Eradicating smallpox in Indonesia: the archipelagic challenge.

From 1804 to 1974, the colonial Dutch East Indies government and the postcolonial Indonesian state attempted to tackle the problem of smallpox. The vaccination efforts in the colonial era virtually eliminated smallpox by 1940. Unfortunately, as a consequence of the war smallpox was reintroduced into the archipelago in 1947. Indonesia finally succeeded in eradicating smallpox in 1974 through campaigns of mass vaccination and surveillance. In the last few years of the fight against smallpox, a detection system was set up in order to have every suspected case of smallpox isolated and investigated by the health authorities until verified in the government laboratory at Bandung. This paper looks at the impact of the archipelagic nature of Indonesia on the smallpox eradication campaigns.