Ruth
A chosen daughter
Written by Neil Rawlins, MD
Haskell County Kansas is an unusual starting place for something popularly called the “Spanish flu”.  The Influenza outbreak occurred at a time when most of the world was at war and under stringent media censorship.  Spain was a not involved in WW1 and reported in the papers about the flu. That reporting made people think that it started there.  The flu actually was taken from Haskell County in Kansas to Camp Funston by a soldier named Dean Nilson and others at the end of February in 1918.  Within 3 weeks 1100 people at camp Funston had been hospitalized.  Twenty four of the largest Army camps had outbreaks with the next 2 months.  Most people recovered from these initial infections. For the most part, the people that died were the same people that usually die in regular flu outbreaks, i.e. the elderly, chronically ill, babies and the pregnant. The infection traveled to Europe with the soldiers for the summer then returned with a vengeance.  It was a major factor in halting the German advance in the summer of 1918.
 
The Influenza may well have been stopped in Kansas had the commander of the Camp Funston listened to the doctors who had recommended quarantining the soldiers rather than sending them off to war.  The commander took his life when he began to realize how his decision had affected the world. 
 
When the infection found its way back to the United States through Philadelphia in early September, the virus had altered such that it now caused an intense immune response in the healthy.  It caused fluid to build up in their lungs and they drowned from it.  Medical advances from the 1960’s and 1970’s would dictate using a ventilator to treat the problem.  Ventilators weren’t available at that time and even in the year 2009 there would be a dramatic shortage of ventilators even if it were a much milder pandemic.
In Philadelphia, the flu met a very crowded city and a corrupt government that ignored health officials’ recommendations.  As the infection spread like wildfire through Philadelphia the fabric of society was stretched to the breaking point.  There were reports of nurses being kidnapped and being forced to take care of family members that were sick.  
 The flu then marched across America leaving many deaths in its wake.  In the end, one in 76 soldiers died from the flu, but the civilian toll was estimated to be 15 times higher.  The hospitalized pregnant women died at a rate ranging from 23-71%.  Of the surviving women 26% lost the child. The total estimates for the world is was about 5-10% of the total population.
 
The infection reached Salt Lake and marched up and down the state.  The LDS church as an organization helped maintain social order.  Cora May Burbank Rawlins was the relief society president of the Lewiston 1st Ward about this time.  Her son, Lindsay described that Cora was one who rendered care to those in need.  One of the duties of the relief society president at the turn of the century was to prepare the bodies for burial within their ward boundaries.  We didn’t have the mortuary services we have today.  Cora would perform that service and help arrange for taking care of the families with illnesses.  While we do not know if she was performing this service or just rendering aid as a member of that organization, Lindsay described how because of her concern about bringing the flu home to her family, she would come in on the back porch, where she would change her clothes and wash up to decrease the chance of bringing the infection into the home.  She must have been very distressed when her 8 month old baby contracted the flu and quickly died.  
(From Lindsay Rawlins History)
      My Sister Ruth
       I never did know much about Ruth. She died before I was born. She died in November of 1918, and I was born in January of 1920. I always thought I took her place. I don't know if I've done her justice or not. I asked Dad about her one time and he said that burying that little girl was the toughest thing he ever did. Then he began to cry, and that's all I ever got out of him.  At another time, I asked Mother. I said, "Mother, I don't want to bother you but if you felt like you could tell me a little about Ruth, I'd like to know. (She didn't live very many months.)
      Mother said, "Well, she took sick and died so fast, and Dr. Parkinson was a good doctor but just couldn't seem to do anything about it. I just grieved and grieved and grieved over the loss of that little girl and I just couldn't quit. One night, I don't know if it was a dream or whether it was a reality but Mother came back to me and said, 'Cora, I am taking care of Ruth and I will do it till you come to get her. Now, cut it out."' Mother said, "After that, I quit grieving. I knew my mother would take care of her."

 This was a very difficult time.  In “The Great Influenza” by John M. Barry, (P 461) he warned that “society cannot function if it is every man for himself.”  By definition, society cannot survive that.  He also quotes Victor Vaughn who was noted for not overstating to make a point warned “Civilization could have disappeared within a few more weeks.”  
Ruth live just a short time but we know through the atonement and plan of salvation she is with her heavenly and earthly parents.  Cora showed great courage and faith as she dealt with a loss of a loved one.  Her story helps reassure us of the eternal nature of the family.  
There are many disasters and pestilences that occur in this life.  The gospel of Jesus Christ helps us endure heartache and sorrow.  Knowing that in the end the Lord will take care of it.  
Note
Information for the historical context was obtained from “the Great Influenza” by John M. Barry.  Neil Rawlins obtained some of this information when he studied influenza in Medical School.  I would discuss the historical aspects with my father as he would describe it from his persective.  It is unclear if Cora was Relief society president at that time or if she was just one of the members that helped in this trying time.  
Addendum (not to necessarily be put in the book.)
At the time of writing this story of Ruth, I was preparing an influenza preparedness plan for Kadlec Clinic, Richland, WA where I am employed.  The looming influenza we are facing in 2009 is the same H1N1 type that caused the loss of 5% of the world’s population around 1918.  The last week in July was the deadliest for this season in the US.  This is unusual for the summer.
Much like the preparation for Y2000 computer problem there are those that felt the preparation was not sufficient and those that thought it was way overblown.  There were a number of seminars for lawyers on how to sue when things went bad from Y2K.  In the end, it was not a big event and those lawyers were disappointed.  Some said it was because of the preparation and some felt it was mostly overblown.  Like Y2K, the preparation for a major pandemic or any medical disaster has to take place way ahead of time.  When the disaster occurs the time for preparation is past.  We cannot prepare for every eventual outcome so reliance on the Lord to help us know what we should prepare for is essential.  I have included a few thoughts on preparation that some may find useful.  If a pandemic occurs I will be working.  That is my profession.  I have some grandsons that have enough health problems the survival would be difficult if the contracted this flu.  I also have two daughter-in-Laws that are pregnant.  In Aug 2009 H1N1 influenza is hitting the pregnant women the hardest of any subgroup.  Our family plan is reverse isolation for the women and the babies.  Try to work from home for my sons and daughter if they are allowed.  As a Physician, I will need to live elsewhere in order not to bring home the illness.  Not everyone needs to prepare in such a manner but in our situation we feel inspired to do so.  
There are several important lessons about pandemic infections that I took away from this history.   
	•	The people who did strict reverse isolation did well.  It requires preparation well before the infection.  You will need to be able to be isolated for weeks to months.
	•	The infection will travel much faster now than it did then and it will be difficult to predict when to go to reverse isolation.  Preparation with food, duct tape, rolls of plastic, 100 rolls toilet paper/ person, paper towels, garbage bags and kitty litter will all have to be done ahead of time.
	•	The organization of the church will help to keep the fabric of society together.  The Ward bishops and priesthood quorums will have a critical role in keeping the society together.  
	•	The number of ventilators in the country will come under strict rationing without a good way to decide whom to use it them on.