The Politics of Disease Control. Mari K. WebelЧитать онлайн книгу.
illness was also called mongota in Luganda, translating as “one who sleeps” and deriving from the verb glossed contemporarily as “to nod” or “to be drowsy.”91 Centered on unpredictable sleepiness or disrupted sleep to define the malady, news of mongota peppered the diaries and notes of European observers around Lake Victoria in the few dozen months between the epidemic’s outbreak and the identification of the causative pathogen and vector in 1902. After that point, Europeans generally referred to a specific biomedical entity, sleeping sickness/maladie du sommeil, or sometimes trypanosomiasis after the parasite believed to cause the disease.92 Despite the dangers of illnesses brought about by Kaumpuli, pox-causing diseases, respiratory infections, and the ever-present potential precariousness of rural agricultural life, mongota appeared to be different in how people deteriorated and died, causing severe degenerative changes in a person’s body as well as their temperament. Grave illness was far from unknown, and misfortune in its many forms struck islanders, but this illness slowly and inexorably brought weakness, thinness, unpredictable behavior, and impenetrable sleep: death in a new form.
Missionaries’ reports of early sleeping sickness patients and subsequent government reports of the wider epidemic focus on the abject misery and illness of the afflicted, but also, markedly, on a fatalism in their Ganda and Soga interlocutors.93 Colonial-era sources frequently characterized African responses to epidemic sleeping sickness around Lake Victoria as a combination of fatalistic, brutal, and primitive: the sick were cast out completely by their families, chiefs sent away the sick to suffer “in the bush,” people killed and consumed all of their household’s livestock at once, the dying were discovered in squalor and alone. These early accounts, while likely capturing the physical and psychological toll of illness and death, have also had the consequence of creating a durable narrative where shock and inaction characterize the African response. Particularly in descriptions of the “pagan” or “heathen” practice of casting out the sick rather than abiding with them, tropes of Christian charity were at the forefront of missionaries’ writings about the disease, serving strategically to emphasize the ongoing need for evangelization and resources to their readers (and funders) back home and to underscore the missionaries’ commitment to particular communities or individuals amid the epidemic. Though Kuhanen and others have noted that Ganda authorities attempted to respond proactively to control the spread of disease, Ssese sources flesh out how these elite mainland moves were paralleled by energetic activity in affected households and villages on the islands.94 Further, this close reading, alongside a rough sketch of the known historical epidemiology of the disease, offers a sense of the practical strategies that Ssese populations used and underscores that their approaches shifted as the epidemic unfolded. Examining these shifts not only illuminates the changing nature of the epidemic and its widening impact, but also helps us understand why islanders engaged as they did with different therapeutic possibilities, first with missionaries who remained as the islands’ population declined, and subsequently with the German sleeping sickness research expedition that arrived in 1906. Ssese islanders fit their experiences with mongota into wider political changes commensurate with their position amid Ganda and British imperial spheres as well as within existing intellectual and therapeutic frameworks and experiences of illness in previous generations. Mongota generated diverse responses on the islands, particularly given its overlap with British colonial encroachment and the widening availability of mission-centered medicine for people living on the lake’s shores and islands.
An initial response to mongota was elemental: islanders spoke of it, named it, and discussed it with travelers or those in wider clan or kinship circles. Generally, across the Great Lakes region, distinctive, locally specific names for an illness associated with nodding were in use at the time: mongota in Luganda and isimagira in Oluhaya, for instance.95 This novelty and relative simultaneity suggests that people in nearby communities were contemporarily categorizing a set of changes to the body and temperament—here, a nodding sleepiness—as a single illness and differentiating this from others.96 Informants in the 1910s underlined the initial novelty of mongota on the islands, for example, though other illnesses causing fever and sleepiness had been known.97 CMS missionary George Pilkington’s Luganda-English dictionary (one of the earliest made) glossed bongota and simagira as “to nod” or “to be drowsy” in the 1890s, with distinct words—tulo and ebaka—glossing “to sleep.” But the connotations of the words mongota or isimagira seem to have changed over time amid the early epidemic, shifting from an association with nodding or drowsiness in the 1890s and early 1900s to a firmer connotation of sleep in subsequent years. As nodding gave way to sleeping or unconsciousness in “those who were drowsy,” mongota became an illness of sleeping. The meanings of bongota, correspondingly, seem to have cohered around sleeping rather than sleepiness or nodding amid and after the burgeoning epidemic.98 By 1902, Ssese islanders also called the illness tulo, a word that glossed sleep, but not nodding, even as missionaries referred to it as mongota.99 As well, at some point before 1904 people around Lake Victoria came to associate peculiar swelling on the body—it is unclear whether exclusively on the back of the neck, or more widespread on the body—with illness that ended in sleeping and death.100 Some also attributed the illness to the lubaale Kaumpuli, generating the talk that led European observers to report connections between sleeping sickness and that extant nosology of serious and widespread illness.101
As they discussed and defined mongota, Luganda-speaking Ssese islanders fit it within their experience of concurrent political change, making sense of illness and death in relation to the potential consequences of dwindling communities. H. T. C. Weatherhead recounted how, by 1904, missionaries “hear[d] it said that the English have brought this sickness by the ‘magic,’that they may ‘eat’ the land. ‘Has not the Government made a law that all uninhabited land shall belong to the English?’Therefore, they want to kill the people off the coast lands and islands that they may claim them.”102 Land tenure at the time oriented around paternal and agnatic relationships and social reproduction depended on access to land. Islanders knew that deaths among them and on the mainland on the scale that mongota caused could disrupt land tenure and fundamentally change such durable arrangements. With “the English” as the new players in the region claiming “uninhabited land,” Weatherhead’s Ssese informants reasoned that depopulation could only redound to the benefit of the British colonial regime.103 That Weatherhead’s informants also explained mongota as a sickness brought by “magic” by the “English” indicates that people fitted colonizers into cosmological and nosological systems where human malevolence wreaked widely felt havoc. The association between English presence and widespread mortality also underscores that people categorized mongota as something new—or, at least, significantly different in its scope and impact—and intimately linked with experiences of recent British arrival in the region.104
Within households and villages, people reconfigured life around mongota in several ways.105 Illness and death triggered changes in mobility that we might compare to earlier responses to kaumpuli on the mainland, encouraging circulation away from areas where people were sick and perhaps also movement to consult lubaale shrines and powerful kubándwa mediums. On the Sseses, mongota began to erode remaining islanders’ prosperity and livelihoods as it sickened fishermen and farmers, men and women, across the archipelago. Locally, people deployed strategies to mitigate mongota, setting the sick apart from the well, but also settling sick people together. Some might have acted similarly to nearby Ganda communities that in 1902 isolated the sick, avoiding smoking from the same pipe or eating together.106 Missionary sources recount early recognition of the illness on the Ssese Islands in 1902–3 and particular steps taken to isolate, but also care for, the sick, such as settling a group of sick people together or lodging a sick person away from other homes and providing a caretaker. In November 1902, for example, CMS missionary Aileen Weatherhead wrote in her journal of a house that had recently been built around twenty minutes’ walk away from the Bugala mission. This house was a space for the sick, not a preexisting home for particular people, and was notable enough that the Weatherheads took British researcher Cuthbert Christy there directly when he journeyed through the area in search of cases of sleeping sickness.107
The case of a young man named Isaya, employed as a servant in the Weatherhead