The Politics of Disease Control. Mari K. Webel
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of sleeping sickness in the early twentieth century. This orientation introduces the reader to specific social, political, and environmental aspects of life on the Ssese Islands and the northern rim of Lake Victoria, setting the scene for chapters focused on healing, mobility, and the interaction between established and new ways of addressing illness. Chapter 1, “Finding Sleeping Sickness on the Ssese Islands,” argues that important continuities existed between historic responses to widespread illness and those to seemingly new forms of misfortune at the turn of the twentieth century. It first establishes the general contours of islanders’ lives and livelihoods in the late nineteenth century, focusing on the islands’ political and ritual importance within Buganda and also situating Ssese mobility and livelihood within the islands’ distinctive environments. These elements of life would be fundamental to Ssese experiences of serious illness to come. This chapter then examines the range of responses that islanders and lakeshore populations historically employed in times of illness and misfortune, looking at kaumpuli to highlight responses that involved new mobilities or reorientations to domestic spaces and surrounding environments. With the serious illness kaumpuli as a key point of reference, chapter 1 closes with an exploration of changing responses to an increasingly common form of wasting death, mongota, which European researchers would come to translate as sleeping sickness. It demonstrates that Ssese islanders made important moves to mitigate this new form of illness and death, drawing upon both established strategies for healing and avoiding illness as well as the resources of increasing therapeutic diversity on the islands.
Chapter 2, “Healing Mongota, Treating Trypanosomiasis: Research on the Ssese Islands,” continues to follow the history of mongota on the archipelago, anchored by a research expedition on the Ssese Islands led by German scientist Robert Koch in 1906–7. This chapter argues that Ssese islanders’ experiences of previous misfortune and illness and the diverse therapeutic landscape they inhabited shaped their engagement with entrepreneurial German scientists. Ssese islanders’ engagement with the German expedition’s diagnostic techniques and therapeutic regimens influenced both practical research techniques and theories of disease control that would be exported throughout German East Africa and define the German anti–sleeping sickness campaign. In particular, the historic importance of the Ssese Islands and recent uses of specific sites on Bugala Island, where the German research site was located, significantly impacted Ssese engagement. I examine the advent of the Schlafkrankheitslager, or sleeping sickness camp, and Koch’s attempts to suppress sleeping sickness through the use of months-long regimens of atoxyl, an arsenic-derived drug.
Research on the Ssese Islands led colonial scientists to historic relationships—epidemiological, economic, and social—that connected the islanders to the Haya kingdoms of the western lakeshore, specifically to the kingdom of Kiziba. Kiziba would ultimately become the key site in the region for German anti–sleeping sickness measures. Part II begins with a brief orientation to important social, political, and environmental aspects of life in Kiziba, one of the eight kingdoms of Buhaya in modern northwestern Tanzania, in the late nineteenth century. It offers deeper historical detail on the local factors that shaped royal power and the political economy of land and labor, elements that would shape Ziba and colonial efforts to mitigate the impact of illness. Chapter 3, “The Prince and the Plague: Politics, Public Health, and Rubunga in Kiziba,” argues that the political and social dynamics of sleeping sickness must be understood in the context of another illness, rubunga. This chapter explores the social, political, and environmental factors that shaped Ziba society and wider Haya approaches to illness, healing, and misfortune, including approaches to both rubunga and sleeping sickness. I analyze outbreaks of rubunga (usually translated as bubonic plague) in the 1880s and 1890s to uncover intersections of tactics to prevent disease and mitigate misfortune by Ziba royal authorities and the newly arrived German colonial regime. I argue that rubunga served as a foundational experience for the implementation of both Ziba and German understandings of disease prevention in the early colonial era, during a time of significant change in many aspects of Ziba life. Rubunga provided a practical model of how health and politics could intertwine in the early colonial era, one that shaped subsequent responses to widespread death and disease.
Directly on the heels of rubunga came another widespread illness and, with it, further colonial public health interventions. Chapter 4, “Gland-Feelers, Elusive Patients, and the Kigarama Camp,” explores the creation of the flagship German intervention at Lake Victoria: the sleeping sickness camp at Kigarama. Focusing on the local economies of land and labor that shaped the location and trajectory of the camp, it examines the engagement of the Ziba kingdom’s young monarch, Mutahangarwa, with German colonial officials. This chapter illuminates the factors that shaped how and why people sought or rejected the treatments offered at Kigarama, pointing to the importance of clan-based land distribution, seasonal labor, and shifting royal power. I argue that Haya practices of land allocation overlapped with place-centered traditions of royal authority to make Kigarama a space imbued with Ziba political power as well as a site for the acquisition of material resources and access to colonial therapies. This chapter also follows the fortunes of a cohort of new colonial auxiliaries, Drüsenfühlern (gland-feelers), whose work to search for hidden cases of sleeping sickness reveals the complex interplay between royal prerogatives, colonial desires, and individual interest in the thick of the public health campaign. Here, I offer new readings of the spaces and tactics of colonial public health in order to interrogate local meanings alongside colonial intentions and understand the Kigarama camp within Ziba geographies and economies.
Though the Lake Victoria epidemic commanded colonial attention firmly and quickly in the first decade of the twentieth century, German energies in eastern-central Africa soon turned to Lake Tanganyika, where sleeping sickness appeared to spread unchecked. Part III shifts to focus on the littoral of Lake Tanganyika, where German sleeping sickness interventions had begun in parallel to those at Lake Victoria. Part II begins, like parts I and II, with a brief orientation to important social, political, and environmental aspects of life on the coastal lowlands of Lake Tanganyika known as Imbo and areas on the western shore with connections to those lowlands. I focus particularly on contexts useful for understanding the particular dynamics of mobility and illness that shaped anti–sleeping sickness work in the region. Chapter 5, “Mobility, Illness, and Colonial Public Health on the Tanganyika Littoral,” examines mobility between the opposite shores of Lake Tanganyika—the lowlands of the southern Imbo region in German Urundi and the Ubwari peninsula of the Congo Free State/Belgian Congo, areas connected by vigorous trade and migration. I show how lacustrine mobilities and their routes and hubs contributed to the spread of sleeping sickness and came to define the emplacement and scope of subsequent colonial prevention efforts. I piece together the importance of historic mobilities across the lake for life, livelihood, and experiences of illness for linked Rundi and Bwari (and other Congolese) populations. I argue that the parameters and constraints of colonial interventions, particularly bush-clearing work aimed at destroying tsetse habitats, resulted from the vigorous mobilities, distinctive environmental conditions, and heterogeneous populations in the southern Imbo. The book concludes with a discussion of how histories of sleeping sickness and its control help us understand current global health challenges.
A NOTE ON LANGUAGES AND CONVENTIONS
This book relies upon source materials created by speakers of English, French, German, Oluhaya, Kiswahili, Kirundi, and Luganda, some of whom also used distinctive dialects within those major languages. I have maintained German special characters or spelling in use in the early twentieth century, but have standardized German translations of African place-names and terms to reflect modern