The Politics of Disease Control. Mari K. Webel
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illnesses could and did move into and out of the framing of kaumpuli—it was not a universally applicable etiology. But kaumpuli provided a coherent, meaningful, and capacious means of understanding sudden and serious illness in Buganda by the late nineteenth century. Moreover, kaumpuli could catalyze mobilities and reorientations to domestic spaces and evinces the kinds of intellectual and pragmatic resources available for people faced with outbreaks of illness. Discussions of kaumpuli and cholera in missionary texts from the 1880s and 1890s open up space to consider central elements in Ganda nosologies as well as strategies of seeking treatment and healing in the late nineteenth century. Focusing on illness categorized as kaumpuli in the period between roughly 1880 and 1905 underscores the flexibility and expansiveness of Ganda etiologies and nosologies and discourses of illness and causation. It also proves a complex, multilayered problem that is good to think with. Considering kaumpuli allows us to apprehend the simultaneity of intellectual work in different but intersecting systems, situating Ganda ideas of illness and wellness within an era of widespread social, political, and epidemiological change, while also exploring the mutability of European biomedical models in the same era.
By the late nineteenth century, two specific balubaale were associated with certain kinds of illness and death that struck Ganda populations. The minor lubaale (Ndaula/Ndahura) Kawali was associated with irruptions on the skin, while the better-known Kaumpuli, a deity born of ancient transgression and misfortune, brought “plague” into people’s lives.61 While Kawali seems to have been associated with a particular type of illness—one which caused raised bumps or lesions on the skin—the lubaale Kaumpuli could have diverse impacts on human health. Important for epidemics to come was how his power registered in widespread illness in Ganda communities, striking people with disease and driving them from their homes.62
Between the 1880s and early 1900s, illnesses causing wasting, vomiting, and/or diarrhea fit into the etiology of kaumpuli, as did illness causing fever, pain in the chest, inflammation in the armpits, groin, and glands.63 These categorizations, gleaned from mission diaries and contemporary ethnographies, varied over time. In the 1880s, for example, missionaries equated kaumpuli with cholera, based on conversations with their African interlocutors and observations of a few sick people, suggesting that signs of Kaumpuli’s power could involve weakness or rapid wasting, diarrhea, and vomiting, as well as fever and changes to skin tone or appearance (e.g., bluish or darkened lips, sunken eyes). More often than not, its end was death.64 While contemporary definitions provide an extensive terminology covering pain in the belly, vomiting, and diarrhea, among others, the symptoms missionaries recorded at the time as signs of cholera had no specific Luganda gloss, other than an association with kaumpuli, underscoring both the novelty and severity of this way of ailing.65 In the early 1890s, another missionary clearly equated kaumpuli with an illness vaguely defined as “plague,” describing it as “a disease attended generally with swelling of the glands, and pain in the chest,” and noting further that “it is very prevalent after the rains.”66 By the late 1890s, however, Europeans around Lake Victoria firmly understood kaumpuli to be bubonic plague (Fr., peste bubonique), a disease characterized by dramatic swelling of glands in the armpits and groin (buboes), fever, weakness, blackening or suppuration of the skin around the buboes, and death. This particular iteration of plague, well known in European history, had by the late 1890s also become associated with an identifiable germ.67 Kaumpuli, therefore, could align with the presence of Yersinia pestis in the body. But within another few years, further diversity was fitted into kaumpuli. In 1902 to 1903, an itinerant British scientist reported that Ssese islanders named as kaumpuli an illness associated with fever, swelling of the face and areas of the neck, swelling of the glands, wasting, sleepiness, and death. Severe diarrheal disease also remained an aspect of other cases of kaumpuli simultaneously.68 In each situation, missionaries or scientists used the Ganda word kaumpuli to describe specific, widespread illness around them, both reporting the presence of epidemic disease and disseminating a “local” name for it. The term kaumpuli’s utility, for missionaries, was in facilitating translation and communication, and they used the term freely, if sporadically, over two decades as an equivalent for illnesses they defined variously as cholera, plague, and sleeping sickness.
A rich body of historical epidemiological scholarship considers, broadly, what killed people in the past based on historical narratives, archaeological data, or genetic research; indeed, epidemiological analysis of historical sources often illuminates connections between populations, or relationships between climate, food production, and disease, that might have otherwise fallen away from political or social histories.69 The era I examine—the late nineteenth and early twentieth centuries—has received significant and diverse scholarly attention owing to the depth of the crises that occurred to challenge regional health and prosperity at the time, and for the implications of these early crises on long-term epidemiological and social change in the region.70 Scholars of this region and era benefit from a rich set of sources on causes of illness and death on the Ssese Islands and the Lake Victoria littoral, particularly as Anglophone and Francophone clergy, colonial officials, and Ganda narrators sought to fix morbidity and mortality to specific and consistent modern biomedical causes. At first glance, their accounts confirm several key milestones in the global history of disease: that the disease known today as bubonic plague (caused by the bacterium Yersinia pestis) killed many in the 1890s, that the disease modern readers would recognize as smallpox (caused by the virus Variola major or V. intermedius) periodically devastated the region in the nineteenth century, and that an illness correlating with symptoms of cholera (caused by the bacterium Vibrio cholerae) struck populations in the latter third of the same century.71 These milestones allow us to link eastern-central African disease histories to changes in migration, commerce, or climate in Eurasia and Africa or the Indian Ocean littoral. Such historical epidemiological scholarship is centrally concerned with positively isolating and identifying causative agents of past epidemics. As such, it is oriented around discovering the possibilities of what, in biomedical and microbiological terms, historic vernacular illnesses were biomedically and how this information might illuminate the related histories of migration, environmental change, or politics, for instance. Here, I am not concerned with which presently known pathogens can be equated with episodes of kaumpuli in the past. A preoccupation with what a historic illness actually was in modern biomedical terms first obscures how people understood or experienced disease at the time, and, second, privileges microbiological and biomedical logics of explanation over those in use at the time (which would, in the case of late nineteenth-century Buganda, be anachronistic). The equivalence or nonequivalence of bubonic plague and kaumpuli or cholera and kaumpuli is not at issue.
Indeed, the complexities of African, and particularly interlacustrine, cosmologies, nosologies, and healing practices are flattened in European accounts that sought to associate a given term with a suite of symptoms and outcomes based on European biomedical concepts. European missionaries’ growing confidence in associating a “local” (meaning African-language) name to a specific biomedical entity paralleled scientific and medical practitioners’ efforts in the same era to deploy the growing consensus around germ theory to fix pathogens, etiologies, symptoms, and, ideally, prevention measures or treatments.72 Particularly in colonial contexts, these processes of defining, glossing, and equating illness and disease subordinated extant etiologies and nosologies—and their related intellectual worlds—to those of colonizers (or, at times, of the missionaries that preceded them).73 Further, in the long view of history, the productive uncertainty of the early colonial period—years of interplay, of mutual observation, of discussion and engagement, of contention, of violence—is then lost in the shadow of teleologies of scientific sophistication and biomedical precision globally. Thus, the concern about defining an illness like kaumpuli biomedically reorients inquiry toward present-day knowledge and intellectual worlds. Instead, I emphasize that kaumpuli demonstrates how thoroughly the late nineteenth century was an era of fundamental contingency and uncertainty for both African and European populations in the Great Lakes region when, in some cases, extant nosologies and etiologies were strengthened, rather than weakened, by irruptions of novelty and unpredictability.
I place these three consecutive accounts of illnesses under the rubric of kaumpuli to consider several different implications for understanding populations’ historical