by Geoffrey Clarfield (September 2010)
When primary rain forest covered Africa, the mosquito had no need to adapt to urban environments, and thus city dwellers were more protected from the disease. However in the post colonial era, as hardwood logging and population growth have attained critical mass, with bush replacing forest and concrete replacing bush, the malaria-bearing mosquito did not die off, but evolved. It can now thrive anywhere, especially since the forest's destruction led to soil erosion and subsequent flooding, which further encouraged the mosquito's proliferation.
---Robert D. Kaplan
The Ends of the Earth-A Journey at the Dawn of the 21st Century
I lay in my clean, but spartan hospital bed, a legacy of British imperialism, where I suppose comfort in a hospital would have then been considered a luxury by the crisply attired and no nonsense nurses of yesteryear. However, this was the beginning of a new century and the fact that this was still the only fully functional modern hospital in the entire East African region explained a certain accidental, cultural continuity.
Here there were no more British doctors and no more British nurses. They had been replaced by the newly trained elites of this modernizing region, and who together with a smattering of adventurous European, North American plus African and Kenyan doctors of Asian descent, catered to the foreign community of Nairobi and to those Africans who had the money to pay for modern, up-to-date, medical services.
Our second son had been born in this same hospital in the late nineteen eighties, early one morning, and since they were short of staff that day I was the nurse who assisted at the birth. Twice I have done this and after each time, despite the compliments that I have received from both friends and family, the experience left me uneasy. I am coming around to the point of view of the nomadic tribesmen of Kenya's northern desert frontier, whose traditions tell them that childbirth is mysterious and dangerous, and should be left to women. I would have rather, nervously paced the hospital corridors with a close friend or two, and when they announced the birth of our son, I would have passed out cigars to all and sundry.
Every time I had to go to that hospital I was asked to fill out a form. For the birth of our son it included the usual details; name, age, residence, mailing address, means of payment and then something that always reminded me that I lived on a continent far from the land of my birth. The form asked for my tribal designation.
I was reminded of an anecdote that a French colleague once told me. During W.W.II one of the generals fighting with De Gaulle and the Free French forces in Algeria was taken ill and evacuated to a hospital run by Catholic nuns. When asked what his religious affiliation was he answered, "Fetishiste, non practicant" (animist, non-practicing). However, this time I was too weak to lift a pen, since I was the patient being admitted.
I think I know where I got it. I could have been bitten anywhere, because malarial mosquitoes are mutating and spreading across Africa faster than the AIDS virus. I had been out visiting a group of Turkana nomads. The Turkana are a Nilotic speaking tribe of traditional camel and cattle pastoralists, who stormed out of their homeland in Western Uganda one hundred years before the British arrived in East Africa. Since then they have adopted the habit of violently displacing, other, similar tribes who used to inhabit what is now called Turkanaland.
Turkana are warriors and nomads. The men are tall and thin, with colored mud packs on their heads where they place colored feathers. These feathers signify the generation set of the wearer. Those who are called mountains, and who were born within a similar period, wear feathers of one color. Those who are called leopards, and who are classified as belonging to the next generation, wear a feather of a contrasting color. Thus all Turkana males are classified as either fathers or sons. Each group knows what kind of respect, decorum and most important, what kind of military cooperation is owed to the tribe in different circumstances.
The Turkana carry spears and clubs (and most have M-16s hidden away near their straw huts). They are a new force to be dealt with in the region, for as many African states whither, tribes like the Turkana, living in a non historical and cyclical, mythopoeic world of oral tradition and tribal mythology, are now almost politically autonomous in their respective tribal territories. They often take the offensive against the frightened and demoralized soldiers of the so called "national" armies.
The Turkana always reminded me of one of those imaginary communities described by the novelist Edgar Rice Burroughs (not surprisingly, the creator of Tarzan) who populated Mars and Venus with exotic ethnic groups who fought against each other with archaic weapons across the dusty plains of those red and white planets. Turkanaland has a red hue to its desert soil. Apart from the few towns on the main road there is no sign of civilization as we know it and one could imagine that this is how Mars will look, if ever terraformed and given an atmosphere. It will not resemble the Garden of Eden.
During my years living among the Turkana, NASA sent satellite photographs of the Martian landscape to the National Museums of Kenya where I worked. The pictures were startlingly beautiful-stark, desert like, landscapes of different hues with enormous undulating plains that showed no signs of vegetation. When I showed some of these pictures that had been reproduced in a glossy American popular scientific magazine to a Turkana elder, he looked at them, shrugged and said, "Turkanaland before the rains."
I had been in a remote area of Turkanaland for a few days spending evenings in the homesteads of a family that I had befriended. I had just documented an initiation ceremony, whose ritual stages have the initiate act out a symbolic rebirth, where he is stripped naked, covered in mud, cleansed and then dressed as an elder, symbolizing his transformation from youth to a member of a fighting age set.
I was driving back to the regional capital, a dust covered town called Lodwar in the Turkana language, when I began to feel unwell. Feeling unwell in Turkanaland is not an unusual state. During most of the year the average afternoon temperature is over one hundred degrees Fahrenheit, hot winds blow regularly, there are more bugs than God managed to put in Noah's ark, most of them bite and, even if you drink your minimum three liters a day you can sill feel thirsty when you go to bed. Only when you drive south, four hours across the plain into the cool highlands of the enemies of the Turkana, an equally fierce group of Kalashnikov carriers called the Pokot, do you realize that you have been living in a sauna for the last month. So being in a continuous sweat in Turkana was nothing unusual.
An eccentric Scottish doctor friend of mine, who had worked in Lodwar for years, confidentially told me that, on the average, certain Turkana bones were thicker than the norm (could it be possible that a few centuries of natural selection, of kill or be killed, had caused this ?) I was reminded of the comment by a British colonial administrator in the nineteen twenties, and who had participated in the violent and heavily resisted pacification of Turkanaland during the pre-independence period.
He marveled that there were almost no old men to be found in the district in those days. One could conclude that constant intertribal warfare literally favored the survival of the fittest in this clearly defined ecological niche and the old hadn't survived very well during that time before colonial rule. The proof of this statement is quite simple. In nineteen twenty five there were about twenty five thousand Turkana with few if any elders to be found. By 1985 there were more than a quarter of a million Turkana tribespeople in the district and significant numbers of elders could be found in every homestead.
I thought I had a cold. I was a bit sweaty. I had a stuffy nose and I felt weak. I drank lots of tea and took it easy for a couple of days but my symptoms did not disappear. I had no one around to discuss my physical state. The local hospital looked like the last scene of the film, Lawrence of Arabia, where Lawrence to his shame, discovers that the Turkish prisoners captured by his Bedouin irregulars and incarcerated in a neglected Damascus hospital, were without water and were dying like flies.
I finally resolved to drive to the town of El Doret, five hours to the south in the highlands and ask an English friend to take me to the local Asian doctor who ran a clean, Nairobi style clinic. I thought I had a bad case of the flu and considered that I might have needed a round of antibiotics.
The drive south from Lodwar is dreamlike. The Turkana plains extend for as far as the eye can see. To the West are steep, gray green hills, the Loima, on the border with Uganda, evoking the time when the Turkana came down from these hills to occupy the plains, armed only with clubs, spears and rhinoceros hide shields. Why they had succeeded where other tribes had failed, why they had conquered and displaced the previous nomadic inhabitants who in those days were no more or less numerous than they were, and who were no more or less technologically advanced (one step behind the iron age of the ancient Near East) is a mystery that anthropologists do not like to consider.
It raises arguments about the selective advantage of cultural differences and brings up Hegelian notions like "national spirit" or "will to power", topics that are taboo amongst the "celebrators" of cultural diversity in the halls of academic anthropology.
In Turkanaland, unlike the deserts of the Middle East, there are no ancient ruins. There are no stately palaces like those at Persepolis near Iran's salt deserts, no Hellenistic or Roman ghost towns that are found across the North African littoral. There, ten years earlier, I lived in the tents of the Bedouin who, serving small cups of bitter coffee to guests in their woven woolen tents would speak of the Crusaders and the Romans (the Byzantines) as if they had departed just a few years ago.
If North Africa still looks much like it did during the reign of Justinian, the Turkana and their landscape have not changed significantly for four thousand years. Before that, people very similar to the Turkana in size, shape, stature and material culture inhabited a moister, East Africa that was ecologically part of an enormous east/west swathe of well watered savanna woodland, stretching across the verdant plains of what later became the Sahara. Rock art depicting the daily life of what archaeologists call these "pastoral neolithics" can be found as far away as Algeria's Tassili caves, where the cultural ancestors of people, in many ways similar to the Turkana, have left us a visual record of their daily life in their rock art.
As I lay on my hospital cot, watching the quinine enter my arm through the simple looking intravenous apparatus that was standing beside me, I remembered driving south from Lodwar and how, despite the intense heat and my jeep's lack of an air conditioning system I had begun to feel cold.
I had arrived in the highlands and made it to my friend Peter's house. Peter is one of the happier and hospitable people on the face of the earth and was always glad to see me. He was the exception that proved the rule of the distant, reserved Englishman. His door was always open to weary travelers. We spent a pleasant evening catching up on each other's news. I went to bed early. But all night I felt colder and colder and I kept on piling blanket upon blanket, upon my bed in the guest room.
In the morning after breakfast, it dawned on me that I felt like I was slipping down an embankment. I was losing control over my physical movements and my thoughts were becoming disengaged from one another. I told Peter that I thought I may have malaria and I asked him to drive me home to Nairobi since he was going in the same direction that day. I suddenly realized that I couldn't have kept my hands on the wheel of my jeep for more than a few seconds without collapsing.
By the time we reached Lake Naivasha, just north of Nairobi, I lay on my side in the back seat of the car burning up with fever and barely able to stand. When we finally reached Nairobi my wife took one look at me and rushed me to the hospital. Within an hour I was lying on my hospital cot, taking in as much quinine as I could, intravenously.
Unlike morphine there is no worry that you will ever get addicted to quinine. Intravenous quinine has too many unpleasant side affects. The most serious is a continuous buzzing in the ear, as if you had picked up a blurred, short wave signal that you can't shake. It also causes a fair amount of hallucinations, none of which I can clearly recall. Nausea was the other main symptom, but had more to do with the malaria itself.
Perhaps I was in a state of what psychoanalysts would call "infantile regression." I remember praying to God, or some higher power, to carry me through my time of trouble and travail. It was definitely the God of the Bible who I called upon in my need, tempered with a bit of the God of the Philosophers that I had picked up in my University days.
When I look back at the experience I conclude that I had been mildly, but effectively imprinted with the simple religious faith of my grandparents. Yet, I do believe that there was some sort of real struggle going on inside of me for the possession of my soul.
I cannot claim to have the arrogance of a follower of Ayn Rand, or of a student of Nietzche, in order to say that I alone, willed myself back to health. I would have liked that to be the case. It would be consistent with my daily prejudices when I am awake, well fed, not in pain and healthy. The mood that I was in was much closer in feeling and spirit to a Fellini film, or to that memorable scene in the Bergman film, The Seventh Seal, when Max Von Sydow plays chess with the Devil for the sake of his soul.
There was a battle going on. It was simple and elemental. It was the battle between life and death. I very much wanted to live and looked forward to the future and whatever it may bring. And, I suppose that on the hospital cot I made my covenant with God, or some equivalent higher power, then and there, that I wanted to live and that I would put my heart and soul into getting better.
Seven days and seven nights later I was taken off my intravenous and allowed to go home while continuing to take oral medicines to reduce any secondary infection and any possible residual malaria. A killer bug had bitten me, the one that causes cerebral malaria, the most violent strain.
Some said that I had been lucky to survive. I agree. But it was not just luck; it was something else as well. A month later, back in Turkanaland I ran into an Irish nun who was ministering to those Turkana who had converted to the Catholic faith. Over a cup of tea I remarked to her that if I hadn't believed in a higher power before I was sick, I certainly did now.
While I was recuperating in my hospital ward my wife would come in and out of my room to visit me. I wasn't much for conversation but it was a nice break to see her. She couldn't have known at the time that I felt like a wrestler, wrestling with Thanatos, and that her visits were like the ring side visits of a friend or trainer, during those minutes before the bell goes off and you are thrown into another round with your opponent.
Later, she told me that she had also been visiting a woman across the hall, actually two women, a mother and her daughter. The patient was a young English girl who had gone to school with our eldest son. As I sat struggling to regain my consciousness, the girl had lain on a bed across the hall from me in a coma, after having hit her head falling from a horse in a freak riding accident.
The mother was a woman just a few years younger than I was. Her daughter was her only child. She had divorced and remarried an English business man who worked for a Canadian company in Nairobi. Our son knew the girl from school and we had met the parents at a number of school functions.
My wife spent a fair amount of time visiting her at her daughter's bedside in a vigil that had a tragic outcome. Within a few days of my release the mother, father and doctors realized that the girl would never recover and they let nature take its course. During the mother's ordeal she kept on repeating that if her daughter died, she could not go on living. Within a few days of her daughter's passing she entered her garage, put a rubber pipe to the exhaust of her car, ran it through the window, closed the window and within a short while passed away without a struggle.
We were saddened by the news when we found out through an announcement at school that the young girl had passed away and that her mother had taken her own life in grief. My wife felt that she had not done enough to prevent her suicide. She felt that had she been more assertive with the hospital staff and with school acquaintances she may have been able to prevent a suicide and found the woman some psychiatric assistance. She said that had she acted more in harmony with her Mediterranean instincts she may have been able to break through the atmosphere of "stiff upper lip" that still pervaded the hospital and get the woman the help that she needed to live. But at the time, her overwhelming fear was that I would slip away and leave her a widow with two children to raise. She could not have been more effective.
The angel of death had been stalking the corridors of Nairobi Hospital while I and the young girl lay in our beds across the hall from one another. He had come to my bedside and I had wrestled with him for seven days and seven nights. I had felt very much alone, at best, like Jacob beside the ladder to heaven. A depth psychologist might point out that the myth of Jacob was my rock and strength during my illness and provided me with a vehicle for my recovery. As I began to feel better it was as if the angel of death had never really been close by, and that my suffering was part of my malarial dreams and quinine induced hallucinations.
The death of my son's schoolmate and the suicide of her mother took the joy out of my recovery. My satisfaction at having survived was sobered by a realization that the angel of death, had been near. He had been biding his time in the hospital hallway. He had taken a mother and daughter in one go, leaving me behind as a witness to his awesome power.
Geoffrey Clarfield is an Anthropologist at large.
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