This chapter explores how the evolving disease environments of the tropics shaped free and forced migration patterns at English sites. The globalization of forced labor markets and trade were catalysts in the spread of yellow fever and falciparum malaria, diseases that originated in Africa and that disproportionately weakened or killed English migrants to the tropics. These were the two deadliest mosquito-borne fevers that the English encountered in the tropics. The ways in which the English understood and responded to evolving tropical disease environments and their differential effects on European and non-European populations contributed to the rise of enslaved majorities in the tropics and informed ideas about human difference that would coalesce into nineteenth-century racism. The chapter will also show how epidemiology made English footholds in the tropics much more precarious and dependent on non-Europeans than the English footholds in other more temperate zones of the empire. The chapter relies on case studies of disease outbreaks in the Caribbean, on the West African Gold Coast, and in Sumatra at key points in the seventeenth century.

This chapter details the circumstances and techniques behind the colonial acquisitions and conquests of Nigeria during the late nineteenth and early twentieth centuries. It details two broad categories of methods used by colonial forces: forceful acquisitions and acquisitions achieved through diplomacy. While broad categorizations of colonial techniques are made, this chapter outlines that different techniques could and were used for every Indigenous polity involved. The strategy behind every colonial conquest depended on numerous factors such as the size, “sophistication,” geography, and local political landscape of the polity in question. However, while the techniques behind the colonial acquisitions could drastically differ, this chapter outlines the common goals behind each strategy: to drive a set of processes that weakened the power and authority of indigenous power structures. This would create a power void that, through gradual or rapid action, would be filled by colonial forces or actors aligned with colonial interests. The reactions and independent actions taken by indigenous polities are equally crucial to the history in question. Like their European counterparts, the indigenous states of Nigeria reacted to colonial meddling and the actions of their fellow polities in many different ways, with varying degrees of success.

This chapter analyses the historical evolution of the creation and aesthetics of Nigerian artists during the colonial period through local musicians and actors. Moreover, the importance of oral traditions before the interaction with Europeans – such as proverbs, panegyrics, and rituals – incorporated Christianity through schools by the Nigerian elite and Western music and instruments. In the case of music, the chapter mentions how precolonial cultural traditions shaped it, the influence of ex-enslaved people from the Caribbean (such as Brazilians) who returned to the city of Lagos, and European contributions. Methodologically, the chapter follows musicians such as Fela Sowande, Victor Olaiya, and Bobby Benson. They, in different ways, integrated precolonial elements to create a national tradition that would create unity in the colonial period. In the case of theater, the chapter also mentions its historical evolution: from traveling theater to the work of Hubert Ogunde, Kola Ogunmola, and Duro Ladipo, as icons representing creativity and aesthetics, introducing Nigerian cultural elements to theater, such as Yoruba, Hausa, and Igbo language, myths, and stories, linking with Western traditions such as Christianity. The chapter concludes that the artists of the colonial period sought, through their musical and theatrical works, to preserve precolonial traditions.

This chapter discusses the extent to which standard economic efficiency analysis can be applied to the economics of reducing ill health caused by environmental factors. This type of analysis is relevant when production functions can be applied to public health environmental situations such as those involving the public supply of safe water and sanitation. On the other hand, different analytical approaches are required to assess more holistically the social economic efficiency of public policies to control most environmentally related diseases. Concrete theoretical evidence about the analytical significance of the presence of externalities is backed up with examples. These cases include cadmium poisoning, drinking water contaminations, issues involved in the control of COVID-19, and the willingness of individuals to vaccinate against infectious diseases. In addition, particular attention is paid to problems involved in determining the social economic efficiency of the amount and use of methods of controlling environmentally related diseases when their effectiveness declines with use.

Chapter 5 builds on the argument that the Brazilian military government largely ignored the social and environmental costs of its big dams because it was under pressure to build them quickly and cheaply and because it believed that its pharaonic environmentalism would satisfy its critics. It covers the twenty-year period from the late 1970s to the late 1990s, when reservoir floodwaters submerged cherished land and waterscapes that had been protected as national parks, engendered profound transformations to local fisheries, and set in motion ecological changes that led to devastating mosquito-related torments among communities living along the margins of reservoirs. To be sure, not all changes spelled disaster. Fisheries boomed in the decades following the formation of reservoirs, and malaria outbreaks were mild by historic standards. But in many places, disregard for the environment led to a series of local disasters that drew attention to the high environmental costs of big dams.

About 40 million people travel from abroad to the United States per annum; many international travelers arrive in urban centers, and those who are ill will seek care there. Clinicians working in urban hospitals or near points of international arrival must be familiar with diseases commonly acquired abroad as well as uncommon but potentially serious conditions such as emerging and re-emerging infectious diseases. The assessment of the ill international traveler begins with a thorough history including the patient’s itinerary, activities, and risk factors. A familiarity with conditions endemic to the region of travel, timing of exposure, and knowledge of incubation period will allow the clinician to form a focused differential diagnosis. Knowledge of the specific diseases for which the patient is at risk, their potential complications, and the patient’s clinical status will determine need for diagnostic testing, empiric treatment, and ultimate disposition.

A broad range of parasites were present in ancient Egypt and Nubia, with 15 different species, including ectoparasites, helminths, and protozoa. Some are spread directly from one person to another (such as pinworm and head lice), some pass through animals as part of their life cycle (such as Taenia tapeworms, fish tapeworm, and trichinella), while others require biting insect vectors to spread them (such as malaria, leishmaniasis, and filariasis). Around 40% of ancient Nubians had head lice, 10% of Nubians were infected by visceral leishmaniasis, 22% of Egyptian mummies were positive for malaria, and 17% were positive for schistosomiasis. As malaria and schistosomiasis cause chronic anaemia and fatigue during physical work, they must have been responsible for a considerable drain upon the capabilities of the workforce in these civilizations along the Nile.

Despite major investment in sanitation infrastructure, intestinal parasites spread by faecal contamination of food and water were a particular problem everywhere in the Roman world. Similarly, ectoparasites such as lice and fleas were common despite the Roman enthusiasm for washing in communal bathhouses and the use of delousing combs. However, some parasites seem to be much more regional in their distribution, likely due to climate variations. Fish and Taenia tapeworms, spread by eating raw or undercooked fish, pork, or beef were more common in northern Europe than southern Europe, possibly due to the fact that the hot climate in the south made raw fish and meat go off faster than in the cooler north. In contrast, malaria seems to have been much more common in the Mediterranean region than in northern Europe, as the warm climate of the south created breeding sites for the Anophales mosquito, which transmitted the parasite. Roman period medical texts by Galen and other physicians showed awareness of a number of parasites and tried to explain them in the context of the humoral theory. Treatment involved trying to rebalance the humours in order to return the individual to health.

We have explored some of the ways in which parasites can tell us about past human migrations. Sometimes an expansion to the endemic area of a parasite shows that migration had found an environment receptive to that species’ life cycle. Examples date across evolutionary time, from lice in our hominin ancestors to transatlantic slavery in the last few hundred years. In contrast, in many more examples the parasite failed to become endemic in the new region due to the lack of key elements required for its life cycle. The role of human ectoparasites in the spread of epidemic and pandemic disease has been vitally important throughout human history. As humans move they take their ectoparasites with them, their bodies acting as an incubator for bacterial infectious diseases. While bubonic plague is certainly the best recorded and researched of these epidemics, many others such as epidemic typhus and trench fever would have caused disease and death in past societies. Although human fleas and lice in themselves have only limited impact upon health, it seems likely that far more of our ancestors have died from diseases spread by their ectoparasites than ever died from intestinal parasites.

The generation of transgenic plants and animals is discussed in Chapter 16. The technology is now well established, but remains a controversial area in terms of public perception and acceptance. Scientific, regulatory, ethical, political and commercial factors together present a complex framework within which the development of transgenic plants and animals is placed. As well as considering the technical procedures used to generate transgenics, these broader aspects (and their impact on the success or failure of a transgenic product) are considered. The development of Golden Rice, and the subsequent political issues around its deployment, illustrate the complexity of the topic. Paradoxically, transgenic animals often generate less negative reaction from the anti-GMO (genetically modified organism) movement than transgenic plants, with most concerns being around animal welfare issues. This is particularly true where the product is, for example, a demonstrably positive therapeutic; when transgenic animals are generated for consumption, the GMO debate tends to become polarised to the same extent as transgenic crops.

Chapter 6 investigates the WHO’s malaria and tuberculosis control programs in the 1950s and 1960s, which made use of statistical collection and analysis. Numbers had become omnipresent in program design and implementation by this time, and experts at the WHO and in the Taiwanese government used their public health knowledge to justify their selection of statistics. WHO experts and Taiwanese health officers also used numbers to advocate for their programs. In particular, experts curated numbers to bolster their arguments in the context of ongoing policy debates at the WHO. Their ways of curating numbers were different as they occupied different positions within global health policy-making. Experts within the WHO mobilized their knowledge on the diseases in question to justify their selection of certain statistics over others, while their Taiwanese colleagues used numbers to present Taiwan as a viable testing ground for WHO policies, with a view to obtaining financial and technical support.

Long-haul tourists visiting South Africa are always fascinated by the clicks of isiXhosa. Foreign to their ears, the eighteen click consonants can be grouped into three types: the ‘c’ is a dental click made by the tongue at the back of the mouth, the lateral ‘x’ is made by the tongue at the sides of the mouth, and the alveolar ‘q’ is made by the tip of the tongue on the roof of the mouth.

IsiXhosa is part of the Nguni language group, which also includes Zulu and southern and northern Ndebele. Yet few of these or the other South African vernacular languages have clicks, and those that do have them use them far less. How is it that isiXhosa came to use clicks so commonly?

One clue comes from the other languages of southern Africa that also make use of clicks – and there are lots of them.