Free The Fever: How Malaria Has Ruled Humankind for 500,000 Years by Sonia Shah Page B

and dancing. A few are sprawled on the clay floor, facedown, passed out. We’ve arrived in the midst of a fiesta, Calzada whispers to me. A local girl has recently menstruated for the first time, and so the community has spent the day drinking
chicha fuerte
, a brew made from fermented corn. As we watch, a woman and a boy lift a comatose mud-caked man off the ground and drag him home. Two women from inside the rancho follow them to the doorway, smiling. Aside from a few furtive looks, they ignore us almost entirely.
    It wasn’t like this the year before, when Calzada first came here.
    There is no English-language record of what happened to Chepo’s Kuna community in 2005, save the one you are reading now. The mosquitoes that hatched from Chepo’s stagnant puddles, the edges of the lake below, in the open-water cisterns, had gone on a rampage. Contaminated with the most malevolent malaria parasites known to humankind in their spittle, they alit on the exposed and unclad Kuna around them. By the time Calzada and his team arrived, nearly half of the settlement was fevered, terrified, immobilized in their hammocks.
    After days of triage, Calzada brought samples of the Kuna’s infected blood back to his lab at the Gorgas Institute to analyze. The most common malaria in this part of Panama is the relatively benign vivax strain, caused by malarial parasites called
Plasmodium vivax
. Instead, Calzada identified parasites called
Plasmodium falciparum
, which are more commonly found in sub-Saharan Africa. Worse, this was no regular strain of
P. falciparum
, but a particularly nasty one that had evolved resistance to standard antimalarial drugs, a trick theparasites may have picked up somewhere in Southeast Asia. Malaria experts around the world had been tracking the spread of this bug for years. At Chepo, Calzada had discovered its northernmost beachhead.
    There was precious little evidence, when we first arrived in Chepo, of the village’s connection to modern industrial life. In one rancho, I saw a battery-powered radio, but other than that, we might have been in the preindustrial world: there were no toilets, no running water, no electricity. But then, as the rain steadily turned the dirt lanes between the ranchos into mud, impromptu streams formed, ferrying Chepo’s hidden debris to the lake: a blue plastic sandal, a crushed orange juice container, a small gas can, and a shopping bag came bobbing down the hill. We were, after all, less than two hours’ drive from a boisterous city of three million, a center of international commerce through which passes 5 percent of the world’s trade. 1 The scene of malaria’s malevolent homecoming in this secluded settlement cast its shadow over the very doorstep of the global economy.
    The 2005 epidemic at Chepo did not occur in a vacuum. On the contrary, between 1998 and 2004, malaria cases in Panama quadrupled. 2 And globally, malaria’s death toll has grown inexorably since 1981. 3
    In 1995, Europe suffered ninety thousand cases of malaria. Then, in 1996, military troops in war-torn Afghanistan sparked a malaria epidemic across Central Asia. Soon, Azerbaijan, Tajikistan, and Turkey suffered malaria outbreaks. 4 By 2003,
Plasmodium
had preyed on ten times more people in Central Asia than just a decade before, 5 and a tsunami of people carrying the parasite from Africa and Asia began showing up in Europe. Today, eight times more malaria patients arrive at clinics and hospitals across Europe than did in the 1970s, and back then, most of the
Plasmodium
imported into Europe was of the vivax strain. Now, nearly 70 percent is the deadly
P. falciparum
. 6
    These days, mosquitoes infect between 250 million and 500 million people with malaria every year, and close to 1 million perish. Equally shocking is the sheer length of malaria’s tenure upon us. Humans have suffered the disease for more than 500,000 years. And not only does it still plague us, but it has also become even more lethal.