I have been thinking about my great-grandfather, and how I am alive because he self-isolated over a century ago. Around the end of the nineteenth century, two major African trypanosomiasis epidemics swept through what is now Eastern Uganda, and Western Kenya. Better known as sleeping sickness, the disease is transmitted to human beings by tsetse flies that have acquired the infection from infected people or animals.
Once infected, the patient develops joint pain, headaches, and a fever, then becomes drowsy. The infection also causes swelling of the lymph nodes at the back of the neck. Once the pathogen crosses the blood-brain barrier and infects the central nervous system, the patient becomes lethargic or insane, then goes into a coma, and finally dies. The disease was, and still is, particularly active around the shores of Lake Victoria.
During the first epidemic, that lasted between 1896-1906, approximately 300,000 and 500,000 people died in the Congo Basin, and in present-day Uganda and Kenya respectively.
A few years later, shortly after the end of the First World War, a second epidemic occurred. The epidemic began in a number of African countries in 1920 and died down by the late 1940s. My great-grandfather, Amoko wuon Agak, lived somewhere close to Lake Victoria, in a tsetse-fly dense area. As the disease quickly spread through the region, several of his peers and relatives died. Before the epidemic, Amoko had six wives. However, as people died of the disease, the number of wives increased. Among the Luo, there was a custom called Lako. Lako was an institution that stipulated that upon the death of a husband, his ‘brother’ takes up the roles and responsibilities of the deceased’s home including towards his wife (wives) and children. As the jalako, Amoko became, according to my father, the husband of ten wives. He also ended up playing the role of a stand-in-dad for several brides between 1930 and when he passed away in 1960.
My great-grandfather and his wives survived because they effectively self-isolated themselves by moving away physically from all their friends and relatives to a relatively unoccupied part of Western Kenya in Kendu Bay. Kendu held sway for him because his friend, Paul Mboya, who would later write a book about the culture of the Luo (Luo Kitgi Gi Timbegi, in 1938), lived nearby, but also because a group of Christian missionaries had built a hospital in there.
Human sleeping sickness has existed in Africa for centuries. The earliest written records of the disease in Western history are by Atkins in 1742, when he referred to it as a “sleepy distemper”, and David Livingstone in 1857, when he called it a “fly disease.” However, even before them, African communities knew about the disease, and knew that it was transmitted by tsetse flies, which were sometimes called “elephant flies” because of their size. People would set fire to large areas of bush to clear them of tsetse flies, and animals such as warthogs and bush-pigs on whose blood the flies fed. As early as the 14th Century, the Arab historian Ibn Khaldun wrote that King Diata II of the Mali Empire had died of it.
There are different theories for the appearance of sleeping sickness in East Africa. Because local populations didn’t travel much, sleeping sickness was mostly limited to small pockets. However, according to one theory, the movements of Arab slave traders brought the Gambian sleeping sickness up the Congo River, and further East. Another theory attributes its spread to Henry Morton Stanley and his 1887 expedition up the Congo River to rescue Emin Pasha. According to John Ford, an entomologist for the British colonial administration in East Africa, Africans had established a rough equilibrium between two ecosystems: the human and domestic on the one hand, and the natural and wild on the other. This equilibrium was shattered by the invading Europeans, causing a series of ecological crises that included famines and epidemics of rinderpest, sleeping sickness, jiggers, and others.
My great-grandfather’s self-isolation and physical movement during the second sleeping sickness epidemic was part of a larger colonial strategy for dealing with the disease. The strategy was different in different colonies. During the first epidemic, Hesketh Bell, the governor of Uganda, ordered Africans to move to fly-free areas two miles or more away from Lake Victoria and forbade fishing and the sale or possession of fish. He said, “We must withdraw from the insects the source of their infection. The whole country must be depopulated. There seems to me to be no other course than to remove everyone from reach of the fly for an indefinite period.
In the Belgian Congo, the Belgians imposed a cordon sanitaire around the fly-infested people. They opened camps for the infected, camps which were guarded by soldiers to prevent people from escaping. In the camps, the detainees were injected with atoxyl. Later, they devised a system of mobile medical teams who went from village to village, examining people.
In Angola, a Portuguese colony, convicts were made to clear undergrowth near human settlements, drain swamps and fell trees. Tsetse flies were attracted to black cloth, so the Portuguese had workers dressed in black go around catching and killing the flies. Inhabitants were examined and injected with atoxyl, and the sick were placed in camps. Entire villages in infested areas were moved, and the inhabitants monitored. By 1914, only 0.64% of the population still had the trypanosomes as opposed to 26% in 1907.
In Tanganyika, during the second epidemic, the British pursued the same approach they had in Uganda. They made Africans burn all vegetation that might harbor the flies and thereby create “fly barriers” around human habitations. In 1926–1928, 12,000 square miles of tsetse-infested land were evacuated and their inhabitants relocated to areas free of flies. Travel was strictly controlled and pedestrians and vehicles were searched for flies. Animals that might harbor trypanosomes were hunted down. The areas that were thereby depopulated remained so for a long time thereafter; many became the wildlife reserves for which Tanzania is famous today.
On April 6, the Kenyan government banned travel in and out of capital Nairobi from Monday for three weeks. At the time the announcement was being made, I was in an isolation ward in a Nairobi hospital as a precautionary measure. One hundred years after my great-grandfather self-isolated, the wheels of history have turned, and now here we go again.
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