The fight against malaria in Sardinia at the turn of the 20th Century: a lesson for the present (original) (raw)

2019, Popolazione e storia

Another important limitation of the cause-specific statistical data comes from the presence of a proportion of deaths attributed to unknown and undetermined causes, which is, in itself, an indicator of the quality of the data. This proportion was exceptionally high in Sardinia, much higher than the national average 6 and the incidence of this item appears to be particularly high for the youngest age groups 7 , the most affected by malaria mortality, as we shall see. Cases of malaria were not notifiable until the beginning of the 20 th Century (and remained seriously underestimated until much later). Moreover, the destitute population living in the rural areas, which was the group most affected by the disease, had very little contact with medical doctors. Even after the advent of cause mortality statistics, «the incidence of malaria remained seriously underreported» (Snowden 2006, 8). This article intends to fill this research gap, at least partially, and to estimate the demographic and health burden of malaria in the island of Sardinia, between the last decades of the 19 th Century and the first decades of the 20 th Century, emphasizing its peculiarities, in terms of both total intensity and structural characteristics in comparison with the rest of the country. In addition, the article aims to reconstruct the evolution of malaria mortality in Sardinia in the years before and during the first 'antimalaria crusade' (Snowden 2006, 53), documenting the relevance and the effectiveness of the sanitary campaign with the free distribution of quinine, as well as its limits and failures. The period studied, in the choice of the initial data, is affected by the temporal limits of the available documentation, but it covers significant decades for the evolution of malaria mortality in the island. It includes, in fact, the phase that immediately followed the severe exacerbation of the disease, in the second post-unification decade, according to Tognotti (1996, 2008), but also the years of declining mortality, influenced by the quinine campaigns introduced from the beginning of the 20 th century. The decline in malaria mortality, interrupted during the 1911 cholera epidemic, was reversed at the end of World War I and in the following years. The article is organised as follows. In the next section, without neglecting the just mentioned difficulties arising from the quality of the statistical sources available, we analyse the first official statistics on malaria mortality in Sardinia and in the rest of the country as well as its structural characteristics by age and sex in 1887 and 1888, comparing the experience of the island with that of the other Italian most affected regions. In the third section we describe malaria mortality trends in Sardinia (at the regional and provincial level 8) and in the regions mentioned above, between national unification and the mid-twenties, providing a correction of the malaria mortality data and some interpretative comments on the tendencies observed.