Photo: Joe T. Marshall (standing, farthest right) with members of the 1919 Red Cross Inter-Allied Medical Commission, sent to investigate the typhus situation in Poland, and officers of the Polish Army, Poland, 1919. The photo courtesy of Harvard University Archives.://lithub.com/what-my-grandfather-saw-photographing-the-1919-typhus-epidemic-in-poland/
Author: Katarzyna Litak, M.D.
Following World War I, the United States extended substantial aid to war-torn European countries through financial assistance, food, clothing, and technical support. This relief effort, initiated in Belgium in 1914, later expanded to other nations, including Poland. Poland, having been heavily impacted by the war as a major battleground, also faced the challenges of the Bolshevik invasion and widespread infectious disease epidemics. Consequently, Poland was among the countries that benefited from American assistance during this period.
Poland regaining independence in 1918 marked the end of a long period of foreign rule and division. The United States had supported Poland since 1915, with President Wilson's Fourteen Points outlining a pro-Polish policy. However, the rebuilding process was challenging due to the integration of three partitioned territories into a unified Second Polish Republic. The Treaty of Versailles brought ambiguity to Poland's borders, leading to conflicts with neighboring countries. The country also faced infectious epidemics, including typhus, the Spanish flu , and other diseases, further exacerbating the situation.
In August 1917, President Woodrow Wilson established the United States Food Administration (USFA) to provide food to armies and civilians affected by the war. The U.S. had to provide food to its armies and the Allied armies, Allied civilians, and Americans at home. Herbert Hoover was the head of the USFA when that organization was wound down with the November 1918 Armistice.
After the November 1918 Armistice, the American Relief Agency (ARA ) succeeded the USFA. With a budget of over 100 million USD, the ARA played a significant role in post-war relief efforts. American humanitarian workers surpassed the aid provided by other countries such as Great Britain, Italy, and France combined. The ARA's continued efforts helped stabilize the economy, generate employment opportunities, and promote trade between Central European countries. The Polish government secured favorable loans and credits from American banks, and Polish Americans supported the cause by purchasing Polish Bonds. The arrival of American Red Cross personnel, including doctors, nurses, and dentists, facilitated the provision of much-needed food, medical supplies, and clothing. The first shipment arrived in Danzig (Gdansk) in January 1919, and a group of Polish Gray Samaritans affiliated with the ARA arrived in June 1919. The aid provided crucial support to the fragile Polish government, helping to stabilize and sustain it during this challenging period.
The spread of Bolshevism and the outbreak of typhus fever posed significant concerns in Central Europe. Typhus, endemic in Russia before World War I, first emerged on the Eastern Front in Serbia in 1914. The entrance of the Russian army into Polish lands in 1915, along with the movement of refugees and armies, likely facilitated the spread of typhus.
Typhus is transmitted by infected lice, making it particularly problematic in vulnerable populations affected by war, revolutions, imprisonment, crowded encampments, and ships. These conditions, coupled with famine and the destruction of sanitary infrastructure, further exacerbated the spread of the disease. The earliest known description of typhus dates back to 1546 in Italy by Fracastoro.
By the end of 1919, it is estimated that Poland had over 200,000 typhus cases and more than 18,000 related deaths. The situation worsened as the retreating Austrian and German armies stripped food and medical facilities of equipment and supplies. Recognizing the urgent need to address the epidemic, a Red Cross-appointed commission assessed the situation, but adequate funding was lacking.
In August 1919, the U.S. Typhus Relief Expedition arrived in Poland, commencing an educational campaign to raise awareness about the spread of the disease, the role of lice as vectors, and the importance of sanitation. The Medical Corps unit, fully funded by the American Army, spearheaded the efforts. The American Army provided a range of supplies, including clothes, hair clippers, soap, portable beds, baths, mobile laundries, vehicles, and steam disinfecting plants, which were sent to support the Polish nation. According to historian Christopher Blackburn, the United States delivered over 750,000 metric tons of supplies to Poland, with a value of $200,000,000, in the years following the end of World War I and the Polish-Bolshevik War.
A comprehensive cleaning campaign was instituted, with orders for all residents to thoroughly cleanse themselves and their homes, farm buildings, settlements, villages, and towns. The arrival of refugees from Ukrainian and Russian territories presented a particular challenge, as their sheer numbers overwhelmed the system. To address this, a sanitary cordon was established along Poland's eastern border, which included quarantine measures and mandatory delousing. Despite the concerted efforts in 1920, the number of new cases remained high, reaching approximately 30,000 per month. Tragically, many physicians lost their lives after becoming infected by their patients.
To document the relief efforts, Joe Marshall, a photographer educated at Harvard, was assigned the task on behalf of the League of Red Cross Societies. His photographs, accompanied by journal entries, provide a testament to the devastation that followed World War I during the months of August to September 1919.
“ The U.S. foreign minister, with whom the commissioners had conferred in Warsaw before venturing into the countryside, had warned that “Belgium is a paradise compared to Poland.” They would find “human sparrows living on grass, bark, and nettle soup.” Joe Marshall
By the summer of 1919, the struggles over Polish borders had started to calm down, but the clashes with the Soviet Bolsheviks continued. The Polish-Bolshevik War ensued as the Russian Bolshevik troops advanced into Ukraine and Belarus. Although the Polish military achieved some success, there was a real threat of Poland's complete destruction in August 1920,.
The advance of the Bolshevik army brought forth new challenges. Winston Churchill believed that the deliberate spread of typhus by the Red Army aided their military objectives. The Soviet invasion significantly disrupted the efforts to combat typhus, particularly in areas and homes occupied by the Soviet soldiers. The war concluded with an armistice in October 1920 and the signing of the Treaty of Riga in March 1921.
While the Polish military achieved victories in the war, the battle against typhus proved to be a different story. The Red Army destroyed much of the ongoing typhus eradication efforts, seizing equipment and damaging medical facilities. Although the American Army's mission to completely eradicate typhus from Poland was unsuccessful, their efforts still saved many lives and alleviated the burden of the epidemic.
Further reading:
Marchall, Megan., "What My Grandfather Saw Photographing the 1919 Typhus Epidemic in Poland From Harvard to the Red Cross; https://lithub.com/what-my-grandfather-saw-photographing-the-1919-typhus-epidemic-in-poland/
Anthony Bevor, Russia: Revolution and Civil War 1917-1921
Goodall, W.E, "Typhus fever in Poland 1914-1919, " https://journals.sagepub.com/doi/pdf/10.1177/003591572001301507
Blackburn, Christopher, " When Typhus Rode a Red Horse- Weaponizing disease during Polish- Bolshevik War."
Blackburn, Christopher, "The Rebirth of Poland: American Humanitarianism after the Great War," Studia Historyczne, R. LVII (2014), Z. 4 (228) PL ISSN 0025-1429, 521-539.
https://niepodlegla.gov.pl/o-niepodleglej/medycyna-w-ii-rzeczpospolitej/