District 7 included the Rue de Derriere, Chemin Neuf, and Conway Street; district 8, the area of the front immediately west of the harbour, included Rue de la Chausee, Mulcaster Street, Bond Street, Cross Street, Hope Street, and Wharf Street; district 9 comprised the Havre de Pas area; while districts 10 and 11 covered the east and north-east of the town. District 12 related to the centre of the town, including Halkett Place, Don Street, Waterloo Street, King Street, and Royal Square.
28 August was the turning point of the epidemic for then, not only the number of deaths declined sharply but also the daily total of new cases. Though the epidemic continued till the second week in October, by 18 September the outbreaks in the country districts were finished except for a small resurgence in Gorey. By the end of the epidemic, cases had been reported in St John, St Lawrence, Trinity, and St Martin as well.
Two areas escaped
Only two areas escaped the epidemic completely - the parish of St Mary, on the north coast, and the town of St Aubin, at the west end of St Aubin's Bay. The reasons for this immunity are uncertain but it seems likely that lack of communications was an important factor in the immunity of St Mary's parish - access to St Helier was difficult and during the outbreak probably non-existent because the market of St. Helier was closed and produce could not be sold there.
The reasons for the immunity of St Aubin are more difficult to establish. It is unlikely that throughout the epidemic there was no travel between the two towns separated only by a short and easily travelled distance. However Hooper's suggestion that it was less owing to chance, than to advantages of locality, and thinness of population ... (and that) extreme misery and want ... (were) seldom found, should not pass unregarded. The poor in St Helier were one of the major victims of the disease in the island due to malnutrition and general lack of resistance to disease resulting from this.
The position of St Aubin on the seaward facing slope of the plateau enabled a more efficient drainage system to be built or, at least, a drainage system sufficient to meet the needs of the population at this time.
Both the map and the table are constructed from the detailed breakdown of cases and deaths included in Hooper's account. The most outstanding feature of the map is the concentration of the disease in the south and east of the island: the area of greatest population density. With respect both to the number of cases and the number of deaths, the parish of St Helier was the worst hit - only 37 of the 348 (10.6%) deaths from the disease occurred in other parishes. Within St Helier itself, of the 341 fatalities, 267 (78%) were in the Vingtaine de la Ville - the overcrowded south-east of the parish, containing the town of St Helier itself.
Areas of higher and denser population - St Helier, St Saviour, and Grouville, with 43%, 6%, and 5% of the island population respectively, suffered most. It should be noted here that most of the deaths in Grouville were in the small town of Gorey and not in the more rural districts of the parish. The rural parishes with widespread populations suffered little from the epidemic unless definite contacts with St Helier or the south-east were made. This is reflected in the lower number of fatalities in the outlying western and northern parishes.
From a demographic viewpoint, just over 2% of the island population suffered from the disease and nearly 1% died - 43% of the cases proved fatal. Hooper gives a detailed breakdown by age and sex of both cases and deaths but similar information is not contained in the census reports for the island, so it is impossible to describe with any accuracy the effect of the disease on the population. However we can discover from the figures given by Hooper that the disease was fairly evenly distributed: of the cases listed 356 were women, 316 were men, and 134 were children below 14 (respectively 44%, 39% and 17% ). The percentages for fatalities are almost identical - women 152 (44%), men 138 (40%), and children 58 (16%).
It would seem that though the epidemic of 1832 was serious its effects on the population were not catastrophic. The later pandemics of the 19nth century reached Jersey in 1849 and 1867. In 1849 nearly 300 people died, but no statistics appear to be available for 1867; however the pattern of the earlier epidemic was repeated, most of the cases and fatalities being in the poorer districts of St Helier, with only a few cases in the rural areas.
Lack of comparable statistics have limited this study but it is hoped that further studies of a similar type both of Jersey and elsewhere may provide materials for more general studies of a medico-geographical type.