Isabel Zendal Gómez is one of the most outstanding nurses in all of history. She is considered one of the most relevant figures in the field of solidarity and nursing.
She played a key role in the “Royal Smallpox Philanthropic Expedition” that, in 1803, set sail from the port of La Coruña to America with the aim of curbing one of the most deadly diseases of all time: smallpox.
The World Health Organization (WHO) declared that Isabel Zendal was the first nurse in history to participate in an international mission.
Childhood and family of Isabel Zendal
Isabel Zendal Gómez was born in 1771, in Santa Mariña de Parada, a small Galician village, near La Coruña, of very poor agricultural parents.
Her father was called Jacobo Zendal. Her mother, María Gómez, had nine children: Bernarda, Isabel (1771), Juan (1774), María Antonia (1776), Joseph (1778 and died at birth), Francisca Antonia (1779), Joseph and Catalina (1782, twins. , died in the first year) and Joseph (1784).
At that time there was no possibility of studies for the women of the villages. Therefore, this extraordinary woman did not receive any special training. However, the parish priest appreciated the worth of Isabel Zendal and offered to give her private lessons.
She accumulated experience by having to take care of her mother, who died of smallpox, when Isabel was thirteen years old.
Isabel Zendal works at the Orphanage of Charity
At the age of 19, in 1790, Isabel began to work at the “Orphanage of Charity” in La Coruña. Thanks to her experience in caring for her younger siblings, she quickly gained the love and trust of the children.
On July 31, 1793, her son Benito was born. Isabel was a single mother and she alone took care of her son.
On March 24, 1800, she began her work as Rector of the Orphanage. Her salary was fifty reales a month; in addition, the payment in kind of a daily pound of bread and half a pound of meat (the Spanish pound was equivalent to 460 grams).
The Spanish real was a 3.35 gram silver coin that began to circulate in Castile in the 14th century and was the basis of the Spanish monetary system until the mid-19th century.
Her total dedication to caring for the children at the “Orphanage of Charity”, along with her skill and intelligence, made her an effective nurse.
Smallpox epidemics in the world
Smallpox is a serious, contagious and life-threatening infectious disease caused by the Variola virus. Smallpox emerged in human populations around 10,000 BC. C.
The disease spread throughout history through periodic outbreaks. The infections were caused by the contact of sick people with healthy people or through the exchange of objects contaminated with the virus.
In addition to painful symptoms, smallpox caused bumps that turned into pustules and then scabs, which fell off and left ugly scars on the skin.
The mortality rate was around 30% of infected people, with particularly high percentages in babies. The survivors were left disfigured and sometimes blind.
Smallpox epidemics have occasionally occurred for hundreds of years. Smallpox was devastating in 18th century Europe, killing an estimated 400,000 people each year and disfiguring millions of survivors.
It was not until 1796 that the first modern vaccine against smallpox was created, thanks to Edward Jenner.
In 1980, the World Health Organization was able to certify the eradication of the disease from all over the planet.
Smallpox epidemics in Spain
At the beginning of the 19th century, smallpox affected 60 percent of the population of Spain. This virus killed millions of people and spread terror throughout the population.
No one was exempt from suffering from it. Anyone could be infected with this terrible and deadly virus. Even Gabriel de Borbón, brother of Carlos IV, lost his life with his wife and a newborn daughter.
King Carlos IV was therefore very sensitive to the disease, and decided to attack it in Spain and overseas territories, where it had also already spread.
The happy discovery of Dr. Jenner
Around this time, an English doctor named Edward Jenner discovered that peasant women who tended cows rarely contracted smallpox. They were immune.
Seeing the good health of these peasant women, Dr. Jenner deduced, with great success, that the smallpox virus that cattle suffered, immunized against “common” smallpox.
In 1796, Edward Jenner began a trial of pustule samples from the hand of a farmer infected with the cowpox virus.
He began by inoculating the pus into an eight-year-old boy. After a period of seven days the boy became unwell, but did not have the terrible symptoms of smallpox. He repeated the experiment several times, with identical results.
This method of experimentation by Dr. Jenner did not conform to the principles of medical ethics, but it was the beginning of the end of this terrible epidemic.
In 1798, Dr. Jenner published his work and coined the Latin term “variolae vaccine” (cow pox). Thereafter, the inoculation of a small amount of the pathogen was called a “vaccine.”
For this discovery, Jenner is considered a figure of enormous relevance in the History of Medicine.
Dr. Balmis was a pioneer in the application of the vaccine
The good results of Dr. Jenner’s work reached the ears of Francisco Xavier Balmis, a scientist from Alicante and doctor of the Court of King Carlos IV.
At the beginning of the 1800’s, a smallpox epidemic had broken out again throughout the Spanish territory, decimating the populations, without distinction of social classes: nobles, aristocrats, rich and poor. Along with illness and deaths, the damage to the economy was more than worrying.
Dr. Balmis, an enterprising and tireless man, dedicated himself to studying and applying the smallpox vaccine.
The other doctors of the King’s Chamber and all the doctors of the universities were dedicated to disseminating the vaccine, to instructing the doctors of the populations in the practice of vaccination, to create “Vaccination Boards” in the capitals and main cities of the country.
Special units were created in charge of ensuring the conservation of active bovine fluid over time.
The results were spectacular and encouraging; very soon Dr. Balmis had the opportunity to take another gigantic step in his fight against smallpox, this time in the Spanish overseas countries.
The Royal Vaccine Philanthropic Expedition
Also in Mexico and the countries of America, smallpox had begun to sow and decimate the population.
On March 13, 1803, for the first time, Francisco Requena, a member of the Council of the Indies, asked Madrid for information about the possibility of extending the vaccine to overseas countries.
With the utmost urgency, José Felipe Flores, king’s chamber doctor, prepared the report and added several proposals and recommendations for measures and provisions that should be taken for the best success of the company and the rapid implementation of the vaccine in overseas territories.
Francisco Xavier Balmis offered his services and experience to bring this vaccine to all corners of the Spanish empire.
The main problem was that in those years, to take them from Spain to Mexico there was no other means of transport than boats. The faster ships took too long.
In Spain, the vaccine was transported from one place to another protected between crystals. But, on a long voyage across the ocean, on ships that did not have deep-freezer refrigerators, the vaccines would have arrived at their destination, totally useless.
Then the legendary Spanish genius appeared. Dr. Balmis and his colleagues came up with the novel idea of selecting a group of 22 children between the ages of 3 and 7 to be used as carriers of the vaccine, on the basis that the children were the ones who reacted best to it.
The technology they invented consisted of passing from one to the other the serum that their bodies produced after they were inoculated into a small cut in their skin, attenuated smallpox virus.
King Carlos IV authorized in that same year 1803, a great project that was called “Royal Philanthropic Expedition of the Vaccine“.
It was necessary to solve the selection of the personnel, the logistics of the transport and the financing of the expenses.
The Expedition expenses were generated mainly by the financing of the ship and by the salaries of the expedition members. But any expense was worth it, not only from a humanitarian point of view, but also in order to prevent the economies of the affected countries from being further affected by the many deaths of taxpayers.
The preparations for the Expedition were carried out during the spring and summer of 1803 and were oriented around three lines of action:
- recruiting the personnel who would be in charge of it;
- to hire the ship that was going to move the expeditionaries from the Peninsula to the Overseas territories;
- determine and choose the criteria for optimal preservation of the vaccine.
The staff of the Royal Vaccine Expedition
The selection of qualified personnel was very difficult. After hearing the Opinion of the Council of the Indies and the Council of the Treasury and their Chamber doctors, the monarch decided that the Expedition would be directed by the Chamber Doctor D. Francisco Xavier Balmis and by Dr. José Flores, who had prepared the project initial of the Expedition.
Balmis was a unique individual and he put into action all his qualities: energy, tenacity and great organizational skills.
As second in command was José Salvany, who was all heart, enthusiasm and courage. He did not excel as an organizer, but he contributed effectively to the success of the Expedition.
They were joined by medically trained physicians, practitioners (2), surgeons, barbers, nurses (3) and seafarers. In Francisco Balmis’s opinion, people who were trained for sanitary and prophylactic work were preferable, rather than those who possessed degrees.
The valuable collaboration of Isabel Zendal.
The organizers of the “Royal Vaccine Philanthropic Expedition” based the entire project on children. They would leave La Coruña with about twenty children, who would be inoculating the bovine pox virus in shifts. Thus the vaccine sera would arrive “fresh” to the Overseas territories.
But this collided head-on with many people, especially anti-vaccine groups. It was absolutely necessary to guarantee the health and care of these “little angels” who were going to save tens of thousands of people.
For this reason, one of the pillars in the success of the Expedition was the Rector of the “Orphanage of Charity” in La Coruña, Isabel Zendal Gómez.
In the letter of October 14, 1803, which the Secretary of Grace and Justice of the Kingdom addressed to the President of the Hospital de Caridad de La Coruña, on which the “Orphanage of Charity” depended, he expressed the will of the king that the Rector of the Orphanage, Mrs. Isabel Zendal Gómez, was included in the Expedition as a nurse.
In this letter, it was specified that the Rector would receive salary and help to take care of the assistance and cleaning of the children during navigation. And that with this provision the discomfort and “disgust” that many felt, would be alleviated knowing that the children were in the care of a woman of “integrity”.
Isabel Zendal Gómez left her position at the hospice to take care of the 22 children who would carry the vaccine. There were 6 children who came from the Casa de Desamparados in Madrid, another 11 from the Hospital de la Caridad in La Coruña and 5 from Santiago.
Each child received a pack, which contained: two pairs of shoes, six shirts, a hat, three pants with their respective canvas jackets and another cloth pants, for the coldest days. For personal hygiene: three handkerchiefs for the neck, another three for the nose and a comb; and to eat: a glass, a plate and a complete set of cutlery.
The vaccine had to be carried by children who had not had smallpox and was transmitted from one to another every 9 or 10 days. Children among whom was Benito Vélez, nine years old, son of Isabel Zendal.
The rules of the Expedition clearly indicated the care that children should be well treated, maintained and educated. And that at the end of the Expedition they would be returned to their towns.
Nobody doubted that Isabel Zendal had experience and outstanding qualities. The appointment of this wonderful nurse served to reassure everyone that the children would be well cared for if they were in the care of the Rector of the Orphanage.
Choice of transport and defeater of the Expedition
At first it was thought that the Expedition would be transported in war mail ships because they were the lightest and because they had frequent communication with the American territories. The criterion that motivated the choice of boats was speed.
The hiring of the corvette María Pita was carried out in the port of La Coruña on October 8, 1803.
The Captain of the corvette María Pita was Pedro del Barco y España, a native of Somorrostro, Vizcaya. A sailor of brilliant intelligence, good performance, and proven worth.
One of the concerns of the authorities of the metropolis was the choice of the expedition’s course and the ideal place for the expedition’s departure. As the project took shape, it was decided to leave from the port of La Coruña.
The Royal Philanthropic Expedition of the Vaccine set sail with 37 people, on November 30, 1803, from La Coruña.
The Royal Philanthropic Expedition fulfilled its mission
The Expedition arrived in Santa Cruz de Tenerife, where they spent a month vaccinating.
The Expedition left the Canary Islands on January 6, 1804 and arrived in Puerto Rico on February 9, 1804.
The strategy devised by Francisco Balmis worked as planned. The children responded well to treatment. With the pus extracted from the wounds caused by the vaccine, the doctors obtained material to immunize dozens of people.
After its stopover in Puerto Rico, the Royal Philanthropic Expedition reached Venezuela, Colombia and the Philippines, making possible the vaccination of half a million people.
Above all, it was possible to consolidate a vaccination system that made it possible to immunize many millions more.
In this way they were saving thousands of compatriots in Puerto Rico, Cuba, Venezuela, the Philippines and Mexico from smallpox.
Those populations that received the Expedition were able to verify the effectiveness of the vaccinations. They gave the expedition members excellent treatment, provided them with accommodation, entertained the children and showered them with gifts.
The trip aboard the corvette María Pita lasted eight months and ten days and her work was quickly recognized on her return to Spain.
Corvette Captain María Pita, Pedro del Barco, was promoted to Lieutenant of the Ship and received a life pension.
On February 7, 1805, another branch of the Expedition set out for the Philippines with a group of 26 children, among whom was Isabel’s son, and arrived in Manila on April 15, 1805.
Isabel Zendal always accompanied her boys, bravely carrying out the excessive work and rigor of the different climates. The children counted on her at all times, as a tender nurse who assisted them entirely in their illnesses.
On this new route, the Expedition directly vaccinated some 250,000 people.
On August 14, 1809, the Expedition returned to Acapulco. Isabel remained in Puebla with her son; they no longer returned to Spain.
The Expedition fulfilled its objective. They immunized half a million people, set up centers to continue with vaccinations, and gave children a better future.
Her work provoked the admiration of the world. The young nurse Isabel Zendal, the only woman on the Expedition and a fundamental part of the project, was the first nurse in history who was a key player in an international mission.
Acknowledgments to nurse Isabel Zendal
For too long, Isabel Zendal’s feat was forgotten and for many it remains unknown.
Isabel Zendal deserves that her name be recognized and that her life is never forgotten.
- The San Martín de Texmelucan School of Nursing in Puebla is named after Isabel Zendal.
- The Spanish writer María Solar in her book “Children of Smallpox” tells the story of Isabel Zendal Gómez as the director of the orphanage and how she became part of the Royal Vaccine Philanthropic Expedition.
- Since 1974 the government of Mexico has awarded the National Nursing Award “Cendala Gómez” in her honor.
- On November 30, 2003, on the occasion of the 200th anniversary of the expedition, a monument was erected in the port of La Coruña in honor of the orphaned children who left on the expedition, the work of Acisclo Manzano.
- Novelist Julia Álvarez wrote a fictional story (“Saving the World”) about the Balmis expedition from the perspective of Isabel Zendal Gómez. (2006).
- In 2015, the writer and journalist Javier Moro wrote a fantastic novel about the Royal Philanthropic Expedition of the Vaccine (“A flor de piel”). The novel is full of adventures where the main figure is Isabel Zendal and her travels through the Spanish colonies carrying the vaccine against the dreaded smallpox.
- Isabel Zendal Gómez was named favorite daughter of the Ordes city council unanimously by the local corporation, in a session held on November 30, 2016.
- In 2016, the “Foundation for the Development of Nursing” awarded the special award to the documentary “Isabel Zendal, the nurse who changed the course”.
- The “Isabel Zendal Association” was born in La Coruña in October 2016 with the aim of investigating, disseminating and promoting, at local, national and international levels, the leading role of Galicia in the Royal Vaccine Philanthropic Expedition.
- The city council of La Coruña gave its name, Isabel Zendal Gómez, to a street in the city, on December 5, 2017.
- In 2017, the Nursing Union in Galicia named the awards given at its “Galician Scientific Meeting of Nursing and Physiotherapy” with the name of Isabel Zendal Awards.
- In 2018, the University of La Coruña and Círculo Escéptico created the Isabel Zendal Awards for the promotion of critical thinking.
- In 2018 the comic “New World. Isabel Zendal in the vaccine expedition” was published, whose author is El Primo Ramón.
- The name of Isabel Zendal was included in the “Periodic Table of Women Scientists” that commemorated in 2019 the International Year of the Periodic Table of Chemical Elements, to celebrate the 150th anniversary of Mendeleev’s publication.
- In 2019, SUMMA 112 delivered the Isabel Zendal Nursing Awards.
On December 1, 2020, the government of the Community of Madrid inaugurated a modern emergency hospital that has been built in a record time of three months, to treat in case of epidemics, such as Covid-19.
The new hospital is called “Hospital de Emergencias, Nurse Isabel Zendal“.
It is a center designed to manage pandemics, but it will also help with the flu, complement the hospital network and relieve waiting lists.