‘War against the mosquito’: Allies,Italians and malaria during the occupation of Puglia, 1943–1946

War and healthcare are inextricably linked. In fact, the prevalence of disease in the armed forces can inflict more damage than the enemy. The case of endemic malaria during the Italian campaign of 1943–1945 in the Second World War is an excellent example. The region of Puglia was one of the most malarial regions in Italy and provides a noteworthy case of Anglo-American endeavours to eliminate the mosquito during the Second World War. The high prevalence of endemic malaria in the area represented a substantial threat to the health of Allied forces and as a result to the Allied war effort. This article explores Allied efforts to protect both Italian civilians and Allied troops from malaria, in order to demonstrate how Allied health policies affected the Allied–Italian relationship.     

Imperial Nightmares: The British Image of 'the deadly climate' of West Africa,c. 1840-74

In the first half of the ninteenth century West Africa became associated with the term 'white man's grave'. This was mostly due to the extremely high European mortality rates resulting from endemic disease, especially malaria. The second half of the nineteenth century is usually described as the birth of tropical medicine, which indicates a development in scientific medicine partially attributed to the empirical experiences of the mid-century. The treatment and prevention of the above-mentioned disease changed substantially in the period. This article discusses the public perception of West Africa in the years between the Niger Expedition in 1841 and the Ashanti campaign in 1874. The two events, which mark the chronological framework of the paper, both played a significant part in the history of malaria as much as in the history of British imperial expansion in the region. Using mostly contemporary printed works, it is argued that despite the development that occurred in the field of medicine and subsequent decline in European mortality, the associated image of 'the deadly climate' of West Africa prevailed between the two events for a variety of political, economic and cultural causes.     

“Marsh fever”—The geography of malaria in England

The marshlands of Kent and Essex had exceptionally high levels of mortality from the sixteenth to the nineteenth century. The unhealthiness of the environment aroused frequent comment during this period and it was attributed to an endemic disease known as “marsh fever” or “ague”. Marsh parishes were perceived both as a danger to the local inhabitants and as a deterrent to potential settlers. This paper traces the geography and history of the “marsh fever” in England and shows that the disease was, in fact, plasmodium malaria transmitted by anopheline mosquitoes. Malaria, once indigenous in the coastal marshes of England, had a striking impact on regional patterns of disease and death. The discussion concludes with an examination of the reasons for the clinical disappearance of malaria during the nineteenth century, its reappearance after the First and Second World Wars and the possibility of new outbreaks of malaria in the future.     

Connecting global health interventions and lived experiences: suspending ‘normality’ at funerals in rural Tanzania

In this paper, we use the funeral space and its liminal nature as a milieu for exploring how a ‘modern’ health intervention, the mosquito bednet, is negotiated by its recipients in relation to its (non)-usage in such spaces. With a focus on sleeping arrangements at funerals and drawing on empirical data from participants living in rural southern Tanzania, we discuss how the bednet is linked to the notion of being unsympathetic to the death. Viewed as a symbol of modernity and a reflection of wealth and individual pride, the bednet becomes physically and symbolically inappropriate in the more sacred, ‘in-between’ site of the funeral. We also uncover how risk perceptions regarding malaria transmission are re-cast in funeral spaces, with socio-cultural practices and health-related behaviours being simultaneously ‘risky’ for individual mourners and reinforcing in terms of group social cohesion. As individual mourners' concerns about malaria risks are suspended, notions of pain and discomfort come to the fore as part of the mourning process and respect for the deceased.     

Development narratives and the uses of ecology: malaria control in Northwest Argentina, 1890–1940

This study traces the evolution of social–environmental models of malaria control in Northwest Argentina. Beginning in the 1890s, the rationale for malaria control hinged on a narrative that placed malaria as the root cause of the Northwest's chronic backwardness. Insalubrious rural and urban landscapes, underutilized agricultural potential, unproductive labor, and even racial decay were all bound together as a public health problem. The framework for understanding malaria in the environment was derived from miasmatic theory and medical geography, anchoring the disease firmly in particular landscapes. Wetlands, representing both economic waste and a public health hazard, were singled out as targets for reclamation. Thus ‘environmental sanitation’ techniques, especially wetland drainage, became the preferred strategy for the federal government's malaria campaign, initiated in 1907. The ‘socio-ecological’ orientation of the Italian malaria campaign under Fascism, in which large-scale wetland reclamation for malaria control seemed to produce a comprehensive transformation of rural land and life, had a strong influence in Argentina, further entrenching environmental sanitation methods. By the 1930s, however, it became apparent that Italy's wetlands served poorly as landscape analogues for Argentina's Northwest. In particular, the main mosquito vector in the region turned out not to be a stereotypical ‘swamp breeder,’ rendering pointless most wetland drainage efforts. A counter-model, which adopted the framework of ecological science, proved to be more sensitive to the behaviors and microenvironments of different mosquito species, while disentangling malaria control from the broader and mostly unrealistic social development goals of the older model.     

"God bless General Péron": DDT and the endgame of malaria eradication in Argentina in the 1940s

This article explores the politics of malaria eradication in Argentina during the first government of Juan D. Perón. The article develops the theme of historical convergence to understand the rapid mobilization and success of the climactic battle against malaria in Northwest Argentina. The nearly complete eradication of malaria in Argentina resulted from a combination of three factors. First, Carlos Alvarado, the director of Argentina's Malaria Service, had already developed a solid but flexible organizational base that allowed a dramatic change in control strategy. Second, an infusion of new technologies, especially DDT but also motor vehicles, was instrumental. Lastly, a radical reorientation of national public health policy in the 1940s, under the direction of Perón and his health minister, Ramón Carrillo, encouraged eradication. These figures embraced and refashioned long-standing organicist ideologies that hitched the strength of the nation-state to the health and vigor of its ordinary citizens. This ideological orientation was reflected in bold, populist political strategies that showcased swift, massive, and expensive public health campaigns, including malaria eradication. In the conclusion, the article explores the ambiguous connections between malaria eradication and an ecological perspective on the disease.     

A PL/I Free-Field Handling System

Integration of mortality data by cause of death is typically problematic for researchers because of the inadequacies of historical records. Two aspects of cause-of-death (or disease) data processing are discussed here: vocabulary and specificity. By developing a system of processing in which causes of death are in nested tables that are linked with a relational database program, the researcher can integrate highly specific and sensitive disease data with data that are less specific. Vocabulary variations can also be maintained by the system. The result of integrating data of differing specificity levels and vocabularies allows one to use mixed data for longitudinal analyses. The author developed the present system to allow the use of nineteenth-century British army statistical data, and an example of the application is presented.     

State,peasant, mosquito: The biopolitics of public health education and malaria in early republican Turkey

State officials in early republican Turkey framed malaria as both a medical and a political issue. In doing so, they engaged in public health education campaigns not only to resolve medical concerns but also to better govern the country's population and promote a broader modernist agenda. This article employs primary sources from Turkish archives and other collections in order to examine the governmental and the biopolitical implications of this experience. We thus scrutinize the civilizational discourse employed by politicians and physicians as they dealt with this “village disease,” the peoples who they encountered—and taught, and the obstacles that they perceived to exist within the traditional curative beliefs and practices found throughout rural Anatolia. Emphasizing modernist ideals in their medicine as much as in their politics, we conclude that health officials' lessons for waging an effective “war” on malaria targeted not just the disease but also its perceived societal sources of origin and—hence—the very populace it presumably sought to protect.     

Disease, Social Identity, and Risk: Rethinking the Geography of AIDS

The emergence of new diseases and the re-emergence of 'old' diseases necessitates a relook at what shapes vulnerability to ill health. A framework is proposed that combines a realist approach to mapping vulnerability with feminist and post-structural approaches that focus more attention upon the role of social identities and cultural framings of disease. Too often investigations of disease focus either upon structural determinants of risk such as political policy and the economy, or on discursive definitions of disease that impact its experience. A combination of these approaches would result in a more effective framework for evaluating vulnerability, and subsequently for generating effective disease prevention strategies. The social, economic, political, and cultural context of HIV/AIDS in Malawi is given as an illustration of this framework.     

Governing population, public health, and malaria in the early Turkish republic

In the early Turkish republic of the 1920s, population was a central question of concern for the leadership of the Kemalist state. This article focuses on how a demographic discourse concerning population – in terms both numerical and medical – provided a basis for emerging programs in public health, confronting the very real threats posed by disease. Employing the example of the nascent republic’s anti-malarial campaigns, this study thus examines the discursive, cartographic, and legislative measures employed in combating this widespread disease in the wider contexts of nation-building. In doing so, it traces one vital trajectory of the development of modern governmentality (i.e., that of public health) in the case of Turkey during the 1920s and 1930s, prior to the wartime slowing of state investments (due to national defense priorities), the post-World War II infusions of foreign aid and the incorporation of DDT in confronting malaria.     

Reproduction rates in multiregion modeling systems for HIV / AIDS

The persistence of HIV/AIDS has seen a revival of academic interest in the development of modeling systems to assist understanding the population dynamics of this infection. Moreover, it has become increasingly recognized that a key component of these systems for interpreting disease prevention is their reproduction rate, which provides an indication of whether an epidemic might start in a community described by a particular set of epidemiological characteristics. The properties of these rates have been explored in detail for models of a single risk behavior but not for multiregion formats that allow for the transfer of infection between geographical units. Therefore, in this paper I derive reproduction rates for a multiregion HIV/AIDS model together with their associated critical thresholds that estimate the minimum population of susceptibles necessary for an epidemic to begin. These statistics are interpreted for a simplified global setting representing regional variations in the potential onset of HIV/AIDS. In the discussion I examine the potential applicability of these results to understanding HIV/AIDS prevention.     

A short history of dapsone, or an alternative model of drug development

From 1936 until 1996, the drug dapsone treated a diverse array of diseases, including tuberculosis, leprosy, malaria, and AIDS-related pneumonia. This article explores how dapsone transformed from a cure for one disease into a treatment for a totally different malady. This process of reinvention in the clinic represents an alternative model of drug development that the historical literature, focused on success in the laboratory, has largely ignored. The core of the paper discusses the reinvention of dapsone as an antimalarial in the Vietnam War through trials led by Robert J. T. Joy, a physician and military officer. As a case study, it offers a fresh perspective on the clinic-as-laboratory approach that other scholars have addressed in a civilian context. Viewing the randomized clinical trial (RCT) through a military prism will demonstrate how a combat environment combined with the regimentation of the armed forces affected the standard methodology of the RCT.     

Environment, disease and mortality in early Virginia

Early Virginia (1607-24) was a nightmarish world of disease and death, perhaps uncurpassed in the annals of English colonization. Typhoid fever and dysentery visited Jamestown in recurrent epidemics killing 30 per cent or more of the colonists with each onslaught. Yet Jamestown endured because the leaders of the Virginia Company misapprehended the nexus between the estuarine environment and water-borne, non-immunizing diseases. Each summer, death stalked the town as invading salt water pushed up the estuary and concentrated pathogens in the town's water supply. The prevention of disease and death required the abandonment of Jamestown and relocation into healthier niches, which occurred with the dissolution of the Virginia Company in 1624.     

关于建立国内馆藏文物防震应急管理体系的探讨

我国地处环太平洋地震带和欧亚地震带间,因地震导致的馆藏文物损毁现象时有发生。近年来,我国馆藏文物防震技术研究取得了不少成果,并在部分博物馆成功进行了一体化防震示范应用。但总体而言,馆藏文物防震风险预防和应急管理水平仍相对滞后,部分博物馆存在防震措施不合理、日常管理匮乏、应急能力不足等现象,亟待健全馆藏文物防震应急管理体系,其中应急预案的编制尤为重要。通过建立完善的应急管理体系,博物馆能够全面提高防震意识和应急处置能力,合理利用各类防震措施降低潜在风险,更好地保护馆藏文物。     

Health status of the Venda,a post‐antibiotic community in rural South Africa

This paper examines the health status of a rural African community during the emergence of Westernisation. A total of 157 skeletons, which included 120 adults (55 males and 51 females), 37 juveniles, and 14 individuals of unknown age, were analysed. Date of death ranged from 1910 to 1999, with the majority of individuals (52%) being buried after 1960. The bones were examined for infectious diseases, trauma and degenerative changes. More than half of the individuals in the sample had no pathological lesions on their skeletal remains. No cribra orbitalia was present. One case of leprosy and three cases of osteomyelitis were recorded. The most common findings were osteophytes on the vertebral bodies (syndesmophytes) (17%) and osteoarthritis (7%). The low occurrence of chronic disease is unexpected given that malaria was endemic and intestinal worms were common. Explanations for these results include adequate intake of iron from dietary sources, death from acute infectious diseases, administration of antibiotics, and poor preservation of adult skeletal remains. Copyright © 2007 John Wiley & Sons, Ltd.     

Malaria and malaria‐like disease in the early Middle Ages

Malaria impairs human reproduction, augments excess mortality, and lowers productivity. It can exercise a debilitating effect so profound that it defines regions. The disease is an essential element in histories of places and periods in which it was endemic. Although many European regions are thought to have had a long association with malaria, evidence for the disease, the parasites that cause it, and the mosquitoes that transmit it, is thin before 1900. Malaria's early medieval history is opaque. This paper clears up contours of malaria's occurrence in Frankish Europe. It surveys sources relevant to its study and establishes guidelines for retrospectively diagnosing the disease. It argues that malaria was plentiful north of the Alps before 1000 and that it influenced demographic trends where it was endemic.     

AIDS Activism in Pakistan: Diminishing Funds,Evasive State

This article draws on a year of ethnographic fieldwork in the HIV/AIDS sector of Pakistan at the moment of rolling back a World Bank‐financed programme. Classified by UN agencies as at ‘high risk’ of a generalized HIV epidemic, Pakistan has an epidemiology driven by injecting drug use, and a Penal Code and Islamist legislation which criminalize non‐therapeutic drug use and extra‐marital sex. In recent years, a sharp increase in the numbers of registered HIV‐positive people has necessitated a shift from HIV prevention among ‘high risk groups’ to the provision of care to those living with HIV/AIDS. The rolling back of external funding, which was further compounded by the effects of devolution on the Ministry of Health, created challenges for AIDS activism in Pakistan, as reflected in the everyday lives — and deaths — of the patient‐activists and their community‐based organizations. This article recounts the story of one such aspiring AIDS activist caught in multiple dilemmas emanating from these macro‐processes. This story throws light on the limitations of the complex agency of actors in development, and shows how the shifting loci of power from the state to non‐state entities in the global neoliberal order impacts the provision of vital services like HIV prevention and AIDS control.     

The Cultural Queasiness Factor: Intersections of Gender,Sexuality and HIV Prevention in Burma/Myanmar

The Ministry of Health in Burma/Myanmar considers HIV its first priority in disease prevention, and HIV prevention represents a significant element of the work of many of the international non-governmental organisations (INGOs) based in the country (CBI, 2006; Ministry of Health, 2008). Yet inBurma/Myanmar, as elsewhere in Southeast Asia, there is a “cultural queasiness” around HIV. This queasiness is a dis-ease of the emotions, transmitted through the ongoing linking of HIV transmission with “bad behaviour” (resulting, in part, from HIV prevention's own repeated use of a “risk group” approach). Indeed, the mere existence of HIV prevention work, inand of itself, sparks waves of cultural queasiness because it transgresses the norms regarding which topics are considered appropriate for public airing, and which are not. Through reference to empirical research involving in-depth interviews and observation of field work practice, this article demonstrates how the desire to minimise this queasiness can result in disavowal of the experiential and emotional complications so deeply embedded in HIV prevention and HIV transmission. Thus HIV prevention both is affected by, and reinforces, cultural queasiness.     

Constructing Images,Constructing Policy: The case of Filipina migrant performing artists

In 1991 a Filipina performing artist died while working in Japan. Her death became an international incident and a catalyst for action on the issue of migrant exploitation. In particular, a series of policies was constructed by the Philippine Government in an attempt to afford protection to migrant workers. In this paper I critically examine the construction of these policies, with the purpose of identifying how specific notions of gender and sexuality are incorporated into the construction and reconstruction of policy. I demonstrate how the representation of exploitation within systems of labor migration serves the purposes of dominant factors of society, with little regard to the actual lived experiences of migrant workers. Findings indicate that current policy is based on an image that only illegally-deployed, hence immoral and disreputable women are exploited, overlooking the observation that both illegally- and legally-deployed women are susceptible to abuse. At one level this paper reflects an ontological attack against the employment of categories previously conceptualized as natural within the construction of migration policy. At a second level this paper is also concerned with the issue of 'who speaks for whom,' and the implications of this for viable protective policies. The significance of this paper extends beyond the confines of the Philippines, for it encompasses a growing international awareness of abuses toward migrants.     

新中国社会主义卫生事业和防疫体系的创立与发展

新中国社会主义卫生事业的创立和发展带有鲜明的时代变革特点,在中共中央领导下,党和政府在建国初高度重视发展新中国卫生事业,不仅迅速改变了广大农村医疗卫生事业极度落后的局面,大力开展妇幼卫生保健,而且开创了少数民族地区医疗卫生工作新领域,对促进少数民族地区社会文明进步具有重大意义。与此同时,还建立了面向全民预防为主的新中国卫生防疫体系,对新中国卫生事业的全面进步产生了深远的影响。