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Artigo Original
This is a short story about malaria in Portugal; the story
of a time when malaria was not just a disease of the
tropics but also a domestic ailment that hassled rural
populations at intervals. I intend to consider malaria
as perceived and defined by former rural workers as
a methodological standpoint that reveals this disease
as a broad social, ecological, economic and political
event with multiple definitions (Saavedra 2014).This is
where a biosocial and syndemic perspective (Hanna and
Kleinman 2013; Singer 2009), as proposed by medi-
cal anthropology, proves appropriate. Although each of
these approaches has its specificities, both consider dis-
ease causation as the result of the interaction between
political, social, biological and environmental factors
and their historical framework. Moreover, both take
the impact of these interactions on people’s lives as the
centre of their action-oriented analysis.
Documents in archives and libraries in Lisbon men-
tion rural workers, especially migrant groups, mainly
as subjects of medical research and action (Cambournac
1938, Hill 1938, Landeiro and Cambournac n.d.). So-
cial factors as disease causation were discussed among
Portuguese doctors as fundamental parts of preventive
medicine and of the State’s social and medical services
(Faria 1934). But such factors were not considered in
their deepest structural causes. A few doctors did write
accounts of malaria describing the living conditions of a
great portion of the rural population, drawing attention
to their poverty and how all these compromised any at-
tempt at eliminating the disease (Ramos 1944).However,
in a country where censorship controlled every printed
text, not much could be said lest too much was said.
By recovering personal memories of people who had
malaria, I intend to retrieve the physical dimension of
the disease, the local appropriation of medical models
and resources, and the coexistence of different ways
of perceiving the disease (Saavedra 2014). Narratives
about experiencing malaria reveal its broader ecology,
combining natural environment, personal, social, cul-
tural, political, economic and historic factors. Thus,
malaria memories add to the medical narratives about
this disease, meeting contemporary approaches to
health issues in the fields of history of medicine, medi-
cal anthropology and in critical epidemiology (Singer
2009, Breilh 2008, Rosenberg 1992) that emphasise
the multiple dimensions of disease. On the other hand,
personal narratives about ‘having malaria’ may also in-
spire a reflection about the estrangement between the
21st century’s scientific agendas for malaria research,
control and prevention and the compound everyday ex-
perience of living with and managing this disease.Thus,
history meets the present and calls attention to some-
times overlooked perspectives on health and illness.
Taking personal memories of malaria experiences as a
source among others for writing one of the many pos-
sible histories of malaria in Portugal also means going
beyond concerns about objectivity and truth. Certainly
I mean to be as accurate as an anthropologist/historian
should be in my account and analysis of the sources that
I have deliberately chosen, actually accessed or acciden-
tally found. But through the research process I relished
the contradictions, misunderstandings and intersect-
ing meanings, taking this as fundamental to a broader
understanding of malaria’s complexities patent in the
distance between scientific knowledge, sanitary regula-
tion, institutional norms and the everyday practice of
malaria control and treatment on the ground.
Malaria memories and rice fields
By privileging former rural workers’ memories I fol-
lowed medical accounts of malaria as a rural disease. I in-
terviewed fifty men and women from 65 to 90 years old,
almost all of them former rural workers.Also according
to the medical and official sources, I looked for malaria
memories in Alcácer do Sal, Águas de Moura, Azambuja
and Benavente.These villages and small towns, as well as
the surrounding areas, had been medically classified as
malarious; specially following a 1933 survey carried out
by two Portuguese doctors (Fausto Landeiro and Fran-
cisco Cambournac), under the sponsorship and supervi-
sion of the International Health Division of the Rockefel-
ler Foundation (Landeiro and Cambournac n.d.). This
brings us to a medical geography of malaria in Portugal
evincing its ecological aspects.
“Intermittent fevers” in Portugal, as in the rest of the
world where European science gained ground, had long
been medically described and popularly perceived as
the result of bad airs emanating from swampy lands and
putrefactive vegetable matter. Thus, since the increase
of rice cultivation in flooded fields during the 18th cen-
tury, rice fields became connected to malaria:
We have widely made known the effects of the stagnant
waters and floods, but those that remain on the fields
after rice cultivation are the most pernicious. It is known
that, to fructify, that plant needs to be covered in water
and have the fields where the seeds lay flooded. And if
landowners do not drain these waters as soon as sowing is
over through channels, drawbridges and dykes then those
waters remain exposed to summer heat during the months
of August and September; the air becomes infected and
people pay the price with every sort of fevers that finish
by death or illness that lasts a life long
(Sanches 1757,
84, 85).
Swampy lands and decaying vegetable matter, high tem-