The Orange County Department of Health owes its existence to the Spanish Influenza of 1918. Prior to this grim period, which saw the deaths of more than 13,000 North Carolinians, there was no consistent delivery of public health services in North Carolina.
"The sparse medical facilities of the era were overwhelmed by the masses of sick and dying," writes David Cockrell in the North Carolina Historical Review.* The systemic failings revealed by the pandemic "provided a major impetus to the development of newer medical facilities and technology and gave a boost to the state's budding public health movement." A positive good to emerge from this terrible time was a strong state-local system of public health services.
Although the North Carolina State Board of Health had existed since 1877, by 1918 there were only a few county public health departments. Starting in 1917, ten counties participated in a pilot program to create a movement of public health departments, but Orange County was not among them.
In the counties that did participate, the general population resisted, apparently "more interested in what Moses and the Prophet have to say than they were in modern medicine," said one contemporary observer. The opposition, writes Cockrell, "was rooted in the larger struggle between local autonomy and centralized authority then occurring in many rural areas as federal and state governments expanded their bureaucratic power over more and more facets of American life."
The sudden outbreak of influenza prompted state government to take distancing measures familiar to us now, which meant crowd bans and business closures. But enforcement was challenging. So Gov. Thomas W. Bickett directed the formation of "home relief groups" in each county.
Then as now, people were already coming together to take care of each other without formal sanction or structure. State government officials saw an opportunity to formalize relationships with counties by recognizing these efforts.
In October 1918, when the state issued a stern warning to all counties of the influenza's rapid spread with suggestions on what to do about it, the Orange County Board of Commissioners stepped into action. Writes Cockrell,
"It was realized at this [Commissioners'] meeting that there was no County Board of Health," Annie Sutton Cameron recalled in her unofficial minutes, "and so one was created." Recognizing the absence of any organization to marshal efforts to help those indisposed by the virus, the commissioners assembled an ad hoc system for this purpose and appointed civic leaders who, despite the danger to themselves, brought needed supplies and comfort to their ailing community, particularly people in the rural areas. In many cases the volunteers themselves procured food and supplied the transportation to deliver it, often at their own expense.
(Mrs. Cameron's invaluable Record of the War Activities in Orange County, North Carolina, 1917-1919 is online at Documenting the American South, UNC.)
As the pandemic subsided, North Carolinians came to appreciate the need for a strong public health system. "Clearly the pandemic had transformed the concept of a permanent public health organization into a concrete reality that people felt their community could not afford to be without," Cockrell concludes. Today's DHHS Division of Public Health and its 86 county and regional health departments are the direct result of the positive improvements that came out of the influenza pandemic of 1918.
Apart from official records like those collected in Professor Cockrell's article, few archives from the impact of the influenza pandemic of 1918 in North Carolina exist. The state archives would like for future generations of North Carolinians to have a much fuller record of how we are experiencing the Covid-19 pandemic. "We know that future researchers will want to learn about the ways in which this life-altering, worldwide coronavirus outbreak affected North Carolinians," they are saying:
The State Archives of North Carolina is interested in preserving and sharing stories from the COVID-19 era from people all around the state. There is still a long way to go in terms of dealing with and documenting this time in our lives, but we would like to hear from you NOW as we experience and navigate this crisis together. Larger scale projects may emerge from what we gather today and over the next several months.
They're looking for diaries, photos and videos, oral histories, school lesson plans, any meaningful documentation of the pandemic. Artifacts, objects associated with living in quarantine for example, might be of interest to the N.C. Museum of History.
"You don't have to be famous for your life to be history." That's the motto embraced by UNC's Southern Oral History Program. And it's true! We are all doing our best day by day with this crisis so unlike anything we've ever seen. In the midst of the unsettled present, let's remember that we're in a position to tell very personal stories to future readers and researchers who will be eager to hear them. Please spread the word.
