The 19th century, a time of lights and shadows, of scientific advances and terrible diseases, was also witness to one of the greatest feats in the history of medicine: the Royal Philanthropic Vaccine Expedition. This monumental mission aimed to eradicate smallpox in the territories of the Spanish Empire. However, behind the success of this mission is the figure of a brave woman forgotten by the books: Isabel Zendal, the Galician nurse who dedicated her life to caring for the most vulnerable and who played a crucial role in this medical crusade. Her heroic and tragic story in equal parts reveals how compassion and personal sacrifice can change the destiny of thousands of people.
1) Childhood and youth of Isabel Zendal
Isabel Zendal Gómez was born in 1773 in the parish of Santa María de Parada, in Ordes, Galicia.. Life in rural Galicia in the 18th century was not easy; peasant families lived on the edge of subsistence and women, in particular, had to face the hard work of the home and the fields. In the midst of this harsh existence, Isabel grew up in a humble family, where she developed a sense of responsibility and deep compassion for others. Isabel’s biography, before her involvement in the expedition, is full of gaps, but it is known that, while still young, she moved to Coruña, where she began to work at the Charity hospital, intended to welcome the poorest. and marginalized from society. There she worked first as a nurse and eventually as rector of the center in charge of caring for orphaned children. These experiences prepared her for the destiny that awaited her.
2) Smallpox, a devastating disease in the 18th century
Smallpox was one of humanity’s greatest enemies in the 18th century. This highly contagious disease made no distinctions, devastating entire cities with its pustules, very high fever and lethality. Throughout history, smallpox was responsible for several epidemics. It caused approximately 400,000 deaths a year just in Europe, since its mortality rate could reach up to 30 %; those who survived were marked by disfiguring scars that for many were as terrible as the disease itself. Smallpox, which is caused by the Variola virus, was primarily transmitted by direct contact between people through respiratory droplets or by touching body fluids of an infected person. It could also be spread through contaminated objects such as bedding.
2a) Edward Jenner, the discoverer of the smallpox vaccine
At the end of the 17th century, the English doctor Edward Jenner discovered that cowpox virus inoculation could protect people against human smallpox. To test his theory, dr. Jenner inoculated an eight-year-old boy named James Phipps with material taken from the pustules of a woman infected with cowpox. He then exposed the child to human smallpox and he did not contract the disease, thus confirming the effectiveness of the vaccine. From that moment on, the word vaccine, which derives from the Latin cow, became popular to refer to this prevention technique.
3) The Royal Philanthropic Vaccine Expedition
News of this revolutionary discovery quickly reached Spain, where Charles IV, whose kingdom had been ravaged by disease, ordered that an expedition be launched to bring the vaccine to the Americas and beyond. The mission would be known as the Royal Philanthropic Vaccine Expedition and the man chosen to lead it was Francisco Javier Balmís, doctor of the Court. But he needed more than medical knowledge to meet this challenge. He needed logistics and, above all, he needed people willing to accompany him on a mission that would last years. And that is how Isabel, due to her experience in caring for children and her ability to manage a hospital, was recruited as the main nurse of the expedition.
3a) A chain of children
One of the biggest challenges the expedition faced was keeping the vaccine alive during long ship voyages across the Atlantic and Pacific. At that time, technology did not allow the vaccine to be stored in bottles for a long time and the most effective method of transportation was to do so in human reservoirs.. This required children who had never been infected with smallpox to be able to inoculate the vaccine into one arm and transfer the pus from their newly formed wounds to another, thus creating a living chain of immunity.
Twenty-two orphaned children participated in the expedition, almost all of them from the Foundling House of A Coruña and it is at this point where the figure of Isabel Zendal becomes crucial. The Galician nurse’s job was not only to ensure that the vaccination chain remained intact, but also to take care of these children, protecting them from the harsh conditions of the trip and giving them comfort when loneliness and fear became unbearable. In 1803, Isabel Zendal, along with Francisco Javier Balmís, the doctors who made up the team and the orphaned children, set sail from the port of A Coruña on the ship María Pita heading to Puerto Rico. Storms, disease, and long voyages on the high seas were constant challenges. The children suffered from dizziness and fever. Some cried at night, missing the home they had never known. For them, Isabel was more than a nurse: she was their protector, their mother.
3c) The arrival in America
When the expedition reached the new continent, they had to face new challenges in places like Puerto Rico, Venezuela, Cuba and Mexico, where smallpox had already wreaked havoc. There, Isabel and her team began massive vaccination campaigns. However, it was not easy: in many cases, local authorities did not trust European methods and viewed the arrival of the expedition with distrust. Despite everything, Balmís and Isabel managed to vaccinate thousands of people and save lives at an unprecedented rate. Isabel not only took care of children, but also organized vaccination processes in hospitals, helped train other nurses, and was responsible for ensuring that vaccines reached the most vulnerable populations. In Mexico City the situation became particularly complex. The prejudices of local authorities and communities made vaccination a slow and exhausting process. But Isabel never gave up; Their patience and tenacity, along with the firm belief that the vaccine could save lives, were key to the campaign continuing.
3d) A new mission in the Philippines
The expedition’s journey did not end in America, since Balmís decided to take the vaccine to the Philippines. For her part, Isabel, exhausted by years of incessant work, she remained in Mexico, where she continued to direct vaccination and making sure the vaccine stayed alive and active. Isabel did not return to Spain after the expedition. Little is known of her later life, but records indicate that she remained in Mexico, where she continued to work as a nurse and care for the most vulnerable until the end of her days. It is unknown if she ever saw her homeland again, but what is clear is that her personal sacrifice was immense.
4) Isabel Zendal, a leading woman in the world
At a time when the role of women was seen as secondary, Isabel broke barriers and became a fundamental pillar of one of the most important medical missions in history. What Isabel left behind was a legacy of humanity and courage. Her ability to face the toughest challenges, to protect the orphaned children who trusted her, and to ensure that the vaccine reached the most remote corners of the Empire is a testament to the important role of women in medicine, although For centuries her name was forgotten. Today the name of Isabel Zendal is beginning to be recognized for what it really represents: a pioneer in the field of public health, a woman who risked everything to save the lives of millions of people. people. In 1950, the World Health Organization recognized the importance of the Philanthropic Vaccine Expedition and In 2016 Isabel was declared the first nurse on an international mission. Her life is an example of personal sacrifice in the name of the common good and her figure deserves to be alongside those of other medical heroes. Although for centuries its history was overshadowed by that of Balmís, today we know that without it the expedition would not have been possible. Isabel is the mother of the orphans who took the vaccine to the end of the world, the forgotten heroine who with her compassion and bravery changed the history of humanity.
