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Book review

The invisible enemy – Variola vera 1972

Radina Vučetić
  • The Official Gazette of the Republic of Serbia, Belgrade, 2022 ISBN 978-86-519-2797-6

ABSTRACT


BOOK REVIEW

In Serbia, just within the span of an average person’s lifetime, dramatic changes have occurred in all segments of life. However, on this occasion, the latest book written by Radina Vučetić, Associate Professor at the Faculty of Philosophy of the University of Belgrade, focuses our attention to the segment of illness and health. In her monograph THE INVISIBLE ENEMY -Variola vera 1972, the author treats, with scientific precision and attention to detail, the outbreak, course, impact on everyday life, and socio-political implications of the largest European smallpox epidemic after World War II, which befell Yugoslavia half a century ago. In order to understand this issue, it is important to take into consideration the wider context.

In recent years, until the outbreak of COVID-19, illness, and especially mortality form infectious diseases in Serbia, did not pose a particularly significant public health issue. Of a little over 100,000 deceased persons per year, over 50% were victims of cardiovascular diseases, malignant tumors caused approximately 21% of deaths, followed by other diseases and disorders. Infectious diseases were at the very bottom of the list of causes of death, with a total of 100 deaths, which amounted to less than 0.1%. According to official statistical data, when the most common diseases amongst them, the flu and AIDS, were set aside, the risk of falling victim to an infectious disease was approximately equal to the risk of being struck down by lightning.

Such an epidemiological situation is strikingly different from the morbidity and mortality structure in the years following World War II. For example, it is estimated that, only in 1946, in a country with a population of 15 million, malaria struck 1.2 million people. In that year alone, 900 typhus related deaths were registered, as well as 300 tetanus related fatalities.

Comprehensive programs of suppressing tuberculosis and typhus were then set in motion, followed by the malaria eradication program, and finally programs for eliminating diphtheria, tetanus, polio, and other infections. These were endeavors which required huge funds and mass engagement of staff, but which yielded impressive results. However, not only because it has remained imprinted in collective memory, but also because of objective indicators, especially regarding its intensity, the fight against the smallpox epidemic in 1972, remains unprecedented.

Professor Vučetić took upon herself the challenge of critically assessing this complex event, approaching it from different sides and at different levels. Her distinguished Croatian colleague, Mirko Dražen Grmek, wrote about the three levels of historical conceptualization. The fist level relates to what actually happened in the past (res facta), which usually sinks into oblivion. The second level comprises available documents (res scripta), and it is supposed to accurately reflect the events of the past. The third level relates to what is believed of the events and which, sometimes independently of the facts, has a decisive role in forming the attitude towards reality.

In approaching her research, Professor Vučetić was aware that the variola epidemic remained a dramatic event in collective memory, which was sometimes more and sometimes less romanticized, and which was almost always approached with evident pride stemming from the success in conquering the virus. The author relied on the testimonies of still living witnesses, whether active participants in the fight against the disease or involuntary victims of the imposed anti-epidemic measures. Some of these witnesses shared their faded memories with the author in person, while others wrote down their own accounts of the fight against variola. All of these testimonies seemed authentic yet were often quite different from one another.

Even professional literature on the epidemic – primarily two large symposia on the events in Belgrade and the whole territory of Yugoslavia, along with a series of other scientific, professional and popular publications and individual articles – did not paint a unified picture of the events of the spring of 1972. In reconstructing the past, as expected of a historian, the author relied significantly on popular newspapers, magazines and literature, and, primarily on archives preserved at the Archives of Yugoslavia and within other related archival fonds and deposits. The result of this dedicated and comprehensive effort is a multiperspective and reliable account of the outbreak, course, and termination of the epidemic. Professor Vučetić succeeded in comparing and critically evaluating unconsciously biased memories, fragmented accounts of participant activities, as well as available archive material, and amalgamating all the collected documents and accounts into a coherent whole. She did not adhere merely to dry facts and numbers, rather, to put it poetically, she gave the patients, quarantined citizens, and health personnel who treated and cared for them, life. She placed special focus on the ‘ordinary’ person in times of trouble.

This reliable analysis shows that the government was well prepared to face variola or any other quarantine disease. The book acknowledges the government’s good organization (it certainly was not easy to vaccinate 18 million people in a matter of weeks) and commends the health workers for the professional conduct that they exhibited. The description of the executed activities involuntarily elicits a comparison with the outbreak of the ongoing COVID-19 epidemic, which was met with complete unpreparedness and which health authorities were incapable of managing, but which the health workers met with dedication and selflessness, this being one of the few bright sides in the situation.

The author, however, also points out some observed failings, with an emphasis on an initial delay in notification. It is a fact that the news on the outbreak of variola in Kosovo and Metohija was two days late, and that the public was officially informed of the incidence of the disease in Belgrade with a few days delay. However, as emphasized in the book, with these exceptions, announcements made to the public were meaningful and timely.

The author particularly stresses the bickering amongst the federal entities and connects them to the weakening of federal government, perceiving in these disagreements the impending dissolution of the state.

For the reader focused on formal points, the following information may be important. The publisher of this book is The Official Gazette of the Republic of Serbia, the book has around 240 pages, and is divided into six chapters – The Virus, The State, The Profession, Vaccination, Life during Variola, In Lieu of a Conclusion: The Invisible Enemy Lies in Wait.

The reviewer’s conclusion: Professor Radina Vučetić has written a valuable, useful, and necessary book, which provides a rounded view of the costliest, most dramatic, most comprehensive, and most ambitious endeavor of the healthcare services in post-war Yugoslavia.

Dr Zoran Radovanović
Retired Professor of Epidemiology at the
Medical Faculty in Belgrade

Informations

Volume 3 No 3

September 2022

Pages 384-387
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  • Cite this article:
    Radovanović Z. Book Review: The invisible enemy: Variola vera 1972, by Vučetić Radina. The Official Gazette of the Republic of Serbia, Belgrade, 2022. Serbian Journal of the Medical Chamber. 2022;3(3):384-7.



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