When Mama Nzito finished talking, many questions remained: Why would the headmaster agree to let these experts steal the students’ blood? When and how did the children die? How was the blood stolen? Where was it sold, and to whom? I asked her these questions, and Mama Nzito had no answers. But, while she couldn’t answer my questions, she also didn’t back down in the face of my questioning. She sensed my growing skepticism and told me—with impeccable logic—that just because she didn’t know the specifics of how blood was stolen and what was done with it didn’t mean that it wasn’t true.
During the course of the hour-long interview, Mama Nzito spoke repeatedly of damu (blood), its value, and the government’s role in the stealing of it. As she discussed the work of medical researchers in her area, she also posed many questions without clear answers: “You will ask yourself: Why does he want my blood? Where will he send it? What will it be used for? . . . They will take your blood, but they won’t return with answers.”3 Linked with her discussion of damu were frequent references to dawa. As she saw it, dawa was a way to lure people to give blood, a common payment for blood, and an excuse to get into a place, like a school, where blood could be obtained. Mama Nzito raised the topics of damu and dawa together frequently enough to lodge both words firmly in my mind.
The story of children murdered by blood-stealing researchers should have been easy to dismiss—it followed the model of baseless and hard-to-believe rumor—but I found it difficult to dismiss as such. In this case, I discovered that a version of the story was well documented in local archives. Medical and police reports showed that in 1965, six children died at a school just up the road from Mama Nzito’s village after receiving an injection of a bilharzia drug.4 The deaths occurred at Busirasonga Primary School in Sima, in Geita District in western Tanzania. Six out of 123 children died after receiving an injection with a drug intended to treat bilharzia. The Ministry of Health called the administration of drugs at Busirasonga Primary School “mass treatment”; publicly, the deaths were attributed to poor-quality or inappropriately administered medicine. While it is impossible to know the actual cause of death, it is plausible that the mass treatment was part of a research project testing small variations in dose or treatment schedule—lending credence to the local idea that the children died at the hands of researchers.5
It’s worth noting that just one year before the deaths, the drug given as mass treatment in Busirasonga was still being tested by the East African Institute for Medical Research. The 1963–1964 drug trials of TWSb (sodium antimony dimercaptosuccinate) were conducted on school children in the Mwanza region to determine appropriate doses. A group of children were given the drug at school, while others were admitted as patients in the hospital and received much higher test dosages. Being part of the inpatient trial meant receiving up to five injections per day, and many children experienced side effects of anorexia, nausea, and vomiting. As the combination of the hospital stay, the frequent injections, and the obvious side effects made people increasingly nervous and angry, mothers pulled some of the children out of the project.6 The East African Institute for Medical Research was based in Mwanza and had been very active in testing bilharzia drugs in the region in the years prior to 1965. It’s quite likely that even if a particular family did not have a child who had received a drug either at school or in a hospital, they knew someone who had. The idea of “researchers” or “experts” arriving at a school with drugs in hand, with the sickness or death of children as the result, seems to have been well accepted and almost expected. In my own interview with an older couple, they recounted how “We’d hear that today they coming to the schools to test blood [kupimwa damu]. The parents would not send the kids to school because they didn’t want them to be killed . . . but maybe this is wrong.”7
Bwana Matende, Blood Stealing, and Filariasis Research
When I asked about medical research, many people told stories of Bwana Matende.8 Bwana is the Swahili word for “Mister” and can be used as a sign of respect; matende is elephantiasis, which is a common symptom of lymphatic filariasis. Thus, one translation for Bwana Matende is Mr. Elephantiasis.9 More important than the name, though, was the perceived true work of Bwana Matende: creeping around in the middle of the night, stealing African blood, and selling it internationally. He was a white doctor or researcher who worked in a lab in Mwanza near the government hospital. He stole and dealt in blood, and also gave out dawa. Mr. Elephantiasis sucked (kunyonya) blood—never to drink, but to sell. Bwana Matende was not a vampire but an unrepentant businessman.10 It was while pursuing his main goal of collecting blood to be sold that he inadvertently killed Africans. His unlucky subjects would be “finished” (kumaliziwa) and the body disposed of. The African blood was sold abroad for white people to make extremely potent dawa used in Europe and the United States. Bwana Matende was most active in the 1950s and 1960s, and was no longer in the Mwanza Region today.
As his name made clear, Bwana Matende focused on the disease of filariasis. One of the peculiarities of lymphatic filariasis is that, for accurate testing, blood samples must be taken between eleven at night and two in the morning, when the microfilariae are active in the peripheral blood.11 This medical necessity created a set of conditions that brought researchers during both the colonial and immediate postindependence eras into villages in the dead of night, where they would round people up in the center of town or go door to door, and take blood that they then stored in small vials. Those vials were carefully placed inside coolers, put into vehicles, and driven away to some unknown place, for an unknown use.
During interviews, stories of Bwana Matende frequently broadened into discussions of the connections between blood, medicine, money, and the government. In meandering accounts, people explained how African blood was stolen, that blood was turned into medicine, and that medicine was sold to Europeans or rich locals. The stories also had to explain why the government would allow citizens to be killed and their blood stolen. When asked if the government approved of Bwana Matende’s work, Tanzanians responded with a version of “Eh—the Government? He is the government!”12 As one man told me, if a person was unlucky enough to be taken by Bwana Matende, the police wouldn’t help. Since Bwana Matende was part of the government, the case would be closed, and the police officer would write that the death was due to “bad luck.”13
This linking of Bwana Matende with the government is important. He was active before, during, and after the Tanzanian independence and consolidation process of the early 1960s, and when I pressed people to be more specific about which government Bwana Matende was working for, they responded by saying “government is government.”14 Any government could be bloodthirsty or act as a profiteer on the back of its citizens—that was not a characteristic singular to the colonial state. By giving the government a role (even that of tacit bystander) in blood stealing, people implied that blood stealing, murder, and profiteering were open secrets.15 In fact, the Swahili word siri (secret) was often invoked during discussion of medical research, the government’s complicity in blood stealing, and the larger nature of government and its relationship to its citizens.
Aspects of the stories told about Bwana Matende resonate with the history of medical research in western Tanzania from the late 1940s through the 1960s. In the late 1940s, the Filariasis Research Unit and East African Medical Survey were established in the port city of Mwanza on Lake Victoria, and they continued to operate in the area through the 1960s; the original building still houses medical researchers today. The Filariasis Research Unit was particularly active, and thousands of East Africans came into contact with its members as they conducted large-scale surveys (to establish prevalence rates), tested new drugs, determined appropriate doses of effective therapies, and then attempted to provide mass treatment.16
In the decade between 1950 and 1960, well over 50,000 Tanganyikans had their blood taken by researchers during the darkest hours of the night.17 On Ukara Island alone, drug trials conducted in 1950 involved more than 35 percent of the population giving blood and taking pills. Thousands of other residents in villages around Mwanza also had blood samples taken at night and received experimental therapies in the form of pills and injections.18