Balmis Expedition
The Royal Philanthropic Vaccine Expedition (), commonly referred to as the Balmis Expedition, was a Spanish healthcare mission that lasted from 1803 to 1806, led by Dr Francisco Javier de Balmis, which vaccinated millions of inhabitants of Spanish America and Asia against smallpox. Background. Smallpox, a devastating disease, decimated the populations of the Americas after it had been brought over from Europe by the Spanish conquistadors in the 1500s. Vaccination, that is inoculation with cowpox material, is a much safer way to prevent smallpox than older methods such as variolation, inoculation with smallpox material, which ran the risk of  itself spreading smallpox. Vaccination had been pioneered by the English physician Edward Jenner in 1798. At that time, about 400,000 Europeans died each year from the disease. Expedition. The expedition set off from A Coruña in northwest Spain on 30 November 1803. It may be considered the first international healthcare expedition in history. Jenner himself wrote, "I don't imagine the annals of history furnish an example of philanthropy so noble, so extensive as this." King Charles IV of Spain supported his royal doctor Balmis since his daughter, Infanta Maria Teresa, had died from the illness. The expedition sailed on  Maria Pita and carried 22 orphan boys (aged 3 to 10) to act as carriers of the cowpox virus. The boys were necessary because the vaccine consisted of infecting patients with cowpox, which is a virus closely related to smallpox but produces a much milder disease that confers immunity to both. However, only an active infection could be transferred to successive patients, so two boys were infected with cowpox at the beginning of the voyage, with two more infected at a time as it progressed across the Atlantic and beyond. The medical staff and caretakers for the boys consisted of  Balmis, a deputy surgeon, two assistants, two first-aid practitioners, three nurses, and Isabel Zendal Gómez, the rectoress of "Casa de Expósitos", an A Coruña orphanage. The mission took the vaccine to the Canary Islands, Puerto Rico, Venezuela, Colombia, Ecuador, Peru, Mexico, the Philippines and China. The ship carried also scientific instruments and translations of the "Historical and Practical Treatise on the Vaccine" by Moreau de Sarthe to be distributed to the local vaccine commissions to be founded. In Puerto Rico, the local population had already been inoculated from the Danish colony of Saint Thomas. In Venezuela, the expedition divided  at La Guaira. Balmis went to Caracas and later to Havana. The Venezuelan poet Andrés Bello wrote an ode to Balmis. José Salvany, the deputy surgeon, went toward today's Colombia and the Viceroyalty of Peru (Ecuador, Peru, Chile, and Bolivia). They took seven years and the toils of the voyage brought death to Salvany (Cochabamba, 1810).In New Spain, Balmis took 25 orphans to maintain the infection during the crossing of the Pacific. In the Philippines, they received help from the Catholic church, which was initially reluctant until Governor-General Rafael Aguilar made an example by vaccinating his five children . Balmis sent most of the expedition back to New Spain while he went on to China, where he visited Macau and Canton. On his way back to Spain in 1806, Balmis offered the vaccine to the British authorities in Saint Helena, despite the ongoing conflict between Spain and Great Britain. Julia Alvarez wrote a fictional account of the expedition from the perspective of its only female member in "Saving the World" (2006).