The Fever: How Malaria Has Ruled Humankind for 500,000 Years (29 page)

Local health officers knew as well as the residents that the impounded water played a role in the malaria outbreak. “The more I see of malaria conditions,” a U.S. public health service officer wrote to his boss in 1913, “the more I think that ‘p-o-n-d’ spells ‘malaria.’”
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“The fever come when the water was backed up over the trees,” remembered Bass. “They began rotting and that put the fever in the air.”
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Similar transformations had wreaked misery upon the New England residents near milldams in the late eighteenth century. And entomologists had by then recorded precisely how subtle changes in larval habitats could transform malaria transmission by attracting more effective malaria vectors.

County health officials pleaded for funding to enact Gorgas’s antimalarial methods. Malaria “exacts the heaviest tribute from the energies of our people,” wrote one health officer in a 1914 report. “Will not the same kind of antimalarial work as was done on the Canal Zone bear the same kind of fruit if done around every household and every farm in Alabama?”
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But the power company denied any connection between its dam and the malaria. After all, it could see that many of the residents lived on properties rife with mosquito hatcheries, from muddy hog and cow pens to old wells, and couldn’t figure out how a few more, along the edges of the new lake, could hurt. Plus, the residents’ antipathy toward the company, which they didn’t think would provide much electricity to them in the end anyway, was well known. Even before the dam closed, the “dam business” had been something of a “cuss word” for area residents, the local paper noted.
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Company officials dismissed their complaints as the work of “rip-off artists looking for another way to make money without having to work,” as the historian Harvey H. Jackson says.
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Enraged, the Coosa’s fevered residents filed more than seven hundred lawsuits against Alabama Power, seeking over $3 million in damages. One resident sued the company for “the biggest figure of money he could think of.” Area merchants banked on their impending victory, extending credit to customers who’d filed suits.
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Landrift Hand’s case against the power company was one of the first to be heard. A rough-and-tumble sixty-five-year-old farmer, Hand lived on the river a few miles east of Shelby, Alabama. His land had always been boggy and mosquito-infested,
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but every thing had changed for Hand when the dam closed. Water flooded his land, its still edges lined with green scum, and a different, more malevolent type of mosquito infested his home. By the time the court heard his case, Hand had been suffering from malaria for weeks. Ears ringing
from quinine, he’d been hit by a train he hadn’t heard coming, mangling his right arm.
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Gorgas himself took the stand as an expert witness against Hand, on behalf of the company. He testified that Hand’s malaria couldn’t possibly have come from mosquitoes roosting in the dammed lake. Hand’s domicile, some fifteen hundred yards away from the lake’s edge, was too far away, Gorgas said, and the mosquitoes wouldn’t have been able to fly that far. Rather, they must have emerged from the small dirty pools and puddles that littered Hand’s property, just as the company maintained.

In fact, the lake’s edge was the only viable larval site for the malaria-carrying mosquitoes that most likely bit Hand.
Anopheles quadrimaculatus
specialize in clear water with marginal vegetation, not dirty puddles. Entomologists had established as much years earlier, in a 1903 entomology book with which Gorgas was likely familiar. (The Harvard malariologist Andrew Spielman had a copy of the text on his bookshelf, signed by Gorgas’s colleague LePrince.)
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But in his testimony, Gorgas didn’t distinguish
Anopheles
by species, which he said he considered as relevant as “the various subdivisions of the dog family.”
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Nor was it true, as Gorgas testified, that
Anopheles
mosquitoes never flew more than two hundred yards from their birthplace. Military officers of the time had reported finding
Anopheles
two miles away from the bodies of water from which it hatched. Today, most mosquito biologists consider no less than five miles a safe distance.
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Nevertheless, Gorgas’s testimony carried the day. After all, he was a national hero, an esteemed Alabaman, and the surgeon general of the U.S. Army. The Supreme Court of Alabama ruled that the Coosa’s frightened locals suffered from “imaginary fears” of “imaginary dangers,” and were not “qualified to form or have an opinion” on the condition of their flooded lands. The court threw out Hand’s case after just a half hour of deliberation, and dismissed the 699 others.
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In 1916 and 1917, Alabama experienced “the greatest outbreak of malaria the state has ever seen,” according to the state’s health officer, S. W. Welch. “Not a family within three miles of the impounded
water on both sides escaped malaria.”
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The state board of health felt helpless. “The stage is set in Alabama for epidemics of every known disease,” Welch wrote in his annual report, “and your Board is helpless to prevent the impending catastrophe because it has no money.”
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There wasn’t much they could do. Alabama Power had been authorized to build its dams by an act of Congress, and its activities were sanctioned by the most famous doctor in the world.
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The selective antimalarial approach of nineteenth-century Britain and the early twentieth-century United States could have vanquished malaria. Aggressively stanching the disease for a select population in a circumscribed area allows the malaria-free to achieve important political or economic goals. Through this limited strategy, wars are won and engineering feats are accomplished, which brings greater security and prosperity, which in turn allows for more malaria control, and more prosperity, and so on. Some modern malariologists, such as Harvard’s Spielman, think so. It’s the trickle-down theory of malaria control.

We’ll never know. For in both the United States and Britain, malaria receded on its own, thanks to demographic and agricultural changes that disrupted malarial ecologies.

In the United States, the first rumblings occurred in the 1830s, when Americans discovered the rich seams of coal underlying their vast continent. The industrial development that coal unleashed paved over acres of mosquito habitat. Hundreds of thousands of miles of railroad track laid across the country for new coal-fired steam engines allowed people to move themselves, their homes, and their goods away from the
Anopheles
-dense riversides and toward the rails. Coal-fired factories sited conveniently close to workers and markets rapidly eclipsed the quaint riverside facilities, and the
Anopheles
-laden mill-ponds that powered them.
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In the Mississippi Valley, farmers agitated for drainage schemes to rid the Midwest of its sixty million acres of wetlands, those squishy
barriers to agricultural expansion that slowed horse travel around Chicago to as little as twelve miles a day. The wetlands were “solely tenanted by every worthless specimen of amphibious, vegetable, and animal creation,” an 1847 farm journal article complained. Eradicating them by drainage was “all that is necessary to secure millions of acres” for wholesome, productive agriculture.
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First by burying U-shaped tiles underground and later with industrial-strength machines, farmers shipped the pesky water off their lands into ditches and then into rivers and streams. Soon the valley’s wetlands “began to look just like the other farmland,” writes the environmental historian Ann Vileisis. “In a matter of generations, farmers would even forget where the tiles were laid unless they kept their grandfather’s drainage plans in a desk drawer.” As the spongy land dried out, downstream flooding worsened, and waterfowl and shorebird populations plummeted.
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Mosquito habitats steadily vanished. The dairy cows that dotted the region’s farms diverted the few mosquitoes that remained, and malaria parasites died out in the ruminants’ inhospitable bodies.

By the end of the 1930s, malaria was a thing of the past in the Upper Mississippi Valley.
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Economic uplift measures in the South sent malaria packing there, too.
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In 1933, President Roosevelt signed the Agricultural Adjustment Act, which helped Southern farmers mechanize their farms. A stream of black sharecroppers, made redundant by the farm machines, abandoned their swampy cabins for the city. Malarial mosquitoes’ access to their bodies declined accordingly.
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Roosevelt also created the Tennessee Valley Authority, which built nine dams across the Tennessee River. By then, federal officials had established antimalarial regulations for the hydropower industry, requiring the clearing of potential reservoirs, the modulation of the level of impounded waters to alternately strand and wash away mosquito larvae, and the diagnosis and treatment of malaria-infected workers. (The industry’s vulnerability to the animus of the “species
Homo
,” who are “willing to go to any length to harass and extract money,” as one public health official noted, had inspired the regulations.)
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The TVA’s cheap, plentiful electricity enriched the region, allowing for better roads and housing, which further reduced the mosquito’s habitat and protected humans from its bite.
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By the time Rockefeller Foundation malariologists started staging popular anti-mosquito projects, and the United States created the Malaria Control in War Areas program in 1942 (which would later become the Centers for Disease Control), the weaknesses of their antimalarial methods didn’t matter anymore. Malaria had already nearly vanished.
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Agricultural, economic, and demographic shifts broke malaria in Britain, too.

There, the first seismic shock occurred in the early eighteenth century, when a former politician named Charles Townshend started proselytizing to English farmers about a new agricultural method, borrowed from Holland, of planting four crops—wheat, barley, clover, and turnips—in constant rotation. For centuries, England’s agricultural production had remained stubbornly stagnant. At any given moment, about one fifth of the country’s arable land lay fallow, slowly recharging for another round of planting.
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Medieval British farmers ritually slaughtered all their livestock on November 11, during the festival of Martinmas, before the cold set in, for they didn’t produce enough to feed the animals over the winter. With four-crop rotation, no land had to stay fallow, and there’d be enough turnips to nourish livestock during the cold season.
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In 1670, fewer than 5 percent of farms in Norfolk and Suffolk grew turnips; by 1710, more than half did. Townshend’s idea took off in malarious Essex, thanks to “the pursuit having become fashionable,” one commentator drily noted.
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Liberated from the annual cull, livestock populations grew. Between 1640 and 1730 in the Thames Valley and the uplands of Oxfordshire, flocks of sheep more than doubled in size, and the proportion of cattle herds over five animals strong grew from around a third to nearly half.
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As with the dairy cows in the American Midwest, the greater availability of cow and hog flesh attracted the interest of malarial mosquitoes. When faced with the exposed arm of a human or the flank of a calf, England’s
Anopheles maculipennis
bit the calf four out of five times. Hovering between home and stable in search of a meal, she flew toward the stable ninety-nine out of one hundred times. That bit of anopheline caprice cost
Plasmodium
dearly.
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As cows and sheep sprouted across the English countryside, malaria transmission ground to a halt. (Years later, when malariologists realized what had happened, some took to calling for “a pig under every bed” as an effective substitute for a mosquito net.
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)

Between 1700 and 1850, England’s population boomed from fewer than six million to more than sixteen million,
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despite regular outbreaks of typhus, typhoid, and diptheria, waves of cholera, and widespread tuberculosis, all untreatable by the medicine of the day.
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England logged its last case of indigenous malaria in the final years of the nineteenth century.
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These stories do not appear on colorful posters about malaria, such as those that hung inside Parliament House in 2006. It’s important to project an aura of agency, of the potency of collective will against indignations like killer mosquitoes in a modern world. It helps raise money, and it makes us feel better, too, about the mastery of our tools, the depth of our commitment, the power of our technology.

The truth is, the world’s most powerful nations knowingly sacrificed whole generations to malaria’s appetites. The pathogen ran away well before anyone thought to chase it.

For most of humankind’s history with malaria, political indifference, scientific controversy, and tightfistedness have reigned. The post–World War II development of a potent new compound called dichlorodiphenyltrichloroethane—or simply DDT—changed all that.

DDT unloosed the leash that had held us back, turning on its head every calculation about malaria and our ability to challenge it. A smoldering new collective resolve emerged. Political and scientific leaders from around the globe decided, en masse, to abandon its partial solutions: to stop trying to diminish malaria’s burden, give up attempting to slow its progress or soften the suffering of its victims. Like some long-tormented creature exploding into a violent howl, they declared a fight to the finish. They’d use DDT to wipe
Plasmodium
off the face of the earth.