Encounter 34 · 34 of 42 · October 1977
The last case
In October 1977 a hospital cook in Merca fell ill. Nobody in that room could know he would be the last person on earth to catch smallpox in the wild.
Merca, Somalia
The kitchen is ordinary. The certificate is later.
What does last mean, the week it is only a patient?
The situation
Ali Maow Maalin was about twenty-three, a cook at the hospital in Merca. He had worked briefly as a vaccinator and had not been successfully vaccinated. In October 1977 he was exposed to two children with smallpox and became ill.
Last is a word that only history gets to use. In the hospital in October it was a man with a rash. He is not turned into a mascot for a programme. He declined a successful vaccination, fell ill, lived, and later spent himself on other people’s children.
Hope, here, is not the later certificate. It is the ordinary work of finding contacts while the ending was still available to go the other way.
What they knew
- Variola was still circulating in the Horn of Africa after it had gone from almost everywhere else.
- WHO’s eradication programme was in its last hard miles.
- A case in a hospital cook would have many contacts.
What they could not know
- Whether this infection would seed another chain.
- Whether he would live.
- Whether another case was already walking.
What was at stake
His life, and whoever he had already stood near. Eradication is a claim you can only make afterward.
The next move
He was isolated. Contacts were found and vaccinated. He recovered. WHO later recorded 31 October 1977 as the date the last endemic case was discovered.
What they had
- A containment habit
- Vaccine
- A cook who stayed in the record
What happened
No contact developed the disease. Smallpox was certified eradicated in 1980. A laboratory outbreak in Birmingham in 1978 is a different story and does not unmake the wild ending. Maalin later worked on polio vaccination. He died of malaria in Merca on 22 July 2013 while that work was still unfinished.
What does last mean, the week it is only a patient?
Private. No one else will see it.