Novel “A flor de piel” by Javier Moro

It may surprise us now how easily we are vaccinated and thus prevented from many diseases. Of course, this was not always the case. Precisely in the book At the surface of the skinjavier Moro recounts the impressive humanitarian feat of bringing the newly-discovered smallpox vaccine to the overseas territories

Skin-deep is the story of a journey. An exciting journey that changed the course of history and helped prevent millions of deaths

It is also the story of three fascinating characters. The physician Francisco Xavier Balmis, court physician to Charles IV and director of the expedition known as the “Royal Philanthropic Vaccine Expedition” (1803-1812). Balmis has been portrayed as a relentless, ambitious, constant and tenacious man. It is also the story of José Salvany y Lleopart, deputy director of the expedition and a man with an intense vocation for whom, moreover, this enterprise represented the added challenge of overcoming the serious health problems he was suffering from. And that of a woman, Isabel Zendal Gómez, a humble woman, poor “de solemnidad”, but brave, enterprising, passionate and committed. A fighter at a time when women still had to fight hard to make their way in society. Born in Santa Marita de Parada, in La Coruña, and a single mother, she became the first woman to take part in an international health expedition

Since 1950, Isabel Zendal has been considered by the World Health Organisation (WHO) as the first nurse in history on an international humanitarian mission.

But, above all, we must not forget that this is the story of those twenty-two brave orphan children who, with Isabel’s help and care, carried the vaccine in their bodies (“from arm to arm”) in order to keep it active and thus manage to take it to America, saving so many lives. During the expedition, around 250,000 people were inoculated. The figure of Zendal was crucial to the success of the expedition, as during the journey he devoted himself to the care and comfort of these children, ensuring that they arrived in the best possible health conditions

The voyage

On 30 November 1803, the expedition set sail on the corvette María Pita from A Coruña. During the voyage, the protagonists will have to show their bravery and courage to face the vicissitudes they will encounter along the way.

A flor de piel by Javier Moro is an essential, delightful work. A historical novel that also gives us a socio-political picture of the period, the scientific advances and the difficulties of the reign of Charles IV. It is full of dates and historical details. But, above all, it is a story of bravery, courage and determination. A novel that reminds us of the importance that science has played throughout history and the crucial role that vaccines have in preventing us from so many diseases that, today, we may consider “harmless” but which, without these massive vaccination campaigns, would have continued to cause millions of deaths around the world. All in all, a reading that does not disappoint


Smallpox is one of the diseases that has caused most human suffering, with a mortality rate of 10-30%. But it is also one of the few diseases that has been eradicated thanks to a worldwide vaccination programme

Smallpox is caused by one of two DNA viruses: V. major and V.minor. V. minor infection is usually milder and has a lower mortality. In 5-10% of cases it can manifest as two extremely virulent atypical forms: haemorrhagic and malignant

Let us now turn to V. major infection. After initial exposure (which usually occurs by inhalation of virus-containing saliva droplets or through contact with contaminated clothing or bedding) symptoms usually appear within 12-14 days. Symptoms consist of high fever, malaise, vomiting, headache and a maculopapular rash that starts on the face and extremities and spreads to the trunk. The skin lesions later evolve into vesicles and eventually become crusted pustules. Smallpox is highly contagious. Suspected cases must therefore be subjected to strict isolation. The treatment of smallpox is supportive. If we managed to eradicate it worldwide in 1980, it was thanks to the vaccine discovered by Edward Jenner in 1796.

Author, Javier Moro

Javier Moro was born in Madrid in 1955. In addition to A flor de piel published in 2015, he is the author of Senderos de libertad ( 1992), El pie de Jaipur ( 1995), Las montañas de Buda ( 1997) and Era medianoche en Bhopal, in collaboration with Dominique Lapierre (2001). Subsequently, his books El sari rojo ( 2008) and Pasión inda (2005), brought him great critical and sales success both in Spain and worldwide. In 2011 he won the Planeta Prize for his novel El imperio eres tú

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