Politics and everyday life during the 1972 smallpox epidemic in socialist Yugoslavia

Between 16 February and 11 April 1972, 175 inhabitants of the Socialist Federative Republic of Yugoslavia were infected by smallpox; 35 of them died. All but one of the 25 localities affected were on the territory of wider Serbia, with the autonomous province of Kosovo being hit the first and hardest (124 infected, 26 dead). This was the last smallpox outbreak in Europe before the disease was officially declared eradicated in 1980, and the largest since the Second World War. No cases of smallpox had been registered in Yugoslavia since 1930. The disease returned at an unpropitious moment, when a massive reshuffling was taking place within the ruling League of Communists of Yugoslavia, especially in Croatia and Serbia, when economic growth was lagging, and when nationalism (re)emerged as a potent political force.

Radina Vučetić, a prominent historian of socialist Serbia and Yugoslavia, wrote the book Nevidiljivi neprijatelj: Variola vera 1972 with the 50^th anniversary of the epidemic in mind. It is also obvious that the book was written during the COVID-19 pandemic. Interestingly, the book complements the documentary Zadah proleća ‘72 (The Smell of Spring ‘72), by Nataša Mijušković, with which it shares much of the sources, interpretations, and conclusions.

The book consists of an introduction, five chapters and a conclusion that links 1972 to 2022. True to the style of her previous work, Vučetić does not limit the narrative to the emergence, spread, and suppression of the epidemic. Instead, by combining the official records, individuals’ recollections, and media reports, she addresses the fear and confusion, dedication and prejudices, high politics and everyday life during the epidemic. 

Relying on a vast body of secondary literature, the introduction explains the etiopathogenesis and speaks of numerous earlier smallpox epidemics, showing their societal impact and reception in culture. Vučetić discusses the nineteenth-century public health campaigns that led to smallpox being absent from Yugoslavia for decades prior to 1972. The first chapter, “The Chronology of the Disease,” makes for a tense read of the sort we have largely grown unaccustomed to. The reconstruction of the spread of infection—first within Kosovo, then to narrower Serbia, Vojvodina, and Montenegro—on the basis of epidemiological reports suggests it was pure luck that the infection did not spread even further in the early days of the epidemic. The Hajji Ibrahim Hoti, patient zero who had returned from the pilgrimage to Mecca and Medina (he was most likely infected in Baghdad on the way back), and Latif Mumdžić, who was the first to die, are just some of the numerous people that Vučetić mentions—many, especially medical workers, with obvious sympathy and compassion.

“There is never a good time for disease and death, but the moment when the smallpox epidemic broke out in Yugoslavia was among the worse,” Vučetić suggests (p. 75). The second chapter, “The State,” observes the epidemic in the context of the social, political, and economic perturbations of the early 1970s in Yugoslavia. Vučetić argues that the debate over who should bear the financial burden—the federation or constitutive republics—was indicative of a wider crisis of the federation’s functioning: while the messaging was centrally controlled, the response and economic costs were decentralized. Although the preparedness for and response scenarios to a possible smallpox outbreak were examined on two occasions in the 1960s, in 1972 the state apparatus was nevertheless caught off guard. The fact that the epidemic started in Kosovo, the least developed part of the country, and that the virus was brought from the Hajj, shaped the initial media reaction. The Hajj, Kosovo, and the virus itself were constructed in Orientalist terms as antithetical to the rational and secular socialist modernity that Yugoslavia was building.

The juxtaposition of the “state” and the medical “profession” (the focus of chapter three) is conceptually and methodologically problematic. Pitting politicians and bureaucrats against dedicated, occasionally even heroic, medical professionals (although Vučetić also points to the less exemplary conduct of individuals) might help organize the narrative, but it is reminiscent of the belief of older historiography in an inherent conflict between the state-party apparatus and the intelligentsia, including medical professionals, in socialist societies, whereas it is the entanglement of politics, science, and medicine in all socio-political systems that has for a long time been the object of study of historians of science and medicine, science and technology studies, and cognate disciplines.

The tension between the “state” and the “profession” is visible in the emphasis on the fact that Josip Broz Tito did not publicly comment on the epidemic, even though he spoke about numerous other, far less pressing issues, including his own health. He was definitely informed; why, then, did he keep quiet? Vučetić entertains two possibilities: first, it was in order not to politicize the issue, to “let the professionals solve the problem,” which could exculpate the government should something go (even more) wrong; second, Tito and the party leadership were so preoccupied with high politics that they could not sympathize with the plight of regular people. The answer, I suspect, should be looked for elsewhere. Having been exposed to countless press releases and televised briefings on COVID-19, it is worth remembering that “biopower” and “biopolitics” had not always been discussed publicly (or) by heads of states. For comparison, when 21 people were infected by smallpox (four of whom died) in West Germany in February 1970, neither the federal chancellor Brandt nor the president Heinemann became the public faces of the crisis. Admittedly, Tito’s position in Yugoslavia was different and Vučetić is right to note his silence, but the silence is not necessarily surprising.

The tension is also manifested in the treatment of responsibility. Whose fault was it that smallpox entered Yugoslavia in the first place, and that it spread unrecognized and unchecked? Vučetić rightfully criticizes the party leadership, which was reluctant and slow to inform the public, fearing the economic consequences, especially in tourism, and which presented contradictory reports once the news was made public. But the significance of the fact that the virus had been spreading for a full month before it was identified on 16 March, when the second out of three waves was already in full swing, outweighs that of the fact that the party “sat” on the information for three days, between 16 and 18 March. (The “state,” on the other hand, definitely bore responsibility for the fact that by the mid-1960s only 83 percent of Yugoslavia’s population was vaccinated against smallpox, which made conditions for an epidemic ripe.) Though duly noted in the book, this critical lapse of the “profession,” not of the “state,” is overshadowed by the successful mass vaccination campaign. In the final analysis, the cooperation of the “state” and the “profession” is pointed to as the key to containing and suppressing the epidemic.

Getting 18.2 million people out of a total population of around 20.5 million (re)vaccinated within six weeks (the process, including interesting technical details, is described in chapter four) was indeed a tremendous achievement—despite a staggering rate of unsuccessful vaccinations, which had to be repeated, occasionally several times. Vučetić reveals heated debates between public health officials and politicians, as well as among politicians—between the federal party leadership and the leaderships of constituent republics and provinces. Public health officials recommended that vaccination start in the localities and areas that were hit the hardest, such as Kosovo and Belgrade, and work in concentric circles outwards, but it was Slovenia, furthest from the hotspots (and Yugoslavia’s most developed republic) where mandatory mass vaccination campaign started first. This forced a change of plan: now everyone would be vaccinated approximately simultaneously, regardless of the immediate danger and, importantly, the availability of vaccines. Vaccine diplomacy played a crucial role in obtaining vaccines that could not have been produced in Yugoslavia in the needed volume in such a short time.

Chapter five, dedicated to everyday life during the epidemic, especially in quarantines and entire cordoned off areas, addresses the question of how much the lives of Yugoslav citizens were impacted. Not too much, it seems. There was no uniform “Yugoslav” perception of the epidemic. Yes, the overwhelming majority of people were (re)vaccinated, there was fear and uncertainty, distrust, the erosion of “brotherhood and unity” among Yugoslav republics, misinformation, and long lines at vaccination points, but Vučetić also shows that, except in quarantines and cordoned off villages in Kosovo, for most Yugoslavs life carried on with relatively minor disturbances.

The book Nevidljivi neprijatelj is the result of meticulous research. Given the interesting topic and the approachable style of writing, it could easily appeal to wider audiences. However, the book is stronger in its narrative than its analytical aspects. Vučetić wonderfully shows how the contradictions and complexity of early-1970s Yugoslavia were manifested in the response to the smallpox epidemic; yet, some of these contradictions also found their way into her methodological choices. The unfortunate prolific usage of the term “antivaxxer,” which has been recognized as offering little analytical insight and being counterproductive from the perspective of public health efforts, is symptomatic of a certain presentism—of reading the 1972 smallpox epidemic through the lenses of the COVID-19 pandemic—and a dangerous combination of misinformation, conspiracy theories, and vaccine hesitancy in contemporary Serbia (and elsewhere). It also signals a missed opportunity to ask the type of questions and employ analytical frameworks that historians, anthropologists, sociologists, or philosophers dealing more closely with medicine have been asking and employing for quite some time. But this does not diminish the contribution that the book makes to our knowledge of the 1972 epidemic as well as to social and the history of everyday life of socialist Yugoslavia. If anything, it can be a motivation to contemplate the communication and cooperation across the (sub)disciplinary boundaries.