SEVEN. Modern Medical Research and Historical Residue
Appendix B. Further Reading on Global Medical Research
ILLUSTRATIONS
Figures
1.1. Photo of Amani, Tanzania, archival materials
2.1. Photo of finger prick, historical
3.1. Lymphatic filariasis disease lifecycle
5.1. Photo of lumbar punctures in the field, historical
5.2. Malaria disease lifecycle
Maps
0.1. African continent; East Africa highlighted
1.1. East African towns and main research stations
5.1. Western Tanzania/Lake Victoria region
6.1. East Africa research sites
6.2. Malaria vaccine testing sites, East Africa
6.3. Malaria vaccine testing sites, Africa
Tables
2.1. Swahili words for “research” and translations
2.2. Swahili words for types of dawa (medicine) and translations
5.1. Benefits provided by specific research projects at the KEMRI/Wellcome Project in Kilifi, Kenya
6.1. Pare-Taveta Malaria Scheme, 1954–66
6.2. Effects and duration of the RTS,S vaccine
MAP 0.1. African continent; East Africa highlighted. Map by Chris Becker.
PREFACE
Gonja, Take One
It was sometime in the 1970s. Or the 1950s. Or maybe even the 1960s. In any case, it happened years ago. “It” happened in the town of Gonja, in the Pare area of northern Tanzania, and started with angry residents who were unhappy with researchers working in their village. The rabble-rousers were either a group of wholesome, yet angry, residents, or a group of unruly, pot-smoking youth who had recently returned from the war with Uganda. Their anger was directed at a set of researchers who were working in the village at night, either collecting mosquitoes or blood samples. Maybe the researchers were mumiani (bloodsuckers) and murderers, maybe not. In any case, they had made the bad decision to drive home that night rather than sleeping in the village. Their car was forced to a stop on a blocked road. Villagers appeared and began hurling stones. The car was damaged; the researchers sat inside, afraid. Flames appeared: the car was on fire. The researchers fled, and it was only due to the appearance of the police that no one was killed.
The story of Gonja was the first account I heard when I asked people about the history of medical research in East Africa. Researchers remembered some version of the story, local people in the region knew about it, and, depending on the teller, the story was used to emphasize any number of points. When told by current medical researchers, it was a morality tale of what happened when well-intentioned scientists encountered uneducated villagers. Among a certain group of researchers, the only lesson to be learned from Gonja was that African rural residents were uneducated, unpredictable, and had yet to learn the benefits of biomedicine and scientific investigations. In some of the narratives, the teller continued into the present, explaining how the bad behavior of the Gonja residents resulted in the building of one of the largest police stations in the district. It also meant that there was almost no research done in Gonja for decades, and it wasn’t until 1993 that a research team was sent in to “check people’s feelings.” Only at that point—twenty, thirty, or forty years after the initial conflict—had villagers finally learned their lesson and begged for the researchers to return, to help reduce malaria and bring drugs, like in years past.
Although I was happy that people shared their recollections of Gonja with me, I was perplexed by how many competing versions of the story I heard in just a matter of days. It was a story that continued to be told, but it seemed none of the tellers were preoccupied with fine details. The dates changed, the people involved changed, and the rationale and moral changed. I didn’t know what to make of Gonja, but I kept asking about it, kept thinking about it, and kept squirreling away references. I knew Gonja was important, but I wasn’t sure why. So I set the story aside, continued with my work, and hoped that by the end of my research I’d have untangled Gonja’s significance.
Surveying the Pathological Museum
Lieutenant Colonel William Laurie, the Director of the East African Medical Survey, exclaimed in 1952, “The African is a walking pathological museum.”1 Laurie was not the only one to consider the African as such, or to be excited by the myriad tropical diseases found in East Africa. The medical missionary Stanley George Browne used the same phrase when describing his work in the Belgian Congo in the 1940s, remarking, “[The native] is a walking pathological museum.”2 During a survey project in Kenya in 1937, the researcher in charge declared that each of the Africans was an “ambulant pathological museum.”3 In 1944, a colonial worker in West Africa stated, “There is no doubt that the African native is often a pathological museum.”4 It’s unclear how common a refrain it was, but it would appear to be a phrase that circulated among medical researchers—a common remark expressing amazement at the collection of germs, pathogens, viruses, parasites, and other abnormal and unusual diseases likely to be found in a single African body.
The phrase captures much of what was wrong with the East African Medical Survey and belies an expectation of how researchers expected to interact with Africans. It was not unusual or unexpected that medical workers would look at sick Africans as objects. The phrase oriented researchers to focus on pathologies rather than bodies, and on sick body parts rather than sick patients. Research practices and the material culture of medical activities in the 1950s reinforced this tendency to think in terms of objects rather than people: medical tubes and vials suck and store bodily fluids, scissors snip samples of skin, needles drain blood, tightly lidded jars contain stool samples. These pieces of bodies, floating in formaldehyde, stored in glass, packed in ice, were transformed