The Politics of Disease Control. Mari K. Webel
All told, particularly for adults during mongota whose grandparents would have had direct experience engaging with Mukasa and other balubaale as part of life on the Sseses or elsewhere around the lake earlier in the nineteenth century, this constellation of historically important and potent forces made island sites places that people had gone to and could still go to for relief or aid.43 Such processes of treatment-seeking occurred in a dense social field. Given the prominence of Mukasa’s shrine on the islands and the prominent role of Ssese clans and political authorities in shrine activities, people affiliated with Mukasa’s shrine might have also been family or clan members of the supplicant. Further, seeking healing required utilizing social connections to marshal necessary resources. Appeals to balubaale required material goods—contribution of foodstuffs or of livestock, for instance—that signaled veneration and acknowledged a medium’s inter-cessionary powers, and thus also potentially required tapping into wider networks of family or affinity for resources.
By the late nineteenth century, Ssese therapeutic resources were diverse. Mediums or healers, on the one side, and missionaries, on the other, both sought to provide healing within systems that linked material and spiritual etiologies and treatments. The arrival of Arab-Swahili traders at Lake Victoria and in Buganda in the mid-nineteenth century, followed by the arrival of increasing numbers of Christian missionaries in subsequent decades, made for vigorous cultural exchange around the lake that introduced Islamic and European diagnostic systems and therapeutic practices and added to the healing resources available to Ganda and Ssese populations at the time. By the 1890s, mission medicine had become available to many Ssese islanders, as well as to populations elsewhere around the northern shores of the lake.44
The acceleration of both Protestant and Catholic missionizing in the late 1880s meant that many on the Lake Victoria littoral lived within a day’s journey of a Christian mission or community of converts. Two groups—the Catholic Society of the Missionaries of Africa (White Fathers) and the Anglican Church Missionary Society (CMS)—were of particular relevance to the Sseses. Amid the religious and civil wars of the late 1880s and early 1890s, the White Fathers founded missions first at Bugoma, on the westernmost point of Bugala Island near the Buddu shore, and then at Bumangi in the island’s center.45 The Sseses, like most of Buganda, were a contested field of evangelization, and after years of religious unrest and occasional confrontation, British authorities intervened to “divide” the islands into Protestant and Catholic spheres in 1891, much to the chagrin of the White Fathers.46 By 1898, Anglican missionaries had built a station on Bukasa, a southeastern island facing out into the lake, ruled at the time by a Protestant chief, Danieli Kaganda. From Bukasa, missionaries supervised a few dozen small congregations; they began building a church on Bugala in 1902, providing them a base on the eastern end of the island. But the CMS generally encouraged the growth of small churches in the villages under Ssese readers (as they called converts) rather than worship at a central station.47 Both Catholic and Protestant missionaries relied on established missions on the Buganda mainland as springboards for their Ssese outposts. By all accounts, mission staff traveled frequently between islands and mainland, and the Ssese missions also served as way stations for confreres dependent on canoe transport and lakeside routes in traveling elsewhere around the lake.48
Healing was ideologically central to both Catholic and Protestant missions’ ministries, although missionaries’ capabilities and expertise sometimes differed as much as their approaches to converting and saving souls.49 Missionaries often went into the field with some basic medical training, allowing them both to manage ailments that might affect Europeans with no alternative for treatment and to offer treatment and care to those they wished to convert.50 For Ssese islanders, the White Fathers missions at Bugoma and Bumangi on Bugala Island and the CMS missions on Bukasa and Bugala Islands presented an additional source of healing and means to ameliorate misfortune—whether or not it involved the kinds of “genuine” conversions that missionaries sought. Locally on the Ssese Islands, CMS missions made medical care and treatment less of a priority than their mainland Buganda counterparts, while the White Fathers gradually sought to formalize and expand their capacity for medical care.
CMS missionaries offered no formal clinic or hospital to their Ssese parishioners and medical resources for acute crisis were limited.51 Anglican missionaries sent people with complicated or persistent illness to the CMS hospital at Mengo, near Kampala, and would request that a doctor visit the islands when necessary.52 The Ssese CMS missionaries, in comparison to those on the Buganda mainland, did not prioritize medical work in their evangelizing and did not establish sites of formal, regular medical treatment. The structure and nature of the CMS Ssese mission may have hindered it from serving as a resource for healing or medicine, regardless of missionaries’ training or goals. Its early years saw frequent turnover of personnel due to illness, and necessary staff itinerations between posts on large islands and dispersed daughter churches meant that the men who led the mission were often away as much as they were at home. Missionaries’ engagement with their readers did sometimes involve matters of health and illness, however, and was especially focused on women missionaries, women readers, and their children.53
By contrast, the White Fathers on the Sseses actively integrated medical treatment into their mission life and, over time, increased their capacity to do so, dispensing remedies and offering care in hospitals and hospices. By 1895, the White Fathers mission at Bumangi included a school and a small hospital with a few dozen beds, serving an estimated population of fifteen thousand on Bugala Island.54 Priests regularly cared for a few dozen people in the hospital, assisted by local catechists.55 Of note for responses to widespread illness, and ultimately for epidemic sleeping sickness, was the White Fathers’ ready provision of medicines to their Ssese and Ganda charges. They dispensed a variety of available remedies, many typical for the era: a variety of purgatives and emetics, drugs presumed to affect the circulation, and drugs to relieve pain. Priests treated one another, and sometimes African patients, with calomel (mercury chloride) as a purgative, saltpeter (potassium nitrate) for rheumatism, “calaya” for hematuria (blood in the urine) or blackwater fever, citric acid to calm vomiting, and brandy.56 They administered quinine for a wide variety of complaints, including but not limited to diverse manifestations of fever, and also dispensed laudanum. Some of these remedies were also given to their catechists and nearby families.57 For the illness called kaumpuli (which they equated with bubonic plague), in the 1890s, for instance, priests gave their Ganda patients, variously, aloe as an emetic, “acide phénique” (phenol, carbolic acid), quinine, and cantharides, an ancient treatment for edema that could be used to produce blisters on the skin.58 In the main, the White Fathers mission and hospital, despite some staff turnover, gained a strong foothold as a hub for healing, utilized regularly by catechists and their relations as well as by nearby communities more broadly in times of intensifying crisis such as outbreaks of widespread illness.59
Missions on the Sseses, as elsewhere, functioned as points of exchange and distribution of valued goods alongside and sometimes overlapping with medical interventions.60 On the Ssese Islands on the whole, and Bugala Island foremost, Christian missions provided an important precedent for colonial interventions and institutions focused later on addressing epidemic sleeping sickness. The missions would later offer tropical medicine researchers a springboard to launch their work: social connections would facilitate relationships within which experimental treatment and control measures were arranged and make available the physical spaces within which these measures would play out. In parallel to these material and social resources were experiential points of reference for dealing with widespread or disseminated instances of sickness and death. Chief among the causes of those was kaumpuli.
KAUMPULI: INTELLECTUAL WORLDS AND STRATEGIES OF AMELIORATING MISFORTUNE
Experiences of illness, particularly of what appear to be epidemics that sickened and killed many, surface in diverse sources created around Lake Victoria in the late nineteenth and early twentieth century: early colonial reports, missionary letters and diaries, accounts of the occasional traveler making his way through the region, and oral histories and traditions. One of those causes of illness and misfortune, kaumpuli, illustrates how historic Ganda ideas about illness and strategies for mitigating or avoiding it were connected to practices of doing so in