The Fever: How Malaria Has Ruled Humankind for 500,000 Years (8 page)

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Authors: Sonia Shah

Tags: #Science, #Life Sciences, #Microbiology, #Social Science, #Disease & Health Issues, #Medical, #Diseases

BOOK: The Fever: How Malaria Has Ruled Humankind for 500,000 Years
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Miasmatic theory explained the deadliness of Africa’s tropical fevers, and the relative healthfulness of cool highland areas relative to marshy lowlands. But what it couldn’t foresee were the malarial parasites munching on the hemoglobin of enslaved Africans, and
what would happen when American
Anopheles
took their first sips of the Africans’ infected blood.

By the 1500s, the crucial land bridge between the Pacific and the Atlantic—the isthmus that would become Panama—had been rendered a noxious “land of pestilence,” as medical historian James Simmons puts it.
38
The Spanish used the isthmus to transport the fabulous riches of their American colonies back to Spain. Having slaves trek the loot on foot across Panama, where the distance between the Pacific and the Caribbean spanned just forty miles, saved weeks of shipping around the tip of South America.

But those forty miles wended through one of the hottest and wettest places on the planet, covered with dense rain forest. A spine of steep mountains towering over seven thousand feet high sliced through its middle.
39
Rain pelted down in sheets for three quarters of the year, after which the winds arrived, uprooting trees and turning the steaming jungles into a vine-covered matrix of still, green pools.
40
Along the coasts, mangrove trees plunged their spiderlike roots into watery sands, creating sprawling coastal swamps, a dark netherworld of neither sea nor land. The difficult and exposed journey would have ensured steady contact between the African slaves’ parasites and Panama’s mosquitoes.

Once the American
Anopheles
started transmitting falciparum parasites, the Spanish found themselves utterly defenseless. By 1584, the fevers at Nombre de Diós, the Spanish village on the Caribbean side of the isthmus, were so bad that the king ordered it abandoned altogether. The new village they established, Portobelo, was not much better, and the Spanish soon knew it, too, as a “breeding place of malignant fevers,” according to Simmons.
41
Portobelo was an “unhealthy place,” one visitor wrote in 1648, “very hot, and subject to breed Feavers, nay death.” The famous navigator-cum-pirate Sir Francis Drake died of fever not far from there, and was buried in a lead coffin under the soft Portobelo soil.
42

In 1534, the Spanish had surveyed Panama in hopes of building a canal, but after contaminating the isthmus with falciparum malaria,
they were forced to abandon Panama’s fevered jungles to the indigenous Kuna people and the bands of escaped slaves the Kuna sheltered.
43
At the very height of its powers, the Spanish Empire managed to build just a single muddy mule track through the Panamanian jungle and two fever-racked villages at either end. Under constant attack by the pirates who prowled the Caribbean and by falciparum malaria and yellow fever on the isthmus, Panama became the notorious Achilles’ heel of the Spanish Empire.
44

Falciparum malaria from African slaves similarly transformed the European colonies in the West Indies and Carolinas, where local mosquitoes and climate were amenable to year-round transmission. As the number of African slaves in the West Indies increased, so, too, did the number of deaths among the Europeans who lived there. In the West Indies during the 1650s, English planters died three times faster than their new babies could be baptized.
45
European immigration, in the face of the death toll on the islands, ground to a standstill, and those who could do so made their fortunes as quickly as possible and then escaped.

Surviving letters and diaries from colonists in the Carolinas, after African slaves started disembarking in force, describe the arrival of a dreaded, deadly malignant fever. In 1684, one boatload of would-be settlers—warned by their ship captain that only two of the thirty-two “vigorous” people he’d previously carried from Plymouth to Carolina had survived their first year there—turned back before setting a single foot on Carolina’s plagued coast.
46

In 1685, a band of Irish settlers arrived in Carolina hoping to gather timber to take to Barbados. They all sickened with fever. Twenty-nine died.
47
A party of 150 Scots who arrived after a ten-week journey similarly abandoned their attempts to settle the area. “We found the place so extrordinerie sicklie that sickness seased many of our number,” one wrote, “and took away great many of our number and discouraged others, insomuch that they deserted us when we were to come to this place.”
48
Two young men who fled Carolina in 1687 arrived in Boston “pitiable to behold . . . They say,
they have never before seen so miserable a country, nor an atmosphere so unhealthy,” wrote a French settler who met them. “Fevers prevail all the year, from which those who are attacked seldom recover, and if some escape, their complexion becomes tawny.”
49
Before they left Carolina, the refugees said, they’d seen a ship from London arrive with 130 people on board. By the time they left, 115 of those new arrivals were dead, “all from malignant fevers which spread among them.”
50
The deadliness of Carolina’s fevers found its way into proverb. “They who want to die quickly go to Carolina,” said the English. Added a German commentator: “Carolina is in the spring a paradise, in the summer a hell, and in the autumn a hospital.”
51

Characteristic of communities suffering
P. falciparum
’s appetites, infant mortality skyrocketed. Eighty-six percent of European American babies born in South Carolina died before they reached the age of twenty. In one parish, over a third of European American infants died before their fifth birthday, with most dying in their first year between August and November, when the malarial mosquitos were biting. One typical South Carolina couple, married in 1750, bore sixteen children, of whom just six survived to adulthood.
52
Those who could afford to do so fled to the coast and the highlands during the late summer and fall, when malaria broke out most virulently, establishing the still-popular South Carolina resort communities of Summerville, Pawley’s Island, and Sullivan’s Island, among others. Medical authorities warned them not to return until after the first killing frost.
53

Ironically,
P. falciparum
’s heavy toll on the European populations of the West Indies and North America’s southern colonies deepened the colonists’ reliance on the labor of enslaved Africans. Battered, overworked, underfed, and housed in miserable, filthy conditions, most of the enslaved Africans nevertheless possessed Duffy-negative red blood cells that made them completely immune to the Europeans’ vivax malaria, and 30 to 40 percent carried sickle-cell genes and other inherited antimalarial blood cell deformities, which effectively
protected them from the worst ravages of falciparum malaria.
54
European physicians marveled at African slaves’ apparent resilience to the malarial fevers, such as the three-day-cycling “tertian intermittent,” which swept away their own people. “I have not met among them with a pure tertian intermittent in the whole of my practice,” an amazed doctor in the West Indies wrote, “and those of forty years’ experience mention it as a rare occurrence.”
55
“The white man is seen shivering with ague, his countenance cadaverous and his temper splenetic,” a Carolina physician noted. But “the black, is fat plump and glossy, in the full enjoyment of health and vigor.”
56
(This was surely an exaggeration: falciparum malaria killed sufficient numbers of infants that the sickle-cell gene circulated among generations of African slaves in Carolina as lushly as it did in West Africa.
57
)

Planters in the West Indies and the southern colonies were willing to pay top dollar for slaves from Africa. West Indies planters would pay three times more for an African slave than an indentured European worker, with slaves “seasoned” to the local malarias attracting even higher prices than those newly arrived.
58
Southern planters would spend twice as much on a slave from Africa as on a native slave.
59
Thus the institution of African slavery thrived.

One wouldn’t guess that malaria has much to do with the history of Scotland, tucked away in the cool, misty northern highlands.

But even there, in the waning years of the seventeenth century, the bounty of the New World beckoned. Scotland, a poor struggling nation, was banned from trading with the colonial possessions of its more powerful neighbor, England.
60
But the Scottish entrepreneur William Paterson, founder of the Bank of England, dreamed of Panama.

Unlike the Spanish, who considered a canal, Paterson imagined a road through the isthmus. “The time and expense of navigation to China, Japan, and the Spice Islands, and the far greatest part of the East Indies will be lessened by more than half,” he mused, “and the
consumption of European commodities and manufactories will . . . double . . . Trade will increase trade, and money will beget money.”
61
With a road built across Panama, everyone could get a piece of the trade in sugar, slaves, silver, and spices that had made the Spanish Empire and Britain’s East India Company so fabulously wealthy.

Paterson knew precious little about Panama from his own experience. But he’d read journals and books, and studied the maps and drawings of pirates, missionaries, and shipmasters.
62
The journal of the young pirate Lionel Wafer, in particular, inspired him as to the possibilities. Wafer grew up in the Scottish highlands and went to sea at age sixteen as a surgeon to East Indies merchants and, later, Caribbean pirates. After suffering an injury, he was left behind to recover in Darién, the eastern part of the Panamanian isthmus, where steep jungle-covered hills collided with the palm-fringed, white-sanded Caribbean coast. For several months, he lived in the jungle with the Kuna, who nursed, fed, and indulged the bedraggled pirate, painting his body and allowing him to sleep in their hammocks under their plantain-leaved ranchos.

Wafer was mesmerized. He wrote in his journal of the emerald forests full of fat, tasty monkeys, the rivers lined with cinnamon, sugarcane, and prickly pear, the sea teeming with sweet-tasting turtles and crabs. Thick honey and wax, free for the taking from sting-free bees, hung from swollen hives in the trees. Tobacco, plantain, yams, cassavas, and pineapples abounded, as did fabulous trees so useful to humankind that in just six months, a force of three hundred Europeans, Wafer mused, could fell enough to pay for an entire expedition.
63

Paterson was sold. Scotland could become a world power to rival the Spanish and the English, he thought, if only this veritable Eden, this “door of the seas” and “key to the universe,” could be pried open.

Wafer had noted in his diary that Panama was rainy. “’Tis a very wet country,” he’d written. But the Scots knew about rain: over sixty inches of it poured over the country’s rugged highlands every year.
64
Their urban dwellers knew about disease: anyone who lived in Edinburgh had already survived a gauntlet of the illnesses of filth. A viscous slime of watery cow dung covered the city’s streets, and lice were so ubiquitous that fine English gentlemen boasted that they never slept in the city without wearing their gloves and stockings.
65
Scottish settlers had already embarked on several New World ventures, too. Although none had secured a steady flow of riches for their hilly kingdom, they’d already set up colonies in New England, Canada, and Carolina.

And so perhaps Paterson’s dream to establish a Scottish colony on the isthmus, and to build a road across its land bridge, did not seem so fantastic. When the English authorities whom he first approached for support declined to become involved, fearful of upsetting the Spanish and their own East India Company, Paterson took his proposal to England’s northern neighbor. Paterson’s scheme inspired the country, and thousands anted up to fund the venture, “even the poor and landless, the thieves, whores and beggars,” the historian John Prebble wrote, raising four hundred thousand pounds sterling, almost a quarter of all the available capital in the small, rural land.
66
“The whole kingdom,” sniffed Lord Thomas Babington Macaulay, “seemed to have gone mad.”
67

Paterson ordered fine ships to be built to order, and filled them with artillery, nails, tacks, candlesticks, tobacco, and saws and machetes (to knock down the Panamanian trees Wafer had written about). While the Scottish countryside descended into famine, Paterson’s colonists stocked up on salt beef and dried cod, rum, brandy, and claret—a year’s worth of provisions for their venture. They carefully packed all their most desirable things to sell to the other colonies in the Caribbean: thousands of wigs; tartan, muslin, and calico; tobacco pipes; and pewter buttons. To win over the local natives, they packed thousands of Bibles, and combs inlaid with mother-of-pearl. The twelve hundred colonists who would make the journey—including four hundred hardy warrior-farmers from the highlands—outfitted themselves in tartan hose, stockings, and wigs. Paterson promised
each fifty acres of good farmland at Darién and ushered them on board the flotilla of ships, a copy of Lionel Wafer’s sunny journal tucked into their bags.
68

Only after they got out to sea did the colonists realize that somehow their famished Scottish vendors and packers hadn’t provided a year’s worth of beef and cod as promised, but just half that quantity, and even that was already starting to spoil. Forty of the twelve hundred died during the month-long crossing of the Atlantic, relatively few for a seventeenth-century voyage.
69
(It wasn’t uncommon for three times as many to die on such a trip.)
70

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