The Illustrated Insectopedia - Hugh Raffles (2010)
That too-hot, too-shadeless morning, pushing the outboard motor to its very limit, first one river, then the next, those never-ending Amazon rivers—never realized anywhere could be so far, worrying about the gas tank, worrying about fallen trees in the water, worrying about the time, heading for the medical post with poor, sad Lene, her hair hacked short in an act of rebellion that only confirmed her madness; Marco, her husband, stone-faced, watching over her, her body now sprawled under the bench seats in the hull of the bouncing dinghy, motionless, lifeless but not quite dead, lifeless on the outside, but everything happening within, malaria coursing through her veins, bloating her liver, fevering her poor, troubled brain.
Everyone got sick. It made no difference that the area around the house had been cleared of forest, as the public health leaflets insisted. Nor did it matter that each house had its neat, handwritten number on the doorpost to confirm that it had been sprayed with DDT. Everyone got sick, some worse than others, the weakest—the children and the elderly—as always, worst of all. When it was my turn, I just lay in my hammock, burning with icy shivers, my body racked from top to toe, eyes dull, mind listless, utterly dependent on the kindness of people who knew there was nothing to do but wait it out. Every day as night fell, it returned. And then, afterward, in the morning, a feeling of weakness that was pleasantly ascetic, as if I had been purged and cleansed, had survived a trial. But within, the knowledge that my body was stitched fatefully to the rhythm of the day in a new and previously unanticipated pattern.
And my sickness was as nothing compared with that of others. Dora, young and strong, my best friend here, came that close to death. She, like Lene, had falciparum, the most dreaded, she told me. I’d been away when she took ill, and that absence gave her the chance later to narrate with the full melodrama that the crisis deserved. It was the três cruzes, three crosses, she said, though, like me, she had never quite figured out why it was called that. Um cruz, dois cruzes, três cruzes. Some people said it referred to the intensity of the infection. But the printed slip they had given both of us at the clinic in town had three Latin names (although there are really four Plasmodium protozoa that inhabit human hosts) and a space for a tidy little cross beside each. Mine had just one cross, and the box next to P. falciparum was unmarked. Lene and Dora both had three crosses, so one cross had to be inside the box for P. falciparum, the parasite that swims all the way to your brain.
It makes little difference if you clear the vegetation around your house the way the leaflets tell you. It can even make it worse. This is the Amazon floodplain, for heaven’s sake; the houses are on the banks of the river, and when the tide falls, it leaves pools of standing water everywhere. For a few weeks each year, the mosquitoes are so thick in the air at dawn and dusk that everyone burns wood inside the house, hoping that the thick smoke will force the devils to leave. With streaming eyes, slapping ourselves repeatedly on thighs, arms, sides, even the face, hitting each other when we see one land, jumping around like Keystone Kops, we try to eat the evening meal but more often than not simply give up. It’s impossible to sit down or even stay still, and if the needle-sharp bites weren’t so painful, we’d probably find it comical. Within minutes we retreat to the safety of mosquito nets or cover ourselves with cotton blankets, frustrated, sore, hungry.
In the city there are various contraptions for seeing off mosquitoes. But here, without electricity, there is only smoke. With no effective recourse, the insects exhaust us. I never talked to anyone about this, but those insects made me feel like an interloper. Not—as when I first arrived—an awkward intruder in the lives of the people who became my hosts (making me their parasite). Now, when we ran from the clouds of mosquitoes and the billowing smoke, together in our pain and annoyance, it was clear that we all were intruding on this landscape and its forms of life.
Although P. malariae can make a home in a range of primates, falciparum and the others live in humans only. Between the female Anopheles mosquito and its parasitic protozoa, these are life cycles of awe-inspiring elegance, devastation, and persistence. In September 1658, Oliver Cromwell died from malaria he contracted in Ireland. Now Europeans know it only as a disease of the tropics, of poverty, distance, and underdevelopment, a disease without profit. According to the World Health Organization, malaria kills 1.5 million people each year. Thankfully, Lene was not one of them. At least, not then. At the health post, they gave her an injection and some tablets, and we took her back home, more slowly, less anxious.
So many problems, so overwhelming, where even to begin? No nearby health post, no sanitation, insufficient food in summer, the insupportable inequalities of health, life expectancy, and well-being. And then the shame, so much shame, so much uselessness, the overwhelming boredom that drove this woman beyond restlessness and consigned her family to the margins of this margin. The day I went to say my final good-bye, Lene stayed inside the two-room wooden house with her daughters—the four preteen girls who cared for her. I sat outside with Marco on a tree trunk overlooking the creek and his field of maize. He drew on his cigarette and listened patiently as I lied for the last time, telling him about my journey and promising I’d come back to see them all again soon.