Product Description

Customer Reviews (13)

Loved it!
This was a great read... So insightful.It's the perfect book for people who love non-fiction, but may feel a bit overwhelmed by a book like Guns Germs and Steel. That is not to say that Diamond and those types doesn't have a place.However, someone who would never take a text book on vacation for personal reading, but still likes an informative educational book that is well written and light enough to keep your attention throughout may find 'The Fever' to be a good fit. It is definitely deep enough to educate and make you feel like you've learned and stretched your knowledge base.Even more so if you are a fan of medical history, or even just history in general.

Some interesting tidbits, but terribly written and poor grasp of the science
I was excited when I saw the title of this book (one of my biggest problems with Guns, Germs, and Steel was how little focus Jared Diamond gave to the effects of malaria on societal development), but the more I read this book the more frustrated I become. Almost every page has at least one minor error, and many pages contain blatant errors regarding the fundamental biology that any competent editor should have discovered. My favorite howler: "Then again, 10 percent of the parasite's five thousand proteins retain their algaelike chemistry and remnant chloroplasts." A chloroplast is an organelle (large, complicated structure) in plant cells; to say that a protein contains "remnant chloroplasts" is utterly nonsensical.

The greatest misunderstanding comes from her "story of the evolution of malaria" in which P. falciparum (the most deadly of the 4 major plasmodium species) is presented as the latest evolutionary trick in a long line of a heavily-personified malaria species. If we take Ms. Shah's account, P. vivax emerged first, was defeated by the Duffy antigen in the African population and thereby forced into Europe to find new populations to destroy (such hyperbole is distressingly common in this book). Humans "invading the rain forest" (habitat destruction often results in contact with novel infectious diseases, but in this book serves as a trope in which habitat destruction inevitably leads to outbreaks of falciparum malaria and is a not so subtle way of pushing a particular viewpoint on her readership). In fact, P. falciparum has plagued humans since we split from the chimpanzee lineage, so it hardly qualifies as "new" - Ms. Shah implies that it has only been around for the last 4,000 years. The entire evolutionary history is an oversimplified war story with so much anthropomorphization that it is almost unreadable. Her use of the word "species" is similarly confused - it is sometimes used correctly but at other times seems merely to refer to strains, and there is no distinction in the text.

We are informed that the basic vocabulary of malaria research (gametocyte, schizont) is not merely "terms... whispered over cluttered lab benches by a few old-school malaria nerds..." but spoken by "...nearly everyone in the malaria world, from ponytailed Harvard undergrads to queenly Cameroonian researchers..." (not really sure where the adjectives came from...). Not to worry - after dabbling with these terms for little more than five pages, this brief foray with science gives way to wild historical speculation (the review below mine deals with these issues more comprehensively so I won't discuss them here).

I was profoundly disappointed by this book - I was hoping for something like "The Great Influenza" by John Barry but ended up with a randomly referenced (bold assertions are followed by a footnote, if you track these down they often have a tenuous relationship to the subject under discussion - we are even informed that finding references was complicated because the books she wanted weren't on interlibrary loan!), hyperbolic, and confused set of ramblings on a fascinating subject. For all her screeds about "exploitation" by "the West", it seems that Ms. Shah saw an opportunity to make a quick profit off of one of the world's deadliest diseases as it re-enters media prominence. The only problem was that she didn't bother to learn the basic facts of her subject first.

An astounding history of an incurable malady
"The Fever" destroys the myths of humans being able to employ scienfic approaches to end disease as effectively as the financial meltdown of 2008 destroyed the myth of the efficiency of the marketplace. Ms. Shah's book is a revelation. She creates a mostly convincing case that malaria shaped a great deal of cultural history in the world, and that attempts to eradicate it have been largely unsuccessful.

The main problem with malaria, Shah convincingly argues, is its frightening ability to quickly nullify all strategies used to destroy it. From quinine tablets to DDT, all preventative measures have, at best, reduced its malignancy. But only temporarily. New resistant strains of both the malaria parasite and the mosquito species that carry them always emerge, and malaria outbreaks always come back.

She also reveals an incredibly important fact that we in the relatively malaria-free industrialized west--including many of us who initially supported malaria control programs sponsored by the Gates Foundation and endorsed by the self-serving Bono types of the world--fail to understand: Most people who live in heavily malaria-infested areas don't consider it to be a serious disease, because those who survive it are the products of natural selection that long ago killed off those who had no natural defenses against it. Survivors have inherited malarial defenses and pass these on their children. That's why African slaves brought to America were better able to deal with the malarial-infested swamps of the south (and because of this were assigned to labor in these areas) than the Europeans who immigrated here.

Thus, in sub-saharan, Africa, according to Shah, most Africans consider malaria infections to be something they live with--the equivalent of a really bad flu in America. They get infected, they get knocked out for a few weeks as their bodies neutralize the latest infection, and then they're okay until they're infected again. Since death is always a way of life in impoverished areas--whether it's malaria, AIDs, famine, or war--death by malaria isn't considered as significant an event as it is in the west.

According to Shah, when mankind tries to eradicate malaria, it simply makes matters worse. Those born without malaria defenses survive and pass on these 'non-survivor' defenses to their progeny. When malaria once again reasserts itself, often in new mutated forms that survived the latest chemical onslaught, fatal epidemics break out because newer generations no longer have the 'defenses' to cope with it.

Shah also makes the point that the well-meaning but misguided attempts of Bono and Gates to control malaria simply don't work because those who received mosquito nets and pills don't consider the issue important enough to use them. Top-down approaches simply don't work; if malaria is to defeated, it has be done at the local level, with commitments from everyone. But again, mosquito nets won't stop it; mosquitos bite during the day as well. Pills don't stop it; natural selection quickly produces new strains of malarial parasites spread new infections.

And, contrary to what Sachs and others say, malaria is NOT an economic issue. It's a GEOGRAPHICAL issue. Building rows and rows of beautiful houses and setting up factories and businesses in villages bordered malaria-infested swamps won't stop the outbreaks. To kill the disease, one must destroy the habitats where the malarial mosquitos lived. Malaria was largely eradicated in the U.S. and western Europe because we bulldozed over most of nature in these countries, drying out and building cities upon the wetlands where these mosquitos thrived.

Adopting a similar approach in Africa, central and south America and Asia would require clearcutting and draining of all the rainforests and wetlands in these countries. Is that what we want? Even if this were to happen, malaria would probably resurface again, since global warming and increased CO2 resulting from the elimination of rainforests would create an envirnonment for malaria-infected mosquitos to thrive in cisterns, puddles, fountains and fishing ponds.

With the except of a few conjectural theories (for example, her theory that the establishment of Rome was driven by malarial concerns), Shah makes a very convincing case for the idea that malaria had a greater influence on the cultures of peoples coping with it and in thwarting the attempts of empire-builders than nearly any other disease or concern.

The only hole in her argument is her assertion that, in spite of increasing cases of malaria in the U.S. after Hurricane Katrina leveled New Orleans, malaria is unlikely to resurface as a major issue in the U.S. It's hard to understand this, since great portions of Louisiana, Mississippi, Florida and other parts of the south are covered with swamps that provide the ideal environment for malaria to thrive. It's quite likely that malarial mosquitos live in these areas, but since they're generally not permanently inhabited by large populations of humans or cattle, the disease simply doesn't have an opportunity to spread very far. However, a new, drug and insecticide-resistant strain that emerged from the bayous would have the potential to level generations of Americans who were never born with anti-malarial genes. It doesn't even need to emerge on its own; a super-resistant-malaria-infected tourist from another country who got bitten by a malaria-worthy mosquito in New Orleans could create a whole new generation of mosquitos carrying this new strain. It's not a matter of if; it's only a matter of when.

Shah's point: The only way that malaria can be stopped is to totally destroy every mosquito in the world. Doing this would require methods that would be so environmentally harmful that the cure would be worse than the disease. Malaria's continuing existence presents humbling proof that man is not even close to being the master of this planet, and that when humanity finally kills itself off, malarial mosquitos will emerge from their hidden underground pools and find other life to feast on.

The Fever
As the title suggests, the book treats Malaria from a historical perspective--one that is both fascinating and with surprises. Although the author at times makes the evolutionary changes sound purposeful, on the part of both the parasite and the vector, the literary approach probably will make the book a more welcome read for more than just those trained in science and medicine. There is need for science-based literature that is attractive even while it promotes understanding of such concepts. Malaria is ancient, but remains a major killer in a world that seems to have eradicated most diseases from earlier times.

Boring treatment of interesting subject
I think this book would have benefitted tremendously from better editing.It was way too wordy and repetitive.Instead of telling a story in a straight-forward and concise way, this book rambled around its points and had no discernible narrative structure.The subject is fascinating, but the book is dull. ... Read more

Product Description
“Eve Brown-Waite writes as she lives – with verve and humor and a fine sense of the absurd.”  --  Martin Troost, author of Lost on Planet China
 
   Eve Brown’s dream is to join the Peace Corps … and maybe solve world hunger and win a Nobel Peace Prize along the way. But she secretly fears she isn’t tough enough to survive the bug-infested jungle, much less life without toilet paper and decaf cappuccino.  Then she falls head-over-little-black-heels in love with John--a dashing Peace Corps recruiter whose do-gooder passions outshine her own. She becomes more determined than ever to get into the Peace Corps – and to win John’s heart in the process.             

   Assigned to Ecuador, she yearns for warm showers and cold beers (instead of the other way around!) .  And though she occasionally  finds herself overwhelmed  by her work  reuniting homeless children with their families,  she  learns to delight in small successes.  But a year into her service, a tragedy befalls one of her fellow volunteers which unearths troubling memories from Eve’s past and causes her to return, rather unceremoniously, to the US.   Back home, Eve attempts to settle down with John and get reacquainted with the joys of sushi and supermarkets.  But faster than she can say “pass the malaria pills,” John accepts a job with CARE in a remote corner of Africa and Eve gets a second chance to test her mettle in the Third World. 

   With uproarious wit and candor, Eve Brown-Waite details the (mis)adventures that ensue.  From intestinal parasites and guerrilla warfare, to culture clashes, and unexpected friendships, First Comes Love, Then Comes Malaria captures the thrills and absurdities of global humanitarian life in a story any globetrotter - armchair or otherwise - will love.   Amazon.com Review
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Customer Reviews (57)

How to get rid of mango fly eggs and other advice
Anyone who lives for any length of time in a developing country brings something home: native handicrafts, an exotic partner, a recurring infection of malaria. In Eve Brown-Waite's case, she brought funny, poignant stories. It took her fifteen years, but she finally published them in her debut, First Comes Love, Then Comes Malaria: How a Peace Corps Poster Boy Won my Heart and a Third-World Adventure Changed my Life. The paperback has just been released.

Brown-Waite's book is a two-fer. It not only traces her Peace Corps stint in Ecuador, but also her life as an accompanying spouse with CARE in Uganda. Both of the foreign sojourns she chronicles are strangely accessible. Unlike reality TV, where we strain to relate to Type-A celebrity seekers, Brown-Waite drops us quietly off the grid - no fanfare, no cash prize, no risk of being voted off the island. We ride along with her as she searches for her opportunity to save the world, as well as when she's just looking for an ice cold beer.

Brown-Waite begins her story with a confession: Someday she wants to join the Peace Corps. We meet her on "someday," the day of her Peace Corps interview. This is also the day she meets her recruiter, the "Peace Corps Poster Boy" of the subtitle. It's our first glimpse of Brown-Waite's ability to make us laugh out loud -- before she even leaves the country.

The magic of Brown-Waite's memoir is how she manages to turn her mundane stories into adventures, whether she's rationing tampons, ironing "everything" to get rid of mango fly eggs or bartering her pink trousers away at the market. They're believable in the way the stories from our own days are believable, yet she still transports us out of our everyday lives.

There's the romance with "Saint John" (including one of the best come-on lines ever). There's the foreign intrigue, complete with AK-47s. We live through the anguish of a [supposedly] failed Peace Corps assignment. And we watch Brown-Waite's transformation to motherhood (including sonograms in a Ugandan hospital). Mixed in is one cultural surprise after another, as when Brown-Waite, an AIDS educator by profession, learns at a local clinic: "Here in Uganda we have two kinds of AIDS. There is the one you can get from sex...But there is also the kind that you get from being cursed."
It's at the end of each chapter, however, where Brown-Waite shares a letter she's written to friends or family back home, when we get the most personal, in-the-moment perspective: "Sometimes I think what I want is to be able to say `I lived in (fill in the exotic location here) and did (fill in the bold adventure here).' But I'm not sure I'm really prepared for actually having to deal with the hardships of living in the exotic locations or the discomfort of dealing with the bold adventure."

Oregon has sent more than 5,500 volunteers into the Peace Corps. Washington has sent even more [8,244]. Our region is home to international aid agencies such as Mercy Corps and World Vision. To many of us, Brown-Waite's experiences will feel familiar. If we're lucky, they'll prompt us to remember and think about what we brought back from our own adventures - whether handicrafts, life partners or just good stories.

The author continues to donate 10% of royalties from her book to CARE, specifically for fighting malaria in Africa.

Well Done
I am not an adventurous person by any stretch of the imagination. Traveling to me means an all-inclusive resort.After reading this book, I actually toyed with the idea of leaving behind all my American comforts and joining some third-world saving organization.I really enjoyed this memoir and cannot wait for her next tale of worldly adventures!

Peace Corps changed my life; book made me laugh...
Can I rate the first section five stars and the second section three?Being a RPCV (returned Peace Corps volunteer) and ex-"expat" myself, the book rang true.I laughed out loud about gamma globulin shots, weekly Newsweek magazines, host families that, with the best of intentions, will never leave you alone, scary staging in Miami, crazy water heaters, people going through your personal hygiene products trying to figure them out, etc.It was a fun, realistic look at the well-meaning, and often misguided efforts of the idealistic idiots that most of us were, or still are.

On the other hand, being an expat isn't really all that interesting beyond the point when life becomes routine.Eve, as is often the case, met some interesting fellow expats and figured out that hired help can get you through the challenges of working out survival techniques while helping the local economy.She also saw some interesting scenery and stressed about interesting governmental situations which I would have loved to learn more about.The motherhood issues got a bit dragged out for my taste, and the cast of characters got flat in the second section.I wish we'd learned more about her husband and his work, and I wish she'd come away with some deeper friendships with some of the people of Uganda.

Still, the book was enjoyable and worth the "one click" money spent.

Great book
This book is hysterical and a fast read. It's easy to relate to the author's stories, especially being in a third world country and you would do anything for some decent coffee or a washing machine. It's amazing how we Americans take our modern conveniences for granted. She turns her not so pleasant experiences into humorous stories for our enjoyment. I would definitely recommend this book for anyone.

The Toughest Book You'll Ever Not Love
I had high hopes for this book as a fun and informative read. What I got was a whiny, annoying run-on narrative that left me shaking my head in disappointment. I found it very insulting that the author felt it necessary to dedicate so much wordspace to the fact that her oh-so-sensitive nose could hardly stand the fact that she found most if not all Ugandans too "smelly" for her and that their "BO" made life so difficult for her. Poor baby. She even found it necessary to say this was the first thing she smelled getting off the plane in Uganda. I'm sure they would be thrilled to hear this glowing assessment of their culture from her and that she thinks of their country as one big latrine. And speaking of overusing wordspace, this book could have been ten pages shorter (and better off for it) if she would have left out all the minute details about her two cats, which added absolutely nothing to the story. I found myself yelling at the pages "who cares about the cats,move on!!" Her insults about the clothing choices of Ugandan women came off trite and childish. And a word about her anxiety attacks that got her discharged from the Peace Corps herself after one year - I'm not totally knocking it, because I personally have been there and know how awful they can be, however, to say you are envious of a woman who has a brain tumor and wishing you had that issue instead of panic attacks, that's pretty harsh and unbelievable in my opinion. And I do have to agree with another reviewer who said "how convenient that her panic attacks suddenly ended after she got sent home from Peace Corps." It did appear that Eve just wanted to get home to her boyfriend and make him her husband ASAP. The big love story between them that was supposed to be the theme of the book according to the title escaped me and apparently many other readers as well; this was All About Eve. Hey, that would've been a better title. I found her letters to friends and family annoying and too self-depricating, and the "I'll keep you posted" signature line seriously grated on my nerves after the second usage. Her comment about a Ugandan man having 6 wives seemed exaggerated for story effect; even Muslim men in African countries are only allowed to have 4 wives maximum. I almost threw the book away when she commented on not knowing how to light a kerosene lantern, and this was AFTER a year in Ecuador and a year in Uganda - really?? C'mon. Princess indeed. And her comment about not being able to remain a vegetarian in a third world country was not accurate either. I know this, because I served as a Peace Corps Volunteer in Burkina Faso several years ago (yes the same one her husband John served in during his tour of duty), and not only did I go a vegetarian and remain one without problem the whole time, but I also learned to light a lantern the first week there; got my water every day myself in a 20 gallon jug on the back of my own bike, swept my own house, and cooked my own meals (all without "servants"); and used a latrine the entire two years in addition to building them for the village I was in. There were no flush toilets in sight, unlike for lucky Eve. There were a very few points in which I give the author kudos and credit for getting right: hiding your personal trash so the local kids don't go through it; the painfully slow mail service; and the "please send" parts of her letters asking friends and family to send chocolate, among other things. I don't know, I just found this story lacking in appreciation and humility I guess, having been there done that. I haven't written a book about my experience, and I'm sure it's not easy, so kudos for giving it a try. ... Read more

Product Description

Malaria sickens hundreds of millions of people -- and kills one to three million -- each year. Despite massive efforts to eradicate the disease, it remains a major public health problem in poorer tropical regions. But malaria has not always been concentrated in tropical areas. How did other regions control malaria and why does the disease still flourish in some parts of the globe?

From Russia to Bengal to Palm Beach, Randall Packard's far-ranging narrative traces the natural and social forces that help malaria spread and make it deadly. He finds that war, land development, crumbling health systems, and globalization -- coupled with climate change and changes in the distribution and flow of water -- create conditions in which malaria's carrier mosquitoes thrive. The combination of these forces, Packard contends, makes the tropical regions today a perfect home for the disease.

Authoritative, fascinating, and eye-opening, this short history of malaria concludes with policy recommendations for improving control strategies and saving lives.

Customer Reviews (40)

Excellent, intelligent, and comprehensive
A well-written overview and analysis of malaria from all angles - biological, historical, economic, social, etc. Very readable even for someone who has no prior knowledge of malaria.

An Overview of a Disease
Malaria is a disease that is mostly thought to be tropical in nature. This book dispels those thoughts as the author traces the disease from its tropical origins and how it spread as far north as the town of Archangel. Archangel is a town in Northern Russia, about 125 miles from the Arctic circle.

Malaria was thought to be caused by the 'bad air'(the literal translation of malaria) around swamps and bogs. It wasn't until 1900 that the disease was linked to malarial parasites that lived in the bodies of anopheline mosquitoes. These mosquitoes introduced the malarial parasites into humans when they would bite them to draw out blood needed for propagation.

Historically, there is hardly a corner of the globe that has not been affected by malaria. At the present time malaria is mostly a concern of the tropical regions of the world. But the author relates how many factors can cause the disease to be introduced practically anywhere.

Hundreds of millions of people are affected by malaria today, with between 1 to 3 million deaths being attributed to it a year. This book tells the tale of this disease. How it is passed on, what affect it has on people and cultures, and how the present attempts to control the disease fall short.

Fascinating history of the interaction of disease and development
I picked up this book out of a mild curiosity about malaria, something I know little about but I do have a fascination with the way biology intersects history.Not only did I find this book to be a readable exposition of how development patterns and efforts to control and fight malaria have changed and often increased exposure to it, I actually had a hard time putting down a book that would seem to be a fairly dry topic.

The author gives an overview of the types of malaria, the mosquitos that tend to carry them, the variety of symptoms and effects that they have on humans, and the conditions that best foster the entire disease process of germ/parasite/insect/human.Then it gets really interesting, as he explores in depth 4 sites in the world which historically had malarial conditions and how human settlement and environmental changes (natural and human wrought) increased, decreased and changed the experience of the disease.He then moves on to tackle the effects of concentrated attempts to wipe out malaria worldwide in the 20th century and the successes and failures of those attempts, before wrapping up with a look at more effective ways to combat the disease.

Overall I found the historical chapters the most fascinating.To see how malaria increased and decreased over time in places ranging from the southern US to eastern Europe was really interesting.There is good scientific material here but it is all written in a very readable narrative and as a layperson, I understood what was going on.The author concentrates on telling the story and there is a minimum of graphs, number crunching and statistics, which I appreciated as those tend to make my eyes glaze over.

This book is a must read for anyone engaged in policy making on malaria prevention and is instructive for anyone working on larger issues of combating disease and poverty, or even of economic development and the environment.I am none of those things, just a curious reader, and I found the book to be edifying and enjoyable.

Proof that health care nowadays is only for those who can afford it while the poor die like dogs
read this book and realize what globalization does to our world.
to our soul

read this book and realize how wrong we have become

this book is proof positive

you don't like Michael Moore's Sicko (Special Edition)

read this book instead and learn what our economic structure does to poor populations

in-depth discussion of all of the factors associated with the spread of malaria
When I was in high school, malaria was something that I'd heard of, but I'd mentally categorised it with polio and smallpox -- diseases that were still out there occasionally, but were mostly controlled.After all, malaria is spread by mosquitos, and it can't be that hard to control mosquitos.Then a friend spent some time in Brazil, and came home with malaria.She nearly died.Malaria suddenly became real to me.

Mosquitos are vector that spread malaria, but the story of malaria is more than just mosquitos.In this book, Randall Packard argues that the failure of world health policy to consider the holistic problem of poverty rather than just the mosquito problem means that we will always fail in attempts to eradicate malaria.He argues that we can't do it with just medication, mosquito nets, and insecticide.Those are required, but they're not the whole story.Providing low-cost mosquito nets is useless if people still can't afford the subsidised price.Medication is useless if it's not readily available, which means that the infrastructure of the afflicted area must be considered.

Packard considers the history of the spread of malaria to make his case.In each case study, the story is almost identical.At first, this feels repetitive, but as he goes on with case study after case study, it is simply depressing.The world community keeps on making the same mistakes over and over again: not ensuring that the affected area has enough education to recognise malaria in its early stages, not having access to mosquito nets to avoid the bites, not having access to sufficient medication to treat the disease, and not having sufficient infrastructure to do more than just an occasional spray of insecticide when the problem is the worst.

The text is dense, but as a layperson, I did find the book easy to follow.It's obviously not a summer beach read; it's something that you have to make a commitment to read.But it is well-written and well-researched.Packard does a good job of balancing between the larger story and anecdotes of how it impacts the afflicted areas.This is a worthwhile read, certainly for anyone who is interested in global health or global policy. ... Read more

Customer Reviews (24)

Wonderful
My husband and I read this book back in 2006 as we traveled around Tanzania.It was a perfect read for the trip and we still talk about the book today!There aren't many books that keep you laughing and talking more than three years later.A definate must read- especially if you're planning a trip to Africa. An hysterically funny travel book!

Great trip across Africa
Loved this story of a cross-continent trek through Africa.I enjoyed the humor and the sense of reality of the account.The author weaves in political and cultural details bringing to light the different flavors of the countries the travelling pair crosses.I heard it as a book on tape first which I highly recommend.It really puts you on the road with the travellers.When I had to return that to the library I got the book to finish it.

Easy, enjoyable read
I truly enjoyed reading this book.Mr. Stevens does a fantastic job of focusing on what is entertaining and interesting.He does not dwell on useless facts that typically bog a book down; instead he tells witty little stories of his experience.I received this book on a Friday and finished it by Sunday it was a quick highly enjoyable read.

Excellent
After reading some of the other comments, I can only conclude that there is a serious humour deficit amongst some segments of the Amazon book reviewing population.Only the hypersensitive or the irredeemably politically correct could possibly fail to enjoy this book.

The naysayers make a big deal about the author poking fun at the native Africans, but fail to notice the amount of self-depreciation he also engages in.Ultimately, you get the sense of an inexperienced but well-meaning traveller who was completely unprepared for Africa but who realises it and sees the funny side of his own naivete.He is poking fun at himself as much as anyone else.And assuming that the tales he tells of African bureaucracy are true - and having experienced it myself, I'm inclined to believe them - why on earth should he not have a laugh about them?

As a storyteller, the author has a real gift and I found the book difficult to put down.

One star subtracted only because of the abrupt and wholly unsatisfying ending.

Thisisn't paradise
This book, firstof all, is not the typical "vacation book" one may purchase to motivate themselves with tales of lovely places and experiences to relish on your long awaited exotic South African adventure.

It should be acknowledged that this is a tongue in cheek review of either an ignorant gentleman, or an educated travel writer delivering just what the reader loves to read.Taken too seriously, the book is offensive.Taken too literally, one can barely believe anyone so STUPID would undertake anassignment such as the author does with no preparation whatsoever. Taken modestly, with appreciation for the genuine spirit of all people, one can easily see the unique capacity the African people have to live life and share generously with strangers passing by.

The endemic frustrations of travel are mirrored constantly by Mr. Stevens.In comic reproductions, it is recalled for the benefit of the reader, of course.The stories are hilarious and bittersweet.Many times I relished the fact that I washome and not experiencing the agony he was. Many more times, I assured myself that I would never subject myself to such unprepared punishment.But, this is what titillates a travel reader, experiencing a travel writer's life in the insured lounger of one's insured home. I appreciate those that cast their fate tothe winds, and allow their adventures to take shape according to chance.It was just suchopportunities that the author encountered. Unexpectantly, and often at times of great distress, he and his companion were invited into the townspeople's homes. Later, afterbeing fed, bathed and liquored, solid friendships formed, and the true spirit oftraveling in Central Africa was appreciated. ... Read more

Product Description
Of the 620,000 soldiers who perished during the American Civil War, the overwhelming majority died not from gunshot wounds or saber cuts, but from disease. And of the various maladies that plagued both armies, few were more pervasive than malaria--a mosquito-borne illness that afflicted over 1.1 million soldiers serving in the Union army alone. Yellow fever, another disease transmitted by mosquitos, struck fear into the hearts of military planners who knew that "yellow jack" could wipe out an entire army in a matter of weeks. In this ground-breaking medical history, Andrew McIlwaine Bell explores the impact of these two terrifying mosquito-borne maladies on the major political and military events of the 1860s, revealing how deadly microorganisms carried by a tiny insect helped shape the course of the Civil War.

Soldiers on both sides frequently complained about the annoying pests that fed on their blood, buzzed in their ears, invaded their tents, and generally contributed to the misery of army life. Little did they suspect that the South's large mosquito population operated as a sort of mercenary force, a third army, one that could work for or against either side depending on the circumstances. Malaria and yellow fever not only sickened thousands of Union and Confederate soldiers but also affected the timing and success of certain key military operations. Some commanders took seriously the threat posed by the southern disease environment and planned accordingly; others reacted only after large numbers of their men had already fallen ill. African American soldiers were ordered into areas deemed unhealthy for whites, and Confederate quartermasters watched helplessly as yellow fever plagued important port cities, disrupting critical supply chains and creating public panics.

Bell also chronicles the effects of disease on the civilian population, describing how shortages of malarial medicine helped erode traditional gender roles by turning genteel southern women into smugglers. Southern urbanites learned the value of sanitation during the Union occupation only to endure the horror of new yellow fever outbreaks once it ended, and federal soldiers reintroduced malaria into non-immune northern areas after the war. Throughout his lively narrative, Bell reinterprets familiar Civil War battles and events from an epidemiological standpoint, providing a fascinating medical perspective on the war.

By focusing on two specific diseases rather than a broad array of Civil War medical topics, Bell offers a clear understanding of how environmental factors serve as agents of change in history. Indeed, with Mosquito Soldiers, he proves that the course of the Civil War would have been far different had mosquito-borne illness not been part of the South's landscape in the 1860s. ... Read more

Customer Reviews (2)

Great Gallinippers!
If any disease deserves its own military history, it ought to be malaria.Indeed, a British medical officer went further, declaring in 1910 that "the history of malaria in war might almost be taken to be the history of war itself."

Malaria - and its cousin, yellow fever - had significant implications during the war and the debilitating consequences of the disease were already certain before the Civil War had started in earnest and well before its final history had been written.

In his recent book, "Mosquito Soldiers: Malaria, Yellow Fever, and the Course of the American Civil War", Andrew M. Bell, Ph.D., has both removed the mystery and significantly increased our understanding of these two diseases, which he declares "have [been] given short shrift" in most medical histories of the war (p. 6).While seemingly short at 120 pages, in fact Mosquito Soldiers covers much ground, indeed.The title comes from Bell's apt conclusion that the insect served as a "mercenary force, a third army" (p. 4) during the war.

The first chapter describes the science behind the diseases, their transmission by the Anopheles and Aedes mosquitoes, and the sickness and death they caused in antebellum America.Chapters 2-6 offer a military history of the diseases over the course of the war, in which he draws on the Official Records and other sources to make a good case that the insects and disease (and fear of disease) affected campaign and battle strategies.A final chapter describes the role of "biological warfare," through acts of sabotage and terrorism (though based on a misunderstanding of the cause of malaria and yellow fever) and the effect of the Union blockade on Confederate medical supplies, especially quinine.

The book is supported by interesting appendices, including one consisting of maps of malarial incidence among Union troops year-by-year as well as a map of yellow fever outbreaks.The bibliography demonstrates Dr. Bell's use of an array of period newspapers, letters and diaries, and medical reports as well as relevant secondary sources, all supported by excellent explanatory endnotes.The writing is clear and engaging.

His focus on real people is evident when Dr. Bell describes the effects of disease outbreaks and fatalities among civilians; effects that might not have otherwise happened but for the belligerent forces marching through and camping near their communities.

Dr. Bell also spends a good amount of time on quinine, "the most potent weapon Civil War surgeons had in their fight against malaria," (p. 6).Derived from the bark of the South American cinchona tree, the alkaloid was an effective remedy for the fever and debilitating chills caused by malaria; in fact, it was used as a remedy until the 1940s before it was replaced by other drugs.The Union enjoyed a ready supply of quinine and regimental surgeons dispensed many tons of the drug over the course of the war.

Dr. Bell also explains that the South suffered from a quinine shortage for most of the war.The federal blockade limited the availability of quinine and other drugs and what little made it through the blockade or was smuggled through enemy lines was seized by Confederate quartermasters.

Civil War enthusiasts who are interested in the naval aspects of the war will be especially pleased with Mosquito Soldiers.Dr. Bell declares that "Malaria [and yellow fever]...also sickened thousands of Union and Confederate sailors who patrolled the South's inland waterways and coastal harbors during the war," (p. 31).He describes how the diseases affected naval campaigns and life on specific vessels (the USS Delaware and the CSS Florida are only a few of several interesting cases).

As a resident of Houston, I was especially interested in his lengthy discussions of outbreaks among soldiers and civilians on the Lone Star coast, especially in Galveston where an 1864 outbreak of "yellow jack" led to hundreds of deaths.

I recommend it highly.

Mosquito Soldiers
An excellent book. While it is well known that many more soldiers died from disease than from battle, the author makes a compelling case that mosquito-borne diseases had a more complex effect on military operations than attrition. Commanders on both sides were aware of the high prevalence of malaria, yellow fever, and other diseases now know to be caused by mosquitoes, and avoided campaigning in these areas in the summer months. The book is full of examples of military commanders who chose their campaign objectives based on the fear of disease as much as the military and political considerations emphasized by most civil war histories. An interesting side effect of this fear, coupled with the mistaken belief that Africans were immune to these diseases, was one consideration in the push to form colored regiments. The book is well documented with quotes from primary sources, in many cases, from the commander's own writings. ... Read more

Product Description
"Reads like a murder mystery. . . . [Desowitz] writes with uncommon lucidity and verse, leaving the reader with a vivid understanding of malaria and other tropical diseases, and the ways in which culture, climate and politics have affected their spread and containment."—New York TimesWhy, Robert S. Desowitz asks, has biotechnical research on malaria produced so little when it had promised so much? An expert in tropical diseases, Desowtiz searches for answers in this provocative book. ... Read more

Customer Reviews (4)

A very good book which could have been better
As the other reviewers have pointed out, this is a very informative book about two terrible insect-transmitted diseases, malaria and kala-azar. The sections of the book dealing with the mis-management of the efforts in the search of vaccines are particularly interesting. Overall, this is certainly a worthwhile book.

Unfortunately, the writing is not memorable, and I found the author often a bit patronizing and trying too hard to be funny or witty where good, serious prose would have been more welcome. Also, sometimes technical concepts are mentioned without giving the reader sufficient background to fully appreciate their meaning and implications (unlike, for instance, in most of Stephen J Gould's writing, to mention an outstanding example of science essayist).

From this perspective, I think Harrison's "Mosquitoes, malaria and men" is a much better book on the history of the interaction between malaria and men, even if it does have the drawback of being about 30 years old, and hence misses almost all of the post 70s fight against malaria history. Friends tell me that Honigsbaum's "The Fever Trail" is also very good and more up to date, but I have not read it so I have no personal opinion about that.

So, let us put it this way, I found Desowitz to be an intelligent, very competent and compassionate writer, but I also found him a bit condescending, and his balance between clarity (for the layman) and completeness is a bit too tilted towards the former. Still, a good read, and I thank the author for his effort and for the resulting book!

15 years later, the situation's still just as bad
I published this review in 1992. Little has changed since, but for Amazon I have updated a few points.

The biggest disease threat in the world is not AIDS. Not lung cancer. Not heart disease. It's malaria, which kills more people every year than AIDS has killed altogether. (2007 update: No longer true; AIDS now kills about as many people as malaria each year.)
Most of them are young children, with pregnant mothers also a prime target. Almost all are poor, powerless and colored.
And their situation today is worse, considerably worse, than when the rich countries amassed their advanced medical and public health techniques to attack malaria a couple of generations ago.
In this angry book, Robert Desowitz, a (now retired) professor of tropical medicine, medical microbiology and public health at the University of Hawaii, says it did not have to be, and, as he has in past books, he points the finger of blame when other commentators are too scared to.
True, malaria is a tough foe. Of several kinds, only one, caused by a parasite called Plasmodium falciparum, is often fatal, but it is a fearsome predator. Where falciparum reigns, the infant mortality rate runs 40 to 50 percent.
And its imperium is spreading. Malaria used to be relatively uncommon in the cities of black Africa, which, bleak as they were, were inhospitable to mosquitoes. The cities have grown enormously, and failed attempts to eradicate the principal mosquito vector merely bred mosquitoes with urban tastes.
Malaria, however, is not only a tropical disease. Rich countries tend to control their mosquitoes -- by destroying their wetlands, if nothing else -- but as recently as the 1890s, the coast of Georgia was depopulated by malaria, and when Desowitz was studying in London there was malaria there, too. But most of us think seldom of malaria; no one gives dance benefits to raise money for malaria.
To reinforce the difference between the rich and healthy and the poor and diseased, Desowitz also traces the story of another killer of the poor in the tropics, a disease most Americans have never even heard of, visceral leishmaniasis. It is a parasite, too, but spread by a sandfly.
It is nearly as deadly a killer as plague, and where it reigns -- Bangladesh, Bengal, Nepal -- it has the same name, kala azar, the black sickness.
Desowitz, no sensationalist, describes one death from each disease, just to show what it's like, in chapters of relentless horror.
Then he turns to equally relentless analysis. Things get complicated. For example, the leishmania organism has been around as long as man (and undoubtedly a lot longer), but accounts of the disease start only in 1824. Early recorded epidemics apparently spread thanks to the improved transportation system the British brought to India. (Which might seem a bad bargain, but economic historians think that system, especially the railways, ended famine in India, with the exception of one last hunger engineered by Mohandas Gandhi -- yes, the Mahatma, the only lawyer besides Thomas More ever to make saint.)
Complications pile on complications. "Kala azar is not a Stars and Stripes disease like cancer, coronaries, stroke and allergies," writes Desowitz. "No American president is going to introduce a bill for Congress to fund a War on Visceral Leishmaniasis," yet western experts and western money have explained the central problems of the disease, as they did of malaria.
They even found a moderately effective treatment, but it costs $15 (1992 price), which is far beyond the means of the citizens of the empire of kala azar.
So, like malaria, no one, especially in the rich countries, pays much attention to kala azar now. "No major efforts have been made to find an antimalarial to replace chloroquinine," a miracle drug against malaria until the plasmodium adapted to it. Modern medical research has "made the development of drugs to treat the diseases of poor people uneconomical." (2007 update: In testimony before Congress in 2004, Desowitz blamed U.S. AID for continuing to buy chloroquinine, which, he now says, is not only not a cure but in some circumstances is actually harmful.)
But there are even more complications. Skipping over some, we come to the Agency for International Development, which for over 20 years (2007 update: 35 years) has been spending millions to develop a malaria vaccine.
Never mind that "there has never been a vaccine to protect or cure any parasitical disease of humans," or that AID is not normally a medical research bureau. The program was, Desowitz says, in the hands of incompetents, some of whom are already in prison, other awaiting trial for peculations. (2007 update: 5 convictions)
Within its own empire, AID is circulating a self-serving description of this disaster, claiming that despite thievery, the program has made great strides. Desowitz says it has accomplished nothing significant, and I accept his version. (2007 update: no change)
His track record is superb. When all we got was happy talk from the medical community, Desowitz explained (in "The Thorn and the Starfish") why an AIDS vaccine is unlikely; when the rest of the medical community was nearly silent about the feminist attack on Bendectin, the only drug useful against morning sickness, Desowitz told us thatwas hogwash, and in 1991, in a widely unreported decision, the U.S. Supreme Court concluded that the so-called evidence against Bendectin was worthless. But by then it was too late; nobody makes Bendectin any more.
Desowitz is one of my few heroes. Of the AID malaria criminals he says, "It is possible that the villains were not the indicted, but the respectable, established and honored scientists. These were the men and women who said not a word in public protest when their opinions were . . . manipulated into falsifications. These were the men and women who said in private that the AID-sponsored research was of doubtful quality. These were the men and women who disregarded their responsibilities as leaders of their profession. Their silence may have caused irreparable harm . . . ."
In the 19th century, Henrik Ibsen wrote a play whose hero was "An Enemy of the People" because he spoke out when everyone else thought it best to keep quiet. That is exactly the kind of hero Dr. Robert Desowitz is.

Thought-provoking study of Malaria and Kala Azar
Robert Desowitz leaves his readers with many 'cliff-hangers' in "The Malaria Capers".The version I read was published in 1991, so some of his unfinished stories may have endings by now---all except for the most important story of all, which is the search for an effective vaccine against the parasitic protozoans that cause malaria and kala azar (visceral leishmaniasis).

Immunization campaigns have eradicated smallpox and may be on the verge of eradicating polio, but the two diseases that this book focuses on cannot currently be prevented with vaccines.The danger of catching malaria or kala azar can be minimized---unfortunately the majority of the population at risk can't even afford the most effective preventive measure---a bed net soaked in insecticide (according to 2000 World Health Organization statistics this costs about $4, plus $1 per year for a supply of insecticide).

No wonder Desowitz gets so mad and preachy in "The Malaria Capers".Malaria still kills over one million people a year (another 2000 WHO statistic) - most of them young children.None of the vaccines that scientists were working on when this book was written have proven to be effective, which is exactly what Desowitz predicted.In his last chapter, "The Vaccine Felonies", he excoriates the Malaria researchers who spent their AID grants on vaccines that were already proven to be ineffective and unsafe for humans.While doing so, they diverted funding from proven preventive measures such as bed nets, put Owl monkeys on the endangered species list, and (even more feloniously according to our laws) lavished the grant money on themselves and their office assistants.One of the stories that Desowitz couldn't finish in 1991 was whether these researchers were tried, convicted, and sent to prison.

This book is more polemical and as a result, less interesting to the lay reader (myself) than his "New Guinea Tapeworms and Jewish Grandmothers", but it does have a few 'human interest' stories.The most haunting begins in a small Thai village:

"...The school assembly bell, hanging by a rope from a limb of a mango tree, is the nose cone from an unexploded [Japanese] bomb.Next to the school, raised on pillars, is the wooden residence of a group of monks.On this late morning in June their prayers have ended; only the unceasing anguished cries of a monk dying from throat cancer break the subdued quiet of the village.In a one-room, wood-framed, tin pan-roofed house at the village edge, Amporn Punyagaputa, twenty-three years old and big with child, sits alone, feverish and confused by the searing pain in her head."

Stories like this represent Desowitz at his best and most humane.I can almost guarantee that Amporn Punyagaputa will help you remember why Malaria is still such a killer, long after you'veforgotten who misappropriated the AID funds.And you will definitely understand why Desowitz is so angry.You'll be angry, too.

A "Must Read" for Infectious Disease & Public Health Folks
Robert Desowitz's attempt to chronicle the successes and failures of man's quest to leash the ravages of tropical disease (especially malaria and leishmaniasis), results in a very engaging and easy to read book.Through his entertaining and at times, cynical approach, the author explains how throughout history, man's desire to rid himself of the pestilence of infectious disease has sometimes met with success (as in the case of smallpox), as well as with failure (as in the case of malaria).If for instance, we take the case of malaria, just in the figures utilized by the author in his accounting of the US Agency for International Development (USAID) effort to combat malaria, he chronicled over $100 million "thrown at" this disease, with the disease still flourishing today in many parts of the world! The author's method of "personalizing" or presenting the experiences and challenges faced by many people in this world at the individual level, succeeds in engaging the reader from the very first chapter.The opening account of the Indian woman, Susheela, who tries desperately to save her dying daughter from visceral leishmaniasis, only to discover that the medicine required to save her daughter is grossly unaffordable, rivets the reader's attention.Here is a personal account of a human tragedy, which could have been told from the perspective of too many families in developing countries even in today's modern world of globalized interdependence.Additionally, Mr. Desowitz does a good job of giving the reader a historical context in which many of the major events in the history of public health, actually took place.This helps the reader to develop a historical frame of reference and better understand the reasoning and motivations of key individuals and governments involved in tropical disease research during that particular period. Mr. Desowitz seeks to inform the reader as to why there currently exists either cures, treatments or vaccinations to only certain diseases, while other diseases seem to flourish with little to no concerted effort by any government, private or international agency to control them."During the past two decades," states the author, "when biotechnology has made so many stunning advances, the health of tropical peoples has worsened.New, affordable, non-toxic chemotherapeutics have not been developed (because) the drugs-for-profit pharmaceutical industry gives low priority to the diseases of the poor people." Rarely, suggests the author, has human altruism towards his fellow man been the primary reason for the development of protective measures and cures from these diseases.Other more materialistic or self-serving reasons such as economic gain, protection of business, government or military interests, or the quest for recognition and notoriety (such as the Nobel Prize), have been the primary reasons for tropical disease research.The author posits that this motivation continues to this day with relatively little contemporary research effort going into the "poor people diseases" of malaria and tuberculosis. The author presents his main argument first by effectively painting a bleak picture of despair in recent-day India, followed by a detailed chronology of the historical events (and non-events) that lead up to it, and then concludes with an implicit warning.The fact that the health of tropical people has worsened over the past several decades is a physical manifestation of a perceived lack of international concern for certain regions of the globe.Mr. Desowitz cites numerous examples of national and international efforts to combat certain diseases throughout history, and dissects them in a manner by which the reader is left with a more thorough understanding of why the project failed or succeeded in accomplishing its objective.He presents to the reader the "rest of the story" which usually underlies the official version of a project or initiative and uncovers how the human factor of greed, self-service, and ulterior motivations have sometimes driven honest efforts into subversion.On the contrary however, he also very effectively describes how some of the earlier pioneers in the study of infectious disease persevered even in the face of adversity and defeat.A very good example of this is the case of Surgeon Captain Ronald Ross who after over three years of painstaking research and experimentation, discovered that malaria was transmitted by the bite of an infected female Anopheles mosquito through its salivary glands.Captain Ross' discovery was the culmination of not only his own personal work, but also the work of the countless researchers who came before him and contributed towards the building of the existing body of knowledge in malaria.There were many occasions in Captain Ross' quest for discovery that this author would have thought twice about turning my research efforts elsewhere!He was a true testament in perseverance and will. The Malaria Capers is a "must" read for all public health professionals and those aspiring to become one, as well as personnel entering the clinical research field.It is a fundamental book that prepares those seeking to enter the public health arena to face the challenges contained in the field of infectious diseases.It also sheds some light to the infectious disease researcher why research is only conducted on some diseases, and not others.A potential weakness of this book (which is also a strength!) is the author's perceived cynicism, especially when he describes many of the human blunders and indiscretions, which in his opinion may have set back the discoveries of potentially life-saving drugs and programs by many years.Mr. Desowitz appears to be an absolute subject matter expert in the field, and one who has "walked the walk" and not just "talked the talk."He does an absolutely superb job in capturing the reader's attention and instilling in him the knowledge acquired through years of working the business of infectious disease research.I highly recommend this book to anyone even remotely interested in the area of infectious disease.A "highly recommended" book! ... 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Product Description
Malaria control requires an integrated approach, including prevention (primarily vector control) and prompt treatment with effective antimalarials. Since the publication of the first edition of these Guidelines in 2006, most of the countries where P. Falciparum is endemic have progressively updated treatment policies from the failing chloroquine and sulphadoxine-pyrimethamine to the recommended artemisinin-based combination therapies (ACTs); this is the best current treatment for uncomplicated falciparum malaria. Unfortunately, the implementation of these policies has lagged behind due to various factors like high costs.

The second edition of these Guidelines provides simple and straightforward treatment recommendations based on sound evidence that can be applied even in severely resource-constrained settings. The number of antimalarial drug trials published has continued to increase over the years, so the Guidelines have a firmer evidence base than previous treatment recommendations.

Since the release of the first edition, the WHO standard methods for guidelines development has evolved and this second edition was developed in accordance with the updated WHO standards methods for guidelines development. This methodology incorporates a transparent link between research evidence and recommendations. The GRADE system, which has been incorporated into this update, is a uniform approach being widely adopted globally. ... Read more

Product Description
In the last 15 years Malaria has killed 60 times more people than AIDS. There still is no vaccine. "The Fever Trail" is a fascinating boat trip through the history of Malaria and those that have sought to cure it. It is a story of courage; of political machinations and personal bravery, of the New World against the Old. From the jungles of Peru to the high-tech labs in the USA, Mark Honigsbaum reveals the characters and events that, up until now, have been little more than footnotes in history. "The Fever Trail" starts with the hunt for the Cinchono tree, the tree that yielded the cure for Malaria, quinine. Markham, Ledger and Spruce, the trio of explorers given the task of transporting the tree to the colonies, gave most of their lives so that the world could be free of intermittent fevers. They never thought that the disease would mutate. The modern pioneers no longer search out forests, or spend months on dangerous rivers. Instead they battle on in laboratories and facilities desperate to find what has eluded mankind for centuries. A cure. '[An] entertaining but sobering book...full of vivid detail' - "Financial Times". 'A serious book about a deadly disease' - "The Spectator".'A stunning history of the hunt for a cure for malaria' - Beryl Bainbridge, Books of the Year, "Sunday Telegraph". ... Read more

Customer Reviews (1)

What a great book.
I loved this book.I dont remember how I came to own it but I think I ordered it after seeing a review in a magazine.It isnt the type of book I normally buy nor read but I am glad I got it.I liked not just the history or the story, but the cultural insights that are buried in the book too. ... Read more

Product Description
Malaria kills millions each year, targeting pregnant women and children Malaria in pregnancy has been a long-standing conundrum - why do women immune to the parasite after years of exposure suddenly become susceptible to infection during first pregnancies? Recent scientific breakthroughs have shed new light on interactions between the malaria parasite and the placenta, and raised hope for new drugs and vaccines to protect young mothers.
Malaria in Pregnancy leads the reader through decades of research in epidemiology, immunology and parasitology, drawing on scientific expertise from around the world. Maternal malaria is one of the grreat public health problems of our time and may be the first parasitic infection to be controlled with anti-adhesion drugs or vaccines. The current understanding of malaria in pregnancy and the continued controversies surrounding this syndrome will fascinate all students, scientists and policy-makers interested in infectious disease and women's health. ... Read more

Customer Reviews (1)

Fantastic!
Extremely informative and wonderfully written.

Patrick Duffy, you have outdone yourself this time.Kudos to you...Kudos indeed! ... Read more

Product Description
Despite extensive efforts to control it, malaria is still one of the most devastating infectious diseases worldwide. This book, now in its second edition, provides a broad and up-to-date overview of the rapidly expanding field of malaria immunology and its importance in the control of this disease. The first section deals with the malaria parasite and its interactions with both the vertebrate host and the mosquitoes which transmit the disease. In the second part, the mechanisms of immunity and their regulation by environmental and genetic factors are discussed. Finally, this volume contains several chapters on malaria vaccine development, describing the application of the most recent vaccine technologies as well as ongoing and planned vaccine trials. Authored by well-recognized experts, this volume not only demonstrates the rapid progress being made in the search for vaccines against malaria, but also broadens our understanding of immunity to infection in general. ... Read more

Product Description

In Malaria: Poverty, Race, and Public Health in the United States, Margaret Humphreys presents the first book-length account of the parasitic, insect-borne disease that has infected millions and influenced settlement patterns, economic development, and the quality of life at every level of American society, especially in the south.

Humphreys approaches malaria from three perspectives: the parasite's biological history, the medical response to it, and the patient's experience of the disease. It addresses numerous questions including how the parasite thrives and eventually becomes vulnerable, how professionals came to know about the parasite and learned how to fight them, and how people view the disease and came to the point where they could understand and support the struggle against it.

In addition Malaria: Poverty, Race, and Public Health in the United States argues that malaria control was central to the evolution of local and federal intervention in public health, and demonstrates the complex interaction between poverty, race, and geography in determining the fate of malaria.

Product Description
Humanity's Burden provides a panoramic overview of the history of malaria. It traces the long arc of malaria out of tropical Africa into Eurasia, its transfer to the Americas during the early years of the Columbian exchange, and its retraction from the middle latitudes into the tropics since the late nineteenth century. Adopting a broadly comparative approach to historical patterns and processes, it synthesizes research findings from the natural and social sciences and weaves these understandings into a narrative that reaches from the earliest evidence of malaria infections in tropical Africa up to the present. Written in a style that is easily accessible to non-specialists, it considers the significance of genetic mutations, diet, lifestyle, migration, warfare, palliative and curative treatment, and efforts to interrupt transmission on the global distribution of malaria. ... Read more

Customer Reviews (1)

Comprehensive, excellent global history
This exhaustive, comprehensive history of malaria was a wonderful read.I highly recommend this book. ... Read more

Product Description

Customer Reviews (13)

Loved it!
This was a great read... So insightful.It's the perfect book for people who love non-fiction, but may feel a bit overwhelmed by a book like Guns Germs and Steel. That is not to say that Diamond and those types doesn't have a place.However, someone who would never take a text book on vacation for personal reading, but still likes an informative educational book that is well written and light enough to keep your attention throughout may find 'The Fever' to be a good fit. It is definitely deep enough to educate and make you feel like you've learned and stretched your knowledge base.Even more so if you are a fan of medical history, or even just history in general.

Some interesting tidbits, but terribly written and poor grasp of the science
I was excited when I saw the title of this book (one of my biggest problems with Guns, Germs, and Steel was how little focus Jared Diamond gave to the effects of malaria on societal development), but the more I read this book the more frustrated I become. Almost every page has at least one minor error, and many pages contain blatant errors regarding the fundamental biology that any competent editor should have discovered. My favorite howler: "Then again, 10 percent of the parasite's five thousand proteins retain their algaelike chemistry and remnant chloroplasts." A chloroplast is an organelle (large, complicated structure) in plant cells; to say that a protein contains "remnant chloroplasts" is utterly nonsensical.

The greatest misunderstanding comes from her "story of the evolution of malaria" in which P. falciparum (the most deadly of the 4 major plasmodium species) is presented as the latest evolutionary trick in a long line of a heavily-personified malaria species. If we take Ms. Shah's account, P. vivax emerged first, was defeated by the Duffy antigen in the African population and thereby forced into Europe to find new populations to destroy (such hyperbole is distressingly common in this book). Humans "invading the rain forest" (habitat destruction often results in contact with novel infectious diseases, but in this book serves as a trope in which habitat destruction inevitably leads to outbreaks of falciparum malaria and is a not so subtle way of pushing a particular viewpoint on her readership). In fact, P. falciparum has plagued humans since we split from the chimpanzee lineage, so it hardly qualifies as "new" - Ms. Shah implies that it has only been around for the last 4,000 years. The entire evolutionary history is an oversimplified war story with so much anthropomorphization that it is almost unreadable. Her use of the word "species" is similarly confused - it is sometimes used correctly but at other times seems merely to refer to strains, and there is no distinction in the text.

We are informed that the basic vocabulary of malaria research (gametocyte, schizont) is not merely "terms... whispered over cluttered lab benches by a few old-school malaria nerds..." but spoken by "...nearly everyone in the malaria world, from ponytailed Harvard undergrads to queenly Cameroonian researchers..." (not really sure where the adjectives came from...). Not to worry - after dabbling with these terms for little more than five pages, this brief foray with science gives way to wild historical speculation (the review below mine deals with these issues more comprehensively so I won't discuss them here).

I was profoundly disappointed by this book - I was hoping for something like "The Great Influenza" by John Barry but ended up with a randomly referenced (bold assertions are followed by a footnote, if you track these down they often have a tenuous relationship to the subject under discussion - we are even informed that finding references was complicated because the books she wanted weren't on interlibrary loan!), hyperbolic, and confused set of ramblings on a fascinating subject. For all her screeds about "exploitation" by "the West", it seems that Ms. Shah saw an opportunity to make a quick profit off of one of the world's deadliest diseases as it re-enters media prominence. The only problem was that she didn't bother to learn the basic facts of her subject first.

An astounding history of an incurable malady
"The Fever" destroys the myths of humans being able to employ scienfic approaches to end disease as effectively as the financial meltdown of 2008 destroyed the myth of the efficiency of the marketplace. Ms. Shah's book is a revelation. She creates a mostly convincing case that malaria shaped a great deal of cultural history in the world, and that attempts to eradicate it have been largely unsuccessful.

The main problem with malaria, Shah convincingly argues, is its frightening ability to quickly nullify all strategies used to destroy it. From quinine tablets to DDT, all preventative measures have, at best, reduced its malignancy. But only temporarily. New resistant strains of both the malaria parasite and the mosquito species that carry them always emerge, and malaria outbreaks always come back.

She also reveals an incredibly important fact that we in the relatively malaria-free industrialized west--including many of us who initially supported malaria control programs sponsored by the Gates Foundation and endorsed by the self-serving Bono types of the world--fail to understand: Most people who live in heavily malaria-infested areas don't consider it to be a serious disease, because those who survive it are the products of natural selection that long ago killed off those who had no natural defenses against it. Survivors have inherited malarial defenses and pass these on their children. That's why African slaves brought to America were better able to deal with the malarial-infested swamps of the south (and because of this were assigned to labor in these areas) than the Europeans who immigrated here.

Thus, in sub-saharan, Africa, according to Shah, most Africans consider malaria infections to be something they live with--the equivalent of a really bad flu in America. They get infected, they get knocked out for a few weeks as their bodies neutralize the latest infection, and then they're okay until they're infected again. Since death is always a way of life in impoverished areas--whether it's malaria, AIDs, famine, or war--death by malaria isn't considered as significant an event as it is in the west.

According to Shah, when mankind tries to eradicate malaria, it simply makes matters worse. Those born without malaria defenses survive and pass on these 'non-survivor' defenses to their progeny. When malaria once again reasserts itself, often in new mutated forms that survived the latest chemical onslaught, fatal epidemics break out because newer generations no longer have the 'defenses' to cope with it.

Shah also makes the point that the well-meaning but misguided attempts of Bono and Gates to control malaria simply don't work because those who received mosquito nets and pills don't consider the issue important enough to use them. Top-down approaches simply don't work; if malaria is to defeated, it has be done at the local level, with commitments from everyone. But again, mosquito nets won't stop it; mosquitos bite during the day as well. Pills don't stop it; natural selection quickly produces new strains of malarial parasites spread new infections.

And, contrary to what Sachs and others say, malaria is NOT an economic issue. It's a GEOGRAPHICAL issue. Building rows and rows of beautiful houses and setting up factories and businesses in villages bordered malaria-infested swamps won't stop the outbreaks. To kill the disease, one must destroy the habitats where the malarial mosquitos lived. Malaria was largely eradicated in the U.S. and western Europe because we bulldozed over most of nature in these countries, drying out and building cities upon the wetlands where these mosquitos thrived.

Adopting a similar approach in Africa, central and south America and Asia would require clearcutting and draining of all the rainforests and wetlands in these countries. Is that what we want? Even if this were to happen, malaria would probably resurface again, since global warming and increased CO2 resulting from the elimination of rainforests would create an envirnonment for malaria-infected mosquitos to thrive in cisterns, puddles, fountains and fishing ponds.

With the except of a few conjectural theories (for example, her theory that the establishment of Rome was driven by malarial concerns), Shah makes a very convincing case for the idea that malaria had a greater influence on the cultures of peoples coping with it and in thwarting the attempts of empire-builders than nearly any other disease or concern.

The only hole in her argument is her assertion that, in spite of increasing cases of malaria in the U.S. after Hurricane Katrina leveled New Orleans, malaria is unlikely to resurface as a major issue in the U.S. It's hard to understand this, since great portions of Louisiana, Mississippi, Florida and other parts of the south are covered with swamps that provide the ideal environment for malaria to thrive. It's quite likely that malarial mosquitos live in these areas, but since they're generally not permanently inhabited by large populations of humans or cattle, the disease simply doesn't have an opportunity to spread very far. However, a new, drug and insecticide-resistant strain that emerged from the bayous would have the potential to level generations of Americans who were never born with anti-malarial genes. It doesn't even need to emerge on its own; a super-resistant-malaria-infected tourist from another country who got bitten by a malaria-worthy mosquito in New Orleans could create a whole new generation of mosquitos carrying this new strain. It's not a matter of if; it's only a matter of when.

Shah's point: The only way that malaria can be stopped is to totally destroy every mosquito in the world. Doing this would require methods that would be so environmentally harmful that the cure would be worse than the disease. Malaria's continuing existence presents humbling proof that man is not even close to being the master of this planet, and that when humanity finally kills itself off, malarial mosquitos will emerge from their hidden underground pools and find other life to feast on.

The Fever
As the title suggests, the book treats Malaria from a historical perspective--one that is both fascinating and with surprises. Although the author at times makes the evolutionary changes sound purposeful, on the part of both the parasite and the vector, the literary approach probably will make the book a more welcome read for more than just those trained in science and medicine. There is need for science-based literature that is attractive even while it promotes understanding of such concepts. Malaria is ancient, but remains a major killer in a world that seems to have eradicated most diseases from earlier times.

Boring treatment of interesting subject
I think this book would have benefitted tremendously from better editing.It was way too wordy and repetitive.Instead of telling a story in a straight-forward and concise way, this book rambled around its points and had no discernible narrative structure.The subject is fascinating, but the book is dull. ... Read more

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This book reflects the discussions of leading scientists on the potential impact of global change on malaria and other vector-borne diseases. The book makes clear that environmental change, more than climate change, is the driving force behind the observed changes in disease risk. The rapid spread of blue tongue, another highly infectious vector-borne disease, illustrates what might happen if the world looks on unguarded.

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decades of struggle
Nowadays, malaria is typically relegated to a few developing countries around the equator. But it also afflicted Italy during much of the early twentieth century. Especially the warm southern regions. In no small part, it laid low the productivity of the people. Snowden shows how it became the predominant public health issue for many Italian governments.

Progress against malaria was slow and fitful. Quinine was recognised and promoted freely to sufferers. A dramatic and measurable improvement over what came before. As seen in a table, where the mortality per million fell from 490 in 1900 to 57 in 1914. Few public treatments have been as effective and, indeed, as simple and cheap to implement.

But World War 1 led to a resurgence, due to the difficult conditions of hostilities and the drain on government resources for the war effort. The postwar rise of Mussolini gave an episode in the struggle against malaria. He saw defeating it as a huge boost to his government. Thus, massive resources were spent on efforts like draining the Pontine Marshes, and other similar efforts in Apulia and Tuscany.

World War 2 led to the 1944 episode where the Wehrmacht introduced bioterror, by enabling the breeding of Anopheles in swamps, as the German army retreated north. Snowden's description of this is well done. In Europe, at least, it was the only known use of bioterror in the 20th century. And in direct contravention to the Conventions that Germany had signed before the war. Some readers will also see parallels with the Japanese biological efforts in Manchuria during that war. ... Read more

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In the mid-1950s, with planning and funding from the United States, Mexico embarked on an ambitious campaign to eradicate malaria, which was widespread and persistent. This new history explores the politics of that campaign. Marcos Cueto describes the international basis of the program, its national organization in Mexico, its local implementation by health practitioners and workers, and its reception among the population. Drawing on archives in the United States, Mexico, and Switzerland, he highlights the militant Cold War rhetoric of the founders and analyzes the mixed motives of participants at all levels. Following the story through the dwindling campaign in the late 1960s and early 1970s, Cueto raises questions relevant to today's international health campaigns against malaria, AIDS, and tuberculosis.

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Chronicling a 100-year quest, this book tells the fascinating story of the hunt for the still-elusive malaria vaccine. Its clear, engaging style makes the book accessible to a general audience and brings to life all the drama of the hunt, celebrating the triumphs and documenting the failures. The author captures the controversies, missteps, wars of words, stolen ideas, and clashes of ego as researchers around the world compete to develop the first successful malaria vaccine. "The Elusive Malaria Vaccine: Miracle or Mirage?" is based on author Irwin W. Sherman's thorough investigation of the scientific literature as well as his first-hand interviews with today's pioneers in malaria vaccine research. As a result, the book offers remarkable insights into the keys to a successful malaria vaccine and the obstacles hindering its development. Malaria is one of humankind's greatest killers, currently afflicting some 300 to 500 million people. Moreover, malaria infections have begun to spread and surge in places previously free from the disease.With the book's easy-to-follow coverage of such topics as immunity, immunology, recombinant DNA, and monoclonal antibodies, readers gain a new understanding of the disease itself, the importance of microbe hunters, and the need for responsible leadership to face the challenges that lie ahead in the battle against malaria. This book chronicles the successes and failures in the 100-year-old hunt for a malaria vaccine. It offers easy-to-follow explanations that are understandable to a general audience. It provides a unique, single-authored, comprehensive and critical review of malaria vaccines. It incorporates the latest scientific literature as well as viewpoints and perspectives from leaders in malaria vaccine research. It explains the microbiology underlying the discovery of malaria parasites. It helps readers understand why a successful malaria vaccine still does not exist. It serves as essential reading for anyone interested in infectious disease, public health, and public policy regarding malaria prevention and control. ... Read more

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Toward A Malaria Vaccine
This book is reviewed by Brian Greenwood in Science magazine volume 326 page 369. Oct 16, 2009 ... Read more

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An excellent and useful book
This is an excellent book on the history of a terrible disease. It is clear, accurate and very well written. The book is relatively old, so it does not include almost any information on the attempts (unsuccessful so far) to develop a vaccine, but if you are looking for a readable and accurate book to be introduced to the history of the fight against malaria and of the men who mostly contributed to it, I don't think there is a better choice. Desovitz has a more recent book (The malaria capers) which belongs to the same category, but his style is condescending and he tries to be funny without any real sense of humor. Also, while Desovitz intoduces sometimes technical concepts without really giving enough information to the non-expect reader to appreciate the content, Harrison reaches a great balance between scientific accuracy and readibility. Finally, you can buy an excellent used copy of this book for a pittance. Highly recommended! ... Read more

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This is an EXACT reproduction of a book published before 1923. This IS NOT an OCR'd book with strange characters, introduced typographical errors, and jumbled words.This book may have occasional imperfections such as missing or blurred pages, poor pictures, errant marks, etc. that were either part of the original artifact, or were introduced by the scanning process. We believe this work is culturally important, and despite the imperfections, have elected to bring it back into print as part of our continuing commitment to the preservation of printed works worldwide. We appreciate your understanding of the imperfections in the preservation process, and hope you enjoy this valuable book. ... Read more

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An excellent introduction to malaria and a classic work in the early development of it's treatment
This work nicely covers key clinical and scientific information drafted in the late 1800s, before the cause of malaria was understood by science.It offers an excellent and intellectual overview of the illness, what was believed to be the cause, and clinical case histories for various forms of malarial diseases.

It is an excellent overview for the early student of epidemology and for anywone who wants to understand some of the core challenges relating to malaria. ... Read more

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The authors examine the development and consequences of various anti-malaria strategies in Hong Kong, Okinawa, Taiwan, mainland China, and East Asia as a whole. The British and Japanese colonial models of disease control are explored, as is the later American technological model of DDT residue spraying, promoted by the Rockefeller Foundation which played a significant role in the global anti-malaria campaign and the development of public health in Asia.

In the post- World War II period, the use of DDT and international political and economic interests helped to shape anti-malaria policies of the Nationalist government in Taiwan. In mainland China, the Beijing government's mass mobilization and primary health care model of anti-malaria control has given way to new strategies as recent changes in the health care system have affected anti-malaria efforts and public health developments.

This book illuminates an important and largely unexplored dimension of the history of malaria: the interplay of the state (colonial or sovereign), international interests, new medical knowledge and technology, changing concepts of health and disease, as well as local society in the formulation and implementation of anti-malaria policies. It will be of interest to historians of colonialism, medicine and public health, Asia, as well as health and social policy planners.
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