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Disease and Sickness

It would be interesting to see some sort of disease mechanic in the game. I am unsure if this is already planned or thought of, but the idea of not only having to feed your people but make sure they are overall healthy seems like fun.


Disease definitely has possibilities, for a start it can act as a brake on too rapid expansion and it could open a whole branch of technologies to help fight it ( medicine), and buildings ( medicine tent, witch doctors hut, barber, etc…). It could also have its applications in warfare especially during later stages against walled villages, towns and cities.


cleanliness could also play a part, with things like separated toiletries and basic sewerage systems, even if it is just a separated pit. However, not too sure how well this went in the Neolithic/bronze ages

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There is some evidence that in the neolithic timeframe there have been some settlements with basic sewage / waste management principals in place, such as the Scottish village Skara Brae. Also there have been plenty where waste was simply thrown into the streets.


Diseases are planned to be in the game.
We want they to have a key role in the process of become sedentary.
Even if pits were commonly used as a sewage system, living near those pits and very close to an increase number of people or tamed animals, plus the poor quality of food of primitive settlements will have an impact.


It would be great if the game would contemplate the effects of long time periods of isolation in a population making them more vulnerable to genetic diseases, shorter life span, etc and overcome this if the population has some regular input of foreigners.

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Good idea, but perhaps in addition to this, more foreigners coming through increases the chance of exotic diseases coming with them, so it sort of balances out.

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Dont forget, even in medeival times up to a horrific 50% of all women died in child birth.

That figure is heavily exaggerated. The rates of maternal death were roughly 1 - 1.5% per childbirth.

Please do make the diseases selected historically accurate.

I would very much like to know where you got that figure from since your 1-1.5% is about the same or less then what the WHO estimates for african countrys Today.
The very modest estimate for the renaissance states 1-4.5% of what I can find. Also women gave birth more then once so each child increased the chanse of dieing in childbirth or the days after.
Bellow is a link to the subject.

Med school.

Plus furthermore, the WHO statistics for maternal death in Africa are not in excess of 1 - 1.5% per child birth. They have accurate data available for that, see the following:

And in particular the following table if interested in the maternal mortality rates only:

With a mean of 168 per 100.000 childbirths, this is a 0.168% maternal death rate. Roughly a factor 8 difference with the middle ages.

Indeed women do give birth more than once, so each child does increase the chance of dying in childbirth. And that of course accumulates rapidly when you’re talking relatively high mean figures. As such, the lifetime risk for women to die due to childbirth are of course greater, but still would not make a 50% figure.

Afghanistan has for a very long time been extremely poor in its rates, with in 2002 the rates being at roughly 1600 deaths per 100.000 childbirths, this due to the Taliban prohibiting access to medical help. Fortunately, this has since decreased, see also:

But it does give a very good impression on the to be expected rates of maternal deaths during childbirth without medical aid. Still though, the rates of cause of death due to childbirth for women in Afghanistan during those modern dark ages were not 50%, but rather along the lines of 15 - 20%.

And although accurate data is poorly available for the middle ages, it is likely for those rates to not be all that much higher than that.

Of course, it remains excessive compared to the modern rates in the western world, where you’re talking a lifetime risk of roughly 0.005% - 0.01%.


As population grows and squalor builds, will pests be something that you guys will be focusing on?