It was in the 1920s that the mass manufacture of hypodermic syringes began and changed all that. This was crucial for medical teams working in Africa, particularly the Belgian Congo and neighbouring Cameroon, although resources were still scant – the syringes were not expendable – and sterilisation of the needles or syringes was virtually impossible.
These injection campaigns to combat sleeping sickness were the ideal circumstances for the spread of the virus that the young hunter had unwittingly brought to Leopoldville. The injections were carried out in the Belgian Congo by mobile teams with no formal education and a minimal amount of technical training, who visited patients in their villages to give them their monthly shots in order to treat the villagers, but also to protect the native workforce and colonial administrators. Such was the number of people they had to inject there was no time for boiling and sterilising each needle after use. They were simply rinsed quickly with water and alcohol before being used on the next patient. Consequently, all too often the syringes retained small quantities of blood. Just the smallest amount of infected blood was all that was required to transmit the disease. Even after 1956, when disposable plastic syringes became available (these were invented by New Zealand pharmacist and veterinarian Colin Murdoch who wanted to develop a method of vaccination that eliminated the risks of infection) they were still likely to have been reused due to cost.
This practice continued unabated and led Jacques Pepin, a Canadian professor of microbiology, to propose in 2011 that the connection between the initial human source and the global pandemic of the virus was the hypodermic syringe.2 He worked out that around 3.9m injections were given against sleeping sickness, and 74 per cent of these were administered intravenously – right into the vein, not into muscle. This intravenous method of delivery is not only the most direct way of getting a drug into the body it is also the best way to unintentionally transmit a blood-borne virus.3 Also, before 1950, there were only two colonies in the sub-Sahara region of Africa who had blood transfusion programmes. One was Senegal, which started blood transfusion programmes in 1943, the other was the Belgian Congo, where rudimentary blood transfusion programmes had been in place since 1923 and were used specifically to treat infants with severe anaemia, primarily from malaria. Such was the fear of malaria that it appears the benefits of blood transfusions far outweighed the risk of infection from other diseases or blood-borne viruses such as human immunodeficiency virus (HIV).4
There are differing views; some experts doubt that needles were necessary in such a way for HIV to establish itself within humans, suggesting that sexual contact had been enough. But even they agree that injection campaigns, and to a lesser extent blood transfusion programmes, may have played a later role, certainly spreading the virus across Africa once it was established.
According to Pepin, however, it is the injections that might account for the intensification of HIV infections beyond a critical threshold; that is, the moment when the virus had been unintentionally injected into enough people to stop it from burning out naturally, a point whereupon sexual transmission would do the rest. And as travel grew within Africa, thanks to the development of road and rail, so rapid transmission throughout the continent was achieved. From the late 1930s to the early 1950s, the virus spread by rail and river to Mbuji-Mayi and Lubumbashi in the south and Kisangani in the north. At first, it was an infection confined to specific groups of people. But the virus soon broke out into the general population and spread, especially after the Belgian Congo achieved independence on 30th June 1960 and became known as the Democratic Republic of Congo. From here, the virus took hold and formed secondary reservoirs, whereupon it spread to countries in southern and eastern Africa and across the sub-Sahara with an unstoppable momentum.
And, before too long, it had spread to the rest of the world.
3
Seek your happiness in the happiness of all. Zoroaster
On 14th December 1908, the same year that the simian immunodeficiency virus (SIV), which would go on to become HIV, passed from chimp to hunter in the Congo, a woman gave birth to a 6lb 4oz baby boy in a small Indian city to the north of Bombay. The child was named Bomi by his parents and was given the surname of Bulsara after the name of the city of his birth, Bulsar.
Bomi was born into a family of Parsees, a group of religious followers of the Iranian prophet Zoroaster. Meaning ‘Persians’, the Parsees emigrated to India from Iran to avoid brutal religious persecution by the Muslims in the eighth century and settled predominantly in Bombay and towns and villages to the north of the city.
Developing a flair for commerce, the Parsees were receptive of European influence in India and during the 19th century had become a wealthy community, thanks to Bombay’s railway and shipbuilding industries. The Bulsars, however, were not from prosperous Bombay, but lived 120 miles to the north in the state of Gujarat. Here, for many locals, the only realistic source of income was harvesting mangos from the many orchards that dotted the landscape. Consequently, the Parsee community in Gujarat were far from wealthy and many young men from the region were forced to seek work elsewhere, not only in India, but further afield too.
Bomi, one of eight brothers, was no exception. Out of necessity and financial hardship, one by one he and his brothers left India and sailed almost 3,000 miles across the Indian Ocean to the exotically named Zanzibar seeking work.
Upon arrival, Bomi was fortunate and found work almost immediately with the British Government as a high court cashier in Stone Town, settling into life on the island quickly and comfortably, dedicating himself to his work and diligently and slowly building himself a privileged lifestyle. However, he desired a family to share his high standard of living, having arrived in Zanzibar unmarried and alone. Part of Bomi’s job meant that he frequently had to travel throughout Zanzibar as well as returning often to India. During one of those return trips to his homeland he met Jer, a bespectacled and dainty young girl, 14 years his junior. It was love at first sight and they married shortly after in Bombay, whereupon Jer left her own family behind to follow her new husband westwards across the Indian Ocean back to Zanzibar, where they hoped to raise a family of their own.
The newlyweds lived in a two-storey apartment that was accessed by a flight of stairs from the busy Shangani Street in Stone Town on the western side of the island. Compared to other Zanzibaris, the Bulsaras enjoyed a high standard of living, with Bomi’s salary enabling them to employ a domestic servant and even affording a small family car. Almost 60 years later, Jer Bulsara recalled it as being ‘a comfortable life’.1
It was on Thursday, 5th September 1946, the Parsee New Year’s Day, when the Bulsaras’ first child was born at the Government Hospital in Stone Town. The boy, weighing almost seven pounds at birth, was given the name Farrokh Bulsara. One of Farrokh’s cousins, Perviz Darukhanawalla, recalled her memories of him years later: ‘When he was very young, a small child, very young, that is about three to four years old, when his mother used to go to work, she used to leave him with my mother because my mother was a housewife and because both his parents were working.’2 Speaking to author Lesley-Ann Jones, Perviz remembered: ‘He was so small, like a little pet. Even when he was a very young baby, he used to come to my home with his parents. They used to leave him with my mother and go out. When he was a bit older he would play about in our house. He was such a naughty little one. I was much older than him, and I liked taking care of him. He was such a small boy, a very nice child.’3
From the age of five, Farrokh attended the Zanzibar Missionary School, an establishment run by British nuns in Stone Town. Already, according to his mother, Jer, the young boy was showing an interest in music and performing: ‘He used to love playing records all the time, and then sing – any sort of music, folk, classical, or Indian music.’4 When his parents attended various functions or parties, it was always with little Farrokh in tow. It became an accepted routine that, at these parties, he would be asked to sing. Always eager to oblige, perhaps show off even, the small boy