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A globalised malaria?: Musings of a historian on COVID-19

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By Philip Afaha

He stretched himself and scratched his thighs where a mosquito had bitten him as he slept. Another one was wailing near his ear. He slapped the ear and hoped he had killed it. Why do they always go for one’s ear? … “Mosquito,” Okonkwo’s mother told him “has asked ear to marry him, where upon ear fell on the floor in uncontrollable laughter. ‘How much longer do you think you will live? she asked. ‘You are already a skeleton.’ Mosquito went away humiliated and any time he passed her way he told ear that he was still alive.” (Chinua Achebe in Things Fall Apart)

IF I were a scientist I would declare that corona is a globalised malaria. I’m not a medic but a history teacher; but I also know that COVID-19 is too serious a conversation to be left only to scientists. I don’t even have the tools for scientific prognosis as I was only trained to interrogate histories, including those of diseases – and in history, we deploy inferences.

I should never be taken seriously on discussing medical issues, but I am alarmed that COVID-19 appears to exhibit the same symptoms as acute malaria – the very type we call utoenyin-ekpo in Ibibioland. Since it behaves just like malaria, it becomes imperative to revisit the history of the dreaded disease that gave Africa the sobriquet: “the Whiteman’s grave”.

Malaria wasn’t only playing an undertaker for White visitors to Africa, indeed, it ravaged and sent unquantifiable number of Africans to their graves more than any other force known to science. Apart from the initial bursts of the quinine, Western science drag-footed in tackling the malaria menace ostensibly because it was considered to be African limited.

To the Europeans, the disease, along with other factors like slave trade and the Maxim guns, had helped to traumatise and weaken the African resistance to imperialism. Those Europeans who dared to invade Africa at that pristine stage came face to face with the force of malaria.

The disease, whose Latin meaning is ‘bad air’ was first described in the fourth century BC by Hippocrates who gave an accurate description of intermittent malaria fevers. He was also the first to establish a link between the disease and the environment noting that such fevers were prevalent in swampy areas.

Laveran first saw what we now know to be gametocytes of the malaria parasite plasmodium falciparum (which is commonest in Nigeria) in the blood of French soldiers in Algeria in 1880. In 1897 Ross described the mode of transmission via the mosquitoes vector. Its complete life-cycle was elucidated by Shortt and Garmham in 1948.

Malaria is commonly found in Africa. Infection in the human host begins when an infected female anopheles mosquito feeds on a human host and sporozoites are injected into the hosts blood stream. It has been prevalent in the Nigeria area long before the advent of the Europeans and it was managed and treated with local herbs.

The appellation – “The Whiteman’s Grave” was used to paint a gory picture of the severity of the disease in the African continent and the fact that Africans appeared to have developed a level of resistance to the disease.

Early European explorers account for their gory experiences in their forays into the interior of Africa and particularly of their most dreaded enemy, malaria which was “far more deadly than the leopard”. It was generally recognised that they were most prevalent in the swampy areas, but the mode of infection was shrouded in mystery.

Sir Richard Burton, an avid theoretician of disease interests glibly described malaria as “that mysterious agency which, like the pestilence walking in darkness, ever hides origin from the world and leaves us to grope for it in cosmical causes – vegetation, geology, geographical position, a rarefied atmosphere deficient in oxygen…”.

He posited ignorantly that “the malaria’s vapour is condensed and concentrated by the chillness of the ground and is absorbed or rendered innocuous by passing over a sheet of water” hence, he advised the consul to sleep on board a ship anchored off the town in mid-channel to avoid evil disease. Lending support to their ignorance, Winwood Reade theorised that “there can be no doubt…that malaria is contained in rain… rains, dews, winds blowing from malarious localities, marsh exhalations and possibly infections by the human breath may, therefore, be considered as the proximate cause of fever.”

He contended that “those of a nervous temperament of light hair, of a fair complexion, of strenuous habits or a plethoric disposition are the most liable to suffer from fever…” The explorers were often confronted with the fear of fever and death. Of all the river ports, Bonny had the worst reputation.

Burton reported that it was plagued with periodic epidemics of yellow fever, which used to clear off almost all the White population. In 1862, in such an outbreak, “one ship, the Osprey, lost all her crew, 16 to 17 men, except the master…” and out of a total of about 300 Europeans between March and July of 1862, five doctors, five clerks and 146 men died of malaria.

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In Calabar area, a Presbyterian missionary, Hope Waddell, reported how they “used to go to the Coast and Rivers like men condemned, and on first sickness give themselves up for lost… and as even their house at Duke Town was often like a hospital with sick captains and seamen”. In his testimony to the 1841 commission of enquiry on the West Coast of Africa, J. Peters recounted succinctly:

“I know one vessel that was lying at Old Calabar, which lost two entire crews while she lay there”. Such epidemic also occurred in 1862 where some 162 Europeans out of about 300 died at Bonny. In 1873 another such epidemic killed off 75 per cent of Europeans, and again in 1890 three quarters of the European trading population died. In Lagos, despite the work of Macdonald’s medical and sanctuary staff, the mortality rate among the Europeans mounted annually.

In 1896, out of a total White population of 214, there were 20 deaths and 35 invalids; in 1897 out of a slightly lower population of 206, there were 16 deaths and 58 invalids.

Hope later came at the close of the 19th Century in the battle against malaria. In Calabar, within a few years of the declaration of the Protectorate, the effects of the new anti-malarial measures were beginning to be felt. The reduction in numbers of mortality was visible in 1899, out of a population of 316, twenty died and 28 were invalid.

In 1901 the European population had risen to 397 but the number of deaths had fallen to 17. In 1903 there were 12 deaths out of a White population of 460; and in 1905 from a rising population of 533, there were 12 deaths and 88 invalids.

The 20th century heralded a new push in the campaign against mosquito and malaria. The anti-anopheles campaign and other medical and sanitary precautions which were initiated by MacGregor in Lagos were extended and enforced throughout the entire colony and protectorate and this worked remarkably in reducing malaria-induced deaths in both Blacks and Whites.

In 1905, Alan Field announced that, irrespective of the shortcomings recorded in some areas, “the anti-anopheles campaign had led to such incontrovertible results that it is worth turning all energies against that most gifted insect (mosquito).”

He suggested five measures in tackling mosquito and malaria to include quinine, mosquito nets, aspirin, mosquito boots, avoidance of native quarters where all the children have malaria and are the source of infection,  wool next to the skin, cummerbunds to protect the kidneys from chill, sun helmet, spinepads, umbrella against heat-stroke, filtered-boiled water and lastly no “mammy palaver” – an aphorism for sexual escapades with native women.

Although the last measure “no mammy palaver” proved difficult to be maintained by the foreigners, long separated from their wives but had to cool-off in the arms of native women. Nevertheless, the practice of taking quinine with breakfast, evening whiskey became enduring legacies of the mosquito war. The sun helmet and mosquito boots became popular even among the native population that it dominated the fashion of almost the entire 1st quarter of the 20th century.

Notwithstanding, the success recorded by the fight against malaria the disease continued to take its toll on the population. In Akpap Okoyong, apart from the havoc wreaked on the tiny coastal community in 1896, scores of people still died of malaria. When Mary Slessor , who herself had treated the locals with her quinine screamed: “O Abasi, yak mi nyong” and finally gave up the ghost on January 13, 1915, the whole of the Cross River Basin would have to live with the dreaded disease for the next 100 years.

Government has been fighting malaria instead of mosquitoes. The war on malaria can never be won without a complementary onslaught on its vector. After the invention of the DDT, to fight insects, the global community has gone to sleep. In that slumber, the mosquito has developed several tactics that reminds one of Chinua Achebe`s characterisation in his Things Fall Apart.

Conversely, the world appears not very interested in the vector. Even with the initial lame accusation of the Chinese bats, science appears to be satisfied in that it has identified and even named the historic virus that emanated in Wuhan. Whether the world pays attention or not, one thing is certain: COVID-19 has come to stay as the first global shock of the 21st century – in fact, facemask wearing may appear on the runway as a fashion signature from next year.

Instead of the annoying arguments over the Chloroquine placebo, there should be concerted effort to unravel the true characteristics of this strange virus. The world science family must come to terms that unlike malaria that they ignored because it affected only the Black race, Corona is mostly headquartered in their domain.

The way out is for scientists to identify and eliminate the vector, and then dig deeper for cure. History has proven that many diseases are like onions: they come in layers – the world must stop ranting and keep peeling if we must reach the core.

 Afaha is a Reader in the University of Abuja




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