The Sources of the Nile

Lake Victoria

Last week I wrote about David Livingstone and his six vanished years in search of the source of the Nile.  In a comment, Annamaria Alfieri suggested that the enthusiasm for this particular venture was motivated by Britain’s concern to control Egypt and thus the Suez Canal.  No doubt that’s right.  But the issue goes back much further than that.  There is a Latin saying: “Caput Nili quaerere,” which means “searching for the Nile’s head”.  It was used when someone suggested doing something ridiculous or impossible.  It reminds me of our saying: “You might as well fly to the moon,” which has also been outdated by technology.

Nile Delta

Headwaters of the Blue Nile

Speaking of technology, last week I suggested that a couple of hours with GoogleEarth is all one needs nowadays to solve these exploration issues.  So I decided to try with the source of the Nile.  Well, it only takes about fifteen minutes.  (It’s fun to do, but don’t cheat.  Turn off all the borders, roads, photos and the like or it will take you on an obvious tour down the river.)  

Start at the mouth in Cairo and work upstream from there.  It’s pretty obvious up to Khartoum in Sudan and then there’s a problem.  The river splits into two major tributaries, the White Nile and the Blue Nile.  The Blue, which actually carries the majority of water into the main river as well as the fertile silt, wends its way from Lake Tana in the highlands of Ethiopia.  So is that the source?  No, the definition seems to be that the source is the furthest connected waterway from the mouth.  The White Nile is longer, so follow it south through a huge swampy area in southern Sudan. (Yes, Sudan is like Botswana; very dry except where it’s wet.)   Then it crosses into Uganda and once more splits.  The Albert Nile empties from the lakes of the Great Rift Valley while the White Nile heads east and then south.  It exits from Lake Kayoga, which in turn is fed from Lake Victoria.  And that huge East African lake is to all intents and purposes the source of the Nile.  But, of course, one could argue that the longest river flowing into Lake Victoria is actually the source.  In 1934 a German explorer traced the Kagera river back to the hills of Burundi, and as recently as 2006 a British and New Zealand party claimed a spot in Rwanda as the actual source (i.e. that their source was further from Lake Vic than the German’s).  And that wasn’t easy.  The 2006 team traveled 4000 miles in 80 days and one member of the party was killed by rebels. 

Dhows on Aswan Dam

But it was the connection between a great lake and the Nile that the seventeenth century explorers sought.  A nice, safe water supply for the river, and plenty of accolades at home.

John Hanning Speke

In 1856 John Hanning Speke teamed up with Richard Burton (fresh from his trip to Mecca disguised as an Arab pilgrim) and set out in search of the source of the Nile.  It was a strange partnership; the men already disliked each other and had very different personalities – Burton flamboyant and Speke retiring.  Their earlier trip together had seen them both badly injured in Somalia.  My guess is that they went together because each was scared of the other discovering the source alone!  As with all of these explorations into “darkest” Africa, the trip was horrendous.  Both men became ill.  Speke went temporary blind and suffered greatly after trying to remove a beetle from his ear with a knife.  They discovered Lake Tanganyika, but Burton was too weak to continue.  Speke went on without him, discovered Lake Victoria, and declared it – correctly but with no real evidence – as the source of the Nile.

Richard Burton

Nile Catchment

He announced this publicly on returning to England, to Burton’s fury.  On a follow up expedition in 1860, he sailed the northern coast of Lake Victoria and found the Ripon Falls pouring water out of the lake.  Although he didn’t follow the water through Somalia, the evidence seemed conclusive.  But Burton was still pushing the Lake Tanganyika option.  (He wasn’t stupid, at one stage the Albert Nile was indeed fed from that lake, but it was blocked by volcanic activity in geological times.) Eventually a great debate was scheduled between the men before the geographical section of the British Association in Bath on 18 September 1864.  The day before, Speke went bird hunting and, climbing a wall with a cocked shotgun, killed himself.  There were rumors of suicide, but the wound – below the armpit – made that very unlikely.

The matter rested in limbo until our friend Henry Stanley of Livingstone fame confirmed Speke’s discovery in 1875.

Michael – Thursday.  

“Dr. Livingstone, I presume?” Stanley asked. Or maybe not.

Posthumous portrait of David Livingstone

David Livingstone was one of the most well-known explorers of his time, and even today many people at least have heard of the legendary exchange when Sir Henry Morton Stanley  supposedly met him at the Victoria Falls.  Here is the report at the time from The Herald:

Preserving a calmness of exterior before the Arabs which was hard to simulate as he reached the group, Mr. Stanley said: – "Doctor Livingstone, I presume?" A smile lit up the features of the hale white man as he answered: "Yes, and I feel thankful that I am here to welcome you."

The meeting at Ujiji

Well, yes.  Except that it wasn’t anywhere near the Victoria Falls but at Ujiji near Lake Tanganyika.  Certainly the meeting took place, but Stanley tore the pages containing those famous words out of his notebook afterwards.  But they made good copy, and, after all, Stanley was a journalist as well as an explorer.

The two men went on to explore the region together, and established that there was no connection between the huge lake and the Nile River.  It was the source of the Nile that Livingstone sought at the time.  But more on that next week.

So what brought Stanley and Livingstone to this spot in the middle of Africa, and why was there enough public interest to justify two US newspapers financing Stanley’s trip to find Livingstone after he'd disappeared and been reported dead?  It is hard for us to visualize today what excitement the “opening up” of the unknown world generated.  It was also the dawn of the scramble for Africa by the European powers, so national pride was at stake.  Today, if we want to explore somewhere in Africa (or anywhere else for that matter) a couple of hours with GoogleEarth is probably all it takes.  Then, the explorers faced gruelling trips through uncharted terrain with hostile local people.  (They had every right to be hostile; it was, after all, their land, the area was crawling with slave traders, and one of Stanley’s contemporaries commented that he “shoots negroes as if they were monkeys.”)  

Livingstone was one of the most popular national heroes of Victorian Britain.  He had all the right credentials – a Protestant missionary from a working-class background with an inspirational story, an intrepid explorer, anti-slavery crusader, and supporter of the British Empire.  And he died in Africa.  Posthumous heroes are always the best; their feet –  whatever they’re made of - are safely buried with the rest of them.  Although it didn’t work out quite that way for Livingstone.

Statue of Livingstone in Zimbabwe at the Victoria Falls

David Livingstone was born in 1813 in Scotland to devout parents and decided on a calling as a medical missionary.  He hoped to go to China, but politics intervened and he landed up in the northern Cape in South Africa.  Once he’d had a taste of Africa, he was addicted.  (Stanley and I warn all our visitors of this problem, but I suppose no one warned Livingstone.)

In 1854 he crossed Africa from West to East ending at the mouth of the Zambezi River.  This was a mammoth undertaking given the terrain, tropical diseases and unfriendly inhabitants.  But Livingstone had the ability to travel with just a few companions and light supplies, and he approached the local chiefs with respect, asking for their permission, which was usually granted.

Yet things didn’t continue well for him.  He sold the British government on opening up Africa by navigating the Zambezi from the mouth into the interior.  A huge expedition set out under his leadership.  Even before he reached the impassable rapids (that he'd missed on his previous trip), the expedition fell apart.  The opposite of his previous small exploration parties, it soon became clear that the management of a large one was way beyond him. It was summed up by his physician, John Kirk, writing in 1862, "I can come to no other conclusion than that Dr. Livingstone is out of his mind and a most unsafe leader."  Given the British penchant for understatement, this was hardly a rave review!

In 1866 he returned to Africa in search of the source of the Nile.  This expedition was also a disaster as his porters deserted him and his health deteriorated.  After many adventures, he was forced to accept the help of the hated slave traders to get him to Ujiji.

Henry Morton Stanley

Livingstone had no contact with the outside world for six years.  It was falsely reported that he had died.  But his reputation was now so wide, that two US newspapers were willing to fund explorer and journalist Stanley to search for him.  Stanley reported that they told him: "Draw £1,000 now, and when you have gone through that, draw another £1,000, and when that is spent, draw another £1,000, and when you have finished that, draw another £1,000, and so on— BUT FIND LIVINGSTONE!"  In fact he had been touting the trip for two years and finally got agreement.  But his version makes better press, right?  All the same he did find Livingstone, although the explorer was probably not all that ‘hale’.

Memorial near the Mvula tree

David Livingstone died of malaria and dysentery  in the area of present day Zambia on 1 May 1873. Britain wanted the body to give it a proper ceremony, but the tribe there would not give it to them, claiming that he was an African hero and deserved to remain in Africa.  Finally they relented, but cut the heart out and put a note on the body that said, "You can have his body, but his heart belongs in Africa!"  His porters then carried the body “home” on a horrendous journey of over a thousand miles.   But his heart was buried under a Mvula tree near the spot where he died.

Livingstone faced awful ordeals alone and never lost faith, passion, or the need to go further.  Certainly, he had serious flaws and the outcomes of his expeditions had mixed results both for him and his family, and for the local peoples he met and who befriended him.  But, by any standards, he was a truly extraordinary man.

Michael – Thursday.

The Beat Goes On: The Lunatic Express—Part Two

The “Beat” in this regard involves beating the bushes.  Brave and somewhat loony Englishmen did a lot of that in Africa in the Nineteenth Century.  With gratitude to Michael Sears, I invite you to take a look here at MIE’s previous discussions of that subject. 

http://murderiseverywhere.blogspot.com/2013/02/dr-livingstone-i-presume-stanley-asked.html#comment-form

http://murderiseverywhere.blogspot.com/search?q=The+Source+of+the+Nile

You can see from the stories of Livingston, Speke, and Richard Francis Burton that the Uganda Rail Way, whose history I took up last week, had lunacy in the family.  Let me trace its family tree back a generation from when the Brits began constructing it. 

Wanting a more efficient way to move wealth from India to England, Great Britain had dug the Suez Canal.  Then, to make sure the canal remained open and in their hands, they needed to take hegemony over Egypt.  They concluded that to control Egypt, they needed to control the Nile.  And to control the river, they wanted to take control of its source.  Eventually those intrepid and colorful men that Michael so deftly describes went out and found Lake Victoria.

Controlling the lake was not so easy.  To do so the Brits needed to keep administrators and troops there, men who needed supplies and the ability to communicate with the outside world.    Today, in a Mercedes or a lorry one can drive the 840 km (525 miles) between the lake and Mombasa in a day.  But a hundred and twenty years ago, they had to walk and it took months.  To make the trip safer and  much quicker, Great Britain built the railroad that became known as the Lunatic Line—a sobriquet based on facts given in my previous post.  Once the railway was completed, goods and people could make the trip in less than two days.  And they put in telegraph lines along the tracks, making communication all but instantaneous.  Hooray for modern technology.

But that was not the end of their trials.

Having built the railroad, they needed to maintain it.  And they had some special problems to deal with in that regard.

For reasons no one could fathom, rhinos would undermine the tracks, elephants would knock over the telegraph poles, and purloined telegraph wire became the raw material for many a tribesman’s favorite jewelry.  (Not that I blame them for such theft, considering the fact that the British were in the process of stealing their homeland.  But that is much bigger subject, for another post some time in the future.)

The bill for keeping the trains going was causing great consternation on the home front.  The taxpayers were sick of the expense.  What the railroad needed was paying customers.

Though at the equator, the area around a remote station stop called Nairobi, about halfway along the line, was a mile above sea level and had a climate the King’s administrators called “healthful.”  What a perfect area for farms.  Europeans might be enticed to move in and grow coffee and sisal, raise cattle, cut and ship rare woods, and so on and so on.  Then, they and their produce would pay to ride the rails.  What a swell idea.  And so they did.

I fully admit that there were also other forces at work throughout the story given here—from the search for the source of the Nile to the white settlement in the highlands of what is now Kenya.  The motivations I have mentioned so far existed in concert with a worldwide compulsion of “manifest destiny,” in which Europeans saw it as their right, even their duty to take charge of the earth, especially those parts of it that they judged to be savage.  Such as Africa and the American West.

When it came to Africa, there was also the moral imperative to stop the horrors of slavery, which was accompanied by a hope of bringing the pagans of the world to Christianity.

Social change in northern Europe coincided with all this.  Industrialization meant that aristocrats in those countries could no longer remain rich and privileged just by owning land.  But with cheap labor and unexploited resources in Africa, they could have all the servants and entitlements of their former life style.

 

And in the second half of the Nineteenth Century, there developed an ideal of manhood the proof of which lay in striking off into uncharted territory and conquering it.  Perhaps this happened because Europe had become too manicured and tame for the available testosterone.  That would be my guess.

All these factors, working together, resulted in the colonization of pretty much the last habitable and pristine places on earth.   East Africa was one of the victims.

Annamaria- Monday

Mombasa

Annamaria on Monday

 

The setting for my upcoming book—The Idol of Mombasa—has a fabulous exotic history: connected to the Sultanates of Oman and of Zanzibar, trade with ancient China, Portuguese global exploration, the Raj, and the search for the source of the Nile.  The romance of this list gives me gooseflesh.  What a place!  My series character—Vera Tolliver—describes it as a locale where you “expect to see Aladdin walking along, carrying his lamp.”

There has been a trading post on this island at least since the early Middle Ages.  Local oral tradition says it was founded, sometime around 900 AD by a woman—Mwana Mkisi and became the birthplace of the Swahili culture.  The first people to settle there permanently were traders and skilled craftsman.  Links were established with the Indian sub-continent and east as far as China.  Trade was in gold, spices, and ivory.  Once plantations, which relied on slave labor, were in place, trade expanded to include millet, sesame, and cocoanuts.

Modern picture of the historic souk

Mombasa’s harbor and its position on the Indian Ocean made it a natural as an international city, the most important port on the East African coast.  Persian and Arab traders were there early on.  One Arab geographer mentioned it in his documentation of 1151.  The first written account comes from a Moroccan traveler, writing in 1331.  He stopped in overnight and wrote in his journal, “a religious people, trustworthy and righteous.  Their mosques are made of wood and expertly built.”

 As with many other faraway places, Vasco Da Gama was the first European to show up in Mombasa—in 1498.  He must have lusted after what he saw, because he returned two years later and sacked the place.  At the time that Vasco—that villain—arrived, the city was ruled by the Sultan of Mombasa.  At which point there began a series of turnarounds for the citizenry.  Over the next four hundred, years hegemony over Mombasa went like this:

1528—Portuguese attack again and take over

1587—Zimba cannibals (!) put in a brief appearance

1589—Portuguese return and this time build Fort Jesus, which still stands

1698—Sultan of Oman tosses out the Portuguese

1728—Portuguese make another cameo appearance

1729—Sultanate of Oman is back and endures for a century

1824—Britain makes its first sally

Fort Jesus, as it looks today

Tunnel within the fort

Ancient Portuguese grafitti

Then, through a series of deaths, deals, and inheritances within the Sultanate of Oman, by 1886, a ten-mile wide swath of the coast had become the property of the Sultan of Zanzibar.   The Brits had been active in that part of the world for a number of years, trying to get a permanent foothold.  It was from Mombasa that they launched many of their forays in search of the source of the Nile.  British missionaries had moved into the hinterlands with dual and interlinked purposes—to convert the pagans to Christianity and as an important part of their effort to wipe out slavery worldwide.   In 1886, the King’s empire builders made a deal with the Sultan of Zanzibar, who gave them a concession in his territory along the coast.

At that point Mombasa became the capital of the Protectorate of British East Africa, into which they also included all the land going west to Lake Victoria and north to the southern border of Uganda. 

Just then, the Brits started to build a railroad from Mombasa to Lake Victoria, a bold, fascinating project that I have described in two posts before—here and here.  Once the railroad was completed, laborers imported from India for its construction often stayed on and settled in Mombasa, giving the city yet another facet of its fascination.

In 1906, since most of the European settlers were ensconced up country, the Brits moved their administration to Nairobi, where the capital of Kenya remains to this day.

Modern-day Mombasa stands as a pinnacle of historical exoticism. 

My characters walk around in the place as it was a hundred years ago.  Fortunately for me, photographic evidence of what it looked like still exists.  Here are just a handful of the photos I have collected:

 

Lucky, lucky me, I also have eleven volumes of eye-witness accounts—on my shelf in the New York Public Library.

Murder and Contagion

Alex for Michael - Thursday

I enjoy medical thrillers. Often the puzzle is as much in the medical aspects as in the whodunnit which adds to the interest. I 'met' Alex Lettau through a round table forum  for ITW a few months ago, and he had amazing things to say about malaria and other tropical diseases. Not really surprising since he's been practising in the area for thirty years, has several specialities including tropical medicine, has published multiple professional papers, and has been a medical missionary in Malawi, Nicaragua, and Papua New Guinea. Perhaps more surprising is that he  also writes fast-paced thrillers around Kris Jensen a medical detective with CDC. The first in the series is Yellow Death. I recommend you get a copy, not only because it's a really good, intriguing thriller, and not just because it won a National INDIE Excellence Award, but because, as you'll see below, Dr. Lettau is definitely not a person you want to cross!

It was just about the saddest day of my 37 year career in Infectious Diseases after I got the news that my patient, a 24 year-old woman who had contracted falciparum malaria on a mission trip to Liberia, had collapsed at home and died in the emergency room.  Two days earlier I had decided to treat her as an outpatient because she only had minimal symptomatology and had an extremely light parasitemia. Cause of death was spontaneous rupture of the spleen – rare in malaria and then almost always due to vivax rather than falciparum. 

The spleen, called “an organ of mystery” by the Greek physician Galen two centuries ago, is a fist-sized, highly vascular organ in the left upper abdomen tucked under and protected by the rib cage. Because of its rich blood supply, rupture of the normal spleen by severe blunt force abdominal trauma may cause fatal internal bleeding. However when the spleen enlarges, most commonly due to an infection such as mononucleosis or malaria, it emerges out from under the left rib cage and is susceptible to rupture from much milder direct trauma or even can rupture spontaneously. Chronic malaria may lead to a huge spleen as pictured, referred to as the tropical splenomegaly syndrome. Large spleens are also seen in visceral leishmaniasis and bilharzia.                                                              

Man with badly enlarged spleen

It has been known for centuries that an intentional targeted blow (mild enough to leave no mark) can easily cause a fatal rupture of a big spleen (thus it is also an organ of murder mystery!).  A specific weapon and method used in the Celebes was reported in the British Medical Journal November 24, 1951 (p 1281).                                                    

As mentioned by the author of the BMJ report, the Thugee cult of India also used this method to murder travelers, prior to stealing their possessions although their primary method of killing was by strangulation. The Thugees were an organized gang of professional assassins active in 13^th-19^th century India who acted in the name of Bali, the Hindu goddess of destruction. Their mission was to kill travelers by non-blood-letting methods prior to robbing them and it is estimated that they murdered a million or more before the British colonial government put an end to it!

So nowadays, leaving mass bioterrorism out of the discussion, how easy is it in real life to take advantage of an infectious disease or to utilize a micro-organism to murder a specific person (the “target”) and to get away with it? Short answer: It’s hard. The micro-organism needs to be a highly lethal, preferably untreatable infectious agent. The murderer also needs a source that supplies the agent and a means of delivery to infect the target, ideally without the target being aware of the exposure and even better if the infection is never specifically diagnosed. For the remainder of my guest blog, I will focus on rabies virus as a potential murder weapon.

Rabies is essentially 100% fatal once it reaches the brain to cause encephalitis. One problem is the long incubation period. After exposure say on the foot, rabies virus travels along nerve trunks and may take months to reach the brain. If the exposure is recognized, this delay allows for post-exposure rabies prevention using rabies immune globulin and vaccine. So the trick is to expose the target without their knowledge and then sit back and wait. I keep thinking I read once that the Mossad offed a target with a rabies-contaminated needle but I haven’t been able to find an internet reference.

Rabies virus is not a Tier 1 bioterrorism agent that is U.S government-controlled so it’s not illegal to possess a rabid animal carcass as a source of virus. Most countries outside of Western Europe and England have animal rabies. Worldwide, stray dogs are most commonly affected while in the US it’s the raccoon.                                                                 

Maybe not as cute as we thought...

  Needlestick awareness of the target is an obstacle to overcome. If the target had significant neuropathy of the feet, an injection may not be sensed at all. The needlestick could also be set up to be “accidental”, perhaps purported to be a discarded needle from a drug abuser in which case the focus would be diverted to risk of hepatitis B and C and HIV.

There are non-needlestick options. Simple topical application of rabies-contaminated material onto an open wound such as a foot ulcer may transmit the virus. Intravenous injection would work if such an access were available. Presumed transmission of rabies by aerosol has been documented in two spelunkers after they visited a cave full of bats, but spritzing an extract of rabid raccoon saliva up the nose of the target is at best of unknown effectiveness because rabies virus does not attach to nasal mucosal lining cells. Oral exposure does not work either.

One advantage for the murderer is that rabies encephalitis is rare – I’ve yet to see a case in 37 years of practice. For that reason, it may not be looked for and therefore remain undiagnosed especially without an index of suspicion which would be low in the absence of a known animal exposure. The presumption would be that the target died of a more common type of encephalitis such as due to West Nile virus. Autopsies nowadays are rarely done. We recently cared for a woman in her 40’s without prior lung disease who became ill with cough, congestion, and fever just after a trip to Mexico. Four days later, she died of an overwhelming viral-type pneumonia. Multiple tests for influenza were negative. She did test positive for metapneumovirus which normally only causes common cold-type symptoms in patients without underlying lung disease or a weak immune system. She had neither but we had no real reason to refer her case to the Medical Examiner. A private autopsy would have cost the family 5000 U.S. dollars which they elected not to do.

In fiction, a targeted death by infection is much more doable. In one of my novels in progress (“Death by Full Moon”) a mad virologist serial killer is offing homeless people with a hybrid virus (rabies plus vesicular stomatitis virus – VSV). VSV is a logical (fictional) partner with rabies as it is a real virus in the same Rhabdovirus family as rabies and has receptors for nasal mucosal cells. The killer inoculates this hybrid virus into the nasal passages of the targeted victims on the pretense that he is administering a nasal spray influenza vaccine. The hybrid virus attaches and travels the short distance to the brain via the olfactory nerve leading to florid encephalitis in 2 days. The killer is rather obsessed with the full moon and times the exposures so that the victim goes mad on the night of a full moon. My series protagonist Dr. Kris Jensen, a specialist in Infectious diseases and former CDC epidemiologist investigates the deaths and tracks the killer down. Per the construct of thrillers, things go from bad to worse before the final battle between good and evil.  

There are certainly other infectious agents which could be used as a murder

weapon such as anthrax, cholera, Ebola virus, and H7N9 bird influenza. The feasibility will vary greatly around the world depending on factors such as the disease prevalence and the degree of sophistication of medical care, public health support and criminal investigation.

As to the future, a valid concern is that bioengineering will eventually be able to genetically tailor a lethal infectious agent to target a single individual. There is a fascinating lengthy story on that topic published in 2012 in The Atlantic (“Hacking thePresident’s DNA”). If someone could do that, they could easily add on genes for resistance to all antimicrobial drugs. That would be a truly frightening scenario.