The World War On Malaria
pp. 44-47 · Read in the full issue
How John D. Rockefeller, Recently Dead, Gave New Health and Life To Pacific Islands Races
John D. Rockefeller, Multi
** millionaire, died a few months ago, when almost 100 years old. The masses did not grieve. Rockefeller made his mil lions by becoming a successful mono polist, and monopolists are public enemies.
But Rockefeller also established the Rockefeller Foundation, and the enor mous good he did thereby for humanity far outweighs any harm he did by his ruthless control of world commodity markets. There is not a community in the Pacific Islands which has not cause to thank Rockefeller for better health.
Whenever we hear that the Polynesian people are increasing in numbers, we may be sure that the Foundation has had something to do with it.
The story of the Foundation was told, a few months ago, before Rockefeller died, by Dr. Victor Reiser, in one of the finest books of the year, An American Doctor's Odyssey. Dr. Heiser spent the later part of his life in the service of the Rockefeller Foundation, Dr. Heiser says that Rockefeller asked a group of scientists if they could name a disease which affected large masses of people, and which could be removed if attacked on a large scale by an organi
sation with plenty of money. They named hookworm. Rockefeller gave them one million dollars, and the work commenced.
Since then, hundreds of thousands —probably millions —of people, have been freed from this scourge.
The initial success of the hookworm campaign pleased Rockefeller; and he then established the Rockefeller Foun dation, and endowed it with 100,000,000 dollars. The work of the Foundation has been extended all over the world. Where ever there are large numbers of people who can be made healthier and happier by organised hygiene and large-scale treatment —especially by injection—there will be found the officers of the Foun dation, quietly and steadily at work.
They have attacked hookworm, yellow fever, malaria, etc. Their successful cam paigns against hookworm and yaws, in the Pacific territories, are well known.
The substantial annual payment made by the Rockefeller Foundation to the Suva Medical School makes it possible for that splendid institution to turn out, year after year, fine types of young native medical practitioners—Fijians, Tongans, Samoans, Cook Islanders, Solomon Is landers, Gilbertese, etc. —who have been specially trained for work among their own peoples.
DR. HEISER, in his fascinating book describes one of the greatest curses of humanity, malaria. The following is taken directly from his text: Of ail tropical diseases, malaria is the most persistent, the most destructive, the most widespread, and the most difficult to control. Plague is terrible, but rats can be eliminated. Cholera and smallpox have no excuse for being. Dysentery and typhoid could be wiped out. Though leprosy creates horror it seldom inter feres with the march of progress.
But entire races touched by the shak ing finger of malaria have undergone pro gressive decadence. The “glory that was Greece” faded out before its onslaughts and will not shine again until the minute pools in her rocky river beds cease to be a threat. The “grandeur that was Rome” paled centuries ago, assailed by recurrent waves of malaria. In the New World, half the inhabitants of Jamestown, encircled by the miasmic Virginia marshes, died within six months of their arrival. The disease was once bad enough in Washing ton to interfere with the sittings of Con gress.
From earliest times the connection of marshland and malaria had made itself apparent. Miasmas arising, particularly at night, from these moist regions were blamed for the disease, and malaria, “bad air,” was first so called by an Italian in 1753, and introduced into England in 1827 as a specific name for the malady known variously as marsh miasma, ague, jungle fever, or intermittent fever.
Malaria is often deadly in its action.
In the cerebral form, parasites become so thick in the blood that they clog the capillaries of the brain and cause almost immediate death, and the same may be true if they lodge in the kidneys. But a far larger number of cases are chronic; the parasites gradually destroy so many red blood corpuscles that extreme anemia results. The patient’s liver does not func tion properly, he has frightful headaches, cannot eat, and takes no interest in any thing.
Long before the disease was given its present name, its remedy was known in South America. In 1600, Spanish mission aries used the bark quincu quina in Peru.
It became known as Jesuit’s Powder, because the Jesuit order had a monopoly of quinine sales. The priests received its weight in gold from those who could afford to pay; to the poor it was free.
The supply was never equal to the de mand, and in the efforts to adjust the balance, the trees of South America were stripped of their bark and largely des troyed.
The failure of the South American gov ernments to protect the source of supply from destruction brought efforts to culti vate cinchona, so named by the Swedish naturalist, Linnaeus, in 1742, elsewhere.
In 1852 seeds and plants were introduced into the Botanical Garden in Java, where the Dutch tended them carefully. Per fecting a technique of cultivation, the Dutch found they had a monopoly of the quinine supply. And the price was kept so high that thousands died because they could not afford to buy.
To break the Dutch monopoly seemed hopeless, but, because the price of quinine was a matter of world-wide importance, at my suggestion the Health Section of the League of Nations began a campaign of “pitiless publicity.” Its effectiveness lay in its simplicity. The figures of quinine production appeared at stated intervals in League bulletins. “Over 900 tons out of a 1000 were produced in the Dutch East Indies. The price in 1890 was such and such; now in 1917 it has risen to such and such.” The great difference between the early low cost and the later high one told its own story.
On each of my European trips I visited Geneva, and each time I talked cheaper quinine. The campaign continued
with vigour. Nothing was said d'roctly; no attack was made. But the Dutch found the shoe fitted and began to be sensitive.
In time the opprobrium became so great that the cost of quinine was voluntarily reduced.
Quinine is not a prophylactic for mal aria. The drug has not yet been found which will kill all forms and stages of the parasite promptly. But as long as quinine is taken there will be no attack. iS to the actual source of the disease, it was not until the end of the 19th century that the anopheles mosquito was found to be the carrier.
An anopheline is usually distinguish able because of the little black dots on her wings, and because she looks as
though she were standing on her head when biting. A tremendous number of enemies are ready to destroy her; she
cannot even stand wind or bright sun shine. Her life history occupies only about one month, but as long as she lives, she has a meal every two to three nights.
Malaria can only be contracted if she has previously fed on someone who had mal aria parasites in his blood. The swelling from her bite is not large, nor the itch particularly annoying sometimes a persons does not even know he has been bitten—yet one bite is enough to cause malaria.
Malaria flourishes in a broad zone on both sides of the Equator, but the largest centres are in Asia. In India it is the arch-destroyer; half the 350,000,000 popu lation are estimated to suffer from it, and one million die annually. Turkey, Syria, Palestine, Malaya, Siam, Indo-China, Java, Sumatra, the Philippines, and China are all intensely malarial.
In every survey, the first task was to study the habits of the local mosquitoes.
The culprits had to be run down, and then enough facts detected about them so that the proper offense measures might be taken.
For instance, in the Philippines, where there were approximately two million cases of malaria a year, all our attempts at control were unsuccessful. When I returned to the Islands in 1921, Governor General Wood had secured a million dol lars to spend on malaria. And he sug gested that we drain the swamps, as had been done successfully in Panama. I pointed out that we were running into many contradictions in the study of mal aria, that possibly swamps might not be responsible for malaria in the Philip pines.
“They have been everywhere else. Why not here?”
“Nobody’s proved it, and it’s not a scientific way of finding out.”
“Well, that’s the way I want it done!” was General Wood’s categorical response.
“In that case, General, I’d better stop,”
I said. “It won’t be difficult for you to find someone to work on the problem as you may direct, and your method may be right.”
The subject was dropped; but next day the General was apologetic. “What do I know about malaria? Forget every thing I said.”
I then suggested asking the Inter national Health Board to make a survey.
Wood agreed, and all sorts of experiments began. Among others, beds were arranged in trees so that the biting habits at dif ferent elevations might be studied. The beds were baited with men and the sides of the mosquito bars left open. At about eleven, the first mosquito arrived, but the bars were not closed until many had entered. At two o’clock, after having fed, the insects were becoming distinctly un easy, at three they were agitatedly seek ing an exit, at four they were practically committing mass suicide, jamming their heads between the interstices of the net tings, and even breaking off their wings.
They were obvious', y motivated by some tremendous homing instinct.
After having been sprayed with car mine, the prisoners were released and immediately a hunt was organised. Stones were overturned, blades of grass and leaves scrutinized, tree trunks examined.
The search continued for two years and cost thousands of dollars but ultimately the hiding place of the mosquitoes was ferreted out. In the Philippines the streams were always lined with bamboo, and where the current undercut the banks, the bamboo roctlets formed a tangled mass into which the elusive mos quitoes would retreat in the daytime.
It was thus proved that malaria in the Islands was associated not with marshes but with the swift-running waters of the foothills. Had Wood’s million been spent in draining swamps, it would have been completely wasted.
This discovery gave us a fresh start in malaria control. Rice chaff was scat tered on the streams, and as it floated along, an observer noted where it stopped in the little eddies. In those places larvae or wrigglers were often found in abun dance.
Paris green, mixed with 99 parts of fine dry road dust, was then released in clouds above the stream. The mixture is extremely effective in killing the larvae, and has the additional advantage that water treated with it can be used for bathing, washing clothes, or even be drunk with impunity, whereas pouring oil on water renders it unfit for use. A
recent development is a machine run by a paddle wheel in the stream, which scat ters the Paris green automatically.
In almost every problem of malaria, the basic approach is to survey local conditions and then apply the remedy.
It may be as simple as having carabao walk through a stream to disturb the larvae, or compelling natives to turn their discarded coconut shells upside down, or it may consist of the most elaborate and expensive engineering operations. Even drainage operations, when not correctly planned, have some times done great damage by creating breeding places where none existed before.
The Rockefeller Foundation now has engineers who travel from country to country with the sole object of advising on malaria problems. Until some method can be devised which is capable of gen eral application, there is little hope of bringing the disease under complete con trol. The most that can be said to-day is that if enough money is spent, a malarial district can be made healthy; but it is a long and persistent task, and only un remitting care meets with success.