Copyright © The Malta Historical Society, 2005.
Source: Proceedings of History Week 1983. [Malta : The [Malta] Historical Society, 1984(55-64)]
Twenty years ago I drew attention to the existence of a number of medical ex-votos in the form of folkloristic paintings that are to be seen in various churches in the Maltese Islands. These votiva are dedicated to healing saints and have been inspired by the occurrence of a medical catastrophe or life threatening situation occasioned by personal, or collective epidemic, disease. They have been offered to the saints invoked as a token of gratitude and as evidence of having received deliverance from disease and death. 
The Plague of 1813
A number of these ex-votos have been prompted by the plague of 1813-14. They depict various medico-social aspects of the disease. Apart from reflecting the then current religious beliefs of the community, they provide us with pictorial evidence of the measures that our predecessors applied to guard themselves against the onslaught of disease. They are, therefore, historical documents of great significance when one considers that they endeavour to portray happenings at a time when the pictorial documentation of events could not yet be photographed or illustrated in books and newspapers or captured on film.
This paper deals with a votive painting on wood that has attracted little attention but which is worth describing in view of the singular situation it portrays and of the rarity with which one meets such pictorial records. It hangs in the sacristy of the Church of St. Barbara, Republic Street, Valletta. This church was the seat of the Guild of Bombardiers at the time of the Order of St. John.
The ex-voto measures 55cm by 42cm. It is not a professional work but a modest example of polychrome folk art. The unknown painter ignores the laws of perspective especially so regarding the bastions and buildings of Valletta. On the other hand he manages to convey a sense of depth to the composition as [p.56] a whole. He has used the limited space forced on him by the size of the wood panel quite effectively as he has very skilfully turned out a wealth of detail without crowding the scene. While dealing with his theme in a down-to-earth quality, he tempers it with sensitiveness for his human subjects.
During the epidemic the churches and shops in Valletta were closed by order of the sanitary authorities to prevent people from coming in close contact with one another. The streets were deserted as the inhabitants were, at one stage, confined to their homes. A diarist who lived through the epidemic wrote that “a universal mourning and melancholy enveloped the whole city” of Valletta.  The painter has very aptly reflected these sad and oppressive feelings by the marked contrast that he portrays between the lively activities shown in the middle foreground and the depiction of the desolate appearance of the pest-hospital guarded by sentinels, the dead-cart advancing towards us in the middle distance and the deserted bastions of the walled city and its houses with closed doors and windows in the far background. Here the only movement shown is that of the British Red Ensign fluttering over St. James Cavalier. He has, in fact, succeeded in leading us to step back in time and gain a rare glimpse into a spectacle that epitomizes the sort of day-to-day life of our ancestors when forced to live in restricted and macabre surroundings exposed to the hazards of the weather and encircled by the spectre of death on every side.
Description of the painting
For purposes of description the painting may be considered as being formed of three horizontal sections. The top section portrays the Madonna tal-Mellieħa, holding Baby Jesus, and Santa Barbara hovering over Valletta on a bank of clouds. They are the saints through whose intercession the suppliant came unscathed from the epidemic. The invocation to the Madonna tal-Mellieħa is easy to understand as her intercession had been traditionally invoked since early times not only for deliverance from disease but also from other grave emergencies of a non-medical kind. In fact the Madonna tal-Mellieħa has a special link with the plague of 1813 for, following the cessation of the epidemic, a pilgrimage was held by the inhabitants of Valletta who walked all the way from Valletta to Mellieħa and back to offer thanks for their deliverance at her sanctuary in that village. 
The inclusion of Santa Barbara is not easy to explain as this saint is not usually associated with protection from disease especially the plague where the saints traditionally invoked have been Saints Roche and Sebastian. Why [p.57] did this particular suppliant, therefore, seek her help? Was he, perhaps, an ex-bombardier at the time of the Order of St. John some fifteen years previously? The saint is here represented with her appropriate symbols as a martyr with sword and palm and a watch-tower behind her to signify her status as Patroness of Bombardiers.
The bottom section is taken up by an inscription which states in its quaint Italian:- V.F.G.A. NICOLA BARTOLO CARRETTONARO IMPIEGATO DI DARCI L’ACUA ALLE PERSONE CHE ERANO IN QUARANTENA NEL PRIMO FOSSO D. PORTA REALE DELLA CITTA VALLETTA TEMEVA DI MORIRE COL MAL CONDAG.SO PREGAVA ALLA SS.V.M. DI DIO DELLA MELLIHA E S. BARBARA PRIMO DI MAGGIO SIN. O IL MESE D. DECEMBRE SE A OTTENUTO LA GRAZIA DA LUI DESIDERATA. 1813. Freely translated it runs as followers:- “V(otum) F(ecit) G(ratiam) A(ccepit). A vow was made and favour received. Nicola Bartolo was a water-cart driver employed to deliver water to persons kept in quarantine in the first ditch of Porta Reale from the 1st May to the month of December. He was afraid of dying of the plague and prayed (for protection) to Our Lady of Mellieħa and St. Barbara. He received the favour asked for. 1813.”
The middle section depicts the plague encampment or quarantine quarters of the people evacuated from Valletta. The lay-out of the area outside Porta Reale (Bieb il Belt) has undergone considerable structural alterations since 1813. Until then there was a line of defensive outworks — shown in the background of the ex-voto — that has now disappeared but there are sufficient indications to identify the Primo Fosso or First Ditch with the site now filled up and occupied by the Sliema Bus terminus and the Sunday open air market (il monti) on one side; and the still extant ditch below the Phoenicia Hotel on the other. St. John’s and St. James’s Cavaliers can be made out at each end of the bastions respectively.
Plague was believed to be spread by contact between those infected with the disease and healthy persons. In accordance with this theory it was logical to enforce measures aiming at the suspension of all communication among individuals. At the onset of the epidemic (21st May 1813) the sick and the contacts were taken to the Lazzaretto and to Fort Manoel; but with the increased incidence of cases these places could no longer accommodate all the persons requiring isolation. Government, therefore, resorted to the expedient of constructing wooden huts or baracche in the ditches around Valletta, Floriana and Porte des Bombes to serve as homes for the people evacuated from their houses. These huts, which form a striking feature in the middle area of the painting, were about twelve feet square and placed twelve feet distant from one another. They had a reclining roof and small windows on the side walls. 
[p.58] Three emergency hospitals, consisting of baracche, were erected in the ditches of Porta Reale and Porta Sant’Anna. The sick were placed four to six in each hut. They had no beds but were made to lie on straw on the bare floor. No less than nine hundred and ninety-one of them died in these hospitals in July and August 1813.  Many of the occupants of the baracche came from the Mandraġġ and the so-called Archipelago, two very crowded and slum districts of Valletta in those days. Later on a number of residents from Floriana, living in substandard houses, were also transferred to these wooden huts to which were likewise added the ordinary patients of the Civil Hospital of Valletta when three cases of plague appeared among the staff on the 1st September 1813. 
In the right branch of the Porta Reale ditch, there were forty huts, of which nine were of a “large” size, and in the left one, there were fifty huts ten of which were of a “large” dimension. In the Fosso Trepunti there were five of “ordinary” size and five “large” ones; the ditch of Notre Dame contained twenty-eight huts; and that of Sant’Anna Gate thirty-six of “ordinary” and seven of “large” size. Other huts were erected in the enclosure of the Saltpetre Magazine (recinto della salnitriera) and at Marsamxett.  By the end of June 1813, one hundred and two huts were set up in the ditch of the Crown Works outside Porte des Bombes. Wooden partitions were put up at the end of this ditch apparently to prevent communication with persons isolated in this area. Identical huts were erected at Ta Xbiex (thirty of them), in the ditch of Fort Manoel (sixty-five), Bichi promontory (sixty-four); at Birkirkara, Qormi and Żebbuġ; and outside Birgu at Salvatore Gate and the Fortini. A temporary hospital of fifty-nine baracche was opened at Santa Venera in September. 
Huts were raised to serve other purposes then habitations. They provided:- (a) Guard rooms for the soldiers of the Corps of Maltese Veterans as at St. Ursola Street, Wells Street, underneath the loggia in front of the National Malta Library and near St. John’s Church in Valletta; and in Piazza San Calcidonio at Floriana; (b) stalls for a market at Porta Nuova in the Grand Harbour; (c) an abattoir for the accommodation of the butchers on the water-front beneath the Capuchin Convent; (d) offices, in the same area, for the employees of the “post office that distributes letters to the interior” of the island; and for the Sanitary Deputies; (e) temporary magazine for the storage of fodder and grain and for sheltering transport animals in the ditch of Trepunti; (f) a grocery [p.59] shop in the Crown Works ditch; and (g) eight privies provided with “boxes” for the collection of excreta. 
The baracche in the Ex-voto
In the ex-voto the baracche are grouped in three clusters:- (a) Four of them are ranged in the middle distance stretching from the centre of the painting along a slightly curved line towards the left margin of the picture. They are placed at an appreciable distance from one another in contrast to the other baracche which are closer to one another. We know that a number of huts were reserved for the reception of patients suffering from plague forming the so-called pest-hospital (ospedale di peste). The four baracche here shown may well be meant to represent this hospital. Each of them is guarded by a soldier to prevent communication between the sick inside the huts and the rest of the people.
The occupants of these huts suffered considerably from the heat of a scorching sun. On the 10th August, however, a thunder storm unleashed a heavy downpour of rain which lasted for two hours and drenched them to the skin. Some of the huts collapsed giving rise to “confusion and panic” among the occupants.
To the extreme left of the baracche just described, we can make out a priest wearing a black cassock and stole and holding a cross in his outstretched right hand as if in the act of blessing the person lying face upwards on the ground near him — possibly one of the plague-stricken patients who had just died and has been brought out of the pest hospital. 
(b) A second group — this time of five huts — occupies the lower corner in the right foreground. Here we see men and women moving about and communicating with one another without hindrance. They are, however, precluded from approaching the other groups by a sort of wall that reaches up to their waists or shoulders. A number of them are lined up in an orderly manner along the wall. Are they waiting in a kind of queue for the water-cart to fill the tub placed midway against the outside of the wall? These people in this section may be the so-called “suspects” i.e. persons who had been in close contact with plague-stricken relatives and who are being kept under surveillance or in quarantine until the incubation period of the disease has expired when they would be given pratique if no cases of plague [p.60] cropped up amongst them. There is, however, an ominous indication that the disease is already in their midst, for underneath the bastion to the extreme right of the painting there is the figure of a man stretched out helplessly on the ground — presumably a very recent casualty of the plague of whom the persons in his group have not yet become aware.
(c) The people around the five huts in the lower left corner enjoy a greater freedom of movement than the previous group not only among themselves but also in respect of the driver of the water-cart who represents the healthy outside world. They may be the convalescents who, having recovered from the disease, were no longer considered to be dangerous to others as carriers of the disease.
The baracche began to be evacuated from the 5th October onwards when the epidemic showed signs of abating. In fact all this period cases of plague were removed to the Lazzaretto, the “suspects” to Fort Manoel and those with out any signs of the disease were allowed to return to their homes in batches. They were naturally jubilant to go back to their homes but one batch of two hundred and fifty men, women and children had to face a new unexpected hardship. Indeed, in the words of a contemporary diarist, “their elation turned to tears (of sadness) when they found that their houses had been emptied of all their belongings which were burned by order of the Sanitary Committee” to make sure that all traces of the “contagion” had been eliminated. In fact these unfortunate people found nothing more than “the bare floors and roofs” of their homes. They were not even provided with “a little straw to rest their bodies on as horses and animals are want to do.”
Another group of about two hundred and fifty persons were released from the baracche and permitted to enter Valletta. An eyewitness commented that they excited the pity and sympathy of all those who saw them as they bore the marks of their ordeal in their haggard and pale faces. On reaching their homes they, like the previous group, found them completely empty as all their furniture had been destroyed by burning; but they, at least, were given straw for bedding and some financial relief to alleviate their destitution. 
Troops were employed to enforce the isolation of infected persons and to prevent unnecessary communication between households and other groups of people. These soldiers belonged to the Maltese Provincial Battalion and to the Corps of Maltese Veterans. The latter were so called because they were elderly men who had served as soldiers under the government of the Order of St. [p.61] John. Their duties consisted mainly in assisting the civil administration and the police in maintaining order and ensuring compliance with the sanitary regulations. 
After the epidemic the Veterans earned the approbation of the government for their work during the plague as a result of which they had sustained heavy casualties. Up to the 12th October no less than thirty-six of them had died. After this date they were moved from their quarters in Valletta and encamped in the Giardino del Maglio ossia il Giardino Botanico at Floriana. 
The Maltese Provincial Battalion, too, was highly commended for their “regular and steady” conduct in carrying out very essential duties in Valletta and in helping the police to enforce sanitary measures.
Among the most onerous tasks which troops had to carry out was to accompany the dead-carts and to guard the convicts in charge of it; and to form sanitary cordons around highly infected areas, such as Qormi, to prevent access to, and exit from, these places.  In the ex-voto they are shown dressed in a tall black headgear, red coat and white trousers.
The centre of the painting is dominated by a mule-driven dead-cart that has come out from the fortifications of Valletta and is advancing towards us. A medical practitioner who has described the anguish of the residents of Valletta at the mounting mortality among them, wrote that their anxiety was intensified by the sight of the “hourly passing of the dead-cart driving with all the rapidity that its encumbered state would permit.” 
The cadavers are loaded hugger-mugger on one another in an open boxlike wooden contrivance on two wheels. Some of the bodies, in white shrouds, have their limbs dangling out over the sides of the “box.” A similarly constructed open dead-cart is shown in another ex-voto of the plague preserved at the Minsija Church. These hearses are referred to in a contemporary manuscript as “carts with boxes for the transport of corpses.” Six of these vehicles were ordered to be made for use in Valletta and Floriana some time before the 12th June 1813.  Valletta was also provided with twenty open stretchers or litters (cataletti) and four covered ones for the transport of the sick but these litters were also availed of, at times, for the transport of the dead.
[p.62] Four-wheeled dead-carts were provided for Zabbar, Zurrieq, Qormi, Tarxien, Naxxar, Lija, Mosta and the countryside between July and October 1813. The Tarxien dead-cart had a lid. An example of such a lidded four-wheeled carriage is represented in a painting by Pietro Paolo Caruana depicting a plague scene in one of the ditches of Valletta. Two dead-carts for use in Birgu were coated with tar and covered with oil cloth. 
Four corpse-carriers (beccamorti) are shown in the ex-voto following the dead-cart on foot. These men collected cadavers from houses. loaded them on to the box on the cart and conveyed them for burial at Pieta Cemetery. They were also detailed to burn the clothing and other belongings of the plague-stricken. Most of these men were convicts who were eventually mowed down by the disease. 
The terror evoked by the plague was such that corpses were not touched by hand but were removed from houses and hospitals and loaded on to the dead-cart and buried by means of iron rakes, hooks and tongs. The four men in the painting are carrying staves over their shoulders each of which is topped by one of these tools. 
The water-cart (carro d’acqua) seen in the middle fore-ground recalls similar carts with casks with which we were still familiar up to forty years ago and which were used to sprinkle the streets in summer. The ones we knew, however, were two-wheeled carts while the one depicted in the ex-voto has only one wheel at the rear of the framework on which the water cask is mounted. One wonders how the 1813 one-wheeled cart managed to maintain its balance and did not topple over especially when in motion over rough terrain.
A long pipe extends for some distance from the rear end of the cask to pour the water into a low tub from which a man is drawing water and towards which another man is approaching with a bucket in each hand. Another tub is placed midway against the outside of the low wall in the right hand corner.
[p.63] The Cart-driver Nicola Bartolo
The key-figure of the painting is the water-cart driver Nicole Bartolo nicknamed Cirlanca. Very close to him are inscribed the words Il votivo agraziato (sic) detto Cirlanca (The suppliant nicknamed Cirlanca who received the favour). He was employed to deliver water to the people in the baracche from the 1st May to the end of December 1813. Bartolo thus served through the height of the crisis and we are not surprised that, as he confesses in the inscription on the ex-voto, he was afraid of dying from the “contagion”; indeed to come close to the plague-stricken was like going to certain death at a time when no help could be expected from medicine as this discipline had not yet reached a scientific status and as the cause and mode of spread of the plague had not yet been dreamt of. As already mentioned the most commonly accepted theory that tried to explain the appearance and spread of plague was that of “contagion” i.e. the transmission of the disease by contact with infected persons or their belongings. Acting on this concept the only defences against the calamity of plague were (a) the evacuation of infected persons and their immediate contacts from their homes to areas outside inhabited places such as the ditches outside the walls of fortified towns as Valletta and Floriana; (b) the setting up in these areas of temporary habitations or dwellings and hospitals; (c) the imposition of quarantine restrictions enforced by military measures to isolate infected streets and villages by the posting of military guards and sanitary cordons of troops; (d) and imploring Divine help to ward off disease and death by means of prayer and vows. Nicole Bartolo pinned his trust in the last expedient; and the ex-voto which he donated to his health protectors is testimony of his religious faith. In thus recording his thanksgiving for deliverance from disease and death, however, he has also left a memorial to himself. He certainly deserves to be remembered as one of the unsung heroes of those calamitous times for in his humble capacity as a cartman he did his utmost to meet successfully one of the challenges posed by the plague i.e. the provision to the sick and their contacts with one of the essential elements for the sustenance of life — the precious gift of water, the supply of which had run short by June 1813.
Deliverance from disease finally came at the beginning of January 1814 when the epidemic declined markedly; so much so that by the 7th of the month sanitary restrictions began to be lifted. A general pratique was proclaimed on the 27th January when the baracche were dismantled and burned. 
[p.64] In carrying out his task, Nicola Bartolo might not have been animated by an altruistic spirit but only by the force of circumstances; but even so such considerations do not diminish in the least his record of loyal and steadfast service to distressed and languishing humanity for a stretch of seven months with the unceasing threat of death dangling over his head. In fact he stands as a symbol of the resilience and persistence of the human spirit that refuses to admit defeat when faced by the invading forces of massive disease but strives and struggles for survival and, in the end, triumphs amidst a world shattered by destruction and death.
[*] I am grateful to Mr. A. Espinosa Rodriguez for his help and to the Rev. Fr. R. Gauci, Rector of St. Barbara Church for the latter’s permission to study and publish the ex-voto.
 P. Cassar, “Medical Votive Offerings in the Maltese Islands,” The Journal of the Royal Anthropological Institute, 1963, Vol. 94, p. 23; P. Cassar, Medical History of Malta, London 1965, p. 424, pl. X.
 National Library of Malta (N.L.M.), Ms. 1162, f. 31.
 Ibid., f. 126.
 W.H. Burrell, Appendice Va al secondo rapporto sulla quarantena, Londra, 1855, pp. 22-3, 30 & 33; N.L.M., Arch. 1918, fol. 13.
 W.H. Burrell, op. cit., pp. 22-3, 30 & 33; G.M. De Piro, Ragguaglio storico della pestilenza che afflisse le isole di Malta e Gozo negli anni 1813-14, Livorno, 1833, p. 49.
 N.L.M., Ms. 1162, ff. 18 & 68.
 N.L.M., Arch. 1918, ff. 70-3, 79-10, 110, 13, 128 & 132.
 Ibid., ff. 13. 17, 59, 127, 132 & 153; N.L.M., Ms. 1162, f. 100.
 N.L.M., Arch. 1918, ff. 34-5, 61, 70-3, 110-1, 128, 133 & 163-5.
 Among the priests who distinguished themselves for their zeal in tendering spiritual aid to the dying were the Rev. Paolo Dimech, Canon of St. Paul’s Church of Valletta, who assisted the dying in their homes in Valletta and in the baracche, the Carmelite Fr. Angelo Chircop and the Capuchin Friar, Padre Samuele. Burrell, op. cit., p. 46 & N.L.M., Ms. 1162, ff. 53, 55, 75 & 81.
 N.L.M., Ms. 1162, ff. 80, 88, 93 & 98.
 A.G. Chesney, Historical Records of the Maltese Corps of the British Army, London, 1897, pp. 35 & 37.
 N.L.M., Ms. 112, f. 89.
 A.G. Chesney, op. cit., pp. 35-44; G.M. De Piro, op. cit., pp. 35-44.
 J.D. Tully, The History of the Plague as it Has Lately Appeared in the Islands of Malta, Gozo, Corfu and Cephalonia, London, 1821, p. 55.
 P. Cassar, Medical History of Malta, London, 1965, Plate X, N.L.M., Arch. 1918, f. 10, 27 & 127.
 P. Cassar, op. cit., Plate XI: N.L.M., Arch. 1918, fol. 49, 65, 82-4 & 101-2.
 N.L.M., Ms.1162, f. 15 & 33.
 P. Cassar, Guide
to the Exhibition on the Medical Heritage of Malta, Malta, 1970, p. 40.
On the 13th October 1813 government bought thirty-two staves for this purpose. N.L.M., Arch. 1918, f. 167. A number of these iron implements are still preserved at the National Museum of Archaeology, Valletta.
 J.D. Tully, op. cit., p. 64; Ms. 1162, ff. 23, 84, 86 & 88. The popular saying addijo barrakki is used to express an irremediable action or lost opportunity and may have been inspired by the destruction and disappearance of these huts. The plague and the baracche are linked with a Maltese proverb that stresses the relentlessness of fate. It says Min għandu jmut bil forka m’hemmx barrakka għalieh i.e. He who is destined to end his life on the gallows will not die in a plague-hut. A further reminder of the plague and the huts is Triq il-Barrakki at Qormi which has been inappropriately translated into English as Barracks Street with a military implication.