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The creation of an African ‘bloodstream’: Malaria control during the Hitler War, 1942–1945 (Part 3)
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Until 1942, Allied medics had distributed a daily dosage of five grains of quinine to all army personnel, but when supplies ran low, they experimented with synthesised versions of the drug. They tested two prototypes: quinacrine (reverse-engineered by Sterling Winthrop Co. from a captured German I. G. Farben product in 1941) and mepacrine (synthesised by Imperial Chemical Industries in 1939). British Army experiments showed that quinacrine was a superior antimalarial because it had few side effects, but mepacrine was in greater supply, so the Allied doctors in Accra settled on a daily dose of the latter by mid-1943. The White soldiers disliked mepacrine because it caused a yellowish pigmentation on their skin, but they were forced to take it every morning with their breakfast. African soldiers were required to take the drug too, but use of chemical prophylaxes stopped there. Despite the belief that the residents of Accra formed a reservoir for the disease, the Allies never considered offering malaria prophylaxes to their civilian employees or to the broader African community.
At the start of the campaign, the Allies hoped that chemical insecticides might help them avoid the expense of reengineering the Korle watershed. The Americans were especially interested in using a silver-bullet approach to control the local mosquito population because they did not want to fund infrastructure projects that they would have to abandon after the war. In April 1942, the US Army began spraying the larvicide Paris green on open water surrounding the barracks, and trucked pyrethrum aerosol bombs into British camps to clear the buildings of mosquitoes. They proceeded to spray all houses within a one-mile radius of the airport, three times a week. In 1944, when adequate supplies became available, they switched to spraying with dichlorodiphenyltrichloroethane (DDT), and by the end of the year, they were spraying all villages within an eight-mile radius of their camps, including the Accra city centre. Because DDT was not considered toxic to humans, the Malaria Control Group believed it was safe to disperse the chemical into water supplies. By 1944, the Allies commissioned a Piper J-3 cub to aerial spray the Korle, Kpeshi, and Klotey Lagoons, as well as partially spraying at the Sakumo Lagoon, several kilometres to the west of the city.
The spraying campaigns of 1942–45 were conducted at great expense in labour and materiel. For instance, during a three-month surge to eliminate the presence of mosquitoes and mosquito larvae at the airport in 1944, the Americans sprayed more than 1,000 pounds of Paris green, 2,000 pounds of pyrethrum, and 500 pounds of DDT, and they still found larvae in some of the streams leading into the lagoon. Major Macdonald had always believed that it would be cost effective to take the time to build drainage systems that would confine water to ditches and ponds, where smaller amounts of insecticides could be used, and as the war dragged on, the Americans too began to see the necessity of longer-term planning. In 1944, Allied engineers mapped out a pesticide spraying zone, re-dredged the sea outfall, and employed African crew to clear ditches and streams all the way up the Korle watershed. The Royal Army Medical Services followed up by spraying and oiling the waterways on a regular basis, a method that reduced the amount of pesticides used.
While the drainage scheme proceeded, Lt. Ribbands built his aforementioned Malaria Field Laboratory and began by collecting data about mosquito populations in the army camps. An expert on Anopheles gambiae, Lt. Ribbands had already researched the flight and biting habits of mosquitoes through a variety of experiments in India and West Africa, and his first step was to replicate a study that he had conducted in Sierra Leone, collecting mosquitoes from the Gold Coast Regiment barracks. The mosquito crew spread sheets on the floors of the tents and sprayed the air with pyrethrum or DDT to kill any insects inside. Afterward, Lt. Ribbands hired local men to pick up the mosquitoes and take them to a central laboratory at the airport for identification.
Lt. Ribbands and the malariologists expected to eliminate the mosquitoes around the Allied army barracks, but when he analysed the early results, he realised that the health of soldiers was still compromised by the in-flight of mosquitoes from nearby villages. According to the Allied records, the fear of contagion spurred the Malaria Control Group to relocate the villagers outside the airport to a newly conceived one-mile sanitary cordon. If this is true, then the Allies had extended the supposed flight range of a mosquito from one-quarter of a mile to a full mile and relocated the people of nearby Nima and Kanda because they had become “reservoirs of disease.” But though there are brief references to the planned evacuation of these nearby villages, no particular records demonstrate that a forced removal took place. If the evacuations did occur, they would have entailed the movement of hundreds of people (mostly Muslim newcomers to the city) by truck, as well as extensive documentation of claims for property. The lack of a paper trail raises the question of whether the residents of the villages were in fact relocated, but whether they were moved or not, a new spatial reckoning of Accra had been created because of the threat posed by infected mosquitoes.
Once he had established a cordon around the periphery of Korle Lagoon, Lt. Ribbands began to track the movements of Anopheles gambiae using his network of mosquito sheds. Built by African labourers in the employ of the British Army, the traps were single-room, timber-frame structures covered with screens and tar paper and fitted with baffles to let mosquitoes in at night. Ribbands modelled his traps on a prototype developed by American entomologist E. H. Magoon, but with a substantial difference: during his research in Jamaica, Magoon used only horses and mules to attract mosquitoes. Lt. Ribbands preferred human bait. Since he was largely concerned with studying the attraction of mosquitoes to White soldiers, it would have been logical to assign an American or British soldier to live in the traps, but the Allies were shorthanded, and Lt. Ribbands did not want to risk Allied airmen catching malaria. As a compromise, he hired African workers to sleep in the traps: “Africans selected as bait were chiefly men from the Northern Territories of the Gold Coast. They were chosen because most of them were homeless and it was felt that they would welcome the fine shelters provided by the mosquito traps, however, only those who could speak a few words of English were hired because they had to be able to understand the simple instructions. That the traps were home to these men was soon obvious when it was seen that they preferred to remain in the vicinity even during the daytime when they were not working.”
The choice of migrant workers as human bait is not surprising. These men go unnamed in the military records, but they were likely drawn from the same pool of immigrants recruited by the Gold Coast Medical Department as so-called volunteers in experiments at the Accra Laboratory during outbreaks of yellow fever and relapsing fever. But if they were homeless, as Ribbands suggested, it probably did not mean that they had nowhere to sleep. Newcomers to Accra usually were able to find a bed, even if that meant crowding in with their fellow migrants. And even if they did lack permanent residences, it is difficult to believe that they considered the traps desirable places to sleep. The sheds were small, filled with bugs, and lacking the benefit of the slightest breeze to cool the skin. It is also implausible that they thought of the traps as homes, considering that they were located in wooded areas and did not have locks to secure the doors. Moreover, the sheds were spread around a perimeter of several kilometres, and Lt. Ribbands rotated the men through the network of sheds at weekly intervals.
The military records also show that the hired bait did not always follow the rules. The men were required to stay in their sheds from sunset to sunrise. When they awoke, they were to leave the traps, carefully closing the baffles to catch the mosquitoes inside as they left, so that the spraying crew could lay down a tarpaulin, spray the sheds, and collect the insects. To monitor the sleeping patterns, Lt. Ribbands sent soldiers around the perimeter to ensure that the men serving as bait were actually sleeping in the traps and to prevent a reported “tendency to sit outside the trap at night”— an indication that the Africans who took part in the Malaria Control Group studies were not always willing and forthright participants. Though there is no record of outright resistance, the migrants did take measures to avoid mosquito bites and preserve their dignity.
[This piece is culled from a bookauthored by Jonathan Roberts, titled:Sharing the burden of sickness: A historyof healing and medicine in Accra]
The average modern Gold Coaster born and bred in Sikaman is an adventurous creature. Go to any part of the world and you’ll find Ghanaman diligently slugging it out either in the snow or in hot sweltering weather, earning a decent living.
Go to Guinea and see Ghanaman in the garb of a herbalist, curing the sick of various ailments. He makes the Guinean understand that not all diseases are caused by James Lucifer alias Jimmy Satan. On the contrary, most diseases are caused by kooko which can even attack the human nose and turn it upside down.
That kooko is also the cause of poverty and the internal bleeding of personal back-pocket economies. And that kooko can be cured using the chemistry underlying Sikaman herbal medicine which has been blessed by the gods of Larteh.
And before Ghanaman starts dispensing his herbal concoctions, he must attract the passing crowd with some Sıkaman-originated choreography, akin to a combination of adowa and agbadza, such that the dancer can easily dislocate a shoulder and start crying for his mother.
When the crowd is enough to form a quorum, Ghanaman must perform magic as a side-attraction, and proceed to sell his drugs. The drugs are genuinely made from potent herbs which the Pharmacy Board of Sikaman says it has no confidence in. Believe me, Ghanaian herbalists are practising in neighbouring countries like Guinea, Cote d’Ivoire, Sierra Leone and Benin, while we are discouraging them from practising in Sikaman.
Go to Las Palmas and see Ghanaman as a fisherman. He sails on Korean-owned boats and is forced to eat garlic and raw tuna for radiant health. The garlic is also supposed to protect him against witches. But sometimes, he is not good bedfellows with some Korean crew members, and once in a while a fight breaks out.
The typical Korean is a Kung Fu expert and before displaying a golden dragon data. He must first terrify Ghanaman with a Korean dance which consists of wild arms and leg throwing. But Ghanaman is usually not daunted. Why has he been eating cancer kenkey all years without developing cancer? It mean is a superhuman capable of countering Kun fu side-kicks to the ribs.
Anyhow Ghanaman’s most potent arsenal lies in his fists. If he is a southpaw, it mean left fist is probably insured and can cause damage. When Ghanaman lands a cassava blow and it lands on a Korean chest, it has the effect of a cruise missile. If there is no ceasefire a funeral cannot be ruled out.
Greenland
Go to Alaska and find Ghanaman there. Greenland, Iceland, Brazil, Argentina, Madagascar, everywhere and you’ll find him. He has become an international citizen and is generally lauded for his hardwork, sincerity and honesty.
However, some bad nuts are also condemned and despised.
The world and all its parts and corners are for the human race, and anyone can choose to live anywhere and earn a decent living so long as he doesn’t misconduct himself or become a social misfit and a law unto himself.
Sıkaman for instance accepts foreigners, and we are so liberal that people just come in through our borders and we welcome them with the best palmwine in town and goat light soup. Who cares about passports and visas? Our hospitality is, as it were legendary.
So we have Liberians, Nigerians, Sierra Leoneans, Togolese, Europeans, Americans, Scandinavians and Koreans in Sikaman. And some of them have misinterpreted our overzealous accommodation to mean “foolishness” and are misconducting themselves.
The newspapers carry stories of some unscrupulous Nigerians stealing, defrauding and collaborating with their Sikaman counterparts to rob people. You’ll find some good and law-abiding Liberians around but some other Liberians are in the business of fraud, robbery, money printing, money doubling, anything criminal.
Ghanaian hospitality can no longer be extended to such people. I do not think Ghanaians will be treated kindly either, when they misbehave anywhere in the world. Those who come from outside with the intention of bringing down their evil deeds and to practise them here professionally must be getting ready because Ghanaians are getting fed up with the menace.
These days, you’ll find strange people following you as soon as you emerge from a bank. If you are not careful, they’ll wrestle your briefcase from you and speed away in a waiting taxi.
Someone was just saying that many foreign criminals are flocking to Ghana because in their countries, they are enable to operate either because they are being looked for by the police for offences committed or fear instant justice at the hands of mobs. Ghanaians, it is said, are humanitarian in dealing with criminals.
Well, in some African countries, a thief who is being chased runs directly to the police station in his own interest and begs the officer at the counter to lock him up. Otherwise he’ll be lynched or be burnt to death. In Ghana, it is the opposite. The thieves run far away from the cop stations.
The criminals must reform and stay peacefully in Sikaman or quit. No court case!
This article was first published on Saturday September 5, 1998
The human condition is defined by two absolute, biological bookends: the commencement of complex cellular animation and its ultimate, irreversible cessation.
For centuries, medicine treated life and death as strictly separate states. Today, modern pathology and molecular biology reveal a more profound truth: the mechanisms that allow us to live are the exact same mechanisms that dictate how we die.
Understanding this relationship is no longer just a philosophical pursuit. It is a clinical necessity for managing public health in the 21st century.
Part I: How we live – The mechanics of animation
At its core, biological life is a continuous, high-stakes battle against entropy (the natural tendency of systems to degrade into disorder). To maintain form, consciousness, and function, the human body relies on three fundamental pillars:
1. Cellular respiration and energy production
Every second of human life is powered by the conversion of oxygen and glucose into Adenosine Triphosphate (ATP), the universal energy currency of our cells. This process occurs within the mitochondria.
Without a constant supply of ATP, the microscopic pumps that maintain electrical gradients across our cell membranes fail, causing cellular collapse within minutes.
2. Homeostasis: The balancing act
To survive, the internal environment of the body must remain incredibly stable, regardless of external chaos. This balancing act, known as homeostasis, regulates:
Blood pH: Strictly maintained between 7.35 and 7.45.
Core Temperature: Ideally kept around 37°C (98.6°F).
Electrolyte Balance: Precise ratios of sodium, potassium, and calcium that allow nerves to fire and muscles to contract.
3. The Autonomic Nervous System (ANS)
The ANS acts as the invisible conductor of life, split into two complementary branches:
Part II: How we die – The path of cessation
Death is rarely a singular event; it is a progressive biological cascade. Whether caused by old age, chronic illness, or sudden trauma, the final pathways of mortality generally follow a predictable trajectory.
1. The cellular horizon: Senescence and Apoptosis
Every time a human cell divides, the protective caps at the ends of its chromosomes-telomeres-shorten. Eventually, telomeres become so depleted that the cell can no longer divide safely. It enters senescence (a state of permanent arrest) or triggers apoptosis (programmed cell death). This gradual, systemic loss of cellular renewal is the underlying engine of aging.
2. The clinical cascade of somatic death
When the body can no longer maintain homeostasis, somatic death (the death of the organism as a whole) begins. This occurs in a distinct sequence:
1
Clinical Death
Zero to four minutes
The heart stops pumping blood, and respiration ceases. While breathing and circulation have ended, the body’s tissues still contain residual oxygen and cellular energy reserves. At this stage, resuscitation is often still possible.
2
Brain Death (Infarction)
Four to six minutes
Deprived of fresh oxygenated blood, the brain’s highly sensitive neurons begin to starve. Lacking ATP, the brain cells lose their electrical charge, swell, and begin to burst. Permanent, irreversible neurological damage occurs within minutes.
3
Biological Death
Hours to days
The organs fail entirely. Without central control or blood flow, individual cells throughout the body consume their final energy reserves. Enzymes that once aided digestion begin to break down the body’s own tissues from the inside out, a process known as autolysis.
Part III: The modern collision of life and death
In the modern era, the boundary between how we live and how we die has blurred. Historically, humanity died primarily from infectious diseases and acute trauma. Today, global mortality is dominated by non-communicable, chronic lifestyle diseases.
Modern Pathology: How we live (the cause) how we die (the result)
Cardiovascular disease, chronic stress, poor diet, and lack of sleep keep the sympathetic nervous system hyper-activated, damaging blood vessels .Occlusion of coronary arteries leads to myocardial infarction (heart attack) or ischemic stroke.
Metabolic syndrome over nutrition and physical inactivity overwhelm cellular mitochondria, leading to systemic insulin resistance. Multi-organ failure, chronic kidney disease, and severe vascular complications.
Neurodegenerative Disorders Chronic systemic inflammation and sleep deprivation prevent the brain from clearing metabolic waste. Gradual loss of synaptic connections, leading to dementia and the eventual loss of basic autonomic functions.
Conclusion: The unified theory of health
Ultimately, how we live directly shapes the path of how we die. The micro-choices of daily existence-how we manage emotional stress, the quality of our rest, our communal connections, and our nutrition-either preserve the integrity of our homeostatic systems or accelerate their decline.
True medical advancement is shifting away from merely extending the final, frail stages of biological death. Instead, the focus is turning toward optimising our living years-ensuring that the intricate, beautiful machinery of human animation runs smoothly until its natural, quiet conclusion.
By Robert Ekow Grimmond-Thompson
