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Pandemics of influenza and other infectious diseases remain a serious global threat, requiring ongoing preparations by all countries. Such preparations include wide-ranging core capacities for surveillance and response.1,2 There is also increasing emphasis on preventing emergence of new microbial threats with approaches such as the Global Health Security Agenda.3 However, there might be decades between future pandemics, particularly those of the scale seen in the 1918 influenza pandemic. Consequently, this threat can fade from public and official memories. Without clear reminders of the potentially massive effects of such pandemics, there may be little impetus to ensure preparatory efforts and proportionate resourcing.

Memorials might be one way to ensure that a society’s collective recollection of the threat of influenza and other pandemics remains. Physical memorials can provide a locality for civic rituals (such as gatherings at anniversary events), and for visits by school groups and others. Memorials can also be used to enhance awareness around social capital and civil responsibility—in this case by potentially providing examples and narratives of health workers and volunteers who worked to reduce the impact of the pandemic. Some memorials (such as the National War Memorial in New Zealand) even offer educational programmes that interpret the function and meanings of the memorial to visitors.

New Zealand provides a good case study for considering the issues around the memorialisation of pandemic influenza, as it is a relatively small country and there is fairly detailed national documentation of memorials on official websites. It is also a country where there might be at least some modest awareness of the impact of the 1918 influenza pandemic, owing to the major scale of the impact, especially for the Māori population as detailed in a book4 and on a popular official history website.5 As with most other countries, New Zealand has experienced three notable influenza pandemics since 1900; in 1918 (8,573 deaths),4 in 1957–59 (179 deaths in 19576 with even higher excess deaths in 19597) and in 2009 (49 deaths8). The 1968 pandemic reached New Zealand9 but we found no data on excess mortality estimates.

Methods

Searches to identify memorials

We aimed to identify memorials for multiple pandemic deaths or for individual health workers involved in responding to the pandemic. We conducted internet searches using Google and Google Images with search terms covering all of the following terms: “New Zealand”, “influenza”, “Spanish flu” and “memorial/monument/obelisk/statue/plaque/cemetery”. Searches were conducted in December 2015. Also examined were: a New Zealand online encyclopaedia (http://www.teara.govt.nz/en), an online history site (http://www.nzhistory.net.nz/) and an online list of national monuments.10

New Zealand has an online “Historic Heritage” list of historic sites, which includes selected memorials and cemeteries (http://www.heritage.org.nz/the-list). This database was also searched with the terms: “influenza”, “epidemic” and “pandemic”.

To determine if the gravestones of any individuals provided linkages to memorials, we also searched the online Cenotaph database11 (keyword searches: “influenza”, “epidemic”, “pandemic”). Specific books on memorials in New Zealand were also examined.12–14

Local networks and memorial site visits

We utilised informal local history networks to identify potential additional memorials in the Northland Region (which has a relatively high population of Māori who suffered disproportionately in the pandemic4). For selected memorials we conducted site visits to document accessibility, to take photographs and ascertain any associated signage in the vicinity. We also determined if publicly accessible memorials were visible on Google Street View.

Comparisons with other memorials

For comparisons with other New Zealand-based mass fatality events, we selected events with 20 or more fatalities since 1900 (as per a recent study15). To identify any memorials associated with these events, we used the data from an official history website,16 supplemented with internet searches, to see if memorial data were lacking at the primary data source (using the search terms: “memorial”, “monument” and “plaque”). For comparisons with war memorials we used the following official website: http://www.nzhistory.net.nz/map/memorials-register-map.

Results

Memorials related to the pandemic

A total of seven publicly accessible memorials that referred to multiple pandemic deaths or health worker responder deaths from the pandemic were identified (Table 1). Even so, several of these cannot be considered to be fully pandemic-related in that: (i) they also relate to the life work of the named individual (eg, the two memorials to Dr Cruickshank including Figure 1); and (ii) also relate to other causes of death (ie, for soldiers the Featherston Camp memorial and for the nurses memorialised at the two chapels listed in Table 1).

Table 1: The seven identified publicly accessible memorials relating to multiple deaths from the 1918 influenza pandemic deaths (or health worker responders) in New Zealand and which specifically mention “influenza” (organised by north to south location within the country).

Figure 1: Statue of Dr Margaret Cruickshank, a physician who died in the 1918 influenza pandemic, Waimate, South Canterbury (photograph by the lead author, 2016).  

c

For none of these seven memorials was there evidence of signage in the vicinity directing visitors to their location, including the one at Waikumete Cemetery for the 1,128 people who died from the pandemic in Auckland. None of the publicly accessible memorials were specifically for Māori and only three were in cities: at Waikumete in Auckland, the Chapel in Christchurch and the Chapel in Dunedin. There was also fairly limited information on the memorials relating to the pandemic, with only two having information boards (excluding the Chapel in Christchurch which has been closed for some time due to earthquake damage and could not be visited). The role of health workers and/or citizen volunteers during the pandemic was explicit in five of the memorials: at Waikumete, to the nurse Jessie Linton, the two memorials to Dr Cruickshank and to nurses in the Dunedin Chapel. None of the memorial sites had documentation that linked to any related website resources about the pandemic or which linked all the influenza pandemic memorials together in a thematic manner. Six of the seven memorials were identifiable based on internet searches and five had some aspects of the memorial that were visible on Google Street View.

Another 11 memorials for mass deaths or deaths of health worker responders were pandemic-associated but were either in private settings or did not specifically mention the pandemic (Table 2). Nine of these had specific relevance to Māori, and all nine of these were located in the North Island. These memorials to Māori do not have routine public accessibility, as they are in urupā (cemeteries) or are on marae, which are private spaces. Marae are areas with buildings and grounds which are the cultural and social focus for an iwi (tribe), hapū (sub-tribe) or whānau (family). Of these 11 additional memorials, seven had some information about them on the internet.

Table 2: Additional memorials with a relationship to the 1918 influenza pandemic in New Zealand, but which are either in private settings or do not specifically refer to the pandemic (organised by north to south location within the country).

Table 3: New Zealand war memorials, sourced from New Zealand History Online16 with a comparison to the 1918 influenza pandemic (data from this study).

*In addition, there are multiple museum displays related to all these and other wars involving the New Zealand population, eg, in Auckland’s War Memorial Museum, and the “National Army Museum” in Waiouru.
**Combined for both wars since the same memorial is often used for both wars in the New Zealand context.

Comparison with memorials to other mass fatality events

The physical memorial status was ascertained for non-epidemic/non-pandemic mass fatality events for the period 1900 to 2015 in New Zealand where there were 20+ fatalities (n=20 events with 1,414 deaths, Table A3). It was found that there are memorials in existence or currently being constructed for 80% (16/20) of these events. Indeed, for one of these events there are at least eight memorials associated with it: the Mt Erebus aircraft crash. Several other such events had multiple memorials to them and in two cases they have dedicated sections in New Zealand museums (an earthquake and a shipwreck—see Appendix).

It was also apparent that the list of “disasters” at an official New Zealand history website17 includes no epidemics or pandemics at all. That is, it ignores the influenza pandemics of: 1918,4 1957–1959,6,7 1968 and of 2009.8 It also makes no mention of other post-1900 epidemics such as the 53 deaths in a 1913 smallpox epidemic, up to 173 deaths per year in various poliomyelitis epidemics and up to 375 deaths per year in various measles epidemics.18 This research also failed to identify any physical memorials to any of these other pandemics or epidemics.

Comparison with war memorials

The ratio of the number of publicly accessible memorials to deaths in various wars is shown in Table 3. This ratio was 261 times higher for the South African War than the pandemic (213 vs 0.8 memorials per 1,000 deaths). For the two World Wars together (since memorials to these are often combined), the respective value was 38 times higher.

Discussion

Main findings and interpretation

This study found only seven publicly accessible memorials that referred to the 1918 influenza pandemic in New Zealand. The comparison with the much greater number of war memorials and memorials other disaster events (with the latter comprising a much lower total mortality burden) was particularly stark. Such a difference is further compounded when considering the estimated NZD 122 million (around USD 79 million) spent on Second World War memorials by the New Zealand Government (in 2011 dollars),19 and the NZD 120 million spent on a national war memorial park20 that was completed in 2015. Many reasons might explain these differences, but possibilities include: (i) the timing of the 1918 pandemic at the end of the First World War (when New Zealand society was still highly disrupted from the impact of this war); (ii) the perception of these pandemic deaths being less “heroic” than military deaths; and (iii) the limited understanding around this time of potential lessons for the future arising from the pandemic experience. For example, some citizens who promoted the construction of various memorials to preventable causes (eg, to train crash disasters and also war memorials) might have believed that memorialising the dead and the disaster event might provide lessons for prevention. But in the early part of the 20th century the epidemiology of pandemic influenza and the potential for preventing and controlling it was still poorly understood scientifically and in popular culture. Other reasons may also apply given the complex psychological and sociological processes involved in memorialisation processes, particularly as detailed for war memorials.13,21,22

The findings of this study also suggest that the current educational value of these publicly accessible pandemic memorials is likely to be constrained by: (i) only being in three cities; (ii) the limited signage and information on the memorials relating to the influenza pandemic; and (iii) the complete lack of any website resources that link these memorials together and to additional website-based information about pandemics. This situation suggests major scope for enhancing the presence and use of such memorials if a society wishes to better remember the large impacts of the 1918 pandemic and consider the implications for future pandemic preparedness. These impacts include the large numbers dying within months, the social and economic impacts of these sudden deaths, and the disproportionate effects on particular populations—in this case on Māori.6 While future influenza pandemics might only be preventable to some extent, it is very likely the appropriate preparedness could reduce the scale of the impact of a pandemic (hence the support for such preparations by the World Health Organization1).

No published studies on 1918 pandemic influenza memorials in other countries were identified, and our internet searches for New Zealand memorials only rarely incidentally identified such memorials in other countries (eg, the Lueg Monument in Switzerland to 54 Bern cavalrymen who died in the pandemic). Further research could more systematically determine the presence of such memorials in both combatant and non-combatant nations at this time.

Strengths and limitations of this study

This study benefited from New Zealand being a relatively small country in which the 1918 influenza pandemic has at least some level of local documentation in a popular book4 and on a popular New Zealand history website.5 Furthermore, it is a country for which national collections of memorial data have been assembled online. But there are limitations in that some additional memorials may not have been identified, especially if these are in private places such as marae, urupā or consist only of a plaque inside a building that is not documented in any book or website. For example, we are recipients of oral history reports concerning three other possible pandemic-associated sites, but for which no written documentation has yet been identified (Table A2). More detailed involvement of local historians throughout the country may be required to capture data on all such pandemic-associated sites.

Options for enhancing the educational utility of pandemic-related memorials

If a society wished to enhance the long-term educational value of memorials concerning pandemic influenza and its future threat, a range of options exist, as suggested by the New Zealand situation:

  • Upgrading existing publicly accessible physical memorials to include more information about the 1918 pandemic. Also, symbols (eg, quick response codes) on each memorial or on related signage could allow users with smartphones to gain additional information immediately. Signage around the locality could also make the memorials easier to find. In some cases, existing memorials could benefit from restoration work (Figure A).
  • Increasing the number of memorials is an option, especially in cemeteries where there are unmarked graves of those who died in the pandemic. An example of such unmarked graves is at Andersons Bay Cemetery in the City of Dunedin. Funds could be made available to relevant local authorities that wished to identify sites not yet covered by any memorial. For example, this could include Māori tribal (iwi) authorities who might wish to memorialise additional sites where the pandemic had a notable impact.
  • Producing a national memorial (physical or online) that listed all the doctors, nurses and other health workers who died in the pandemic. This could even be done for all the victims, since a comprehensive online memorial exists for all those dying in the wars New Zealand has been involved in (the Cenotaph11).
  • Integrating links to all the memorials into one official website that has a detailed set of information about the pandemic, its local impacts and a discussion of future pandemic threats. An integrated memorial could also contribute materials to a “traveling museum exhibition” that could tour the country.

A deadline for working on these options could be the 100th anniversary of the 1918 pandemic, with the key organising agencies being the government ones concerned about heritage and health. Ideally however, a range of other parties might be involved in such planning including local government, local heritage and health groups, and representatives of indigenous populations who have suffered disproportionately in past pandemics.

Conclusions

Despite the major impact of the 1918 influenza pandemic in New Zealand (~8,600 deaths), only seven publicly accessible memorials that refer to it were identified in this study. This was in marked contrast to other disaster-related memorials and particularly to war memorials. Furthermore, the current educational value of these pandemic memorials is likely to be very limited for a range of reasons such as remote location and limited signage. There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.

Appendix: Additional detail on the identified memorials and selected photographs

Table A1: Additional details on the identified publicly accessible memorials relating to the 1918 influenza pandemic in New Zealand which specifically mention “influenza” (organised by north to south location within the country).  

c

c

Other possible memorials to the 1918 influenza pandemic

Our searches included the following possible memorials (Table A2), but we lack sufficient information to be sure about any link with the 1918 pandemic. Further historical research may be required to clarify any such associations.

Table A2: Possible sites with a relationship to the 1918 influenza pandemic but for which further research is needed to clarify.

Table A3: Presence of physical memorials for all the sudden mass fatality events occurring from 1900 to 2015 with 20 or more fatalities (Wilson et al, Aust N Z J Public Health, e-publication 28 February 2017) (for events occurring within current New Zealand territory, including the Exclusive Economic Zone, and ordered by descending number of deaths).

* If the presence of a memorial was not apparent in the documentation of the primary data sources (http://www.nzhistory.net.nz/map/memorials-register-map), then internet searches were conducted using the search terms: “memorial”, “monument” and “plaque”.
** There are eight memorials listed at: http://www.nzhistory.net.nz/media/photo/memorial-cross-mount-erebus but not all may have a plaque or monument.
*** The MTG Hawke’s Bay Museum Tai Ahuriri in Napier has dedicated a gallery to this earthquake.
# The “Museum of Wellington City and Sea” has a permanent commemorative exhibition to the Wahine sinking.

Figure A: Gravestone of the nurse Jessie Linton erected by the people of Thames after her death in the 1918 influenza pandemic, but now showing scope for renovation work (photograph by Nick Wilson, 2015).

c

Figure B: Obelisk style memorial to military personnel who died in the Featherston Camp, mainly from pandemic influenza in 1918 (photograph by Nick Wilson, 2015).

c

Figure C: Memorial to Māori victims of the 1918 pandemic at the Te Aute Urupā (cemetery), Te Tii Mangonui, Bay of Islands, Northland (photograph by Catharine Ferguson, 2016; with permission from the kaumātua at Te Tii).

c

Figure D: One of three common grave headstones to Māori victims of the 1918 influenza pandemic at Tapikitu Urupā, Omanaia Churchyard, Omanaia, Northland (photograph by Catharine Ferguson, 2016; with permission from the local kaumātua).

c

Figure E: Statue to Dr Charles Little, a physician who died in the pandemic, outside Waikari Hospital, North Canterbury (photograph by Geoffrey Rice, 2016).

c

Figure F: Memorial to Dr Charles Little, a physician who died in the pandemic, at Culverden, North Canterbury (photograph by Geoffrey Rice, 2016).

c

Figure G: Memorial plaque to nurses who died in the pandemic (and the First World War) at the Chapel in Dunedin Hospital (photograph by Nick Wilson, 2016).

c

Summary

Abstract

Aim

To systematically identify physical memorials to the 1918 influenza pandemic in an entire country.

Method

Internet searches, contact with local historians and field expeditions were conducted.

Results

Despite the high impact of the 1918 influenza pandemic in New Zealand (~8,600 deaths), only seven publicly accessible local memorials which referred this pandemic were identified. Another 11 memorials were identified, but these were in private settings or did not refer to the pandemic. There is no national memorial and a marked contrast exists with the number of war memorials (260 times more per 1,000 deaths for one war), and for 20 smaller mass fatality events (one of which has eight memorials alone). The current educational value of these pandemic memorials is likely to be minimal since only three are in cities, there is a lack of supporting signage and there are no links to online resources.

Conclusion

Despite the major impact of the 1918 influenza pandemic in New Zealand, publicly accessible memorials were found to be rare. This was in marked contrast to other disaster-related memorials and particularly to war memorials. There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.

Author Information

- Nick Wilson, Professor, University of Otago, Wellington; Catharine Ferguson, Kerikeri, Northland; Geoffrey Rice, Professor, University of Canterbury, Christchurch; Michael G Baker, Professor, University of Otago, Wellington; Ben Schrader, Wellingt

Acknowledgements

The authors gratefully acknowledge those who helped in Northland to identify memorials and permit photographs to be taken: (i) Te Huranga Hohaia and the kaumtua of the Te Tii Mangonui Community, Bay of Islands, Northland; and (ii) Steve Morunga and Cecelia Morunga of Omanaia, Hokianga, Northland. We also thank Imelda Bargas (Ministry of Culture and Heritage), Aidan Challis and Stuart Park for their helpful assistance.

Correspondence

Professor Nick Wilson, University of Otago, Wellington.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

Nil.

  1. World Health Organization. Pandemic influenza risk management: WHO interim guidance. Geneva: World Health Organization, 2013.
  2. MacDonald G, Moen A, St Louis M. The national inventory of core capabilities for pandemic influenza preparedness and response: an instrument for planning and evaluation. Influenza Other Respir Viruses 2014; 8:189–93.
  3. Frieden T, Tappero J, Dowell S, Hien N, Guillaume F, Aceng J. Safer countries through global health security. Lancet 2014; 383:764–6.
  4. Rice G. Black November: The 1918 influenza pandemic in New Zealand. Christchurch: Canterbury University Press, 2005.
  5. Ministry for Culture and Heritage. The 1918 flu pandemic. Updated 28 October 2014. http://www.nzhistory.net.nz/culture/influenza-pandemic-1918
  6. Wilson N, Telfar Barnard L, Summers J, Shanks G, Baker M. Differential mortality by ethnicity in 3 influenza pandemics over a century, New Zealand. Emerg Infect Dis 2012; 18:71–77.
  7. Viboud C, Simonsen L, Fuentes R, Flores J, Miller MA, Chowell G. Global Mortality Impact of the 1957–1959 Influenza Pandemic. J Infect Dis 2016; 213:738–45.
  8. Wilson N, Summers JA, Baker MG. The 2009 influenza pandemic: a review of the strengths and weaknesses of the health sector response in New Zealand. N Z Med J 2012; 125:54–66.
  9. Pereira MS, Schild GC. An antigenic variant of the Hong Kong-68 influenza A 2 virus. J Hyg (Lond) 1971; 69:99–103.
  10. Ministry for Culture and Heritage. A list of national monuments. 25 March 2015. http://www.mch.govt.nz/nz-identity-heritage/national-monuments-war-graves/list-national-monuments
  11. Auckland War Memorial Museum. Cenotaph database. http://muse.aucklandmuseum.com/databases/Cenotaph/locations.aspx?
  12. Aberhart L. Anzac: Victoria University Press, 2014.
  13. Maclean C, Phillips J. The sorrow and the pride: New Zealand war memorials: Historical Branch, GP Books, 1990.
  14. Bargas I, Shoebridge T. New Zealand’s First World War Heritage. Auckland: Exisle Publishing, 2015.
  15. Wilson N, Morales A, Guy N, Thomson G. Marked decline of sudden mass fatality events in New Zealand for the 1900 to 2015 period: The basic epidemiology. Aust N Z J Public Health 2017; 41:275–279.
  16. Ministry for Culture and Heritage. ‘NZ memorials register map’. Updated 20 December 2012 Memorials. http://www.nzhistory.net.nz/map/memorials-register-map
  17. Ministry for Culture and Heritage. New Zealand disasters timeline. Updated 3 September 2015. http://www.nzhistory.net.nz/culture/new-zealand-disasters/timeline
  18. Maclean F. Challenge for health: A history of public health in New Zealand. Wellington: Government Printer, 1964.
  19. Phillips J. ‘Memorials and monuments - Memorials to the centennial and the Second World War’, Te Ara - the Encyclopedia of New Zealand, updated 13 July 2012. http://www.TeAra.govt.nz/en/memorials-and-monuments/page-6
  20. Forbes M. National War Memorial takes shape. Stuff. 3 October 2013. http://www.stuff.co.nz/dominion-post/news/9240092/National-War-Memorial-takes-shape
  21. Winter J. Sites of Memory, Sites of Mourning: The Great War in European Cultural History: Cambridge University Press, 1998.
  22. Alderman D, Dwyer O. ‘Memorials and Monuments’, Academia, 2009. http://www.academia.edu/6091282?Memorias_and_Monuments
  23. Sertsou G, Wilson N, Baker M, Nelson P, Roberts MG. Key transmission parameters of an institutional outbreak during the 1918 influenza pandemic estimated by mathematical modelling. Theor Biol Med Model 2006; 3:38.
  24. Summers JA, Wilson N, Baker MG, Shanks GD. Mortality risk factors for pandemic influenza on New Zealand troop ship, 1918. Emerg Infect Dis 2010; 16:1931–7.
  25. Summers JA, Shanks GD, Baker MG, Wilson N. Severe impact of the 1918–19 pandemic influenza in a national military force. N Z Med J 2013; 126(1378):36–47.

Contact diana@nzma.org.nz
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Pandemics of influenza and other infectious diseases remain a serious global threat, requiring ongoing preparations by all countries. Such preparations include wide-ranging core capacities for surveillance and response.1,2 There is also increasing emphasis on preventing emergence of new microbial threats with approaches such as the Global Health Security Agenda.3 However, there might be decades between future pandemics, particularly those of the scale seen in the 1918 influenza pandemic. Consequently, this threat can fade from public and official memories. Without clear reminders of the potentially massive effects of such pandemics, there may be little impetus to ensure preparatory efforts and proportionate resourcing.

Memorials might be one way to ensure that a society’s collective recollection of the threat of influenza and other pandemics remains. Physical memorials can provide a locality for civic rituals (such as gatherings at anniversary events), and for visits by school groups and others. Memorials can also be used to enhance awareness around social capital and civil responsibility—in this case by potentially providing examples and narratives of health workers and volunteers who worked to reduce the impact of the pandemic. Some memorials (such as the National War Memorial in New Zealand) even offer educational programmes that interpret the function and meanings of the memorial to visitors.

New Zealand provides a good case study for considering the issues around the memorialisation of pandemic influenza, as it is a relatively small country and there is fairly detailed national documentation of memorials on official websites. It is also a country where there might be at least some modest awareness of the impact of the 1918 influenza pandemic, owing to the major scale of the impact, especially for the Māori population as detailed in a book4 and on a popular official history website.5 As with most other countries, New Zealand has experienced three notable influenza pandemics since 1900; in 1918 (8,573 deaths),4 in 1957–59 (179 deaths in 19576 with even higher excess deaths in 19597) and in 2009 (49 deaths8). The 1968 pandemic reached New Zealand9 but we found no data on excess mortality estimates.

Methods

Searches to identify memorials

We aimed to identify memorials for multiple pandemic deaths or for individual health workers involved in responding to the pandemic. We conducted internet searches using Google and Google Images with search terms covering all of the following terms: “New Zealand”, “influenza”, “Spanish flu” and “memorial/monument/obelisk/statue/plaque/cemetery”. Searches were conducted in December 2015. Also examined were: a New Zealand online encyclopaedia (http://www.teara.govt.nz/en), an online history site (http://www.nzhistory.net.nz/) and an online list of national monuments.10

New Zealand has an online “Historic Heritage” list of historic sites, which includes selected memorials and cemeteries (http://www.heritage.org.nz/the-list). This database was also searched with the terms: “influenza”, “epidemic” and “pandemic”.

To determine if the gravestones of any individuals provided linkages to memorials, we also searched the online Cenotaph database11 (keyword searches: “influenza”, “epidemic”, “pandemic”). Specific books on memorials in New Zealand were also examined.12–14

Local networks and memorial site visits

We utilised informal local history networks to identify potential additional memorials in the Northland Region (which has a relatively high population of Māori who suffered disproportionately in the pandemic4). For selected memorials we conducted site visits to document accessibility, to take photographs and ascertain any associated signage in the vicinity. We also determined if publicly accessible memorials were visible on Google Street View.

Comparisons with other memorials

For comparisons with other New Zealand-based mass fatality events, we selected events with 20 or more fatalities since 1900 (as per a recent study15). To identify any memorials associated with these events, we used the data from an official history website,16 supplemented with internet searches, to see if memorial data were lacking at the primary data source (using the search terms: “memorial”, “monument” and “plaque”). For comparisons with war memorials we used the following official website: http://www.nzhistory.net.nz/map/memorials-register-map.

Results

Memorials related to the pandemic

A total of seven publicly accessible memorials that referred to multiple pandemic deaths or health worker responder deaths from the pandemic were identified (Table 1). Even so, several of these cannot be considered to be fully pandemic-related in that: (i) they also relate to the life work of the named individual (eg, the two memorials to Dr Cruickshank including Figure 1); and (ii) also relate to other causes of death (ie, for soldiers the Featherston Camp memorial and for the nurses memorialised at the two chapels listed in Table 1).

Table 1: The seven identified publicly accessible memorials relating to multiple deaths from the 1918 influenza pandemic deaths (or health worker responders) in New Zealand and which specifically mention “influenza” (organised by north to south location within the country).

Figure 1: Statue of Dr Margaret Cruickshank, a physician who died in the 1918 influenza pandemic, Waimate, South Canterbury (photograph by the lead author, 2016).  

c

For none of these seven memorials was there evidence of signage in the vicinity directing visitors to their location, including the one at Waikumete Cemetery for the 1,128 people who died from the pandemic in Auckland. None of the publicly accessible memorials were specifically for Māori and only three were in cities: at Waikumete in Auckland, the Chapel in Christchurch and the Chapel in Dunedin. There was also fairly limited information on the memorials relating to the pandemic, with only two having information boards (excluding the Chapel in Christchurch which has been closed for some time due to earthquake damage and could not be visited). The role of health workers and/or citizen volunteers during the pandemic was explicit in five of the memorials: at Waikumete, to the nurse Jessie Linton, the two memorials to Dr Cruickshank and to nurses in the Dunedin Chapel. None of the memorial sites had documentation that linked to any related website resources about the pandemic or which linked all the influenza pandemic memorials together in a thematic manner. Six of the seven memorials were identifiable based on internet searches and five had some aspects of the memorial that were visible on Google Street View.

Another 11 memorials for mass deaths or deaths of health worker responders were pandemic-associated but were either in private settings or did not specifically mention the pandemic (Table 2). Nine of these had specific relevance to Māori, and all nine of these were located in the North Island. These memorials to Māori do not have routine public accessibility, as they are in urupā (cemeteries) or are on marae, which are private spaces. Marae are areas with buildings and grounds which are the cultural and social focus for an iwi (tribe), hapū (sub-tribe) or whānau (family). Of these 11 additional memorials, seven had some information about them on the internet.

Table 2: Additional memorials with a relationship to the 1918 influenza pandemic in New Zealand, but which are either in private settings or do not specifically refer to the pandemic (organised by north to south location within the country).

Table 3: New Zealand war memorials, sourced from New Zealand History Online16 with a comparison to the 1918 influenza pandemic (data from this study).

*In addition, there are multiple museum displays related to all these and other wars involving the New Zealand population, eg, in Auckland’s War Memorial Museum, and the “National Army Museum” in Waiouru.
**Combined for both wars since the same memorial is often used for both wars in the New Zealand context.

Comparison with memorials to other mass fatality events

The physical memorial status was ascertained for non-epidemic/non-pandemic mass fatality events for the period 1900 to 2015 in New Zealand where there were 20+ fatalities (n=20 events with 1,414 deaths, Table A3). It was found that there are memorials in existence or currently being constructed for 80% (16/20) of these events. Indeed, for one of these events there are at least eight memorials associated with it: the Mt Erebus aircraft crash. Several other such events had multiple memorials to them and in two cases they have dedicated sections in New Zealand museums (an earthquake and a shipwreck—see Appendix).

It was also apparent that the list of “disasters” at an official New Zealand history website17 includes no epidemics or pandemics at all. That is, it ignores the influenza pandemics of: 1918,4 1957–1959,6,7 1968 and of 2009.8 It also makes no mention of other post-1900 epidemics such as the 53 deaths in a 1913 smallpox epidemic, up to 173 deaths per year in various poliomyelitis epidemics and up to 375 deaths per year in various measles epidemics.18 This research also failed to identify any physical memorials to any of these other pandemics or epidemics.

Comparison with war memorials

The ratio of the number of publicly accessible memorials to deaths in various wars is shown in Table 3. This ratio was 261 times higher for the South African War than the pandemic (213 vs 0.8 memorials per 1,000 deaths). For the two World Wars together (since memorials to these are often combined), the respective value was 38 times higher.

Discussion

Main findings and interpretation

This study found only seven publicly accessible memorials that referred to the 1918 influenza pandemic in New Zealand. The comparison with the much greater number of war memorials and memorials other disaster events (with the latter comprising a much lower total mortality burden) was particularly stark. Such a difference is further compounded when considering the estimated NZD 122 million (around USD 79 million) spent on Second World War memorials by the New Zealand Government (in 2011 dollars),19 and the NZD 120 million spent on a national war memorial park20 that was completed in 2015. Many reasons might explain these differences, but possibilities include: (i) the timing of the 1918 pandemic at the end of the First World War (when New Zealand society was still highly disrupted from the impact of this war); (ii) the perception of these pandemic deaths being less “heroic” than military deaths; and (iii) the limited understanding around this time of potential lessons for the future arising from the pandemic experience. For example, some citizens who promoted the construction of various memorials to preventable causes (eg, to train crash disasters and also war memorials) might have believed that memorialising the dead and the disaster event might provide lessons for prevention. But in the early part of the 20th century the epidemiology of pandemic influenza and the potential for preventing and controlling it was still poorly understood scientifically and in popular culture. Other reasons may also apply given the complex psychological and sociological processes involved in memorialisation processes, particularly as detailed for war memorials.13,21,22

The findings of this study also suggest that the current educational value of these publicly accessible pandemic memorials is likely to be constrained by: (i) only being in three cities; (ii) the limited signage and information on the memorials relating to the influenza pandemic; and (iii) the complete lack of any website resources that link these memorials together and to additional website-based information about pandemics. This situation suggests major scope for enhancing the presence and use of such memorials if a society wishes to better remember the large impacts of the 1918 pandemic and consider the implications for future pandemic preparedness. These impacts include the large numbers dying within months, the social and economic impacts of these sudden deaths, and the disproportionate effects on particular populations—in this case on Māori.6 While future influenza pandemics might only be preventable to some extent, it is very likely the appropriate preparedness could reduce the scale of the impact of a pandemic (hence the support for such preparations by the World Health Organization1).

No published studies on 1918 pandemic influenza memorials in other countries were identified, and our internet searches for New Zealand memorials only rarely incidentally identified such memorials in other countries (eg, the Lueg Monument in Switzerland to 54 Bern cavalrymen who died in the pandemic). Further research could more systematically determine the presence of such memorials in both combatant and non-combatant nations at this time.

Strengths and limitations of this study

This study benefited from New Zealand being a relatively small country in which the 1918 influenza pandemic has at least some level of local documentation in a popular book4 and on a popular New Zealand history website.5 Furthermore, it is a country for which national collections of memorial data have been assembled online. But there are limitations in that some additional memorials may not have been identified, especially if these are in private places such as marae, urupā or consist only of a plaque inside a building that is not documented in any book or website. For example, we are recipients of oral history reports concerning three other possible pandemic-associated sites, but for which no written documentation has yet been identified (Table A2). More detailed involvement of local historians throughout the country may be required to capture data on all such pandemic-associated sites.

Options for enhancing the educational utility of pandemic-related memorials

If a society wished to enhance the long-term educational value of memorials concerning pandemic influenza and its future threat, a range of options exist, as suggested by the New Zealand situation:

  • Upgrading existing publicly accessible physical memorials to include more information about the 1918 pandemic. Also, symbols (eg, quick response codes) on each memorial or on related signage could allow users with smartphones to gain additional information immediately. Signage around the locality could also make the memorials easier to find. In some cases, existing memorials could benefit from restoration work (Figure A).
  • Increasing the number of memorials is an option, especially in cemeteries where there are unmarked graves of those who died in the pandemic. An example of such unmarked graves is at Andersons Bay Cemetery in the City of Dunedin. Funds could be made available to relevant local authorities that wished to identify sites not yet covered by any memorial. For example, this could include Māori tribal (iwi) authorities who might wish to memorialise additional sites where the pandemic had a notable impact.
  • Producing a national memorial (physical or online) that listed all the doctors, nurses and other health workers who died in the pandemic. This could even be done for all the victims, since a comprehensive online memorial exists for all those dying in the wars New Zealand has been involved in (the Cenotaph11).
  • Integrating links to all the memorials into one official website that has a detailed set of information about the pandemic, its local impacts and a discussion of future pandemic threats. An integrated memorial could also contribute materials to a “traveling museum exhibition” that could tour the country.

A deadline for working on these options could be the 100th anniversary of the 1918 pandemic, with the key organising agencies being the government ones concerned about heritage and health. Ideally however, a range of other parties might be involved in such planning including local government, local heritage and health groups, and representatives of indigenous populations who have suffered disproportionately in past pandemics.

Conclusions

Despite the major impact of the 1918 influenza pandemic in New Zealand (~8,600 deaths), only seven publicly accessible memorials that refer to it were identified in this study. This was in marked contrast to other disaster-related memorials and particularly to war memorials. Furthermore, the current educational value of these pandemic memorials is likely to be very limited for a range of reasons such as remote location and limited signage. There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.

Appendix: Additional detail on the identified memorials and selected photographs

Table A1: Additional details on the identified publicly accessible memorials relating to the 1918 influenza pandemic in New Zealand which specifically mention “influenza” (organised by north to south location within the country).  

c

c

Other possible memorials to the 1918 influenza pandemic

Our searches included the following possible memorials (Table A2), but we lack sufficient information to be sure about any link with the 1918 pandemic. Further historical research may be required to clarify any such associations.

Table A2: Possible sites with a relationship to the 1918 influenza pandemic but for which further research is needed to clarify.

Table A3: Presence of physical memorials for all the sudden mass fatality events occurring from 1900 to 2015 with 20 or more fatalities (Wilson et al, Aust N Z J Public Health, e-publication 28 February 2017) (for events occurring within current New Zealand territory, including the Exclusive Economic Zone, and ordered by descending number of deaths).

* If the presence of a memorial was not apparent in the documentation of the primary data sources (http://www.nzhistory.net.nz/map/memorials-register-map), then internet searches were conducted using the search terms: “memorial”, “monument” and “plaque”.
** There are eight memorials listed at: http://www.nzhistory.net.nz/media/photo/memorial-cross-mount-erebus but not all may have a plaque or monument.
*** The MTG Hawke’s Bay Museum Tai Ahuriri in Napier has dedicated a gallery to this earthquake.
# The “Museum of Wellington City and Sea” has a permanent commemorative exhibition to the Wahine sinking.

Figure A: Gravestone of the nurse Jessie Linton erected by the people of Thames after her death in the 1918 influenza pandemic, but now showing scope for renovation work (photograph by Nick Wilson, 2015).

c

Figure B: Obelisk style memorial to military personnel who died in the Featherston Camp, mainly from pandemic influenza in 1918 (photograph by Nick Wilson, 2015).

c

Figure C: Memorial to Māori victims of the 1918 pandemic at the Te Aute Urupā (cemetery), Te Tii Mangonui, Bay of Islands, Northland (photograph by Catharine Ferguson, 2016; with permission from the kaumātua at Te Tii).

c

Figure D: One of three common grave headstones to Māori victims of the 1918 influenza pandemic at Tapikitu Urupā, Omanaia Churchyard, Omanaia, Northland (photograph by Catharine Ferguson, 2016; with permission from the local kaumātua).

c

Figure E: Statue to Dr Charles Little, a physician who died in the pandemic, outside Waikari Hospital, North Canterbury (photograph by Geoffrey Rice, 2016).

c

Figure F: Memorial to Dr Charles Little, a physician who died in the pandemic, at Culverden, North Canterbury (photograph by Geoffrey Rice, 2016).

c

Figure G: Memorial plaque to nurses who died in the pandemic (and the First World War) at the Chapel in Dunedin Hospital (photograph by Nick Wilson, 2016).

c

Summary

Abstract

Aim

To systematically identify physical memorials to the 1918 influenza pandemic in an entire country.

Method

Internet searches, contact with local historians and field expeditions were conducted.

Results

Despite the high impact of the 1918 influenza pandemic in New Zealand (~8,600 deaths), only seven publicly accessible local memorials which referred this pandemic were identified. Another 11 memorials were identified, but these were in private settings or did not refer to the pandemic. There is no national memorial and a marked contrast exists with the number of war memorials (260 times more per 1,000 deaths for one war), and for 20 smaller mass fatality events (one of which has eight memorials alone). The current educational value of these pandemic memorials is likely to be minimal since only three are in cities, there is a lack of supporting signage and there are no links to online resources.

Conclusion

Despite the major impact of the 1918 influenza pandemic in New Zealand, publicly accessible memorials were found to be rare. This was in marked contrast to other disaster-related memorials and particularly to war memorials. There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.

Author Information

- Nick Wilson, Professor, University of Otago, Wellington; Catharine Ferguson, Kerikeri, Northland; Geoffrey Rice, Professor, University of Canterbury, Christchurch; Michael G Baker, Professor, University of Otago, Wellington; Ben Schrader, Wellingt

Acknowledgements

The authors gratefully acknowledge those who helped in Northland to identify memorials and permit photographs to be taken: (i) Te Huranga Hohaia and the kaumtua of the Te Tii Mangonui Community, Bay of Islands, Northland; and (ii) Steve Morunga and Cecelia Morunga of Omanaia, Hokianga, Northland. We also thank Imelda Bargas (Ministry of Culture and Heritage), Aidan Challis and Stuart Park for their helpful assistance.

Correspondence

Professor Nick Wilson, University of Otago, Wellington.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

Nil.

  1. World Health Organization. Pandemic influenza risk management: WHO interim guidance. Geneva: World Health Organization, 2013.
  2. MacDonald G, Moen A, St Louis M. The national inventory of core capabilities for pandemic influenza preparedness and response: an instrument for planning and evaluation. Influenza Other Respir Viruses 2014; 8:189–93.
  3. Frieden T, Tappero J, Dowell S, Hien N, Guillaume F, Aceng J. Safer countries through global health security. Lancet 2014; 383:764–6.
  4. Rice G. Black November: The 1918 influenza pandemic in New Zealand. Christchurch: Canterbury University Press, 2005.
  5. Ministry for Culture and Heritage. The 1918 flu pandemic. Updated 28 October 2014. http://www.nzhistory.net.nz/culture/influenza-pandemic-1918
  6. Wilson N, Telfar Barnard L, Summers J, Shanks G, Baker M. Differential mortality by ethnicity in 3 influenza pandemics over a century, New Zealand. Emerg Infect Dis 2012; 18:71–77.
  7. Viboud C, Simonsen L, Fuentes R, Flores J, Miller MA, Chowell G. Global Mortality Impact of the 1957–1959 Influenza Pandemic. J Infect Dis 2016; 213:738–45.
  8. Wilson N, Summers JA, Baker MG. The 2009 influenza pandemic: a review of the strengths and weaknesses of the health sector response in New Zealand. N Z Med J 2012; 125:54–66.
  9. Pereira MS, Schild GC. An antigenic variant of the Hong Kong-68 influenza A 2 virus. J Hyg (Lond) 1971; 69:99–103.
  10. Ministry for Culture and Heritage. A list of national monuments. 25 March 2015. http://www.mch.govt.nz/nz-identity-heritage/national-monuments-war-graves/list-national-monuments
  11. Auckland War Memorial Museum. Cenotaph database. http://muse.aucklandmuseum.com/databases/Cenotaph/locations.aspx?
  12. Aberhart L. Anzac: Victoria University Press, 2014.
  13. Maclean C, Phillips J. The sorrow and the pride: New Zealand war memorials: Historical Branch, GP Books, 1990.
  14. Bargas I, Shoebridge T. New Zealand’s First World War Heritage. Auckland: Exisle Publishing, 2015.
  15. Wilson N, Morales A, Guy N, Thomson G. Marked decline of sudden mass fatality events in New Zealand for the 1900 to 2015 period: The basic epidemiology. Aust N Z J Public Health 2017; 41:275–279.
  16. Ministry for Culture and Heritage. ‘NZ memorials register map’. Updated 20 December 2012 Memorials. http://www.nzhistory.net.nz/map/memorials-register-map
  17. Ministry for Culture and Heritage. New Zealand disasters timeline. Updated 3 September 2015. http://www.nzhistory.net.nz/culture/new-zealand-disasters/timeline
  18. Maclean F. Challenge for health: A history of public health in New Zealand. Wellington: Government Printer, 1964.
  19. Phillips J. ‘Memorials and monuments - Memorials to the centennial and the Second World War’, Te Ara - the Encyclopedia of New Zealand, updated 13 July 2012. http://www.TeAra.govt.nz/en/memorials-and-monuments/page-6
  20. Forbes M. National War Memorial takes shape. Stuff. 3 October 2013. http://www.stuff.co.nz/dominion-post/news/9240092/National-War-Memorial-takes-shape
  21. Winter J. Sites of Memory, Sites of Mourning: The Great War in European Cultural History: Cambridge University Press, 1998.
  22. Alderman D, Dwyer O. ‘Memorials and Monuments’, Academia, 2009. http://www.academia.edu/6091282?Memorias_and_Monuments
  23. Sertsou G, Wilson N, Baker M, Nelson P, Roberts MG. Key transmission parameters of an institutional outbreak during the 1918 influenza pandemic estimated by mathematical modelling. Theor Biol Med Model 2006; 3:38.
  24. Summers JA, Wilson N, Baker MG, Shanks GD. Mortality risk factors for pandemic influenza on New Zealand troop ship, 1918. Emerg Infect Dis 2010; 16:1931–7.
  25. Summers JA, Shanks GD, Baker MG, Wilson N. Severe impact of the 1918–19 pandemic influenza in a national military force. N Z Med J 2013; 126(1378):36–47.

Contact diana@nzma.org.nz
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Pandemics of influenza and other infectious diseases remain a serious global threat, requiring ongoing preparations by all countries. Such preparations include wide-ranging core capacities for surveillance and response.1,2 There is also increasing emphasis on preventing emergence of new microbial threats with approaches such as the Global Health Security Agenda.3 However, there might be decades between future pandemics, particularly those of the scale seen in the 1918 influenza pandemic. Consequently, this threat can fade from public and official memories. Without clear reminders of the potentially massive effects of such pandemics, there may be little impetus to ensure preparatory efforts and proportionate resourcing.

Memorials might be one way to ensure that a society’s collective recollection of the threat of influenza and other pandemics remains. Physical memorials can provide a locality for civic rituals (such as gatherings at anniversary events), and for visits by school groups and others. Memorials can also be used to enhance awareness around social capital and civil responsibility—in this case by potentially providing examples and narratives of health workers and volunteers who worked to reduce the impact of the pandemic. Some memorials (such as the National War Memorial in New Zealand) even offer educational programmes that interpret the function and meanings of the memorial to visitors.

New Zealand provides a good case study for considering the issues around the memorialisation of pandemic influenza, as it is a relatively small country and there is fairly detailed national documentation of memorials on official websites. It is also a country where there might be at least some modest awareness of the impact of the 1918 influenza pandemic, owing to the major scale of the impact, especially for the Māori population as detailed in a book4 and on a popular official history website.5 As with most other countries, New Zealand has experienced three notable influenza pandemics since 1900; in 1918 (8,573 deaths),4 in 1957–59 (179 deaths in 19576 with even higher excess deaths in 19597) and in 2009 (49 deaths8). The 1968 pandemic reached New Zealand9 but we found no data on excess mortality estimates.

Methods

Searches to identify memorials

We aimed to identify memorials for multiple pandemic deaths or for individual health workers involved in responding to the pandemic. We conducted internet searches using Google and Google Images with search terms covering all of the following terms: “New Zealand”, “influenza”, “Spanish flu” and “memorial/monument/obelisk/statue/plaque/cemetery”. Searches were conducted in December 2015. Also examined were: a New Zealand online encyclopaedia (http://www.teara.govt.nz/en), an online history site (http://www.nzhistory.net.nz/) and an online list of national monuments.10

New Zealand has an online “Historic Heritage” list of historic sites, which includes selected memorials and cemeteries (http://www.heritage.org.nz/the-list). This database was also searched with the terms: “influenza”, “epidemic” and “pandemic”.

To determine if the gravestones of any individuals provided linkages to memorials, we also searched the online Cenotaph database11 (keyword searches: “influenza”, “epidemic”, “pandemic”). Specific books on memorials in New Zealand were also examined.12–14

Local networks and memorial site visits

We utilised informal local history networks to identify potential additional memorials in the Northland Region (which has a relatively high population of Māori who suffered disproportionately in the pandemic4). For selected memorials we conducted site visits to document accessibility, to take photographs and ascertain any associated signage in the vicinity. We also determined if publicly accessible memorials were visible on Google Street View.

Comparisons with other memorials

For comparisons with other New Zealand-based mass fatality events, we selected events with 20 or more fatalities since 1900 (as per a recent study15). To identify any memorials associated with these events, we used the data from an official history website,16 supplemented with internet searches, to see if memorial data were lacking at the primary data source (using the search terms: “memorial”, “monument” and “plaque”). For comparisons with war memorials we used the following official website: http://www.nzhistory.net.nz/map/memorials-register-map.

Results

Memorials related to the pandemic

A total of seven publicly accessible memorials that referred to multiple pandemic deaths or health worker responder deaths from the pandemic were identified (Table 1). Even so, several of these cannot be considered to be fully pandemic-related in that: (i) they also relate to the life work of the named individual (eg, the two memorials to Dr Cruickshank including Figure 1); and (ii) also relate to other causes of death (ie, for soldiers the Featherston Camp memorial and for the nurses memorialised at the two chapels listed in Table 1).

Table 1: The seven identified publicly accessible memorials relating to multiple deaths from the 1918 influenza pandemic deaths (or health worker responders) in New Zealand and which specifically mention “influenza” (organised by north to south location within the country).

Figure 1: Statue of Dr Margaret Cruickshank, a physician who died in the 1918 influenza pandemic, Waimate, South Canterbury (photograph by the lead author, 2016).  

c

For none of these seven memorials was there evidence of signage in the vicinity directing visitors to their location, including the one at Waikumete Cemetery for the 1,128 people who died from the pandemic in Auckland. None of the publicly accessible memorials were specifically for Māori and only three were in cities: at Waikumete in Auckland, the Chapel in Christchurch and the Chapel in Dunedin. There was also fairly limited information on the memorials relating to the pandemic, with only two having information boards (excluding the Chapel in Christchurch which has been closed for some time due to earthquake damage and could not be visited). The role of health workers and/or citizen volunteers during the pandemic was explicit in five of the memorials: at Waikumete, to the nurse Jessie Linton, the two memorials to Dr Cruickshank and to nurses in the Dunedin Chapel. None of the memorial sites had documentation that linked to any related website resources about the pandemic or which linked all the influenza pandemic memorials together in a thematic manner. Six of the seven memorials were identifiable based on internet searches and five had some aspects of the memorial that were visible on Google Street View.

Another 11 memorials for mass deaths or deaths of health worker responders were pandemic-associated but were either in private settings or did not specifically mention the pandemic (Table 2). Nine of these had specific relevance to Māori, and all nine of these were located in the North Island. These memorials to Māori do not have routine public accessibility, as they are in urupā (cemeteries) or are on marae, which are private spaces. Marae are areas with buildings and grounds which are the cultural and social focus for an iwi (tribe), hapū (sub-tribe) or whānau (family). Of these 11 additional memorials, seven had some information about them on the internet.

Table 2: Additional memorials with a relationship to the 1918 influenza pandemic in New Zealand, but which are either in private settings or do not specifically refer to the pandemic (organised by north to south location within the country).

Table 3: New Zealand war memorials, sourced from New Zealand History Online16 with a comparison to the 1918 influenza pandemic (data from this study).

*In addition, there are multiple museum displays related to all these and other wars involving the New Zealand population, eg, in Auckland’s War Memorial Museum, and the “National Army Museum” in Waiouru.
**Combined for both wars since the same memorial is often used for both wars in the New Zealand context.

Comparison with memorials to other mass fatality events

The physical memorial status was ascertained for non-epidemic/non-pandemic mass fatality events for the period 1900 to 2015 in New Zealand where there were 20+ fatalities (n=20 events with 1,414 deaths, Table A3). It was found that there are memorials in existence or currently being constructed for 80% (16/20) of these events. Indeed, for one of these events there are at least eight memorials associated with it: the Mt Erebus aircraft crash. Several other such events had multiple memorials to them and in two cases they have dedicated sections in New Zealand museums (an earthquake and a shipwreck—see Appendix).

It was also apparent that the list of “disasters” at an official New Zealand history website17 includes no epidemics or pandemics at all. That is, it ignores the influenza pandemics of: 1918,4 1957–1959,6,7 1968 and of 2009.8 It also makes no mention of other post-1900 epidemics such as the 53 deaths in a 1913 smallpox epidemic, up to 173 deaths per year in various poliomyelitis epidemics and up to 375 deaths per year in various measles epidemics.18 This research also failed to identify any physical memorials to any of these other pandemics or epidemics.

Comparison with war memorials

The ratio of the number of publicly accessible memorials to deaths in various wars is shown in Table 3. This ratio was 261 times higher for the South African War than the pandemic (213 vs 0.8 memorials per 1,000 deaths). For the two World Wars together (since memorials to these are often combined), the respective value was 38 times higher.

Discussion

Main findings and interpretation

This study found only seven publicly accessible memorials that referred to the 1918 influenza pandemic in New Zealand. The comparison with the much greater number of war memorials and memorials other disaster events (with the latter comprising a much lower total mortality burden) was particularly stark. Such a difference is further compounded when considering the estimated NZD 122 million (around USD 79 million) spent on Second World War memorials by the New Zealand Government (in 2011 dollars),19 and the NZD 120 million spent on a national war memorial park20 that was completed in 2015. Many reasons might explain these differences, but possibilities include: (i) the timing of the 1918 pandemic at the end of the First World War (when New Zealand society was still highly disrupted from the impact of this war); (ii) the perception of these pandemic deaths being less “heroic” than military deaths; and (iii) the limited understanding around this time of potential lessons for the future arising from the pandemic experience. For example, some citizens who promoted the construction of various memorials to preventable causes (eg, to train crash disasters and also war memorials) might have believed that memorialising the dead and the disaster event might provide lessons for prevention. But in the early part of the 20th century the epidemiology of pandemic influenza and the potential for preventing and controlling it was still poorly understood scientifically and in popular culture. Other reasons may also apply given the complex psychological and sociological processes involved in memorialisation processes, particularly as detailed for war memorials.13,21,22

The findings of this study also suggest that the current educational value of these publicly accessible pandemic memorials is likely to be constrained by: (i) only being in three cities; (ii) the limited signage and information on the memorials relating to the influenza pandemic; and (iii) the complete lack of any website resources that link these memorials together and to additional website-based information about pandemics. This situation suggests major scope for enhancing the presence and use of such memorials if a society wishes to better remember the large impacts of the 1918 pandemic and consider the implications for future pandemic preparedness. These impacts include the large numbers dying within months, the social and economic impacts of these sudden deaths, and the disproportionate effects on particular populations—in this case on Māori.6 While future influenza pandemics might only be preventable to some extent, it is very likely the appropriate preparedness could reduce the scale of the impact of a pandemic (hence the support for such preparations by the World Health Organization1).

No published studies on 1918 pandemic influenza memorials in other countries were identified, and our internet searches for New Zealand memorials only rarely incidentally identified such memorials in other countries (eg, the Lueg Monument in Switzerland to 54 Bern cavalrymen who died in the pandemic). Further research could more systematically determine the presence of such memorials in both combatant and non-combatant nations at this time.

Strengths and limitations of this study

This study benefited from New Zealand being a relatively small country in which the 1918 influenza pandemic has at least some level of local documentation in a popular book4 and on a popular New Zealand history website.5 Furthermore, it is a country for which national collections of memorial data have been assembled online. But there are limitations in that some additional memorials may not have been identified, especially if these are in private places such as marae, urupā or consist only of a plaque inside a building that is not documented in any book or website. For example, we are recipients of oral history reports concerning three other possible pandemic-associated sites, but for which no written documentation has yet been identified (Table A2). More detailed involvement of local historians throughout the country may be required to capture data on all such pandemic-associated sites.

Options for enhancing the educational utility of pandemic-related memorials

If a society wished to enhance the long-term educational value of memorials concerning pandemic influenza and its future threat, a range of options exist, as suggested by the New Zealand situation:

  • Upgrading existing publicly accessible physical memorials to include more information about the 1918 pandemic. Also, symbols (eg, quick response codes) on each memorial or on related signage could allow users with smartphones to gain additional information immediately. Signage around the locality could also make the memorials easier to find. In some cases, existing memorials could benefit from restoration work (Figure A).
  • Increasing the number of memorials is an option, especially in cemeteries where there are unmarked graves of those who died in the pandemic. An example of such unmarked graves is at Andersons Bay Cemetery in the City of Dunedin. Funds could be made available to relevant local authorities that wished to identify sites not yet covered by any memorial. For example, this could include Māori tribal (iwi) authorities who might wish to memorialise additional sites where the pandemic had a notable impact.
  • Producing a national memorial (physical or online) that listed all the doctors, nurses and other health workers who died in the pandemic. This could even be done for all the victims, since a comprehensive online memorial exists for all those dying in the wars New Zealand has been involved in (the Cenotaph11).
  • Integrating links to all the memorials into one official website that has a detailed set of information about the pandemic, its local impacts and a discussion of future pandemic threats. An integrated memorial could also contribute materials to a “traveling museum exhibition” that could tour the country.

A deadline for working on these options could be the 100th anniversary of the 1918 pandemic, with the key organising agencies being the government ones concerned about heritage and health. Ideally however, a range of other parties might be involved in such planning including local government, local heritage and health groups, and representatives of indigenous populations who have suffered disproportionately in past pandemics.

Conclusions

Despite the major impact of the 1918 influenza pandemic in New Zealand (~8,600 deaths), only seven publicly accessible memorials that refer to it were identified in this study. This was in marked contrast to other disaster-related memorials and particularly to war memorials. Furthermore, the current educational value of these pandemic memorials is likely to be very limited for a range of reasons such as remote location and limited signage. There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.

Appendix: Additional detail on the identified memorials and selected photographs

Table A1: Additional details on the identified publicly accessible memorials relating to the 1918 influenza pandemic in New Zealand which specifically mention “influenza” (organised by north to south location within the country).  

c

c

Other possible memorials to the 1918 influenza pandemic

Our searches included the following possible memorials (Table A2), but we lack sufficient information to be sure about any link with the 1918 pandemic. Further historical research may be required to clarify any such associations.

Table A2: Possible sites with a relationship to the 1918 influenza pandemic but for which further research is needed to clarify.

Table A3: Presence of physical memorials for all the sudden mass fatality events occurring from 1900 to 2015 with 20 or more fatalities (Wilson et al, Aust N Z J Public Health, e-publication 28 February 2017) (for events occurring within current New Zealand territory, including the Exclusive Economic Zone, and ordered by descending number of deaths).

* If the presence of a memorial was not apparent in the documentation of the primary data sources (http://www.nzhistory.net.nz/map/memorials-register-map), then internet searches were conducted using the search terms: “memorial”, “monument” and “plaque”.
** There are eight memorials listed at: http://www.nzhistory.net.nz/media/photo/memorial-cross-mount-erebus but not all may have a plaque or monument.
*** The MTG Hawke’s Bay Museum Tai Ahuriri in Napier has dedicated a gallery to this earthquake.
# The “Museum of Wellington City and Sea” has a permanent commemorative exhibition to the Wahine sinking.

Figure A: Gravestone of the nurse Jessie Linton erected by the people of Thames after her death in the 1918 influenza pandemic, but now showing scope for renovation work (photograph by Nick Wilson, 2015).

c

Figure B: Obelisk style memorial to military personnel who died in the Featherston Camp, mainly from pandemic influenza in 1918 (photograph by Nick Wilson, 2015).

c

Figure C: Memorial to Māori victims of the 1918 pandemic at the Te Aute Urupā (cemetery), Te Tii Mangonui, Bay of Islands, Northland (photograph by Catharine Ferguson, 2016; with permission from the kaumātua at Te Tii).

c

Figure D: One of three common grave headstones to Māori victims of the 1918 influenza pandemic at Tapikitu Urupā, Omanaia Churchyard, Omanaia, Northland (photograph by Catharine Ferguson, 2016; with permission from the local kaumātua).

c

Figure E: Statue to Dr Charles Little, a physician who died in the pandemic, outside Waikari Hospital, North Canterbury (photograph by Geoffrey Rice, 2016).

c

Figure F: Memorial to Dr Charles Little, a physician who died in the pandemic, at Culverden, North Canterbury (photograph by Geoffrey Rice, 2016).

c

Figure G: Memorial plaque to nurses who died in the pandemic (and the First World War) at the Chapel in Dunedin Hospital (photograph by Nick Wilson, 2016).

c

Summary

Abstract

Aim

To systematically identify physical memorials to the 1918 influenza pandemic in an entire country.

Method

Internet searches, contact with local historians and field expeditions were conducted.

Results

Despite the high impact of the 1918 influenza pandemic in New Zealand (~8,600 deaths), only seven publicly accessible local memorials which referred this pandemic were identified. Another 11 memorials were identified, but these were in private settings or did not refer to the pandemic. There is no national memorial and a marked contrast exists with the number of war memorials (260 times more per 1,000 deaths for one war), and for 20 smaller mass fatality events (one of which has eight memorials alone). The current educational value of these pandemic memorials is likely to be minimal since only three are in cities, there is a lack of supporting signage and there are no links to online resources.

Conclusion

Despite the major impact of the 1918 influenza pandemic in New Zealand, publicly accessible memorials were found to be rare. This was in marked contrast to other disaster-related memorials and particularly to war memorials. There appears to be major scope for enhancing public education around the persisting threat of future pandemics via improved use of physical memorials and linkages to online resources.

Author Information

- Nick Wilson, Professor, University of Otago, Wellington; Catharine Ferguson, Kerikeri, Northland; Geoffrey Rice, Professor, University of Canterbury, Christchurch; Michael G Baker, Professor, University of Otago, Wellington; Ben Schrader, Wellingt

Acknowledgements

The authors gratefully acknowledge those who helped in Northland to identify memorials and permit photographs to be taken: (i) Te Huranga Hohaia and the kaumtua of the Te Tii Mangonui Community, Bay of Islands, Northland; and (ii) Steve Morunga and Cecelia Morunga of Omanaia, Hokianga, Northland. We also thank Imelda Bargas (Ministry of Culture and Heritage), Aidan Challis and Stuart Park for their helpful assistance.

Correspondence

Professor Nick Wilson, University of Otago, Wellington.

Correspondence Email

nick.wilson@otago.ac.nz

Competing Interests

Nil.

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