Fluid Lives

Malaria, dengue and health in contemporary South Asia


The idea of this blog is to provide an informal space to think about my research explores the experiences and challenges of living with mosquito-borne diseases in contemporary South Asia.  I am a postdoctoral researcher on the Wellcome Trust funded ‘Invisible Crises, Neglected Histories: Malaria in Asia 1900-present’ a comparative history project at the University of Oxford. I get the post-1945 beat in South Asia, while colleagues draw on their regional and temporal expertise to look at malaria in South Asia 1900-1945, in Burma, and in Japanese occupied China/Manchuria, from a Korean perspective. As the tide of DDT, as cover all solution to malaria, rose in the 1950s and 60s, it is arguable that many specific, local and institutional knowledges about mosquito control were washed away. Who needs an entomologist to know which kind of anopheline mosquito is feeding in certain kinds of home in an area, if DDT will kill it anyway? Historical records allow the consideration of the impact of a range of variables on malaria transmission and mortality, which might be difficult to test today. In short, in the face of newly emergent resistance to drugs, insecticides and repellants, what can the historical record contribute to understanding malaria control today?

From my perspective an an anthropologist, this new malaria project builds on my continuing my fascination: how do people live with mosquitoes? It continues my research on the emergence of dengue fever in rapidly urbanising South Asia, in particular in Delhi. Dengue fever is a mosquito borne virus and according to the World Health Organisation, one of the fastest spreading tropical diseases in the world. The mosquito vector in South Asia has predominantly been Aedes aegypti, a rather pretty black and white mosquito, although the four serotypes of the dengue virus are also transmitted in other mosquito vectors, including Aedes albopictus, which prefers more wooded, sometimes temperate climes.

Mosquitoes require somewhere wet to lay their eggs and a source of blood meals to provide protein for their eggs. Consequently, urban humans, living in close proximity to each other, with their parallel need for water and tendency to travel widely have suited dengue fever and its domestic dwelling vector, Aedes aeygypti, very well. Delhi, a national and international transport hub, with its rapidly growing population (16.8 million in 2011), scarce water supply stored in large domestic tanks has provided the mosquito with a conducive home.

In 1996 Delhi saw the first major outbreak of dengue haemorrhagic fever and the city is now endemic for all four dengue virus serotypes. Dengue Fever (DF) gives most people relatively mild, if unpleasant symptoms, often analogous to a nasty bout of flu. Indeed, in South Asia, the coincidence of outbreaks with the monsoon often leads people to put such fevers down to ‘season change’. Unfortunately, in some people (exactly who is hard to predict), the virus can take a nasty turn for the worse, with the fever returning for a second time, as the virus precipitates a cascade of biochemical reactions in the immune system, causing blood vessels become rapidly permeable and the patient go into sudden shock and bleeding (dengue haemorrhagic fever (DHF)). The virus has no vaccine, nor prophylactic or treatment, unlike malaria, leaving severe cases to simply be managed with a combination of fluids, pain relief and blood transfusions.

While there are increasing amounts of important research on the genetic, entomological, bimolecular dimensions of dengue fever and Aedes mosquitoes, there has been less exploration of the social, political, economic, historical, technical, and structural dimensions of the relationships between humans and mosquitoes. These relationships are important as humans largely shape the urban landscape, and appear in various guises as individual householders and government officials, public health campaigners, and are informed by different knowledge and experiences of fever and wellbeing, uneven access to water, healthcare and green space, and different ways of living in the city. This research seeks to explore these relationships to better understand a political urban ecology of health and urbanisation in a global city.

The title of the blog, ‘fluid lives’ reflects the dynamic, but quite sometimes fragile nature of urban livelihoods and wellbeing, as they encounter both the illness and governance measures taken against this rapidly spreading ‘neglected tropical disease’. Posts may take the form of reflections on debates in the literature, contemporary concerns in development circles, observations on Delhi happenings, and other interesting things. Crucially all these thoughts and posts are provisional. As Teo Ballvé eloquently puts it: ‘This blog is my motley space for commentary, summary, research notes, study, and whatever else I might want to do.

‘Beware of the Bite: Dengue is caused by mosquitoes’

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  1. Pingback: Casting off – Fluid lives in a South Asian megacity | Fluid Lives

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