Isabel Cendala y Gómez (sometimes anglicized to Isabel Zendal), a nurse from 18th-century Spain, became an unsung public health hero when she joined the Balmis Expedition, . Her work with orphaned children, who were used to carry the smallpox vaccine from Europe to the far reaches of the Spanish Empire, laid the foundation for modern global health initiatives. During this National Nurses Week, we want to recognize the first Public Health Nurse and her role in vaccine history.
Early Life and Career: A Passion for Care
Born in 1771 in Santa Mariña de Parada, a small village in Galicia, Spain, . By adulthood, she had become the director of the Orfanato de la Caridad (Charity Orphanage) in A Coruña, a coastal city in northwest Spain. Her role involved managing the daily lives of orphaned children, ensuring they received food, shelter, and education. This experience honed her organizational skills and compassion, qualities that would later define her work on the Balmis Expedition.
Joining the Balmis Expedition: A Historic Mission
In 1803, Spain’s King Charles IV launched the to combat smallpox, a disease that had devastated populations in Spanish colonies. The mission’s leader, physician (sometimes anglicized to Francisco Javier Balmis), needed someone to care for 22 orphan boys carrying the vaccine. .
The boys, aged three to nine, were inoculated with cowpox virus, the precursor to the smallpox vaccine, and accompanied the expedition. They kept the vaccine alive by transferring it from child to child—a method known as “arm-to-arm” inoculation. Isabel’s role was critical: she monitored the boys’ health, ensured their safety, and maintained hygiene standards. Without her care, .
The Journey: Challenges and Triumphs
Isabel’s journey began on November 30, 1803, aboard the corvette María Pita. The expedition faced harsh conditions, including storms, sweltering heat, and skepticism from local communities. Despite these obstacles, Isabel remained dedicated to her charges.
When the expedition split in 1805, Isabel traveled to with 26 new orphan carriers, including her son. The group vaccinated over 250,000 people in Asia alone, establishing vaccination centers that continued their work. By 1809, Isabel had settled in Puebla, Mexico, where she stayed permanently after the expedition ended.
Post-Expedition Life: A Quiet Legacy
After the expedition, Isabel likely continued her work in healthcare in Puebla, Mexico. Though she never returned to Spain, her contributions resonated globally. The Balmis Expedition vaccinated an estimated 500,000 people, paving the way for organized vaccination campaigns.
Isabel’s legacy gained recognition decades later. In 1950, the World Health Organization (WHO) . Today, her name is featured on streets, hospitals, and academic institutions in Spain and Mexico, including the San Martín de Texmelucan School of Nursing in Puebla. The Mexican government awards to nurses whose work in public health stands out.
Why Isabel Cendala y Gómez Matters Today
Isabel’s story offers timeless lessons:
- Collaboration in Public Health: The Balmis Expedition relied on teamwork among physicians, sailors, and caregivers, such as Isabel. This model mirrors modern efforts to combat diseases like COVID-19.
- Innovation in Vaccine Delivery: The expedition solved a logistical challenge by using children as carriers, helping to save millions of lives. Similar creative strategies are still essential in global health.
- Gender Pioneers in Science: As the only woman on the expedition, Isabel defied societal norms to lead. Her story inspires women in STEM and healthcare today.
A Lasting Tribute: Honoring Isabel Zendal
Isabel’s impact is visible in modern Spain. During the COVID-19 pandemic, Madrid opened the Hospital de Emergencias Enfermera Isabel Zendal, a temporary facility named in her honor. In 2018, a Spanish pharmaceutical company renamed itself Zendal to celebrate her legacy. These tributes reflect her enduring influence on global health.
A Trailblazer’s Legacy
Isabel Zendal’s life proves that even in the face of monumental challenges, one person can change the course of history. Her work with the Balmis Expedition not only saved countless lives but also set a precedent for international health cooperation. As the world continues to grapple with infectious diseases, her story reminds us of the power of compassion, ingenuity, and perseverance.`
Sources and Additional Reading
- Bustamante M. E. (1975). La primera enfermera en la historia de la Salud Pública, Isabel Cendala y Gómez [The 1st nurse in the history of Public Health, Isabel Cendala y Gómez]. Salud publica de Mexico, 17(3), 353–363.
- Botet FA. La real expedición filantrópica de la vacuna (Xavier de Balmis/Josep Salvany): 1803-1806 [The royal philanthropic expedition of the vaccine (Xavier de Balmis/Josep Salvany). 1803-1806]. Rev Chilena Infectol. 2009;26(6):562-567.
- Bowers JZ. The warm chain. Assignment Child. 1985;(69-72):231-233.
- Tuells J. Letters from Balmis to Gutiérrez: fracture of the friendship between two vaccine expeditionary personages. Cartas de Balmis a Gutiérrez: la fractura de la amistad entre dos expedicionarios de la vacuna. Gac Med Mex. 2022;158(6):435-441. doi:10.24875/GMM.M22000724