Fighting Disease

Objectives:  Students will

• Learn about the threat of disease during the Modern Era and compare this issue to present day concerns about epidemics and pandemics
• Define and use vocabulary associated with this issue
• Understand how disease motivated public health initiatives

Assessments:

• Students will make connections between the threat of disease today and in history through discussion and examining historical artifacts.
• Students will use primary documents to research a historical event.
• Students will write a persuasive essay in character.

Procedure:

• Pass out a handout from the TN4me.org website. Ask students if they think this poster is recent or from the past. Why or why not?  Tell them this was issued by the U.S. Navy in 1918 because of the influenza pandemic.  Go over the instructions on the poster one by one and decide which ones could be used today.  [The only ones that don’t work are about walking to work and going to bed and waiting for the doctor.]  Explain that in 1918, most people rode trains or buses to work since there weren’t many personal automobiles.  Walking kept people away from the germs of other passengers on the train or bus.  And, of course, today, doctors do not make house visits like they did in 1918. (Help students make connections between concerns over H1N1 and pandemics in the past)
• Have students access the TN4ME website and define pandemic (an episode of illness that spreads to different countries) and quarantine (a place of isolation to keep people from entering or sometimes leaving a location to try and prevent the spread of an infectious disease). http://www.tn4me.org/article.cfm/a_id/145/minor_id/58/major_id/20/era_id/6
• Select students or have them volunteer to act out and read the St. Mary’s letters, written during the yellow fever epidemic in Memphis. Pass out the name tags with the scripts attached to the backs.  There are only five reading parts:  Sister Constance, Dr. Charles Parson, Sister Thecla, Sister Ruth, and an unknown Sister.  Pass out the rest of the name tags.  Tell the students to listen to the script and when their character “dies”, they need to sit down.
• The characters will gather in front of the class.  Tell the students that they are listening to diary or journal entries made by priests and sisters at St. Mary’s Episcopal Cathedral Church.  When the Yellow Fever epidemic first was diagnosed in Memphis in 1878, nearly 27,000 people fled the city.  Yellow Fever was a feared disease.  People who caught the disease had the whites of their eyes turn yellow—thus the name.  Then they would start bleeding from every opening in their body including their eyes, ears and mouth.  Only about 19,000 people were left in Memphis—of that number 17,000 people got sick with 5,000 dying.  Many religious orders, preachers, and doctors stayed to help take care of the sick and dying including these at St. Mary’s.
• By the end of the letters, this activity will give a visual representation of the disastrous effects of yellow fever and the traumatic experience endured by those who lived during this time and place in history. These letters and drama activity will also tie this moment in history to present day concerns about disease.
• Lead the class in a group discussion about the decision made by these individuals to stay with the sick. Would they have made the same decision? Why do they think that the nuns and priests stayed? What about the doctors?
• Students will then be asked to right a persuasive letter in character. Student could choose to be a fellow nun, priest, or doctor. They could also choose to be a city leader who is concerned with the epidemic. Also, the letter could be from a family friend or relative and should express concern or loss. The student should write in a persuasive tone, asking for changes in the system or attitude toward health and disease.

Extensions:Have students

• Have the students research the 1918 Influenza pandemic.  Information may be found at http://1918.pandemicflu.gov/the_pandemic/01.htm website run by the U.S. Department of Health and Human Services.
• Have the students list some of the public health improvements in the United States during the 20th century.  According to the Center for Disease Control, these include:
  • Vaccination, which has resulted in the eradication of smallpox; elimination of poliomyelitis in the Americas; and control of measles, rubella, tetanus, diphtheria, Haemophilus influenza type b, and other infectious diseases
  • Improvements in motor-vehicle safety have resulted from engineering efforts to make both vehicles and highways safer and from successful efforts to change personal behavior (e.g., increased use of safety belts, child safety seats, and motorcycle helmets and decreased drinking and driving).
  • Work-related health problems, such as coal workers' pneumoconiosis (black lung), and silicosis -- common at the beginning of the century -- have come under better control. Severe injuries and deaths related to mining, manufacturing, construction, and transportation also have decreased.
  • Control of infectious diseases has resulted from clean water and improved sanitation. Infections such as typhoid and cholera transmitted by contaminated water, a major cause of illness and death early in the 20th century, have been reduced dramatically by improved sanitation.
  • Decline in deaths from coronary heart disease and stroke have resulted from risk-factor modification, such as smoking cessation and blood pressure control coupled with improved access to early detection and better treatment.
  • Since 1900, safer and healthier foods have resulted from decreases in microbial contamination and increases in nutritional content. Establishing food-fortification programs have almost eliminated major nutritional deficiency diseases such as rickets, goiter, and pellagra in the United States.
  • Healthier mothers and babies have resulted from better hygiene and nutrition, availability of antibiotics, greater access to health care and technologic advances in maternal and neonatal medicine. Since 1900, infant mortality has decreased 90%, and maternal mortality has decreased 99%.
  • Access to family planning and contraceptive services has altered social and economic roles of women. Family planning has provided health benefits such as smaller family size and longer interval between the birth of children; increased opportunities for counseling and screening; fewer infant, child, and maternal deaths.
  • Fluoridation of drinking water began in 1945 and in 1999 reaches an estimated 144 million persons in the United States. Fluoridation has played an important role in the reductions in tooth decay (40%-70% in children) and of tooth loss in adults (40%-60%).
  • Recognition of tobacco use as a health hazard and subsequent public health anti-smoking campaigns have resulted in changes in social norms to prevent initiation of tobacco use, promote cessation of use, and reduce exposure to environmental tobacco smoke.