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The creation of an African ‘bloodstream’: Malaria control during the Hitler War, 1942–1945 (Part 6)
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KORLE AFTER THE SECOND WORLD WAR
But the major reason that the antimalarial campaign of the Second World War was forgettable is because it was never completed. By 1945, just as Lt. Ribbands and Major Macdonald declared victory over the mosquito, the Allies had opened up the Mediterranean, and transshipment across the Sahara was no longer necessary. The number of troops stationed in Accra dwindled, and the Americans hastily terminated their involvement in the antimalaria campaign. From 1942–45, the Gold Coast government had been responsible for funding only eight per cent of the work done by the Malaria Control Group, while the rest had been covered through the Lend Lease programme (65 per cent) and by the British armed forces (25 per cent). In 1945, the Allied forces left the Gold Coast Public Works Department with the entire cost of maintaining the massive drainage works built on the Korle watershed as well as the responsibility of spraying DDT around the city. A year later, it was evident that the Gold Coast government would never muster enough funding to keep a perpetual campaign against malaria going—the Public Works Department did not even have a budget to screen the windows of bungalows in the city, let alone reinforce miles of concrete embankments along the Odaw River. Major Macdonald’s attempt to squeeze infrastructure funding out of the Americans had worked temporarily, but the war was simply too short to complete the project.
In 1946, crew working for the Gold Coast Public Works Department were further disheartened when aerial photos revealed dozens of quarries, salt pans, and borrow pits around Accra, too numerous to monitor and too expansive to spray regularly. The effects of human habitation had created a niche for mosquitoes to flourish, and any dream of eradication was untenable. The British returned to a policy of malaria management—by relying on quinine prophylaxis and the occasional spraying of waterways to prevent mosquito infestations. In the short term, the effects of DDT made the city notably healthier, and use of the chemical became commonplace. For the price of only four pence a tin, DDT even found its way into homes, where people used it to control lice and bedbugs. Kingsway, the largest department store in Accra, dispensed the drug at their chemist department and advertised it as a product created for the “eternal benefit of mankind.” Unfortunately, the mosquitos in the area quickly developed a resistance to the chemical, as they did in many other parts of the world. By the 1950s, the Korle Lagoon and its tributaries became mired in silt, and malaria was once again endemic in Accra.
When the soldiers were demobilised and the spraying crew departed, the identity of the lagoon as a goddess among the Ga was easily revitalised. In 1946, after several years of bitter disputes over the stool, Nummo Ayiteh Cobblah II was installed as the priest of Korle. Cobblah became a prominent religious leader in Accra, as a moderate during anticolonial riots in 1948 and as a friend to Ghana’s first president, Kwame Nkrumah. When Cobblah was enstooled, he resuscitated the rituals of the annual harvest festival of Homowo, establishing his rights to communicate with the spiritual forces that inhabit the lagoon. As she had for centuries, Naa Korle asserted herself as a moral force within Ga culture, a goddess with the ability to define states of collective well-being in the city.
INTERLUDE: HEALING THE SICKNESS OF COLONIALISM
In the early 1950s, when the colony of the Gold Coast was on the verge of independence, a unique type of healing culture developed among a group of Zarma-speaking migrants from western Niger, known in Accra as the Zabarima. At the time, the Zabarima were the fastest-growing segment of the Muslim population in Accra, reaching 4,000 by 1954. Working in the most menial of jobs, such as carrying loads around the market, recycling used flour bags, or scavenging for used tins and bottles, the Zabarima survived on the margins, and their religious and healing practices reflected their social station. The Zabarima had immigrated from a part of Africa that had been Islamised for hundreds of years, but many of them were also worshippers of a pantheon of deities known as the Hauka (a Hausa word meaning “crazy”). Jean Rouch, a French filmmaker who followed the activities of migrants around West Africa, claimed that at the peak of the Hauka movement, there were approximately 100 Hauka gods in West Africa and that approximately 30 per cent of Zabarima migrants to the Gold Coast were possessed. Unlike Ga priests and spirit mediums, who worshipped and practised in public, the followers of the Hauka operated in secret. Indeed, their ceremonies would have remained largely unknown if not captured on film by Rouch, who was invited to one of their gatherings in a village suburb of Accra.
Jean Rouch’s footage of a Hauka spirit possession ceremony is striking. It includes several men and one woman gathered around a Hauka shrine in a courtyard decorated with fluttering Union Jacks. Rouch, the narrator, tells the viewer that those gathered are suffering from illnesses caused by sorcery and witchcraft and that they have come to seek the help of the Hauka deities. On the cue of a single note from a violin, the participants are slowly filled with spirits representing different colonial characters, perambulating chaotically before the camera, making grotesque faces, and foaming at the mouth. The most powerful god was Gomno, the “governor,” a deity represented by a colourful mound with a pith helmet—an image that Rouch paralleled by interposing a scene of the Gold Coast governor Arden-Clarke wearing full regalia at an official ceremony in Accra. Other prominent characters represented the network of colonial officials, including the train engineer (who marches relentlessly back and forth), the sergeant at arms (who berates the participants), and a doctor’s wife (who mediates disputes). The film climaxes with a series of heated arguments among the spirits, and a frenzied meal of dog-meat soup. After they eat, the spirits slowly leave the bodies of the possessed, and the exhausted migrant workers load themselves onto a truck, bound for their regular lives in Accra.
When Rouch screened the film in Paris in 1954, it created a scandal. Some critics thought the film, entitled Les Maitres Fous (The mad masters), was a fake made with paid actors. Others thought it was a racist portrayal of colonial subjects as ethnographic specimens. Anthropologist Marcel Griaule called the film a “travesty” because it stereotyped Africans as savages; he urged Rouch to destroy it. More recently, Les Maitres Fous has been celebrated because it depicts a form of mimicry that expresses the colonial mentalities of African subjects. As Rouch had always argued, the Hauka cult made a bold statement about the psychological effects of colonialism, representing a kind of social healing that allowed immigrants to cope with their subordinate status under White colonial rule. The “mad masters,” he maintained, were not Africans but the colonial ruling classes, who, within the context of the cult, represented the authoritarian structure of colonialism. The antithesis of benevolent colonialism, these spirits revealed a menacing crowd of military and technocratic elites fumbling about, fighting, arguing, and screaming. Even the character of the doctor’s wife, who plays the role of the mediator among the gods, becomes complicit in Hauka imaginings of colonialism, adding strength to the argument that the colonial subjects of the Gold Coast always regarded medical workers as agents of colonial power.
[This piece is culled from a book authored by Jonathan Roberts, titled: Sharing the burden of sickness: A history of 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
